Fallopian Tube Cancer Clinical Trial
Official title:
A Randomized, Double-Blind, Placebo-Controlled Phase II Study of VTX-2337 in Combination With Pegylated Liposomal Doxorubicin (PLD) in Patients With Recurrent or Persistent Epithelial Ovarian, Fallopian Tube or Primary Peritoneal Cancer
The purpose of this study is to compare the overall survival of patients treated with
VTX-2337 + pegylated liposomal doxorubicin (PLD) versus those treated with PLD alone in women
with recurrent or persistent, epithelial ovarian, fallopian tube or primary peritoneal
cancer.
VTX-2337, a small molecule agonist of Toll-like Receptor 8 (TLR8), activates multiple
components of the innate immune system and is being developed as a novel therapeutic agent
for use in oncology. Experimental data obtained in an animal model of ovarian cancer supports
the combination of VTX-2337 with PLD. In this model, the combination of VTX-2337 and PLD
resulted in a significant reduction in tumor growth compared to either agent alone and an
increase in the number of T lymphocytes infiltrating the tumor. The combination of PLD and
VTX-2337 has been tested in a small number of women with ovarian cancer in a Phase 1b study
and appears to be generally well-tolerated.
OBJECTIVES
Primary Objectives:
- To compare the overall survival (OS) of patients treated with VTX-2337 + PLD versus
those treated with PLD alone in women with recurrent or persistent, epithelial ovarian,
fallopian tube or primary peritoneal cancer.
- To compare the progression-free survival (PFS) between the two treatment groups using
Immune-Related Response Evaluation Criteria in Solid Tumors (irRECIST).
Secondary Objectives:
- To compare the progression-free survival (PFS) between the two treatment groups using
Response Evaluation Criteria In Solid Tumors (RECIST 1.1).
- To compare the nature, frequency and severity of drug-related adverse events (AEs)
between the two treatment groups.
Exploratory Objectives:
- To compare the best overall response rate (ORR) and duration of response (based on the
probability of being in response function [PBRF]) between the two treatment groups using
irRECIST and RECIST 1.1.
- To compare the disease control rate (DCR) between the two treatment groups using
irRECIST and RECIST 1.1.
- To assess the impact of immune status and response on the clinical effects (OS, PFS,
DCR, ORR, PBRF, AEs) of study treatment.
- To assess the effect of TLR8 polymorphisms and BRCA1/BRCA2 mutations on the clinical
effects (OS, PFS, DCR, ORR, PBRF, AEs) of study treatment.
- To assess the effect of immune cell subsets, as measured by immunohistochemistry and
micro RNA in primary tumor tissue (e.g. immune score), on the clinical effects (OS, PFS,
DCR, ORR, PBRF, AEs) of study treatment.
- To assess whether the presence of autoantibodies to tumor-derived proteins are
predictive of the clinical effects (OS, PFS, DCR, ORR, PBRF, AEs) of study treatment.
OUTLINE:
This is Phase 2 multicenter clinical study to evaluate the efficacy and safety of the
combination of VTX-2337 + PLD compared to PLD + Placebo.
The dosing schedule will be the same for both treatment arms, and will be based on a 28-day
cycle. The starting dose schedule is PLD on Day 1 plus VTX-2337 or placebo on Day 3, Day 10,
and Day 17 for the first 4 cycles. Starting with cycle 5, the dose regimen will be PLD on Day
1 plus VTX-2337 or placebo on Day 3.
Blood samples are collected periodically during cycle 1 for pharmacodynamics,
pharmacogenomics, and other research studies.
Patients will receive therapy until disease progression based on Immune-Related RECIST or
until adverse effects prohibit further therapy. Following treatment completion, all patients
will be followed with physical exams and histories every three months for the first two
years, and then every six months for the next three years, and then
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