Purpose

This phase III trial compares the effect of olaparib for one year versus two years, with or without bevacizumab, for the treatment of BRCA 1/2 mutated or homologous recombination deficient stage III or IV ovarian cancer. Olaparib is a polyadenosine 5'-diphosphoribose polymerase (PARP) enzyme inhibitor and may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Bevacizumab is in a class of medications called antiangiogenic agents. It works by stopping the formation of blood vessels that bring oxygen and nutrients to tumor. This may slow the growth and spread of tumor. Giving olaparib for one year with or without bevacizumab may be effective in treating patients with BRCA 1/2 mutated or homologous recombination deficient stage III or IV ovarian cancer, when compared to two years of olaparib.

Conditions

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Criteria

Inclusion Criteria:

- Patients with newly diagnosed, pathologically confirmed, Federation of Gynecology
and Obstetrics (FIGO) stage III or IV ovarian cancer of the following types:

- High grade serous

- High grade endometrioid, and/or

- Other epithelial ovarian cancer with BRCA1/2 deleterious alteration (germline
or somatic)

- Submission of pathology report is required

- Ovarian cancer = ovarian, fallopian, or primary peritoneal cancer

- Patients must have:

- Documented variant (tumor or germline) in BRCA1 or BRCA2 that is predicted to
be pathogenic or suspected pathogenic (deleterious alteration)

- Submission of testing report is required. OR

- BRCA 1/2 wildtype AND known HRD deficient tumor determined by any commercial or
academic, Clinical Laboratory Improvement Act (CLIA)-certified laboratory
(e.g., Myriad MyChoice©)

- Submission of testing report is required

- Patient must have undergone cytoreductive surgery (primary or interval)

- Patients must have completed first line platinum-based therapy prior to
registration:

- Platinum based chemotherapy course must have consisted of a minimum of 4
treatment cycles and a maximum of 9, although it is strongly recommended that
patients receive at least 6 cycles unless medically contraindicated

- For those receiving less than 6 cycles of platinum-based therapy, the
reason for this must be documented and could include hematologic toxicity
or non-hematologic toxicities directly related to therapy

- Intravenous, intraperitoneal, or neoadjuvant platinum-based chemotherapy is
allowed; for weekly therapy, three weeks are considered one cycle

- Patients must not have received an investigational agent during their first
line course of chemotherapy

- Patients must have, in the opinion of the investigator, no clinical evidence of
disease progression following completion of this chemotherapy course (partial or
complete response to platinum-based chemotherapy)

- Patients with treated brain metastases are eligible if follow up brain imaging after
central nervous system (CNS) directed therapy shows no evidence of progression
following completion of this chemotherapy course (partial or complete response to
platinum-based chemotherapy)

- Patients must be randomized at least 3 weeks and no more than 12 weeks after their
last dose of chemotherapy (last dose is the day of the last infusion of platinum
agent)

- No previous treatment with a PARP inhibitor, including olaparib, niraparib, and
rucaparib

- Age ≥ 18

- Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2

- Not pregnant and not nursing

- Absolute neutrophil count (ANC) ≥ 1,500 cells/mm^3

- Platelets ≥ 100,000 cells/mm^3

- Hemoglobin ≥ 9 g/dl

- Creatinine clearance (CrCL) of > 30 mL/min by the Cockcroft-Gault formula

- Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (patients with
known Gilbert's disease who have bilirubin level ≤ 3 x institutional ULN may be
enrolled)

- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 x
institutional ULN

- Patients with known history or current symptoms of cardiac disease, or history of
treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac
function using the New York Heart Association Functional Classification. To be
eligible for this trial, patients should be class 2B or better

- No active infection requiring parental antibiotic(s)

- No current evidence of intra-abdominal abscess, abdominal/pelvic fistula (not
diverted), gastrointestinal perforation, gastrointestinal (GI) obstruction, and/or
need for drainage nasogastric or gastrostomy tube

- No current inability to swallow orally administered medication

- No history of myelodysplastic syndrome and/or acute myeloid leukemia

- No history of allogeneic bone marrow transplant

- No concomitant use of strong or moderate CYP3A inducers

- No known hypersensitivity to olaparib or any of the excipients of the product

Study Design

Phase
Phase 3
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Active Comparator
Arm I (olaparib, bevacizumab)
Patients receive olaparib PO BID on days 1-21 of each cycle. Cycles repeat every 21 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients may also receive bevacizumab IV on day 1 of each cycle. Cycles of bevacizumab repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients also undergo blood sample collection and CT and/or MRI throughout the study.
  • Biological: Bevacizumab
    Given IV
    Other names:
    • ABP 215
    • ABP-215
    • ABP215
    • Alymsys
    • Anti-VEGF
    • Anti-VEGF Humanized Monoclonal Antibody
    • Anti-VEGF Monoclonal Antibody SIBP04
    • Anti-VEGF rhuMAb
    • Avastin
    • Avzivi
    • Aybintio
    • BAT 1706
    • BAT-1706
    • BAT1706
    • BAT1706 Biosimilar
    • Bevacizumab awwb
    • Bevacizumab Biosimilar ABP 215
    • Bevacizumab Biosimilar BAT1706
    • Bevacizumab Biosimilar BEVZ92
    • Bevacizumab Biosimilar BI 695502
    • Bevacizumab Biosimilar CBT 124
    • Bevacizumab Biosimilar CT-P16
    • Bevacizumab Biosimilar FKB238
    • Bevacizumab Biosimilar GB-222
    • Bevacizumab Biosimilar HD204
    • Bevacizumab Biosimilar HLX04
    • Bevacizumab Biosimilar IBI305
    • Bevacizumab Biosimilar LY01008
    • Bevacizumab Biosimilar MB02
    • Bevacizumab Biosimilar MIL60
    • Bevacizumab Biosimilar Mvasi
    • Bevacizumab Biosimilar MYL-1402O
    • Bevacizumab Biosimilar QL 1101
    • Bevacizumab Biosimilar QL1101
    • Bevacizumab Biosimilar RPH-001
    • Bevacizumab Biosimilar SCT501
    • Bevacizumab Biosimilar Zirabev
    • Bevacizumab-adcd
    • Bevacizumab-awwb
    • Bevacizumab-aybi
    • Bevacizumab-bvzr
    • Bevacizumab-equi
    • Bevacizumab-maly
    • Bevacizumab-onbe
    • Bevacizumab-tnjn
    • BP102
    • BP102 Biosimilar
    • CT P16
    • CT-P16
    • CTP16
    • Equidacent
    • FKB 238
    • FKB-238
    • FKB238
    • HD204
    • Immunoglobulin G1 (Human-Mouse Monoclonal rhuMab-VEGF Gamma-Chain Anti-Human Vascular Endothelial Growth Factor), Disulfide With Human-Mouse Monoclonal rhuMab-VEGF Light Chain, Dimer
    • MB 02
    • MB-02
    • MB02
    • Mvasi
    • MYL-1402O
    • Onbevzi
    • Oyavas
    • PF 06439535
    • PF-06439535
    • PF06439535
    • QL1101
    • Recombinant Humanized Anti-VEGF Monoclonal Antibody
    • rhuMab-VEGF
    • SCT501
    • SIBP 04
    • SIBP-04
    • SIBP04
    • Vegzelma
    • Zirabev
  • Procedure: Biospecimen Collection
    Undergo blood sample collection
    Other names:
    • Biological Sample Collection
    • Biospecimen Collected
    • Specimen Collection
  • Procedure: Computed Tomography
    Undergo CT
    Other names:
    • CAT
    • CAT Scan
    • Computed Axial Tomography
    • Computerized Axial Tomography
    • Computerized axial tomography (procedure)
    • Computerized Tomography
    • Computerized Tomography (CT) scan
    • CT
    • CT Scan
    • tomography
  • Procedure: Magnetic Resonance Imaging
    Undergo MRI
    Other names:
    • Magnetic Resonance
    • Magnetic Resonance Imaging (MRI)
    • Magnetic resonance imaging (procedure)
    • Magnetic Resonance Imaging Scan
    • Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance
    • MR
    • MR Imaging
    • MRI
    • MRI Scan
    • MRIs
    • NMR Imaging
    • NMRI
    • Nuclear Magnetic Resonance Imaging
    • sMRI
    • Structural MRI
  • Drug: Olaparib
    Given PO
    Other names:
    • AZD 2281
    • AZD-2281
    • AZD2281
    • KU 0059436
    • KU-0059436
    • KU0059436
    • Lynparza
    • Olanib
    • Olaparix
    • PARP Inhibitor AZD2281
Experimental
Arm II (olaparib, bevacizumab)
Patients receive olaparib PO BID on days 1-21 of each cycle. Cycles repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients may also receive bevacizumab IV on day 1 of each cycle. Cycles of bevacizumab repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients also undergo blood sample collection and CT and/or MRI throughout the study.
  • Biological: Bevacizumab
    Given IV
    Other names:
    • ABP 215
    • ABP-215
    • ABP215
    • Alymsys
    • Anti-VEGF
    • Anti-VEGF Humanized Monoclonal Antibody
    • Anti-VEGF Monoclonal Antibody SIBP04
    • Anti-VEGF rhuMAb
    • Avastin
    • Avzivi
    • Aybintio
    • BAT 1706
    • BAT-1706
    • BAT1706
    • BAT1706 Biosimilar
    • Bevacizumab awwb
    • Bevacizumab Biosimilar ABP 215
    • Bevacizumab Biosimilar BAT1706
    • Bevacizumab Biosimilar BEVZ92
    • Bevacizumab Biosimilar BI 695502
    • Bevacizumab Biosimilar CBT 124
    • Bevacizumab Biosimilar CT-P16
    • Bevacizumab Biosimilar FKB238
    • Bevacizumab Biosimilar GB-222
    • Bevacizumab Biosimilar HD204
    • Bevacizumab Biosimilar HLX04
    • Bevacizumab Biosimilar IBI305
    • Bevacizumab Biosimilar LY01008
    • Bevacizumab Biosimilar MB02
    • Bevacizumab Biosimilar MIL60
    • Bevacizumab Biosimilar Mvasi
    • Bevacizumab Biosimilar MYL-1402O
    • Bevacizumab Biosimilar QL 1101
    • Bevacizumab Biosimilar QL1101
    • Bevacizumab Biosimilar RPH-001
    • Bevacizumab Biosimilar SCT501
    • Bevacizumab Biosimilar Zirabev
    • Bevacizumab-adcd
    • Bevacizumab-awwb
    • Bevacizumab-aybi
    • Bevacizumab-bvzr
    • Bevacizumab-equi
    • Bevacizumab-maly
    • Bevacizumab-onbe
    • Bevacizumab-tnjn
    • BP102
    • BP102 Biosimilar
    • CT P16
    • CT-P16
    • CTP16
    • Equidacent
    • FKB 238
    • FKB-238
    • FKB238
    • HD204
    • Immunoglobulin G1 (Human-Mouse Monoclonal rhuMab-VEGF Gamma-Chain Anti-Human Vascular Endothelial Growth Factor), Disulfide With Human-Mouse Monoclonal rhuMab-VEGF Light Chain, Dimer
    • MB 02
    • MB-02
    • MB02
    • Mvasi
    • MYL-1402O
    • Onbevzi
    • Oyavas
    • PF 06439535
    • PF-06439535
    • PF06439535
    • QL1101
    • Recombinant Humanized Anti-VEGF Monoclonal Antibody
    • rhuMab-VEGF
    • SCT501
    • SIBP 04
    • SIBP-04
    • SIBP04
    • Vegzelma
    • Zirabev
  • Procedure: Biospecimen Collection
    Undergo blood sample collection
    Other names:
    • Biological Sample Collection
    • Biospecimen Collected
    • Specimen Collection
  • Procedure: Computed Tomography
    Undergo CT
    Other names:
    • CAT
    • CAT Scan
    • Computed Axial Tomography
    • Computerized Axial Tomography
    • Computerized axial tomography (procedure)
    • Computerized Tomography
    • Computerized Tomography (CT) scan
    • CT
    • CT Scan
    • tomography
  • Procedure: Magnetic Resonance Imaging
    Undergo MRI
    Other names:
    • Magnetic Resonance
    • Magnetic Resonance Imaging (MRI)
    • Magnetic resonance imaging (procedure)
    • Magnetic Resonance Imaging Scan
    • Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance
    • MR
    • MR Imaging
    • MRI
    • MRI Scan
    • MRIs
    • NMR Imaging
    • NMRI
    • Nuclear Magnetic Resonance Imaging
    • sMRI
    • Structural MRI
  • Drug: Olaparib
    Given PO
    Other names:
    • AZD 2281
    • AZD-2281
    • AZD2281
    • KU 0059436
    • KU-0059436
    • KU0059436
    • Lynparza
    • Olanib
    • Olaparix
    • PARP Inhibitor AZD2281

Recruiting Locations

Memorial Hermann Texas Medical Center
Houston, Texas 77030
Contact:
Site Public Contact
713-792-3245

More Details

Status
Recruiting
Sponsor
NRG Oncology

Study Contact

Detailed Description

PRIMARY OBJECTIVE: I. To determine investigator assessed progression-free survival using Response Evaluation Criteria in Solid Tumors (RECIST) version (v)1.1 (non-inferiority) for one versus (vs.) two years of maintenance olaparib. SECONDARY OBJECTIVES: I. To evaluate overall survival (OS360) in the modified intent to treat (ITT) population, with time at risk for progression/death starting 360 days after randomization. II. To evaluate progression-free survival (PFS), PFS2 and overall survival (OS) in the ITT population. III. To evaluate PFS, PFS2, and OS in the as-treated population. IV. To evaluate toxicity, including rates of myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), and other secondary malignancies, in the safety population. EXPLORATORY OBJECTIVE: I. To evaluate the moderating effect of physician-choice bevacizumab (as stratified) on randomized treatment effect estimates. TRANSLATIONAL OBJECTIVES: I. To assess BRCA reversion mutations in circulating tumor deoxyribonucleic acid (ctDNA) as a predictor of poor response in the BRCA mutated (BRCAm) population. II. To correlate a combined assay assessing quantitative BRCA1 and RAD51C promoter methylation and pathogenic variants in core homologous recombination repair (HRR) genes with clinical homologous recombination deficiency (HRD) testing and outcomes in the BRCA wildtype (BRCAwt) population. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I (REFERENCE): Patients receive olaparib orally (PO) twice daily (BID) on days 1-21 of each cycle. Cycles repeat every 21 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients may also receive bevacizumab IV on day 1 of each cycle. Cycles of bevacizumab repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients also undergo blood sample collection and computed tomography (CT) and/or magnetic resonance imaging (MRI) throughout the study. ARM II (EXPERIMENTAL): Patients receive olaparib PO BID on days 1-21 of each cycle. Cycles repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients may also receive bevacizumab IV on day 1 of each cycle. Cycles of bevacizumab repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients also undergo blood sample collection and CT and/or MRI throughout the study. After completion of study treatment, patients are followed up every 3 months for 2 years, then every 6 months for 3 years.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.