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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02855944
Other study ID # CO-338-043
Secondary ID 2016-000816-14
Status Completed
Phase Phase 3
First received
Last updated
Start date March 1, 2017
Est. completion date September 16, 2022

Study information

Verified date June 2023
Source zr Pharma & GmbH
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to determine how patients with ovarian, fallopian tube, and primary peritoneal cancer will best respond to treatment with rucaparib versus chemotherapy.


Description:

Rucaparib is an orally available, small molecule inhibitor of poly-adenosine diphosphate [ADP] ribose polymerase (PARP) being developed for treatment of ovarian cancer associated with homologous recombination (HR) DNA repair deficiency (HRD). The safety and efficacy of rucaparib has been evaluated in several Phase 1 and Phase 2 studies. An oral formulation is the focus of current development efforts. Rucaparib is currently being investigated as monotherapy in patients with cancer associated with breast cancer susceptibility gene 1 (BRCA1) or BRCA2 mutations. While PARP inhibitors have demonstrated consistent robust clinical activity in patients with relapsed ovarian cancer associated with HRD, prospective studies evaluating efficacy and safety of PARPi versus standard of care chemotherapy have been limited. The primary purpose of this Phase 3 study is to compare the efficacy and safety of rucaparib versus chemotherapy as treatment for relapsed ovarian cancer in patients with a deleterious BRCA1/2 mutation in their tumor.


Recruitment information / eligibility

Status Completed
Enrollment 349
Est. completion date September 16, 2022
Est. primary completion date December 3, 2020
Accepts healthy volunteers No
Gender Female
Age group 18 Years and older
Eligibility Inclusion Criteria: - Be 18 years of age at the time the informed consent form is signed - Have a histologically confirmed diagnosis of high-grade serous or Grade 2 or Grade 3 endometrioid epithelial ovarian, fallopian tube, or primary peritoneal cancer - Received = 2 prior chemotherapy regimens and have relapsed or progressive disease as confirmed by radiologic assessment - Have biopsiable and evaluable disease. Note: biopsy is optional for patients known to harbor a BRCA1/2 mutation - Have sufficient archival formalin-fixed paraffin-embedded (FFPE) tumor tissue available for planned analyses Exclusion Criteria: - History of prior cancers except for those that have been curatively treated, with no evidence of cancer currently (provided all chemotherapy was completed >6 months prior and/or bone marrow transplant >2 years prior to first dose of rucaparib). - Prior treatment with any PARP inhibitor - Symptomatic and/or untreated central nervous system metastases - Pre-existing duodenal stent and/or any other gastrointestinal disorder or defect that would, in the opinion of the Investigator, interfere with absorption of rucaparib - Women who are pregnant or breast feeding - Hospitalization for bowel obstruction within 3 months prior to enrollment

Study Design


Intervention

Drug:
Chemotherapy
Chemotherapy will be administered per local standard of care and regulations. Specific comparator will depend on platinum status and investigator decision.
Rucaparib
Tablets of rucaparib, at a dose of 600 mg, will be taken orally twice a day

Locations

Country Name City State
Brazil Hospital do Cancer de Barretos Barretos SAO Paulo
Brazil Instituto de Oncologia do Parana (IOP) Curitiba Parana
Brazil CEPON-Centro de pesquisas Oncologicas Florianópolis Santa Catarina
Brazil Hospital Haroldo Juacaba Instituto do Cancer do Ceara Fortaleza Ceara
Brazil União Brasileira de Educação e Assistência / Hospital São Lucas da PUCRS Porto Alegre RIO Grande DO SUL
Brazil Instituto Nacional de Câncer Hospital do Câncer II Rio de Janeiro
Brazil Hospital Pérola Byington - Centro de Referência da Saúde da Mulher Sao Paulo
Brazil Hospital São Camilo Sao Paulo
Canada Tom Baker Cancer Center Calgary Alberta
Canada Centre Hospitalier de L'Universite de Montreal (CHUM) Montreal Quebec
Canada The Ottawa Hospital - General Campus Ottawa Ontario
Canada CIUSSS de l'Estrie CHUS Sherbrooke Quebec
Canada Princess Margaret Hospital Toronto Ontario
Czechia Masarykuv Onkologicky Ustav, Oddeleni komplexni klinicke onkologie Brno Jihormoravsky KRAJ
Czechia Fakultní Nemocnice Ostrava Ostrava
Czechia VÅ¡eobecná Fakultní Nemocnice v Praze Praha
Czechia Fakultni Nemocnice v Motole Praha 5 Praha
Hungary Országos Onkológiai Intézet Budapest
Hungary Debreceni Egyetem Klinikai Központ Debrecen Hajdu-bihar
Israel Carmel Medical Center Haifa
Israel Edith Wolfson Medical Center Holon
Israel Hadassah Medical Organization Jerusalem
Israel Rabin Medical Center Petach-Tikva
Israel Chaim Sheba Medical Center Ramat Gan
Israel Tel Aviv Sourasky Medical Center, Oncology Dept. Tel Aviv
Italy Azienda Ospedaliero-Universitaria di Bologna - Policlinico S.Orsola-Malpighi Bologna
Italy Istituto per la Ricerca e la Cura del Cancro Istituto di Candiolo Candiolo
Italy AO per l'emergenza Cannizzaro Catania
Italy Fondazione IRCCS Istituto Nazionale dei Tumori Milano
Italy Istituto Europeo di Oncologia Milano
Italy Azienda Ospedaliero-Universitaria Policlinico di Modena Modena
Italy Istituto Nazionale per lo studio e la cura dei tumori "Fondazione Pascale" Oncologia Medica Napoli
Italy Fondazione Policlinico Universitario Agostino Gemelli Roma
Poland Bialostockie Centrum Onkologii im. Marii Sklodowskiej-Curie Bialystok
Poland Niepubliczny Zaklad Opieki Zdrowotnej Innowacyjna Medycyna Sp z o.o. Grzybnica West Pomeranian Voivodeship
Poland Samodzielny Publiczny Szpital Kliniczny nr 1 w Lublinie Lublin
Poland Wojewodzki Szpital Specjalistyczny w Olsztynie Olsztyn
Poland Szpital Kliniczny Przemienienia Panskiego Uniwersytetu Medycznego im. Karola Marcinkowskiego w Pozna Poznan
Poland Pomorska Akademia Medyczna w Szczecinie, Samodzielny Publiczny Szpital Kliniczny Nr 2 Szczecin
Russian Federation Arkhangelsk Clinical Oncological Dispensary Arkhangelsk
Russian Federation Kursk Regional Oncologic Dispensary Kursk
Russian Federation Moscow Clinical Scientific and Practical Center of Moscow Healthcare Department Moscow
Russian Federation Omsk Region Clinical Oncologic Dispensary Omsk
Russian Federation Pyatigorsk Oncological Dispensary Pyatigorsk
Russian Federation Ryazan Regional Clinical Oncology Dispensary Ryazan
Russian Federation Pavlov First Saint-Petersburg State Medical University Saint Petersburg
Russian Federation State Healthcare Institution Oncologic Dispensary No. 2 - Health Department of Krasnodar Region Saint Petersburg
Russian Federation Saint Petersburg City Oncological Dispensary Saint-Petersburg
Russian Federation Republican oncological dispensary of Republic of Mordovia Saransk
Russian Federation State Healthcare Institution Oncologic Dispensary No. 2 - Health Department of Krasnodar Region Sochi
Russian Federation Republic Clinical Oncology Dispensary of the Ministry of Healthcare of Republic of Bashkortostan Ufa
Spain Hospital Duran i Reynals Barcelona
Spain Hospital Universitari Vall DHebron Barcelona
Spain Hospital Universitari de Girona Doctor Josep Trueta Girona
Spain Centro Oncologico Regional de Galicia La Coruna
Spain Hospital Clinico San Carlos Madrid
Spain Hospital Universitario Ramón y Cajal Madrid
Spain MD Anderson Cancer Center Madrid
Spain Universidad Autonoma de Madrid (UAM) - Hospital Universitario La Paz Madrid
Ukraine Dnipropetrovsk City Multifield Clinical Hospital Number 4 Dnipropetrovsk
Ukraine National Cancer Institute of the Ministry of Health of Ukraine Kyiv
Ukraine Volyn Regional Oncology Dispensary Lutsk
Ukraine Lviv Regional Oncology Dispensary Lviv
Ukraine Sumy Regional Oncology Center Sumy
Ukraine Zakarpattya Regional Clinical Oncological Dispensary Uzhgorod
United Kingdom Cambridge University Hospitals NHS Foundation Trust Cambridge
United Kingdom Velindre NHS Trust Cardiff
United Kingdom University Hospital of Coventry and Warwickshire NHS Trust Coventry
United Kingdom Derby Teaching Hospital NHS Foundation Trust Derby
United Kingdom NHS Greater Glasgow and Clyde Glasgow
United Kingdom University College London Hospitals London
United Kingdom The Christie NHS Foundation Trust - Clinical Trial Pharmacy Manchester England
United Kingdom East and North Hertfordshire NHS Trust Middlesex
United Kingdom Newcastle Hospitals NHS Foundation Trust Newcastle upon Tyne
United Kingdom The Royal Marsden NHS Foundation Trust Sutton Surrey
United States Augusta University Augusta Georgia
United States Rocky Mountain Cancer Center Denver Colorado

Sponsors (2)

Lead Sponsor Collaborator
zr Pharma & GmbH Foundation Medicine

Countries where clinical trial is conducted

United States,  Brazil,  Canada,  Czechia,  Hungary,  Israel,  Italy,  Poland,  Russian Federation,  Spain,  Ukraine,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Investigator Assessed Progression-Free Survival (invPFS) by RECIST Version 1.1 for Rucaparib Versus Chemotherapy (Efficacy Population) The primary efficacy endpoint is invPFS for the Treatment Part of the study. The time to invPFS is calculated in months as the time from randomization to disease progression +1 day, as determined by RECIST v1.1 (Response Evaluation Criteria in Solid Tumors) criteria or death due to any cause, whichever occurs first. Progression is defined using RECIST v1.1, as at least a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. Assessments every 8 weeks from Cycle 1 Day 1 (C1D1) until disease progression, death, or initiation of subsequent treatment. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3.5 years.
Primary Investigator Assessed Progression-Free Survival (invPFS) by RECIST Version 1.1 for Rucaparib Versus Chemotherapy (ITT Population) The primary efficacy endpoint is invPFS for the Treatment Part of the study. The time to invPFS is calculated in months as the time from randomization to disease progression +1 day, as determined by RECIST v1.1 (Response Evaluation Criteria in Solid Tumors) criteria or death due to any cause, whichever occurs first. Progression is defined using RECIST v1.1, as at least a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. Assessments every 8 weeks from C1D1 until disease progression, death, or initiation of subsequent treatment. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3.5 years.
Secondary Investigator Assessed Overall Response Rate (ORR) by RECIST v1.1 (Efficacy Population) A secondary endpoint is the ORR for the Treatment Part of the study. ORR is defined as the percentage of patients with a confirmed CR (complete response) or PR (partial response) by RECIST v1.1. The confirmed response is defined as a CR or PR on subsequent tumor assessment at least 28 days after first response documentation. CR is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. PR is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. Assessments every 8 weeks from C1D1 until disease progression, death, or initiation of subsequent treatment. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3.5 years.
Secondary Investigator Assessed Overall Response Rate (ORR) by RECIST v1.1 (ITT Population) A secondary endpoint is the ORR for the Treatment Part of the study. ORR is defined as the percentage of patients with a confirmed CR (complete response) or PR (partial response) by RECIST v1.1. The confirmed response is defined as a CR or PR on subsequent tumor assessment at least 28 days after first response documentation. CR is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. PR is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. Assessments every 8 weeks from C1D1 until disease progression, death, or initiation of subsequent treatment. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3.5 years.
Secondary Investigator Assessed Duration of Response (DOR) by RECIST v1.1 (Efficacy Population) A secondary endpoint is the DOR for the Treatment Part of the study. The DOR as assessed by investigator is analyzed in the subgroup of patients who had a confirmed response by RECIST v1.1. DOR for any confirmed RECIST CR or PR will be measured from the date of the first response until the first date that progressive disease (PD) is documented. DOR is calculated in months as the time from the first date of the scan showing a response to the first scan with disease progression +1 day. Any patients with an ongoing response are censored at the date of the last post-baseline scan. Only tumor scans up to and within 6 weeks of start of any subsequent anti-cancer treatment are included. Progressive disease (PD) is defined using RECIST v1.1, as at least a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. Assessments every 8 weeks from C1D1 until disease progression, death, or initiation of subsequent treatment. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3.5 years.
Secondary Investigator Assessed Duration of Response (DOR) by RECIST v1.1 (ITT Population) A secondary endpoint is the DOR for the Treatment Part of the study. The DOR as assessed by investigator is analyzed in the subgroup of patients who had a confirmed response by RECIST v1.1. DOR for any confirmed RECIST CR or PR will be measured from the date of the first response until the first date that progressive disease (PD) is documented. DOR is calculated in months as the time from the first date of the scan showing a response to the first scan with disease progression +1 day. Any patients with an ongoing response are censored at the date of the last post-baseline scan. Only tumor scans up to and within 6 weeks of start of any subsequent anti-cancer treatment are included. Progressive disease (PD) is defined using RECIST v1.1, as at least a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. Assessments every 8 weeks from C1D1 until disease progression, death, or initiation of subsequent treatment. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3.5 years.
Secondary Investigator Assessed Overall Response Rate (ORR) by RECIST v1.1 and/or CA-125 Response (Efficacy Population) A secondary endpoint is ORR for the Treatment Part of the study defined as the percentage of patients with best response of CR or PR using RECIST v1.1 or response per Gynecologic Cancer InterGroup Cancer Antigen 125 (GCIG CA-125) criteria. Complete response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. Partial response (PR) is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. Response to CA-125 has occurred if there is at least a 50% decrease from baseline: 1. in a sample collected after initiation of study treatment AND 2. that is confirmed in a subsequent sample collected =21 days after the prior sample. The absolute value of this confirmatory sample must be =110% of the prior sample. The date when the first sample with a 50% decrease from baseline is observed is the date of the CA-125 response. Assessments every 8 weeks from C1D1 until disease progression, death, or initiation of subsequent treatment. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3.5 years.
Secondary Investigator Assessed Overall Response Rate (ORR) by RECIST v1.1 and/or CA-125 Response (ITT Population) A secondary endpoint is ORR for the Treatment Part of the study defined as the percentage of patients with best response of CR or PR using RECIST v1.1 or response per Gynecologic Cancer InterGroup Cancer Antigen 125 (GCIG CA-125) criteria. Complete response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. Partial response (PR) is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. Response to CA-125 has occurred if there is at least a 50% decrease from baseline: 1. in a sample collected after initiation of study treatment AND 2. that is confirmed in a subsequent sample collected =21 days after the prior sample. The absolute value of this confirmatory sample must be =110% of the prior sample. The date when the first sample with a 50% decrease from baseline is observed is the date of the CA-125 response. Assessments every 8 weeks from C1D1 until disease progression, death, or initiation of subsequent treatment. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3.5 years.
Secondary Least Squares Mean Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Global Health Status Score for the First 6 Cycles (Efficacy Population) EORTC QLQ-C30 is a questionnaire that rates the overall quality of life in cancer patients. The first 28 questions use a 4-point scale (1=not at all to 4=very much) for evaluating function (physical, role, social, cognitive, emotional), symptoms (diarrhea, fatigue, dyspnea, appetite loss, insomnia, nausea/vomiting, constipation, and pain) and financial difficulties. The last 2 questions use a 7-point scale (1=very poor to 7=excellent) to evaluate overall health and quality of life. Global scores are converted to a score of 0 to 100, with a higher score indicating improved health status. Mean changes from baseline global score over the first 6 cycles in the Treatment Part of the study were analyzed. Baseline to the end of Cycle 6, or up to approximately 6 months
Secondary Least Squares Mean Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Global Health Status Score for the First 6 Cycles (ITT Population) EORTC QLQ-C30 is a questionnaire that rates the overall quality of life in cancer patients. The first 28 questions use a 4-point scale (1=not at all to 4=very much) for evaluating function (physical, role, social, cognitive, emotional), symptoms (diarrhea, fatigue, dyspnea, appetite loss, insomnia, nausea/vomiting, constipation, and pain) and financial difficulties. The last 2 questions use a 7-point scale (1=very poor to 7=excellent) to evaluate overall health and quality of life. Global scores are converted to a score of 0 to 100, with a higher score indicating improved health status. Mean changes from baseline global score over the first 6 cycles in the Treatment Part of the study were analyzed. Baseline to the end of Cycle 6, or up to approximately 6 months
Secondary Overall Survival (Efficacy Population) Overall survival (OS) is defined as the number of days from the date of randomization to the date of death (due to any cause). Patients who are still alive were censored on the date of their last available visit or last date known to be alive. All patients were followed for survival up to approximately 3.5 years.
Secondary Overall Survival (ITT Population) Overall survival (OS) is defined as the number of days from the date of randomization to the date of death (due to any cause). Patients who are still alive were censored on the date of their last available visit or last date known to be alive. All patients were followed for survival up to approximately 3.5 years.
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