Ovarian Cancer Clinical Trial
Official title:
Randomized, Multicenter, Open-label, Phase 3 Study of Mirvetuximab Soravtansine in Combination With Bevacizumab Versus Bevacizumab Alone as Maintenance Therapy for Patients With FRα-high Recurrent Platinum-sensitive Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancers Who Have Not Progressed After Second Line Platinum-based Chemotherapy Plus Bevacizumab (GLORIOSA)
GLORIOSA is a Phase 3 multicenter, open label study designed to evaluate the safety and efficacy of mirvetuximab Soravtansine as maintenance therapy in participants with platinum-sensitive ovarian, primary peritoneal or fallopian tube cancers with high folate receptor-alpha (FRα) expression.
Status | Recruiting |
Enrollment | 418 |
Est. completion date | April 2029 |
Est. primary completion date | March 2027 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: 1. Patients must be = 18 years of age 2. Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. 3. Patients must have a confirmed diagnosis of high-grade serous epithelial ovarian, primary peritoneal, or fallopian tube cancer. 4. Patients must be willing to provide an archival tumor tissue block or slides, or must undergo a procedure to obtain a new biopsy using a low-risk, medically routine procedure for IHC confirmation of high FRa expression (reported as "positive") as defined by the Ventana FOLR1 Assay. Patients must be confirmed FRa-high as defined by FRa positivity of = 75% of tumor membrane staining at = 2+ intensity (PS2+) for entry into the study. 5. Prior BRCA testing on the tumor or prior germline testing is required for eligibility. If not done prior, tumor or germline testing will need to be done before study entry. Somatic and germline BRCA-positive patients must have received prior treatment with a PARPi in maintenance following first-line treatment. Note: Local tumor or germline BRCA testing will be acceptable for stratification. If the patient has not been tested, recommend archival tumor samples to be assessed for tissue BRCA. All patients who have received prior first line PARPi maintenance and/or bevacizumab are eligible. 6. Patients' disease must have relapsed after 1 line (first line) of platinum-based chemotherapy and must be platinum-sensitive defined as progression greater than 6 months from last dose of primary platinum therapy. 7. Patients must be appropriate for, currently be on, or have completed platinum-based triplet therapy in the second line (recurrent PSOC). 8. After completion of triplet therapy and before randomization, patients must have received no less than 4 and no greater than 8 cycles of platinum-based triplet therapy in the second line, to include no less than 3 cycles of bevacizumab in combination with platinum-based chemotherapy. If the number of cycles received is less than 6 due to toxicity, this must be documented and toxicity assessed as unlikely related to bevacizumab. Note: A minimum of 4 cycles of combination chemotherapy is required. If carboplatin, paclitaxel, gemcitabine, or pegylated liposomal doxorubicin (PLD) is stopped due to toxicity, up to 4 additional cycles of single agent in combination with bevacizumab is acceptable if appropriately documented. 9. After completion of triplet therapy and before randomization: In the case of interval secondary cytoreductive surgery, patients are permitted to have received only 2 cycles of bevacizumab if given in combination with the last 3 cycles of platinum-based triplet therapy in the second line. In the case of primary cytoreductive surgery before secondline platinum-based triplet therapy, patients must have received no fewer than 3 cycles of bevacizumab in combination with platinum-based chemotherapy after their surgery and before randomization. 10. Patients either will receive (per investigator's choice), must be receiving, or have received paclitaxel, gemcitabine, or pegylated liposomal doxorubicin as the partner drug to platinum-based triplet therapy in the second line. 11. After completion of triplet therapy and before randomization, patients must have achieved a CR, PR, or SD, per the investigator, in the second line to be eligible for randomization into the study population. All patients will have CT or MRI scans and CA-125 measurements at least 3 weeks but no more than 8 weeks after their last planned dose of triplet therapy and before randomization. 12. Patients must be randomized no later than 8 weeks from the last dose of platinum-based triplet therapy in the second line. 13. After completion of triplet therapy and before randomization, patients must meet one of the following criteria: 1. Have at least 1 lesion that meets the definition of measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 (radiologically measured by the investigator), and determined by the investigator to either have SD or a PR to their treatment; or 2. Have persistently elevated CA-125 without measurable disease and determined by the investigator to have either SD or a PR to their treatment; or 3. Have clinically no evidence of disease by both radiographic interpretation by the investigator and normalization of their CA-125, determined to be a CR. 14. Patients must have stabilized or recovered (to Grade 1 or baseline) from all prior therapy-related toxicities (except alopecia). 15. Patients must have completed any major surgery at least 4 weeks before the first dose of study treatment (either Run-In or maintenance therapy) and have recovered or stabilized from the side effects of prior surgery before the first dose of treatment on study. 16. Patients must have adequate hematologic, liver, and kidney functions defined as follows: 1. Absolute neutrophil count (ANC) = 1.5 × 109/L (1500/µL) without granulocyte colony-stimulating factor in the prior 10 days or long-acting white blood cell (WBC) growth factors in the prior 10 days of C1D1 of maintenance treatment. 2. Platelet count = 100 × 109/L (100,000/µL) without platelet transfusion in the prior 10 days of C1D1 of maintenance treatment 3. Hemoglobin = 9.0 g/dL without packed red blood cell (PRBC) transfusion in the prior 10 days of C1D1 of maintenance treatment 4. Serum creatinine = 1.5 × upper limit of normal (ULN) 5. Aspartate aminotransferase and alanine aminotransferase = 3.0 × ULN 6. Serum bilirubin = 1.5 × ULN (patients with documented diagnosis of Gilbert syndrome are eligible if total bilirubin < 3.0 × ULN) 7. Serum albumin = 2 g/dL 17. Patients must be willing and able to sign the informed consent form (ICF) and to adhere to the protocol requirements. 18. Females of childbearing potential (FCBP) must agree to use highly effective contraceptive method(s) (as defined in Section 5.10.7) while on study medication and for at least 3 months after the last dose. 19. FCBP must have a negative pregnancy test within 4 days before the first dose of therapy. Exclusion Criteria: 1. Patients with endometrioid, clear cell, mucinous, or sarcomatous histology; mixed tumors containing any of the above histologies; or low-grade/borderline ovarian tumor 2. More than one line of prior chemotherapy before current/planned triplet therapy. Lines of prior anticancer therapy are counted with the following considerations: 1. Neoadjuvant ± adjuvant therapies are considered 1 line of therapy if the neoadjuvant and adjuvant correspond to 1 fully predefined regimen; otherwise, they are counted as 2 prior regimens. 2. Maintenance therapy (eg, bevacizumab, PARPi) will be considered part of the preceding line of therapy (ie, not counted independently). 3. Change due to toxicity will be considered part of the proceeding line of therapy. 3. Patients with PD while on or following platinum-based triplet therapy 4. After completion of triplet therapy and prior to randomization: Patients who receive an intervening dose of bevacizumab after the last dose of triplet therapy before randomization 5. Patients with prior wide-field radiotherapy affecting at least 20% of the bone marrow 6. Patients with > Grade 1 peripheral neuropathy per Common Terminology Criteria for Adverse Events (CTCAE) 7. 7. Patients with active or chronic corneal disorders, history of corneal transplantation, or active ocular conditions requiring ongoing treatment/monitoring, such as uncontrolled glaucoma, wet age-related macular degeneration requiring intravitreal injections, active diabetic retinopathy with macular edema, macular degeneration, presence of papilledema, and/or monocular vision 8. Patients with serious concurrent illness or clinically relevant active infection, including but not limited to the following: 1. Active hepatitis B or C infection (whether or not on active antiviral therapy) 2. HIV infection 3. Active cytomegalovirus infection 4. Any other concurrent infectious disease requiring intravenous (IV) antibiotics within 2 weeks before the first dose of maintenance therapy Note: Testing at screening is not required for the above infections unless clinically indicated. 9. Patients with a history of multiple sclerosis or other demyelinating diseases and/or Lambert-Eaton syndrome (paraneoplastic syndrome) 10. Patients with clinically significant cardiac disease including, but not limited to, any of the following: 1. Myocardial infarction = 6 months prior to C1D1 of maintenance treatment 2. Unstable angina pectoris 3. Uncontrolled congestive heart failure (New York Heart Association > class II) 4. Uncontrolled = Grade 3 hypertension (per CTCAE) 5. Uncontrolled cardiac arrhythmias 11. Patients with a history of hemorrhagic or ischemic stroke within 6 months before enrollment 12. Patients with a history of cirrhotic liver disease (Child-Pugh Class B or C) 13. Patients with a previous clinical diagnosis of noninfectious interstitial lung disease, including noninfectious pneumonitis (exception: Grade 1 noninfectious pneumonitis diagnosed on or within 6 weeks after treatment with an immunotherapeutic agent used in the treatment of their malignancy that has resolved per investigator or resolution of the radiologic findings) 14. History of bowel obstruction (including sub-occlusive disease) related to underlying disease within 6 months before the start of maintenance study treatment (triplet therapy for Run-In patients). 15. History of abdominal fistula or gastrointestinal perforation 16. Intra-abdominal abscess, evidence of rectosigmoid involvement by pelvic examination, bowel involvement on CT scan, or clinical symptoms of bowel obstruction within 4 weeks prior to randomization (or within 4 weeks prior to starting triplet therapy for Run- In patients) 17. Clinically significant proteinuria: urine-protein to creatinine (UPC) ratio = 1.0 or urine dipstick result = 2+; patients with UPC ratio = 1.0 or = 2+ proteinuria should undergo 24-hour urine collection and must show result = 1 g of protein in a 24-hour period. 18. History of Grade 4 thromboembolic events 19. Patients not appropriate for bevacizumab 15 mg/kg dosing at the start of maintenance therapy as per the treating physician 20. Patients requiring use of folate-containing supplements (eg, folate deficiency) 21. Patients with prior hypersensitivity to monoclonal antibodies (mAbs) 22. Women who are pregnant or breastfeeding 23. Patients who received prior treatment with MIRV or other FRa-targeting agents 24. Patients with untreated or symptomatic central nervous system metastases 25. Patients with a history of other malignancy within 3 years prior to signing study consent Note: Patients with tumors with a negligible risk for metastasis or death (eg, controlled basal cell carcinoma or squamous cell carcinoma of the skin, or carcinoma in situ of the cervix or breast) are eligible. 26. Prior known hypersensitivity reactions to study drugs or any of their excipients |
Country | Name | City | State |
---|---|---|---|
Australia | Grampians Health Service | Ballarat | Victoria |
Australia | Cabrini Health | Brighton | Victoria |
Australia | Monash Health | Clayton | Victoria |
Australia | Peter Maccallum Cancer Centre | Melbourne | Victoria |
Australia | Epworth Health | Richmond | Victoria |
Australia | Gold Coast University Hospital | Southport | Queensland |
Australia | Bendat Family Comprehensive Cancer Centre St John of God - Subiaco Hospital | Subiaco | |
Australia | Westmead Hospital | Westmead | New South Wales |
Belgium | Imeldaziekenhuis, Apotheek Klinische Studies, Imeldalaan 9 Centraal Magazjin | Bonheiden | |
Belgium | Cliniques Universitaires St-Luc Woluwe-Saint-Lambert | Brussel | |
Belgium | GHDC Grand Hôpital de Charleroi, Site Notre-Dame, Grand Rue 3 | Charleroi | |
Belgium | AZ Sint Lucas Gent, Groenebriel 1 | Gent | |
Belgium | UZ Leuven, Apotheek Klinische studies, Herestraat, 49 | Leuven | |
Belgium | CHU UCL Namur - Site Sainte-Elisabeth, Route (Road) 471 Place Louise Godin 15, Oncology Day Hospital, 3rd Floor | Namur | |
Belgium | AZ Delta apotheek, Tav Klinische studies, Kwadestraat 78 | Roeselare | |
Canada | Tom Baker Cancer Centre, Alberta Health Services | Calgary | Alberta |
Canada | University of Alberta - Cross Cancer Institute (CCI) | Edmonton | Alberta |
Canada | Juravinski Cancer Centre | Hamilton | Ontario |
Canada | Kinston Health Sciences Center - KGH Site | Kingston | Ontario |
Canada | Centre Hospitalier de L'Universite de Montreal - Centre de Recherche | Montreal | Quebec |
Canada | McGill University Health Centre | Montreal | Quebec |
Canada | Universite de Montreal - Hopital Maisonneuve-Rosemont (HMR) | Montreal | Quebec |
Canada | The Ottawa Hospital Cancer Centre | Ottawa | Ontario |
Canada | CHUS - Hôpital Fleurimont | Sherbrooke | Quebec |
Canada | Princess Margaret Cancer Centre | Toronto | Ontario |
Canada | BC Cancer - Vancouver | Vancouver | British Columbia |
Czechia | University Hospital Brno | Brno | |
Czechia | Nemocnice AGEL Nový Jicín a.s. | Nový Jicín | |
Czechia | University Hospital Ostrava | Ostrava Poruba | |
Czechia | General University Hospital in Prague | Prague | |
Israel | Carmel Medical Centre | Haifa | |
Israel | Wolfson Medical Centre | Holon | |
Israel | Hadassah Medical Ctr. Ein Kerem. Sharett Institute of oncology | Jerusalem | |
Israel | Shaare Zedek Medical Centre | Jerusalem | |
Israel | Meir Medical Centre | Kefar Sava | |
Israel | Rabin Medical Centre | Petah Tikva | |
Israel | Tel Aviv Sourasky Medical Center | Tel Aviv Yaffo | |
Italy | Policlinico S. Orsola-Malpighi | Bologna | |
Italy | AOU Careggi | Firenze | |
Italy | ASST Ospedale Alessandro Manzoni | Lecco | |
Italy | Azienda USL Toscana Nord Ovest Ospedale San Luca | Lucca | |
Italy | IRST - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori | Meldola | |
Italy | Fondazione IRCCS Istituto Nazionale dei Tumori | Milano | |
Italy | IRCCS San Raffaele | Milano | |
Italy | Ospedale di Mirano | Mirano | |
Italy | AOU di Parma | Parma | |
Italy | AUSL Piacenza Ospedale Guglielmo da Saliceto | Piacenza | |
Italy | Nuovo Ospedale di Prato - Santo Stefano | Prato | |
Italy | Fondazione Policlinico Universitario A. Gemelli IRCCS | Rome | |
Korea, Republic of | Keimyung Dongsan University Hospital | Daegu | |
Korea, Republic of | National Cancer Center | Goyang | Gyeonggi-do |
Korea, Republic of | CHA University - Bundang CHA General Hospital | Seongnam | Gyeonggi-do |
Korea, Republic of | Seoul National University Bundang Hospital | Seongnam | Gyeonggi-do |
Korea, Republic of | Asan Medical Center | Seoul | |
Korea, Republic of | Gangnam Severance Hospital, Yonsei University Health System | Seoul | |
Korea, Republic of | Korea University Anam Hospital | Seoul | |
Korea, Republic of | Korea University Guro Hospital | Seoul | |
Korea, Republic of | Samsung Medical Center | Seoul | |
Korea, Republic of | Seoul National University Hospital | Seoul | |
Korea, Republic of | Severance Hospital, Yonsei University Health System | Seoul | |
Korea, Republic of | The Catholic University of Korea, Seoul St. Mary's Hospital | Seoul | |
Philippines | The Medical City -Ortigas | Pasig | Metro Manila |
Philippines | East Avenue Medical Centre | Quezon City | |
Philippines | Cardinal Santos Medical Center | San Juan | Metro Manila |
Spain | Hospital Clinic de Barcelona (Hospital Clinic i Provincial) | Barcelona | |
Spain | Hospital Universitario Vall d'Hebron, CT Pharm General Building-Floor B, Passeig Vall d'Hebron | Barcelona | |
Spain | Instituto Catalán de Oncologia, 199-203 Av Gra Via CT Pharmacy, Hospital Duran i Reynals | Barcelona | |
Spain | Hospital Universitario de A Coruña (CHUAC) | Coruña | |
Spain | ICO-Hospital Universitario de Girona | Girona | |
Spain | Clínica Universidad de Navarra | Madrid | |
Spain | Hospital La Paz CT Pharmacy, 261 Paseo Castellana, North Building Ground Floor | Madrid | |
Spain | Clinica Universitaria Navarra Pamplona | Pamplona | |
Spain | Hospital Clinico Universitario de Valencia | Valencia | |
United Kingdom | Cheltenham General Hospital | Cheltenham | |
United Kingdom | The Royal Marsden NHS Foundation Trust | Fulham | London |
United Kingdom | Guy's and St Thomas' NHS Foundation Trust | London | |
United Kingdom | Mount Vernon Cancer Centre East and North Hertfordshire NHS Trust | Northwood | |
United Kingdom | Southampton University NHS Trust | Southampton | |
United Kingdom | The Royal Marsden NHS Foundation Trust | Sutton | Surrey |
United Kingdom | Singleton Hospital | Swansea | |
United States | New York Oncology Hematology, P.C. (USOR) | Albany | New York |
United States | Northside Hospital | Atlanta | Georgia |
United States | Texas Oncology, P.A. (USOR) | Austin | Texas |
United States | Greater Baltimore Medical Center | Baltimore | Maryland |
United States | Johns Hopkins Medical Institute | Baltimore | Maryland |
United States | Sinai Hospital of Baltimore, Inc. | Baltimore | Maryland |
United States | Texas Oncology - DFWW (USOR) | Bedford | Texas |
United States | UNC-Chapel Hill | Chapel Hill | North Carolina |
United States | University of Virginia | Charlottesville | Virginia |
United States | Rush University Medical Center, 1725 West Harrison Street | Chicago | Illinois |
United States | University of Chicago Medicine, 5841 S Maryland Ave, MC 2115 | Chicago | Illinois |
United States | University of Cincinnati | Cincinnati | Ohio |
United States | Ohio State University | Columbus | Ohio |
United States | John Muir Health | Concord | California |
United States | Texas Oncology-Dallas Presbyterian Hospital (USOR) | Dallas | Texas |
United States | Duke Cancer Center | Durham | North Carolina |
United States | Willamette Valley Cancer Institute and Research Center (USOR) | Eugene | Oregon |
United States | Broward Health Medical Center | Fort Lauderdale | Florida |
United States | Regional Cancer Center/ Florida Gynecologic Oncology | Fort Myers | Florida |
United States | Texas Oncology (USOR) | Fort Worth | Texas |
United States | The West Clinic, PLLC dba West Cancer Center | Germantown | Tennessee |
United States | Corewell Health | Grand Rapids | Michigan |
United States | John Theurer Cancer Center, University Medical Center, 92 Second Street | Hackensack | New Jersey |
United States | Indiana University | Indianapolis | Indiana |
United States | St Vincent Gynecologic Oncology | Indianapolis | Indiana |
United States | University of Iowa Health Care | Iowa City | Iowa |
United States | City of Hope | Irvine | California |
United States | Kaiser Permanente Irvine Medical Center, 6650 Alton Pkwy | Irvine | California |
United States | Baptist MD Anderson Cancer Center | Jacksonville | Florida |
United States | Kettering Health | Kettering | Ohio |
United States | UC San Diego Health - Moores Cancer Center | La Jolla | California |
United States | Dartmouth Hitchcock Medical, One Medical Center Drive | Lebanon | New Hampshire |
United States | Baptist Health Lexington | Lexington | Kentucky |
United States | University of Kentucky | Lexington | Kentucky |
United States | Kaiser Permanente Los Angeles Medical Center, 4950 Sunset Blvd., 6th Floor | Los Angeles | California |
United States | Minnesota Oncology Hematology, P.A. (USOR) | Maplewood | Minnesota |
United States | Mount Sinai Comprehensive Cancer Center | Miami | Florida |
United States | Perlmutter Cancer Center at NYU Langone Health-Long Island | Mineola | New York |
United States | USA Mitchell Cancer Institute | Mobile | Alabama |
United States | LSUHSC | New Orleans | Louisiana |
United States | Ochsner Clinic Foundation | New Orleans | Louisiana |
United States | Mount Sinai Hospital | New York | New York |
United States | Northwell Health Cancer Institute | New York | New York |
United States | Perlmutter Cancer Center at NYU Langone Health | New York | New York |
United States | Womens Cancer Care Associates | New York | New York |
United States | Virginia Oncology Associates (USOR) | Norfolk | Virginia |
United States | OU Health Stephenson Cancer Center | Oklahoma City | Oklahoma |
United States | Nebraska Methodist Hospital | Omaha | Nebraska |
United States | UCI Health- Chao Family Comprehensive Cancer Center | Orange | California |
United States | Stanford University | Palo Alto | California |
United States | The Valley Hospital -Luckow Pavilion | Paramus | New Jersey |
United States | Honor Health Cancer Care, Biltmore, 2222 E. Highland Ave, #400 | Phoenix | Arizona |
United States | Allegheny Health Network | Pittsburgh | Pennsylvania |
United States | Northwest Cancer Specialists, P.C. (USOR) | Portland | Oregon |
United States | OHSU Center for Health & Healing, Building 2 (CHH2), 3485 S Bond Ave | Portland | Oregon |
United States | Center of Hope at Renown Medical Center | Reno | Nevada |
United States | Virginia Commonwealth University (VCU)- Massey Comprehensive Cancer Center | Richmond | Virginia |
United States | Kaiser Permanente Riverside Medical Center, 10800 Magnolia Ave | Riverside | California |
United States | Texas Oncology - San Antonio (USOR) | San Antonio | Texas |
United States | Kaiser Permanente Zion Medical Center, 4647 Zion Ave | San Diego | California |
United States | Kaiser Permanente San Marcos Medical Offices, 400 Craven Road | San Marcos | California |
United States | Sarasota Memorial Health Care System | Sarasota | Florida |
United States | Maine Medical Center | Scarborough | Maine |
United States | Swedish Cancer Institute | Seattle | Washington |
United States | Sanford Gynecologic Oncology, 1309 W. 17th street | Sioux Falls | South Dakota |
United States | Baystate Gynecologic Oncology - Tolosky Center | Springfield | Massachusetts |
United States | Olive View UCLA Medical Center Inpatient Pharmacy, 14445 Olive View Dr, Rm 1C101 | Sylmar | California |
United States | Holy Name Medical Center | Teaneck | New Jersey |
United States | Oklahoma Cancer Specialists and Research Institute | Tulsa | Oklahoma |
United States | University of Kansas Cancer Center | Westwood | Kansas |
United States | Sidney Kimmel Cancer Center Asplundh Cancer Pavilion | Willow Grove | Pennsylvania |
Lead Sponsor | Collaborator |
---|---|
ImmunoGen, Inc. | GOG Foundation |
United States, Australia, Belgium, Canada, Czechia, Israel, Italy, Korea, Republic of, Philippines, Spain, United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Assess Progression-free survival (PFS) | Progression-free survival defined as the time from date of randomization until investigator-assessed progressive disease (PD) or death, whichever occurs first. | Up to 4 years | |
Secondary | Assess Overall survival (OS) | Overall survival (OS), defined as the time from randomization to death | Up to 7 years | |
Secondary | Assess Safety and tolerability | Adverse events (AEs) will be evaluated according to the NCI CTCAE v5.0 | Up to 7 years | |
Secondary | Assess second disease progression (PFS2) | Second disease progression (PFS2)defined as the time from date of randomization until second disease progression or death, whichever occurs first | Up to 7 years | |
Secondary | Assess Objective Response Rate (ORR) | Objective response includes best response of complete response (CR) or partial response (PR). | Up to 7 years | |
Secondary | Assess Duration of response (DOR) | Measured only in patients who achieved a confirmed best overall response of CR or PR upon completion of platinum-based combination chemotherapy with bevacizumab (triplet therapy) | Up to 7 years | |
Secondary | Assess Disease-free survival (DFS) | Measured only in patients who have no measurable disease per RECIST v1.1 at randomization | Up to 7 years | |
Secondary | CA-125 response | Serum CA-125 response determined using the GCIG criteria | Up to 7 years | |
Secondary | Patient-reported outcome health-related quality of life (HRQoL) of disease-related symptoms using the NCCN-FACT Ovarian Symptom Index (NFOSI-18) DRS-P (disease-related symptom subscale - physical). | A questionnaire assessing the health of patients with ovarian cancer. | Up to 7 years |
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