E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with gBRCA mutated metastatic pancreatic cancer whose disease has not progressed on first line platinum based chemotherapy |
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E.1.1.1 | Medical condition in easily understood language |
gBRCA mutated metastatic pancreatic cancer |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
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 determine the efficacy of Olaparib maintenance monotherapy compared to placebo by progression free survival (PFS) |
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E.2.2 | Secondary objectives of the trial |
• To determine the efficacy of Olaparib maintenance monotherapy compared to placebo • To assess the effect of Olaparib on the Health-related Quality of Life (HRQoL) as measured by EORTC QLQ-C30 global QoL scale. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
For inclusion in the study patients should fulfil the following criteria: 1. *Provision of informed consent prior to any study specific procedures 2. *Patients must be male or female ≥18 years of age 3. *Histologically or cytologically confirmed pancreas adenocarcinoma receiving initial chemotherapy for metastatic disease and without evidence of disease progression on treatment 4. Patients with measurable disease and/or non-measurable or no evidence of disease assessed at baseline by CT (or MRI where CT is contraindicated) will be entered in this study. 5. Documented mutation in gBRCA1 or gBRCA2 that is predicted to be deleterious or suspected deleterious (known or predicted to be detrimental/lead to loss of function) 6. Patients are on treatment with a first line platinum-based regimen for metastatic pancreas cancer, have received a minimum of 16 weeks of continuous platinum treatment and have no evidence of progression based on investigator’s opinion. 7. Patients who have received platinum as potentially curative treatment for a prior cancer (eg ovarian cancer) or as adjuvant/neoadjuvant treatment for pancreas cancer are eligible provided at least 12 months have elapsed between the last dose of platinum-based treatment and initiation of the platinum-based chemotherapy for metastatic pancreas cancer. 8. Patients must have normal organ and bone marrow function measured within 4 weeks prior to administration of study treatment as defined below: − Haemoglobin ≥ 9.0 g/dL with no blood transfusions (packed red blood cells and platelet transfusions) in the past 28 days − Absolute neutrophil count (ANC) ≥ 1.5 x 109/L − White blood cells (WBC) >3 x 109/L − No features suggestive of MDS/AML on peripheral blood smear − Platelet count ≥ 100 x 109/L − Total bilirubin ≤ 1.5 x institutional upper limit of normal − AST (SGOT)/ALT (SGPT) ≤ 2.5 x institutional upper limit of normal value unless liver metastases are present in which case they must be ≤ 5x ULN − Serum creatinine ≤ 1.5 x institutional upper limit of normal (ULN) 9. *ECOG performance status 0-1 at date signing of informed consent 10. *Postmenopausal or evidence of non-childbearing status for women of childbearing potential: negative urine or serum pregnancy test. Postmenopausal is defined as: − Amenorrheic for 1 year or more following cessation of exogenous hormonal treatments − Luteinizing hormone (LH) and Follicle stimulating hormone (FSH) levels in the post menopausal range for women under 50 − Radiation-induced oophorectomy with last menses >1 year ago − Chemotherapy-induced menopause with >1 year interval since last menses − Surgical sterilisation (bilateral oophorectomy or hysterectomy) 11. *Patient is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations 12. Formalin fixed, paraffin embedded (FFPE) tumour sample from the primary tumour or a metastatic site if available or 3 unstained cytology slides if available. |
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E.4 | Principal exclusion criteria |
Patients should not enter the study if any of the following exclusion criteria are fulfilled: 1. *Involvement in the planning and/or conduct of the study (applies to AstraZeneca staff and/or staff at the study site). 2. gBRCA1 and/or gBRCA2 mutations that are considered to be non detrimental (eg, “Variants of uncertain clinical significance” or “Variant of unknown significance” or “Variant, favour polymorphism” or “benign polymorphism” etc.). 3. Progression of tumour between start of first line platinum based chemotherapy for metastatic pancreas cancer and randomisation. 4. Cytotoxic chemotherapy or non-hormonal targeted therapy within 28 days of Cycle 1 Day 1 is not permitted. Palliative radiotherapy must have been completed 14 or more days before Cycle 1 Day 1. The patient can receive a stable dose of bisphosphonates or denosumab for bone metastases, before and during the study as long as these were started at least 2 weeks prior to study treatment. 5. *Previous randomisation in the present study. 6. Exposure to an investigational product within 30 days or 5 half lives (whichever is longer) prior to randomisation 7. *Any previous treatment with a PARP inhibitor, including Olaparib. 8. *Patients with second primary cancer, EXCEPTIONS: adequately treated nonmelanoma skin cancer, curatively treated in-situ cancer of the cervix, Ductal Carcinoma in Situ (DCIS), stage 1 grade 1 endometrial carcinoma, or other solid tumours including lymphomas (without bone marrow involvement) curatively treated with no evidence of disease for ≥ 5 years prior to study entry. 9. Resting ECG with QTc > 470 msec detected on 2 or more time points within a 24 hour period or family history of long QT syndrome. If ECG demonstrates QTc >470 msec, patient will be eligible only if repeat ECG demonstrates QTc ≤470 msec. 10. Concomitant use of known potent CYP3A4/5 inhibitors such as ketoconazole, itraconazole, ritonavir, indinavir, saquinavir, telithromycin, clarithromycin and nelfinavir. 11. Persistent toxicities (≥CTCAE grade 2) caused by previous cancer therapy, excluding alopecia and CTCAE grade 3 peripheral neuropathy. 12. *Patients with myelodysplastic syndrome/acute myeloid leukaemia. 13. Major surgery within 2 weeks of starting study treatment: patients must have recovered from any effects of any major surgery. 14. *Immunocompromised patients, eg, patients who are known to be serologically positive for human immunodeficiency virus (HIV). 15. *Clinically significant uncontrolled medical conditions are not permitted (eg active infection requiring IV antibiotics, symptomatic congestive heart failure, unstable angina pectoris, recent (3 months) myocardial infarction, extensive bilateral interstitial lung disease, psychiatric illness that would limit ability to comply with study procedures, and any other medical condition that, in the opinion of the investigator, places the patient at unacceptable risk of toxicity. NB: Diabetes which is controlled by medication does not exclude participation in the study 16. *Patients with a history of treated CNS metastases are eligible, provided they meet all of the following criteria: Disease outside the CNS is present. No evidence of interim progression between the completion of CNS-directed therapy and the screening radiographic study. No history of intracranial haemorrhage or spinal cord haemorrhage. Minimum of 2 weeks between completion of radiotherapy and cycle 1 Day 1 and recovery from significant (Grade ≥3) acute toxicity with no ongoing 17. *Patients unable to swallow orally administered medication and patients with gastrointestinal disorders likely to interfere with absorption of the study medication. 18. *Pregnant or breast feeding women. 19. *Previous allogeneic bone marrow transplant. 20. *Patients with a known hypersensitivity to Olaparib or any of the excipients of the product. 21. *Whole blood transfusions in the last 120 days prior to enrolment to the study which may interfere with gBRCA testing (packed red blood cells and platelet |
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E.5 End points |
E.5.1 | Primary end point(s) |
Determine the efficacy of Olaparib maintenance monotherapy compared to placebo by progression free survival (PFS)-Progression Free Survival (PFS) by BICR using modified RECIST 1.1 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
- Interim PFS analyses (~ 45 PFS events): PFS - Final PFS (~ 89 PFS events): PFS, PFS2, TDT, TFST, TSST, OS, time to deterioration of Global QoL and PAN-26 pain scale Efficacy Data - Final OS analyses (~ 106 OS events): PFS2, TFST, TSST, OS, time to deterioration of Global QoL and PAN-26 pain scale |
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E.5.2 | Secondary end point(s) |
• To determine the efficacy of Olaparib maintenance monotherapy compared to placebo • To assess the effect of Olaparib on the Health-related Quality of Life (HRQoL) as measured by EORTC QLQ-C30 global QoL scale |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
- Overall Survival (observed and predicted using observed PFS and OS data), Time from randomisation to second progression (PFS2), Time from randomisation to first subsequent therapy or death (TFST), Time from randomisation to second subsequent therapy or death (TSST), Time from randomisation to study treatment discontinuation or death (TDT), Objective Response Rate by BICR using modified RECIST 1.1 criteria for evaluable patients, Disease Control Rate at 16 weeks by BICR using modified RECIST 1.1 criteria - Adjusted mean change from baseline in global QoL score from the EORTC-QLQC30 questionnaire |
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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 | Yes |
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) | 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 | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
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 | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 60 |
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 | No |
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 |
Australia |
Belgium |
Canada |
France |
Germany |
Israel |
Korea, Republic of |
Netherlands |
Spain |
United Kingdom |
United States |
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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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the last visit of the last patient undergoing the study |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 30 |