E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
epithelial ovarian carcinoma |
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E.1.1.1 | Medical condition in easily understood language |
epithelial ovarian carcinoma |
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E.1.1.2 | Therapeutic area | Diseases [C] - Female diseases of the urinary and reproductive systems and pregancy complications [C13] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 17.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10061328 |
E.1.2 | Term | Ovarian epithelial cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To explore the effect of adding DCVAC/OvCa to Standard of Care chemotherapy on PFS measured at 2 years after randomization in women with ovarian cancer who have undergone debulking surgery |
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E.2.2 | Secondary objectives of the trial |
•Proportion of patients staying in remission at 6 months after the last dose of first line chemotherapy
•Proportion of patients staying in remission at 12 months after the last dose of first line chemotherapy
•Biological progression free interval
•Immunological response
•Proportion of patients requiring second line chemotherapy
•Time to second line chemotherapy
•OS
•Safety
•Changes in quality of life (QoL)
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Female aged ≥18 years
2. Patients with newly diagnosed, histologically confirmed, FIGO (Féderation Internationale de Gynécologie et d’Obstétrique) stage III epithelial ovarian, primary peritoneal or fallopian tube carcinoma (serous, endometrioid or mucinous) who have undergone initial surgery up to 3 weeks before randomization and are selected to receive first line Standard of Care chemotherapy (optional prolongation to 6 weeks after surgery)
3. Optimally debulked (zero residuum) or maximal residuum <1cm
4. Laboratory criteria:
~ White blood cells (WBC) >4,000/mm3 (4.0 x109/L)
~ Neutrophil count >1,500/mm3 (1.5 x109/L)
~ Hemoglobin (Hb) of at least 10g/dL (100g/L)
~ Platelet count of at least 100,000/mm3 (100 x109/L)
~ Total bilirubin within normal limits (benign hereditary hyperbilirubinemias, e.g. Gilbert´s syndrome are permitted)
~ Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) <2x upper limit of normal (ULN), serum creatinine ≤2.0mg/dL
~ Blood Urea Nitrogen (BUN) <2.0x ULN
5. Adequate coagulation parameters
~ Activated partial thromboplastin time (APTT) ≤1.5x ULN and
~ International Normalized Ratio (INR) ≤ 1.5
~ Post-operative treatment with low molecular weight heparin (LMWH) is acceptable
6. Life expectancy of at least 12 months based on Investigator’s judgment
7. Eastern Cooperative Oncology Group (ECOG) Performance status 0-2
8. Signed informed consent including patient’s ability to comprehend its contents
9. Females of childbearing potential (assessed by Investigator) must have had a negative serum pregnancy test at screening (β-human chorionic gonadotropin [β-HCG]). |
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E.4 | Principal exclusion criteria |
1. FIGO I,II,IV epithelial ovarian cancer
2. FIGO III clear cells epithelial ovarian cancer
3. Non-epithelial ovarian cancer, borderline tumors (tumors of low malignant potential)
4. Post-surgery residual disease with lesion(s) >1cm
5. Prior or current systemic anti-cancer therapy for ovarian cancer (for example chemotherapy, monoclonal antibody therapy [bevacizumab], tyrosine kinase inhibitor therapy, vascular endothelial growth factor [VEGF] therapy or hormonal therapy)
6. Previous or concurrent radiotherapy to the abdomen and pelvis
7. Malignancy other than epithelial ovarian cancer, except those that have been in CR for a minimum of 3 years, and except carcinoma in-situ of the cervix or non-melanoma skin carcinomas
8. Patient co-morbidities:
~ Human immunodeficiency virus (HIV) positive, human T lymphotropic virus (HTLV) positive
~ Active hepatitis B (HBV), active hepatitis C (HCV), active syphilis
~ Evidence of active bacterial, viral or fungal infection requiring systemic treatment
~ Clinically significant cardiovascular disease including:
o Symptomatic congestive heart failure
o Unstable angina pectoris
o Serious cardiac arrhythmia requiring medication
o Uncontrolled hypertension
o Myocardial infarction or ventricular arrhythmia or stroke within a 6 month period before inclusion, ejection fraction (EF) <40% or serious cardiac conduction system disorders, if a pacemaker is not present
~ Pericardial effusion of any National Cancer Institute (NCI) common terminology criteria for adverse events (CTCAE) grade
~ Peripheral neuropathy having a CTCAE ≥Grade 2
~ Active autoimmune disease requiring treatment
~ History of severe forms of primary immune deficiencies
~ History of anaphylaxis or other serious reaction following vaccination
~ Uncontrolled co-morbidities including, psychiatric or social conditions which, in the Investigator’s opinion, would prevent participation in the trial
9. Known hypersensitivity to any constituent in the DCVAC/OvCa
10. Systemic immunosuppressive therapy for any reason
11. Refusal to sign the informed consent
12. Participation in a clinical trial using experimental therapy within the last 4 weeks prior study entry
13. Fertile woman of childbearing potential not willing to use highly effective method of contraception or combination of methods resulting into PEARL Index < 1 (implants, injectables, combination of oral contraceptives with intrauterine devices or barrier method of contraception or spermicidal jelly, vasectomized / sterilized partner or sexual abstinence) for the study duration and at least six months afterwards
14. Pregnant or lactating women |
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression free survival (PFS; time from randomization to documented disease progression, or death from any cause) measured at 2 years after randomization where disease progression is defined as unequivocal progression of any existing lesions or appearance of any measurable lesion or development of tumor-related symptoms documented by computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan. The median PFS will be presented if at least 50% of patients progress |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
At 2 years after randomization. The median of PFS will be presented if at least 50% of patients progress |
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E.5.2 | Secondary end point(s) |
•Proportion of patients staying in remission at 6 months after the last dose of first line chemotherapy
•Proportion of patients staying in remission at 12 months after the last dose of first line chemotherapy
•Biological progression free interval defined by increasing CA 125 levels (PFIBIO) (Gynecologic Cancer Intergroup [GCIG]: http://www.gcig.igcs.org/CA125/respdef_nov2005.pdf)
•Immunological response – detection of entire anti-tumor response (samples to be collected and frozen)
•Proportion of patients requiring second line chemotherapy treatment
•Time to second line therapy (after the last dose of first line chemotherapy)
•OS (time from randomization to death from any cause) until End of Study (EOS)
Adverse Events (AEs), including laboratory abnormalities
Evaluation of QoL using standardized FACT-O (Functional Assessment of Cancer Therapy-Ovarian) questionnaire
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Proportion of patients staying in remission at 6 month after the last dose of first line chemotherapy
Proportion of patients staying in remission at 12 months after the last dose of first line chemotherapy
Time to second line therapy (after the last dose of first line chemotherapy)
OS (time from randomization to death from any cause) until at least 50% of patients in each group have died |
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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 | No |
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 | No |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 |
first line chemotherapy (carboplatin plus paclitaxel) |
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E.8.2.4 | Number of treatment arms in the trial | 3 |
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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 20 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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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The End of Study is defined as 2 years after last patient enrolled in the study is randomized. |
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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 | 3 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |