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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT02655016
Other study ID # 213359
Secondary ID PR-30-5017-C
Status Active, not recruiting
Phase Phase 3
First received
Last updated
Start date July 11, 2016
Est. completion date September 25, 2024

Study information

Verified date March 2024
Source Tesaro, Inc.
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study aims to assess efficacy of Niraparib (GSK3985771) as maintenance treatment in participants with Stage III or IV ovarian cancer. Participants must have completed front-line platinum based regimen with complete response (CR) or partial response (PR). Data collection for Secondary Outcome measures is ongoing and the approximate duration of the study will be 7 years.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 733
Est. completion date September 25, 2024
Est. primary completion date May 17, 2019
Accepts healthy volunteers No
Gender Female
Age group 18 Years and older
Eligibility Inclusion criteria: - Participants must have histologically diagnosed high-grade serous or endometrioid, or high-grade predominantly serous or endometrioid ovarian cancer, fallopian tube cancer, or primary peritoneal cancer that is Stage III or IV according to Federation Internationale de Gynécologie et d'Obstétrique (FIGO) criteria. - Participants with inoperable Stage III and IV disease; All Stage IV participants with operable disease; Participants with stage III or IV disease treated with neoadjuvant chemotherapy and interval debulking surgery; and Participants with stage III disease who have visible residual disease after primary debulking surgery. - Participants who have received intraperitoneal chemotherapy; All participants must have had more than or equal to (>=)6 and less than or equal to (<=)9 cycles of platinum-based therapy; Participants must have had >=2 post-operative cycles of platinum-based therapy following interval debulking surgery; Participants must have physician assessed Complete response (CR) or Partial response (PR) after >=3 cycles of therapy; and Participants must have either Cancer antigen 125 (CA-125) in the normal range or CA-125 decrease by more than 90 percent(%) during their front-line therapy that is stable for at least 7 days (no increase more than (>)15% from nadir). - Participants must be randomized within 12 weeks of the first day of the last cycle of chemotherapy. - All participants must agree to undergo central tumor HRD testing. - Participants of childbearing potential must have a negative serum or urine pregnancy test (beta human chorionic gonadotropin [hCG]) within 7 days prior to receiving the first dose of study treatment. Exclusion criteria: - Participant has mucinous or clear cell subtypes of epithelial ovarian cancer, carcinosarcoma or undifferentiated ovarian cancer. - Participants with Stage III disease who have had complete cytoreduction (no visible residual disease) after primary debulking surgery. - Participant has undergone more than two debulking surgeries for the study disease. - Participant is pregnant, breastfeeding, or expecting to conceive children while receiving study treatment and for up to 180 days after the last dose of study treatment. - Participant has a known hypersensitivity to the components of niraparib or its excipients. - Participant has received prior treatment with a known PARP inhibitor or has participated in a study where any treatment arm included administration of a known PARP inhibitor. - Participant is to receive bevacizumab as maintenance treatment. - Participant has had investigational therapy administered within 4 weeks, or within a time interval less than at least 5 half-lives of the investigational agent, whichever is longer, prior to the first scheduled day of dosing in this study. - Participant has had any known >=Grade 3 anemia, neutropenia or thrombocytopenia due to prior chemotherapy that persisted >4 weeks. - Participant has a condition (such as transfusion dependent anemia or thrombocytopenia), therapy, or laboratory abnormality that might confound the study results or interfere with the participation for the full duration of the study treatment, including: 1. Participant received a transfusion (platelets or red blood cells) within 2 weeks of the first dose of study treatment. 2. Participant received colony-stimulating factors (e.g., granulocyte colony stimulating factor [G-CSF], granulocyte macrophage colony-stimulating factor [GM-CSF] or recombinant erythropoietin) within 2 weeks prior to the first dose of study treatment. - Participant has been diagnosed and/or treated for invasive cancer less than 5 years prior to study enrollment.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Niraparib
Niraparib will be administered.
Placebo
Placebo will be administered.

Locations

Country Name City State
Belgium GSK Investigational Site Bonheiden
Belgium GSK Investigational Site Bruxelles
Belgium GSK Investigational Site Bruxelles
Belgium GSK Investigational Site Charleroi
Belgium GSK Investigational Site Gent
Belgium GSK Investigational Site Hasselt
Belgium GSK Investigational Site Leuven
Belgium GSK Investigational Site Libramont
Belgium GSK Investigational Site Namur
Belgium GSK Investigational Site Sint-Niklaas
Canada GSK Investigational Site Barrie Ontario
Canada GSK Investigational Site Calgary Alberta
Canada GSK Investigational Site Kelowna British Columbia
Canada GSK Investigational Site London Ontario
Canada GSK Investigational Site Montreal Quebec
Canada GSK Investigational Site Montreal Quebec
Canada GSK Investigational Site Montréal Quebec
Canada GSK Investigational Site Ottawa Ontario
Canada GSK Investigational Site Surrey British Columbia
Canada GSK Investigational Site Toronto Ontario
Canada GSK Investigational Site Toronto Ontario
Canada GSK Investigational Site Vancouver British Columbia
Czechia GSK Investigational Site Brno
Czechia GSK Investigational Site Ostrava
Czechia GSK Investigational Site Plzen-Lochotin
Czechia GSK Investigational Site Prague
Czechia GSK Investigational Site Prague
Denmark GSK Investigational Site Aalborg
Denmark GSK Investigational Site Herlev
Denmark GSK Investigational Site Koebenhavn Oe
Denmark GSK Investigational Site Odense
Finland GSK Investigational Site Kuopio
Finland GSK Investigational Site Oulu
Finland GSK Investigational Site Tampere
Finland GSK Investigational Site Turku
France GSK Investigational Site Angers
France GSK Investigational Site Caen Cedex 05
France GSK Investigational Site Montpellier Cedex 5
France GSK Investigational Site Nice Cedex 2
France GSK Investigational Site Paris
France GSK Investigational Site Pierre-Benite cedex
France GSK Investigational Site Rennes Cedex
France GSK Investigational Site Saint-Herblain
Germany GSK Investigational Site Berlin
Germany GSK Investigational Site Essen Nordrhein-Westfalen
Germany GSK Investigational Site Fuerth Bayern
Germany GSK Investigational Site Goettingen Niedersachsen
Germany GSK Investigational Site Hamburg
Germany GSK Investigational Site Heidelberg Baden-Wuerttemberg
Germany GSK Investigational Site Ludwigshafen Rheinland-Pfalz
Germany GSK Investigational Site Mannheim Baden-Wuerttemberg
Germany GSK Investigational Site Muenchen Bayern
Germany GSK Investigational Site Muenchen Bayern
Hungary GSK Investigational Site Debrecen
Hungary GSK Investigational Site Gyor
Ireland GSK Investigational Site Galway
Ireland GSK Investigational Site Waterford
Israel GSK Investigational Site Beer Sheva
Israel GSK Investigational Site Haifa
Israel GSK Investigational Site Haifa
Israel GSK Investigational Site Holon
Israel GSK Investigational Site Tel Aviv
Israel GSK Investigational Site Tel Hashomer
Italy GSK Investigational Site Candiolo (TO) Piemonte
Italy GSK Investigational Site Milano Lombardia
Italy GSK Investigational Site Milano Lombardia
Italy GSK Investigational Site Mirano Veneto
Italy GSK Investigational Site Modena Emilia-Romagna
Italy GSK Investigational Site Napoli Campania
Norway GSK Investigational Site Oslo
Poland GSK Investigational Site Lodz
Poland GSK Investigational Site Lublin
Poland GSK Investigational Site Olsztyn
Poland GSK Investigational Site Poznan
Russian Federation GSK Investigational Site Arkhangelsk
Russian Federation GSK Investigational Site Chelyabinsk
Russian Federation GSK Investigational Site Irkutsk
Russian Federation GSK Investigational Site Ivanovo
Russian Federation GSK Investigational Site Kazan
Russian Federation GSK Investigational Site Krasnoyarsk
Russian Federation GSK Investigational Site Orenburg
Russian Federation GSK Investigational Site Pyatigorsk
Russian Federation GSK Investigational Site Saint-Petersburg
Russian Federation GSK Investigational Site Samara
Russian Federation GSK Investigational Site St-Petersburg
Russian Federation GSK Investigational Site St. Petersburg
Russian Federation GSK Investigational Site St. Petersburg
Spain GSK Investigational Site Badalona
Spain GSK Investigational Site Barcelona
Spain GSK Investigational Site Barcelona
Spain GSK Investigational Site Barcelona
Spain GSK Investigational Site Cordoba
Spain GSK Investigational Site Elche
Spain GSK Investigational Site Girona
Spain GSK Investigational Site Hospitalet de Llobregat, Barcelona
Spain GSK Investigational Site Madrid
Spain GSK Investigational Site Madrid
Spain GSK Investigational Site Madrid
Spain GSK Investigational Site Madrid
Spain GSK Investigational Site San Sebastián
Spain GSK Investigational Site Sevilla
Spain GSK Investigational Site Sevilla
Spain GSK Investigational Site Valencia
Spain GSK Investigational Site Valencia
Spain GSK Investigational Site Zaragoza
Sweden GSK Investigational Site Stockholm
Sweden GSK Investigational Site Uppsala
Switzerland GSK Investigational Site Basel
Switzerland GSK Investigational Site Bern
Switzerland GSK Investigational Site Frauenfeld
Switzerland GSK Investigational Site Zurich
Ukraine GSK Investigational Site Dnipro
Ukraine GSK Investigational Site Dnipropetrovsk
Ukraine GSK Investigational Site Ivano-Frankivsk
Ukraine GSK Investigational Site Kharkiv
Ukraine GSK Investigational Site Kherson
Ukraine GSK Investigational Site Krivoy Rog
Ukraine GSK Investigational Site Kyiv
Ukraine GSK Investigational Site Vinnitsia
Ukraine GSK Investigational Site Zaporizhzhia
United Kingdom GSK Investigational Site Bath Somerset
United Kingdom GSK Investigational Site Blackburn
United Kingdom GSK Investigational Site Exeter
United Kingdom GSK Investigational Site Glasgow
United Kingdom GSK Investigational Site London
United Kingdom GSK Investigational Site Portsmouth Hampshire
United Kingdom GSK Investigational Site Sheffield
United Kingdom GSK Investigational Site Stoke-on-Trent Staffordshire
United Kingdom GSK Investigational Site Truro
United States GSK Investigational Site Atlanta Georgia
United States GSK Investigational Site Augusta Georgia
United States GSK Investigational Site Austin Texas
United States GSK Investigational Site Baltimore Maryland
United States GSK Investigational Site Baton Rouge Louisiana
United States GSK Investigational Site Buffalo New York
United States GSK Investigational Site Burlington Massachusetts
United States GSK Investigational Site Chapel Hill North Carolina
United States GSK Investigational Site Charleston South Carolina
United States GSK Investigational Site Chicago Illinois
United States GSK Investigational Site Cleveland Ohio
United States GSK Investigational Site Cleveland Ohio
United States GSK Investigational Site Columbus Ohio
United States GSK Investigational Site Covington Louisiana
United States GSK Investigational Site Fort Worth Texas
United States GSK Investigational Site Grand Rapids Michigan
United States GSK Investigational Site Harrison New York
United States GSK Investigational Site Hartford Connecticut
United States GSK Investigational Site Hinsdale Illinois
United States GSK Investigational Site Hollywood Florida
United States GSK Investigational Site Indianapolis Indiana
United States GSK Investigational Site Indianapolis Indiana
United States GSK Investigational Site Iowa City Iowa
United States GSK Investigational Site Jacksonville Florida
United States GSK Investigational Site Kennewick Washington
United States GSK Investigational Site Los Angeles California
United States GSK Investigational Site Mayfield Heights Ohio
United States GSK Investigational Site Mesa Arizona
United States GSK Investigational Site Miami Florida
United States GSK Investigational Site Middletown New Jersey
United States GSK Investigational Site Milwaukee Wisconsin
United States GSK Investigational Site Mineola New York
United States GSK Investigational Site Minneapolis Minnesota
United States GSK Investigational Site Morgantown West Virginia
United States GSK Investigational Site Neptune New Jersey
United States GSK Investigational Site New Haven Connecticut
United States GSK Investigational Site New Orleans Louisiana
United States GSK Investigational Site New York New York
United States GSK Investigational Site New York New York
United States GSK Investigational Site Oklahoma City Oklahoma
United States GSK Investigational Site Philadelphia Pennsylvania
United States GSK Investigational Site Portland Oregon
United States GSK Investigational Site Providence Rhode Island
United States GSK Investigational Site Rochester New York
United States GSK Investigational Site Salt Lake City Utah
United States GSK Investigational Site San Antonio Texas
United States GSK Investigational Site San Francisco California
United States GSK Investigational Site San Francisco California
United States GSK Investigational Site Santa Rosa California
United States GSK Investigational Site Savannah Georgia
United States GSK Investigational Site Seattle Washington
United States GSK Investigational Site Silver Spring Maryland
United States GSK Investigational Site Sioux Falls South Dakota
United States GSK Investigational Site Spokane Washington
United States GSK Investigational Site Springfield Oregon
United States GSK Investigational Site Springfield Missouri
United States GSK Investigational Site Springfield Massachusetts
United States GSK Investigational Site Teaneck New Jersey
United States GSK Investigational Site The Woodlands Texas
United States GSK Investigational Site Tucson Arizona
United States GSK Investigational Site Tucson Arizona
United States GSK Investigational Site Tulsa Oklahoma
United States GSK Investigational Site Tyler Texas
United States GSK Investigational Site Warrenville Illinois
United States GSK Investigational Site Willow Grove Pennsylvania
United States GSK Investigational Site Wilmington North Carolina

Sponsors (4)

Lead Sponsor Collaborator
Tesaro, Inc. European Network of Gynaecological Oncological Trial Groups (ENGOT), Gynecologic Oncology Group, Myriad Genetics, Inc.

Countries where clinical trial is conducted

United States,  Belgium,  Canada,  Czechia,  Denmark,  Finland,  France,  Germany,  Hungary,  Ireland,  Israel,  Italy,  Norway,  Poland,  Russian Federation,  Spain,  Sweden,  Switzerland,  Ukraine,  United Kingdom, 

References & Publications (3)

Barretina-Ginesta MP, Monk BJ, Han S, Pothuri B, Auranen A, Chase DM, Lorusso D, Anderson C, Abadie-Lacourtoisie S, Cloven N, Braicu EI, Amit A, Redondo A, Shah R, Kebede N, Hawkes C, Gupta D, Woodward T, O'Malley DM, Gonzalez-Martin A. Quality-adjusted time without symptoms of disease or toxicity and quality-adjusted progression-free survival with niraparib maintenance in first-line ovarian cancer in the PRIMA trial. Ther Adv Med Oncol. 2022 Sep 22;14:17588359221126149. doi: 10.1177/17588359221126149. eCollection 2022. — View Citation

Gonzalez-Martin A, Pothuri B, Vergote I, DePont Christensen R, Graybill W, Mirza MR, McCormick C, Lorusso D, Hoskins P, Freyer G, Baumann K, Jardon K, Redondo A, Moore RG, Vulsteke C, O'Cearbhaill RE, Lund B, Backes F, Barretina-Ginesta P, Haggerty AF, Rubio-Perez MJ, Shahin MS, Mangili G, Bradley WH, Bruchim I, Sun K, Malinowska IA, Li Y, Gupta D, Monk BJ; PRIMA/ENGOT-OV26/GOG-3012 Investigators. Niraparib in Patients with Newly Diagnosed Advanced Ovarian Cancer. N Engl J Med. 2019 Dec 19;381(25):2391-2402. doi: 10.1056/NEJMoa1910962. Epub 2019 Sep 28. — View Citation

Lorusso D, Guy H, Samyshkin Y, Hawkes C, Estenson K, Coleman RL. Feasibility Study of a Network Meta-Analysis and Unanchored Population-Adjusted Indirect Treatment Comparison of Niraparib, Olaparib, and Bevacizumab as Maintenance Therapies in Patients with Newly Diagnosed Advanced Ovarian Cancer. Cancers (Basel). 2022 Mar 2;14(5):1285. doi: 10.3390/cancers14051285. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Other Number of Participants With Any Non-serious Adverse Event (Non-SAE) or Any SAE An adverse event is any untoward medical occurrence that occurs in a participant or clinical investigation participant administered a pharmaceutical product, and which does not necessarily have to have a causal relationship with study treatment. Any untoward event resulting in death, life threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, congenital anomaly or birth defect or any other situation according to medical or scientific judgment was categorized as SAE. Up to 34 months
Other Area Under the Curve (AUC) From 0 to the Last Quantifiable Concentration (AUC[0-last]) Blood samples were planned to be collected for assessment of AUC(0-last). Up to 34 months
Other Peak Plasma Concentration (Cmax) Blood samples were planned to be collected for assessment of Cmax. Up to 34 months
Other Number of Participants With Positive HRD Test Number of participants with positive HRD test was planned to be assessed. Up to 34 months
Primary Progression Free Survival Progression free survival was defined as the time from the date of treatment randomization to the date of first documentation of disease progression or death due to any cause in the absence of documented progression, whichever occurs first. It was assessed by the blinded independent central review (BICR). Median and 95% confidence interval (CI) are presented. Up to 34 months
Secondary Overall Survival Overall survival was defined as the time from the date of randomization to the date of death by any cause. Median and 95% CI are presented for overall survival interim analysis. Up to 34 months
Secondary Time to First Subsequent Therapy (TFST) Time to first subsequent therapy was defined as the time from the date of randomization to the date of the first subsequent anti-cancer therapy or death, whichever occurs first. Median and 95% CI are presented. Up to 34 months
Secondary Progression-Free Survival-2 (PFS2) PFS2 was defined as the time from the date of randomization to the date of progression on the next anti-cancer therapy following study treatment or death by any cause, whichever occurs first. Median and 95% CI are presented. Up to 34 months
Secondary Change From Baseline in Participant Reported Outcome (PRO): Functional Assessment of Cancer Therapy-Ovarian Symptom Index (FOSI) FOSI is a validated, 8-item measure of symptom response to treatment for ovarian cancer. Participants responded to their symptom experience over the past 7 days using a 5-point Likert scale scored from "not at all" (0) to "very much" (4). FOSI score was calculated as (sum of item scores)*8 divided by (number of items answered). The FOSI score ranged from 0 (severely symptomatic) to 32 (asymptomatic). A higher score indicated a better quality of life (QoL). Change from Baseline was calculated by subtracting Baseline value from the post-dose visit value. Baseline was defined as the latest pre-dose assessment (Day 1 pre-dose). Baseline (Day 1, Pre-dose) and Up to Week 24
Secondary Change From Baseline in PRO: European Quality of Life Scale, 5-dimensions, 5-levels of Severity (EQ-5D-5L) Utility Score The EQ-5D-5L is a well-validated general preference-based, health-related QoL instrument. The five-item measure has 1 question assessing each of 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression and 5 levels for each dimension including 1=no problems, 2=slight problems, 3=moderate problems, 4=severe problems and 5=extreme problems. The health state is defined by combining the levels of answers from each of the 5 questions. Each health state is referred to in terms of a 5 digit code. Health state 5 digit code is translated into utility score, which is valued up to 1 (perfect health) with lower values meaning worse state. EQ-5D-5L utility score ranges from -0.281 to 1. Higher scores indicate better health. Change from Baseline was calculated by subtracting Baseline value from the post-dose visit value. Baseline was defined as the latest pre-dose assessment (Day 1 pre-dose). Baseline (Day 1, Pre-dose) and Up to Week 24
Secondary Change From Baseline in Functional Scales of European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC-QLQ-C30) EORTC-QLQ-C30 incorporates 5 functional scales (physical, role, cognitive, emotional, and social), 3 symptom scales (fatigue, pain, and nausea/vomiting), a global health status/QoL scale (global health status, QoL), and 6 single items (dyspnea, appetite loss, insomnia, constipation, diarrhea, and financial difficulty) assessing additional symptoms commonly reported by participants with cancer. Five functional scales had total 15 items (physical-5, role-2, cognitive-4, emotional-2, and social-2). Each functional scales score was calculated by averaging scores of all scale items and transforming average scores linearly (1 minus [average score minus 1] divided by 3*100). All of the functional scales range in score from 0 to 100. Higher score represents a higher ("better") level of functioning. Change from Baseline was calculated by subtracting Baseline value from the post-dose visit value. Baseline was defined as the latest pre-dose assessment (Day 1 pre-dose). Baseline (Day 1, Pre-dose) and Up to Week 24
Secondary Change From Baseline in Global Health Status/QoL of EORTC-QLQ-C30 EORTC-QLQ-C30 incorporates 5 functional scales (physical, role, cognitive, emotional, and social), 3 symptom scales (fatigue, pain, and nausea/vomiting), a global health status/QoL scale (global health status, QoL), and 6 single items (dyspnea, appetite loss, insomnia, constipation, diarrhea, and financial difficulty) assessing additional symptoms commonly reported by participants with cancer. A global health status/QoL scale had total 2 items. Each global health status/QoL scales score was calculated by averaging scores of all scale items and transforming average scores linearly ([average score minus 1] divided by 6*100). The global health status/QoL scales range in score from 0 to 100. Higher score represents a higher ("better") level of health status/QoL. Change from Baseline was calculated by subtracting Baseline value from the post-dose visit value. Baseline was defined as the latest pre-dose assessment (Day 1 pre-dose). Baseline (Day 1, Pre-dose) and Up to Week 24
Secondary Change From Baseline in Symptoms Scales and Symptoms Items (Dyspnea, Appetite Loss, Insomnia, Constipation, Diarrhea and Financial Difficulty) of EORTC-QLQ-C30 EORTC-QLQ-C30 incorporates 5 functional scales (physical, role, cognitive, emotional, and social), 3 symptom scales (fatigue, pain, and nausea/vomiting), a global health status/QoL scale, and 6 single items (dyspnea, appetite loss, insomnia, constipation, diarrhea, and financial difficulty) assessing additional symptoms commonly reported by participants with cancer. Symptom scale had total 7 items (fatigue-3, pain-2, nausea/vomiting-2). Each symptoms scales and 6 single additional symptoms items score was calculated by averaging scores of all scale items and transforming average scores linearly ([average score minus 1] divided by 3*100). All of the symptoms scales and 6 single additional symptoms scales range in score from 0 to 100. Higher score represents a higher ("worse") level of symptoms. Change from Baseline was calculated by subtracting Baseline value from the post-dose visit value. Baseline was defined as the latest pre-dose assessment (Day 1 pre-dose). Baseline (Day 1, Pre-dose) and Up to Week 24
Secondary Change From Baseline in Functional Scales of European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Ovarian Cancer Module (EORTC-QLQ-OV28) EORTC-QLQ-OV28 is supplement to EORTC-QLQ-C30. It includes 3 functional scales (body image, sexuality, attitude to disease/treatment) and 5 symptom scales/items (abdominal/gastrointestinal [GI] symptoms, peripheral neuropathy, hormonal/menopausal symptoms, other chemotherapy side-effects, and hair loss). Functional scales score (body Image and attitude to disease/treatment) was calculated by averaging scores of all scale items and transforming average scores linearly (1 minus [average score minus 1] divided by 3*100). Functional scales score (sexuality) was calculated by averaging scores of all scale items and transforming average scores linearly ([average score minus 1] divided by 3*100). All of the functional scales range in score from 0 to 100. Higher score represents a higher ("better") level of functioning. Change from Baseline was calculated by subtracting Baseline value from the post-dose visit value. Baseline was defined as the latest pre-dose assessment (Day 1 pre-dose). Baseline (Day 1, Pre-dose) and Up to 34 months
Secondary Change From Baseline in Symptoms Scale of EORTC-QLQ-OV28 EORTC-QLQ-OV28 is supplement to EORTC-QLQ-C30. It includes 3 functional scales (body image, sexuality, attitude to disease/treatment) and 5 symptom scales/items (abdominal/GI symptoms, peripheral neuropathy, hormonal/menopausal symptoms, other chemotherapy side-effects, and hair loss). Symptoms scales score was calculated by averaging scores of all scale items and transforming average scores linearly ([average score minus 1] divided by 3*100). All of the symptoms scales range in score from 0 to 100. Higher score represents a higher ("worse") level of symptoms. Change from Baseline was calculated by subtracting Baseline value from the post-dose visit value. Baseline was defined as the latest pre-dose assessment (Day 1 pre-dose). Baseline (Day 1, Pre-dose) and Up to 34 months
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