E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Platinum-resistant, epithelial ovarian, fallopian tube or primary peritoneal cancer |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10033128 |
E.1.2 | Term | Ovarian cancer |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10016180 |
E.1.2 | Term | Fallopian tube cancer |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10061344 |
E.1.2 | Term | Peritoneal neoplasm |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare progression-free survival (PFS) of patients randomised to selected chemotherapy only or to selected chemotherapy plus bevacizumab |
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E.2.2 | Secondary objectives of the trial |
• Objective response rate (ORR) - by RECIST and CA-125 response criteria (“responders”) - by RECIST only (“RECIST responders”) - by CA-125 response criteria only (“CA-125 responders”). • Biological progression-free interval (PFIBIO) - by serum CA-125 and assessed according to the GCIG criteria • Overall survival (OS) • Quality of life (QOL) - QOL and symptom control will be assessed using EORTC QLQ-C30, QLQ-OV28, Hospital Anxiety Depression Scale (HADS), FACT/NCCN Ovarian Symptom Index (FOSI) and symptom questionnaires. • Safety and tolerability
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Signed informed consent obtained prior to initiation of any study-specific procedures and treatment as confirmation of the patient’s awareness and willingness to comply with the study requirements. 2. Patients greater than or equal to 18 years of age with histologically confirmed and documented. The following histological types are eligible: • adenocarcinoma NOS • clear cell adenocarcinoma • endometriod adenocarcinoma • malignant Brenner's tumour • mixed epithelial carcinoma • mucinous adenocarcinoma • serous adenocarcinoma • transitional cell carcinoma • undifferentiated carcinoma. 3. Patients must have platinum-resistant disease (defined as progression within <6 months from completion of a minimum of 4 platinum therapy cycles. The date should be calculated from the last administered dose of platinum therapy). 4. Patients must have disease that is measurable according to RECIST or assessable according to the GCIG CA-125 criteria and require chemotherapy treatment. 5. ECOG PS 0–2. 6. Life expectancy of greater than or equal to 12 weeks.
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E.4 | Principal exclusion criteria |
1. Patients whose disease was refractory to their previous platinum treatment. 2. Non-epithelial, including malignant mixed Müllerian tumours. 3. Ovarian tumours with low malignant potential. 4. History of other clinically active malignancy within the last 5 years 5. Previous treatment with >2 anticancer regimens. 6. Any prior radiotherapy to the pelvis or abdomen. 7. Surgery (incl. open biopsy) within 4 weeks prior to the start of study, or anticipation of the need for major surgery during study treatment. 8. Minor surgical procedures within 24 hours prior to first study treatment. 9. Previous exposure to murine CA-125 Ab (only applicable to those patients with non-measurable disease by RECIST). 10. Current or recent chronic daily treatment with aspirin (>325 mg/day). 11. Current or recent treatment with another investigational drug within 30 days of first study treatment dosing or earlier participation in this study. 12. Chronic daily treatment with corticosteroids, excluding inhaled steroids. 13. Inadequate bone marrow function: ANC: <1.5 x 10E9/l, or platelet count <100 x 10E9/l, or haemoglobin <9 g/dl. Patients may be transfused to maintain haemoglobin values >9 g/dl. 14. Inadequate coagulation parameters: aPTT >1.5 x ULN (patients on heparin treatment must have an aPTT between 1.5 - 2.5 x ULN), or INR >1.5. 15. Inadequate liver function, defined as: serum (total) bilirubin >1.5 x ULN for the institution; alkaline phosphatase, AST/SGOT or ALT/SGPT >2.5 x ULN (or 5 x ULN in the presence of liver metastases). 16. Inadequate renal function, defined as serum creatinine >2.0 mg/dl or >177 µmol/l or calculated creatinine clearance <40ml/min for patients intended to be treated with topotecan. urine dipstick for proteinuria >2+. Patients with greater than or equal to 2+ proteinuria on baseline dipstick analysis should undergo a 24-hour urine collection and must demonstrate ≤1 g of protein in the 24-hour urine. Alternatively, proteinuria testing can be performed according to local standards. 17. History or evidence upon physical/neurological examination of CNS disease unrelated to cancer, unless adequately treated with standard medical therapy (e.g. uncontrolled seizures). 18. Symptomatic CNS metastasis 19. Pre-existing peripheral neuropathy ≥CTC grade 2 for those patients planned to receive paclitaxel. 20. Pregnant or lactating females. Serum pregnancy test to be assessed within 7 days prior to study treatment start, or within 14 days (with a confirmatory urine pregnancy test within 7 days prior to study treatment start). 21. Women of childbearing potential not using highly-effective, hormonal or non- hormonal means of contraception (i.e. intrauterine contraceptive device) during the study and for 6 months after the last dose of study medication. 22. History or evidence of thrombotic or hemorrhagic disorders; including CVA/ stroke or TIA or sub-arachnoid haemorrhage within ≤6 months prior to the first study treatment. 23. Uncontrolled hypertension (sustained systolic >150 mmHg and/or diastolic >100 mmHg despite antihypertensive therapy) or clinically significant (i.e. active) cardiovascular disease, including: myocardial infarction or unstable angina within ≤6 months prior to the first study treatment; NYHA grade II or greater CHF; serious cardiac arrhythmia requiring medication (with the exception of atrial fibrillation or paroxysmal supraventricular tachycardia); peripheral vascular disease >grade 3. 24. LVEF defined by MUGA/ECHO below the institutional lower limit of normal (only applicable for patients intended to be treated with PLD). 25. History of bowel obstruction, including sub-occlusive disease, related to the underlying disease and history of abdominal fistula, gastrointestinal perforation or intra-abdominal abscess. Evidence of recto-sigmoid involvement by pelvic examination or bowel involvement on CT scan or clinical symptoms of bowel obstruction. 26. Non-healing wound, ulcer or bone fracture. 27. Serious active infection requiring i.v. antibiotics and/or hospitalisation at study entry. 28. Known hypersensitivity to any of the study drugs or excipients. 29. Evidence of any other medical conditions, physical examination or laboratory findings that may interfere with the planned treatment, affect patient compliance or place the patient at high risk from treatment-related complications.
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy variable is progression-free survival (PFS). It is defined as the time from the date of randomisation to the first documented disease progression or death, whichever occurs first.
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Tolerability; Biomarker (CA-125) analysis; QoL |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
selected standard chemotherapy |
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E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 123 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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End of study is defined as the date of the last visit of the last patient. The primary analysis will be performed once at least 247 events of disease progression or death have been observed, or at the end of study, which ever occurs first. Patients are anticipated to be followed for a minimum of 46 months for PFS. Follow-up for survival will continue until the last patient has completed 12 months of follow-up and the trial will end at this point. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 10 |
E.8.9.2 | In all countries concerned by the trial days | 0 |