Efficacy and Safety of BCD-100 (Anti-PD-1) in Combination With Platinum-Based Chemotherapy With and Without Bevacizumab as First-Line Treatment of Subjects With Advanced Cervical Cancer (FERMATA)

Cervical Cancer Clinical Trial

— FERMATA  

Official title:

An International Randomized Double-blind Clinical Trial of BCD-100 Plus Platinum-based Chemotherapy With and Without Bevacizumab Versus Placebo Plus Platinum-based Chemotherapy With and Without Bevacizumab as First-Line Treatment of Subjects With Advanced Cervical Cancer

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03912415
• Other study ID #: BCD-100-5
• Status: Recruiting
• Phase: Phase 3
• Start date: October 1, 2019
• Est. completion date: December 1, 2024

Study information

• Verified date: September 2020
• Source: Biocad
• Contact: Sergey N Fogt, MD, PhD
• Phone: +7-(812)-380-49-33
• Email: biocad[@]biocad.ru
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a randomized, multicenter, double-blind, Phase 3 study of efficacy and safety of BCD-100 plus platinum-based chemotherapy with and without bevacizumab versus placebo plus platinum-based chemotherapy with and without bevacizumab

Description:

Subjects will be randomized in a 1:1 ratio to receive either Test Regimen or Comparator Regimen as the first-line treatment for advanced cervical cancer. Subjects will receive study therapy Q3W until progression of the disease or signs of unacceptable toxicity. In the absence of dose-limiting toxicity chemotherapy should be continued for at least 6 cycles, then, upon Investigator's decision and/or subjects' wish, the use of chemotherapy can be stopped while maintenance therapy with BCD-100/Placebo with or without bevacizumab (depending on initial therapy choice) continues until disease progression.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 316
• Est. completion date: December 1, 2024
• Est. primary completion date: December 1, 2024
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Signing an IRB/EC-approved informed consent

2. Females = 18 years of age on day of signing informed consent

3. Histologically confirmed squamous carcinoma of the cervix

4. Progressing thru or recurrent disease treated for curative intent or primary metastatic cervical cancer stage FIGO IVB

5. Agreement to newly obtained core or excisional biopsy of a tumor lesion not previously irradiated for determination of PD-L1 status prior to randomization (using archival biopsy material is only acceptable in subjects in whom obtaining a new sample is contraindicated)

6. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

7. For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or to use a contraceptive method with a failure rate of < 1% per year from the moment of signing informed consent, during the treatment period and at least 6 months after administration of the last dose of study drug. A woman is considered to be of childbearing potential if she is postmenarcheal, has not reached a postmenopausal state (= 12 continuous months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries, fallopian tubes, and/or uterus). Examples of contraceptive methods with a failure rate of < 1% per year include but are not limited to bilateral tubal ligation and/or occlusion, male sterilization, and intrauterine devices. The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical study and the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) is not acceptable method of contraception.

Exclusion Criteria:

1. Indications for potentially curative treatment (surgery or radiation therapy)

2. Prior systemic treatment for recurrent, secondarily progressive or initially metastatic disease

3. Previous use of chemotherapy other than initial treatment for curative intent (e.g. chemotherapy used concurrently with radiation therapy, neoadjuvant or consolidation chemotherapy cycles before radiotherapy or 2 chemotherapy cycles after completion of chemoradiotherapy are allowed)

4. Contraindications to cisplatin, carboplatin, paclitaxel, or bevacizumab

5. Known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Participants with known brain metastases may participate provided that the brain metastases have been previously treated with radiotherapy or surgery only and are radiographically stable

6. Concomitant diseases or conditions which pose a risk of AE development during study treatment:

1. uncontrolled hypertension, defined as systolic > 150 mm Hg or diastolic > 90 mm Hg;

2. stable angina functional class III-IV;

3. unstable angina or myocardial infarction less than 6 months prior to randomization;

4. NYHA Grade III-IV congestive heart failure;

5. serious cardiac arrhythmia requiring medication (subjects with asymptomatic atrial fibrillation can be enrolled if controlled ventricular rate);

6. atopic asthma, Stage III-IV COPD, angioedema;

7. severe respiratory failure;

8. any other diseases which pose unacceptable risk of AE development during study treatment in Investigator's opinion.

7. Active or known or suspected autoimmune disease (subjects with Type 1 diabetes mellitus, hypothyroidism only requiring hormone replacement, or skin disorders (vitiligo, psoriasis, or alopecia) not requiring systemic treatment are permitted to enroll).

8. Condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications within 14 days prior to randomization.

9. History of (non-infectious) pneumonitis that required corticosteroids or current pneumonitis

10. Neutrophils <1500/mcl or platelets <100 000/mcl or hemoglobin <90 g/l.

11. Creatinine = 1.5 x UNL.

12. Bilirubin = 1.5 x UNL (excluding Gilbert's syndrome if bilirubin < 50 µmol/l) or AST/ALT = 3 x UNL (excluding subjects with liver metastases if AST/ALT < 5 x UNL) or alkaline phosphatase = 2.5 x UNL.

13. Chemotherapy or radiation therapy less than 28 days prior to randomization.

14. Major surgery procedure less than 28 days prior to randomization.

15. Previous use of PD-1/PD-L1/PD-L2 agent or another agent directed to stimulatory or co-inhibitory T-cell receptor (e.g. CTLA-4, OX 40, CD137).

16. Previous use of VEGF/VEGFR inhibitors, including bevacizumab, ramucirumab, aflibercept and tyrosine kinase inhibitors.

17. Prior invasive malignancy with any evidence of disease within the last 3 years. Subjects with non-melanoma skin cancer or carcinoma in situ (e.g. breast cancer) who have undergone potentially curative therapy are not excluded.

18. Pre-existing clinically significant (= grade 2) peripheral neuropathy or hearing impairment

19. Any conditions or circumstances that limit subject's ability to comply with protocol requirements

20. Active hepatitis B, active hepatitis ? or history of positive HIV.

21. Active infection requiring therapy or systemic antibiotics use less than 14 days prior to enrollment. Severe infections within 28 days prior to first study drug administration.

22. Administration of a live vaccine within 28 days prior to enrollment

23. Current using of another investigational device or drug study, or less than 30 days since ending of using of another investigational device or drug study

24. Life expectancy less than 12 weeks

25. Significant adverse events (AE) of previous therapy excluding chronic and/or irreversible events which cannot affect study drug safety evaluation (e.g. alopecia)

26. Known hypersensitivity or allergy to paclitaxel, cisplatin, carboplatin, bevacizumab, BCD-100 or any of their excipients. Known hypersensitivity or allergy to drugs derived from Chinese hamster (CHO) ovary cells or history of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins.

27. Pregnancy or breast-feeding

Related Conditions & MeSH terms

• Cervical Cancer
• Uterine Cervical Neoplasms

Intervention

Biological:
• BCD-100
Anti-PD-1 monoclonal antibody, IV infusion
• Bevacizumab
IV infusion

Drug:
• Paclitaxel
IV infusion
• Cisplatin (or Carboplatin)
IV infusion

Other:
• Placebo
Placebo

Locations

Country	Name	City	State
China	Shanghai Tenth People's Hospital	Shanghai
Georgia	High technology Hospital Medcenter	Batumi
Georgia	Acad. F.Todua Medical center "Research institute of Clinical Medicine"	Tbilisi
Georgia	High Technology Medical Centre, University Clinic	Tbilisi
Georgia	Institute for Personalized Medicine Ltd.	Tbilisi
Georgia	Institute of Clinical Oncology	Tbilisi
Georgia	LEPL First University Clinic of Tbilisi State Medical University	Tbilisi
Georgia	Multiprofile Clinic Consilium Medulla	Tbilisi
Georgia	Neo Medi	Tbilisi
Russian Federation	City Hospital No. 5	Barnaul
Russian Federation	Sverdlovsk Regional Oncology Center	Ekaterinburg
Russian Federation	Krasnoyarsk Regional Clinical Oncological Dispensary named after A.I. Kryzhanovsky	Krasnoyarsk
Russian Federation	Moscow Clinical Scientific and Practical Center named A.S. Loginova	Moscow
Russian Federation	N.N. Blokhin National Medical Research Center of Oncology (2)	Moscow
Russian Federation	State Health Care Institution "Moscow City Oncology Hospital ? 62" Moscow Health Department	Moscow
Russian Federation	Murmansk Regional Clinical Hospital named after P.A. Bayandina	Murmansk
Russian Federation	Clinical Oncology Dispensary	Omsk
Russian Federation	LLC "New Clinic"	Pyatigorsk
Russian Federation	AV Medical Group	Saint Petersburg
Russian Federation	JSC "Modern Medical Technologies"	Saint Petersburg
Russian Federation	N.N. Petrov National Medical Research Center of Oncology (2)	Saint Petersburg
Russian Federation	Saint-Petersburg Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (Oncological)	Saint Petersburg
Russian Federation	Federal State Educational Institution of Higher Professional Education "Mordovia State University N.P. Ogareva "	Saransk
Russian Federation	Stavropol Regional Clinical Oncology Center	Stavropol'
Russian Federation	Regional Clinical Oncology Hospital	Yaroslavl
Turkey	Memorial Sisli Istanbul	Istanbul

Sponsors (1)

Lead Sponsor	Collaborator
Biocad

Countries where clinical trial is conducted

China,  Georgia,  Russian Federation,  Turkey, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Overall Survival (OS)	The time from the date of randomization until death	3 years
Secondary	Progression-Free Survival (PFS) per RECIST 1.1	The time from the date of randomization until progression of disease according to RECIST 1.1 criteria or death	3 years
Secondary	Progression-Free Survival (PFS) per iRECIST	The time from the date of randomization until progression of disease according to iRECIS criteria or death	3 years
Secondary	Overall Response Rate per (ORR) RECIST 1.1	The percentage of the participants who have a Complete Response or a Partial Response as assessed by a blind independent central reviewer per RECIST 1.1	1 year
Secondary	Overall Response Rate (ORR) per iRECIST	The percentage of the participants who have a Complete Response or a Partial Response as assessed by a blind independent central reviewer per iRECIST	1 year
Secondary	Disease Control Rate (DCR)	The percentage of the participants who have a Complete Response, a Partial Response or a Stable DIsease as assessed by a blind independent central reviewer	1 year
Secondary	Time to Response (TTR)	TTR will be calculated from the randomization date	1 year
Secondary	Duration of Response (DOR)	DOR will be calculated from the moment of registration of response till event (progression or death)	1 year