Recruiting
Phase 2

Genetic Profile

Sponsor:

University Health Network, Toronto

Code:

NCT05065021

Conditions

Ovarian Cancer

Fallopian Tube Cancer

Primary Peritoneal Cancer

High Grade Serous Cancer

High Grade Endometrioid Cancer

Eligibility Criteria

Sex: Female

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Niraparib

Dostarlimab

Bevacizumab

Paclitaxel

Study Details

Brief summary:

The purpose of this research study is to see how useful it is to look at biomarkers in the blood and tumor tissue of participants with ovarian, fallopian tube or primary peritoneal cancer who have previously received treatment with a drug called a PARP inhibitor, and using the results to determine the best treatment for these participants. Biomarkers are molecules such as genes (molecules that contain instructions for the development and function of cells in the body) and proteins that may be used to see how well a body responds to certain treatments.

Conditions

Ovarian Cancer

Fallopian Tube Cancer

Primary Peritoneal Cancer

High Grade Serous Cancer

High Grade Endometrioid Cancer

Study ID

NCT05065021

Start date

Feb 23, 2023

Status verified date

Jan, 2024

Completion date

Jun 6, 2025

Anticipated

Primary completion date

Jun 6, 2025

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: Female

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
  • Histologically confirmed ovarian, fallopian tube or primary peritoneal cancer, high grade serous or high grade endometrioid histology subtype.
  • Patients must have relapsed disease, either platinum-sensitive, resistant or refractory, with no limit to number of lines of prior systemic therapy.
  • Radiographically documented disease progression within 28 days of registration.
  • Patient must have measurable disease as per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
  • Progression on any prior Poly (ADP-ribose) polymerase (PARP) inhibitor therapy, with no limit to number of prior lines of PARP inhibitors.
  • Patients must have adequate bone marrow, renal and hepatic function within 7 days of registration
  • Left ventricular ejection fraction (LVEF) > 50% by echocardiograms or multigated acquisition (MUGA) scan within 28 days of registration.
  • Patients are willing to undergo tumor biopsy pre-treatment (tissue at the time of progression on PARP inhibitor therapy).
  • Availability of archival tissue (prior to PARP inhibitor therapy) for analysis.
  • Women of child-bearing potential must agree to use a highly effective contraceptive method for study-required period. A negative high sensitive urine or serum pregnancy test within 3 days prior to the initiation of therapy will be required for women of childbearing potential.
  • Patient must agree to not donate blood during the study or for 90 days after the last dose of study treatment.
  • Patient must agree to not breastfeed during the study or for 30 days after the last dose of study treatment.

Exclusion Criteria:

  • Treatment with an investigational (other than PARP inhibitor) drug within 30 days and treatment with PARP inhibitor within 14 days prior to the first dose of study medication.
  • Major surgery within 4 weeks of registration or ongoing clinically significant post-surgical complications.
  • Patients with current or are at high-risk of developing fistula, or any other gastrointestinal disorders likely to interfere with absorption of the study medication.
  • Patients with current or history of bowel obstruction within the last 3 months.
  • Untreated unstable brain or leptomeningeal metastases.
  • Greater than +1 proteinuria on two consecutive dipsticks within 14 days of registration.
  • Unresolved toxicity of > grade 1 from previous anti-cancer therapy (including radiotherapy).

.History of poorly controlled hypertension or resting blood pressure >140/90 mmHg in the presence or absence of a stable regimen of anti-hypertensive therapy within 7 days of registration.

  • Mean QTc >470 msec in screening electrocardiograms within 7 days of registration or history of familial long QT syndrome.
  • Any evidence of severe or uncontrolled diseases such as but not limited to unstable or uncompensated respiratory, cardiac, hepatic, renal disease or psychiatric illness/social situations that would limit compliance with study requirements.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to bevacizumab, paclitaxel, dostarlimab, or niraparib.
  • Patients who have received prior weekly paclitaxel in the recurrent ovarian cancer setting.
  • Patients who have received prior PD-1 inhibitor for ovarian cancer.
  • Active autoimmune disease that has required systemic treatment in the past 2 years.
  • History of interstitial lung disease.
  • Patients with myelodysplastic syndrome/acute myeloid leukemia
  • Previous allogenic bone marrow transplant.
  • Immuno-compromised patients, e.g., patients who are known to be serologically positive for human immunodeficiency virus (HIV), patients with known active hepatitis (i.e., hepatitis B or C).
  • Patients with significant hemorrhage (>30 mL bleeding/episode in previous 3 months) or hemoptysis (>5 mL fresh blood in previous 4 weeks).
  • Patients who have had recent (within 2 weeks of registration, or until any wound has completely healed) major thoracic or abdominal surgery prior to study start, or a surgical incision that is not fully healed.
  • History of stroke or transient ischemic attack within six months.
  • Patients that are receiving other anti-cancer therapy (except patient currently progressing on treatment with PARP inhibitor), radiotherapy, biological therapy or other novel agent prior to start of study treatment.
  • Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator would make the participant inappropriate for entry into the study.
  • History of other primary second malignancies (except for adequately treated cutaneous basal or squamous cell carcinoma or carcinoma in situ) within < 3 years.

Study Design

Enrollment

40 participants

Anticipated

Allocation

Non randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Initial/Cohort C

Niraparib by mouth (orally), once a day, every day. Bevacizumab, by vein (intravenously), once every 3 weeks for up to 1 year, then every 6 weeks.

experimental: Cohort A

Niraparib by mouth (orally), once a day, every day. Bevacizumab, by vein (intravenously), once every 3 weeks for up to 1 year, then every 6 weeks.

Dostarlimab, by vein (intravenously), once every 3 weeks for 4 doses, then every 6 weeks afterwards.

experimental: Cohort B

Paclitaxel, by vein (intravenously), once a week. Bevacizumab, by vein (intravenously), once every 3 weeks for up to 1 year, then every 6 weeks.

Dostarlimab, by vein (intravenously), once every 3 weeks for 4 doses, then every 6 weeks afterwards.

Interventions

Niraparib

Niraparib works by blocking poly(ADP-ribose) polymerases (PARP) 1 and PARP 2 from working. PARP 1 and PARP 2 are proteins that are involved in cell growth, cell survival, and cell death, including cancer cells. It is believed that blocking PARP1 and PARP 2 from working will slow or stop the growth of cancer cells.

Dostarlimab

Dostarlimab is a monoclonal antibody. Antibodies are proteins that are naturally found in the blood stream that fight infections. A monoclonal antibody is a special kind of antibody that is created in a laboratory that seeks out specific proteins in the body that may be involved in cancers to stop tumor growth. Dostarlimab attaches to PD-1 and inhibits the interaction of PD-L1 and PD-L2 with PD-1.

Bevacizumab

Bevacizumab is a chemotherapy drug commonly used for the treatment of various cancers.

Paclitaxel

Paclitaxel is a chemotherapy drug commonly used for the treatment of various cancers.

Primary outcome measure

  • Percentage of participants that achieve biomarker-guided treatment [ Time Frame: 3 years ]
  • Response rate percentage [ Time Frame: 3 years ]

Central Contacts and Locations

Central contacts

Stephanie Lheureux, M.D.

416-946-2818stephanie.lheureux@uhn.ca

Locations

Princess Margaret Cancer Centre

Recruiting

Toronto, Ontario, Canada, M5G 2M9

Contacts

Stephanie Lheureux, M.D.

416-946-2818stephanie.lheureux@uhn.ca

More Information

Sponsor

University Health Network, Toronto

Last update posted

Jan 17, 2024

Last verified

Jan, 2024

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by University Health Network, Toronto on 2024-01-17.