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    The EU Clinical Trials Register currently displays   43871   clinical trials with a EudraCT protocol, of which   7290   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

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    Summary
    EudraCT Number:2018-000413-20
    Sponsor's Protocol Code Number:3000-03-005/ENGOT-OV44
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-01-22
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2018-000413-20
    A.3Full title of the trial
    A Randomized, Double-Blind, Phase 3 Comparison of Platinum-Based Therapy with TSR-042 and Niraparib Versus Standard of Care Platinum-Based Therapy as First-line Treatment of Stage III or IV Nonmucinous Epithelial Ovarian Cancer
    CONFRONTO RANDOMIZZATO, IN DOPPIO CIECO, DI FASE 3 DELLA TERAPIA A BASE DI PLATINO IN COMBINAZIONE CON TSR 042 E NIRAPARIB RISPETTO ALLA TERAPIA STANDARD A BASE DI PLATINO COME TRATTAMENTO DI PRIMA LINEA DEL TUMORE EPITELIALE OVARICO NON MUCINOSO IN STADIO III O IV
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to determine whether the addition of TSR-042, followed by the use of niraparib with TSR-042, delays recurrence of ovarian, primary peritoneal or fallopian tube cancer
    Uno studio per determinare se l'aggiunta di TSR-042, seguita dall'uso di niraparib con TSR-042, ritardi la recidiva del tumore ovarico, peritoneale primario o delle tube di Falloppio
    A.3.2Name or abbreviated title of the trial where available
    The FIRST (First-line ovarian cancer treatment with Niraparib plus TSR 042) Study
    Studio FIRST (Trattamento di prima linea del tumore ovarico con niraparib più TSR 042)
    A.4.1Sponsor's protocol code number3000-03-005/ENGOT-OV44
    A.5.4Other Identifiers
    Name:INDNumber:126,472
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorTESARO, INCORPORATED
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportTESARO, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationTesaro, Inc.
    B.5.2Functional name of contact pointGlobal Regulatory
    B.5.3 Address:
    B.5.3.1Street Address1000 Winter Street, Suite 3300
    B.5.3.2Town/ cityWaltham
    B.5.3.3Post codeMA 02451
    B.5.3.4CountryUnited States
    B.5.4Telephone number0017812572390
    B.5.5Fax number0019785138343
    B.5.6E-mailfirst@tesarobio.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Zejula
    D.2.1.1.2Name of the Marketing Authorisation holderTESARO UK Limited
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/10/760
    D.3 Description of the IMP
    D.3.1Product nameNiraparib
    D.3.2Product code [Niraparib]
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN NIRAPARIB
    D.3.9.1CAS number 1038915-60-4
    D.3.9.2Current sponsor codeniraparib
    D.3.9.4EV Substance CodeSUB177208
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameDostarlimab (TSR-042)
    D.3.2Product code [TSR-042]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDostarlimab
    D.3.9.1CAS number 2022215-59-2
    D.3.9.2Current sponsor codeTSR-042
    D.3.9.4EV Substance CodeSUB181448
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name PACLITAXEL EBEWE, concentrate for solution for infusions, 6 mg/mL
    D.2.1.1.2Name of the Marketing Authorisation holderEBEWE Pharma Ges.m.b.H. Nfg. KG
    D.2.1.2Country which granted the Marketing AuthorisationUkraine
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namePaclitaxel
    D.3.2Product code [Paclitaxel]
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPACLITAXEL
    D.3.9.1CAS number 33069-62-4
    D.3.9.2Current sponsor codePaclitaxel
    D.3.9.4EV Substance CodeSUB09583MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number6
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name CARBOPLATIN EBW 10MG/ML 45ML X 1 FIOLKA
    D.2.1.1.2Name of the Marketing Authorisation holderEBEWE Pharma Ges.m.b.H. Nfg. KG
    D.2.1.2Country which granted the Marketing AuthorisationPoland
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameCarboplatino
    D.3.2Product code [Carboplatino]
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCARBOPLATINO
    D.3.9.1CAS number 41575-94-4
    D.3.9.2Current sponsor codeCarboplatino
    D.3.9.4EV Substance CodeSUB06614MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 5
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameBevacizumab
    D.3.2Product code [Bevacizumab]
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNBEVACIZUMAB
    D.3.9.1CAS number 216974-75-3
    D.3.9.2Current sponsor codeBevacizumab
    D.3.9.4EV Substance CodeSUB16402MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 6
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Carboplatin Bendalis 10 mg / ml, Concentrate for producing an infusion solution
    D.2.1.1.2Name of the Marketing Authorisation holderBendalis GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameCarboplatino
    D.3.2Product code [Carboplatino]
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCARBOPLATINO
    D.3.9.1CAS number 41575-94-4
    D.3.9.2Current sponsor codeCarboplatino
    D.3.9.4EV Substance CodeSUB06614MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for infusion
    D.8.4Route of administration of the placeboIntravenous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Stage 3 or 4 High Grade Non-mucinous epithelial ovarian cancer (serous, endometrial, clear cell, carcinosarcoma, and mixed pathologies)
    Tumore epiteliale ovarico non mucinoso di alto grado in stadio III o IV (sieroso, endometriale, a cellule chiare, carcinosarcoma e patologie miste)
    E.1.1.1Medical condition in easily understood language
    Ovarian cancer
    Tumore ovarico
    E.1.1.2Therapeutic 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.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10070907
    E.1.2Term Ovarian cancer stage III
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10070908
    E.1.2Term Ovarian cancer stage IV
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To compare the progression free survival (PFS) of programmed death ligand 1 (PD-L1) positive patients with Stage III or IV high grade non-mucinous epithelial ovarian cancer treated with platinum-based combination therapy, dostarlimab, and niraparib to standard-of-care (SOC) platinum-based combination therapy.
    To compare the PFS of all patients with Stage III or IV high-grade nonmucinous epithelial ovarian cancer treated with platinum-based combination therapy, dostarlimab, and niraparib to SOC platinum-based combination therapy.
    The primary PFS analysis will be based upon the Investigator's assessment per Response Evaluation Criteria in Solid Tumors (RECIST) v.1.1 criteria.
    Confrontare la sopravvivenza libera da progressione (PFS) di pazienti positive per il ligando 1 di morte programmata (PD-L1) con tumore epiteliale ovarico non mucinoso di alto grado in stadio III o IV trattate con terapia di combinazione a base di platino, dostarlimab e niraparib rispetto alla terapia di combinazione standard (SOC) a base di platino.
    Confrontare la PFS di tutte le pazienti con tumore epiteliale ovarico non mucinoso di alto grado in stadio III o IV trattate con terapia di combinazione a base di platino, dostarlimab e niraparib rispetto alla terapia di combinazione SOC a base di platino.
    L’analisi primaria della PFS si baserà sulla valutazione dello sperimentatore secondo i Criteri di valutazione della risposta nei tumori solidi (RECIST) v.1.1.
    E.2.2Secondary objectives of the trial
    For PD-L1 positive patients and all patients:
    -Blinded Independent Central Review (BICR) determined PFS per RECIST v1.1
    -PFS per immune-related Response Criteria in Solid Tumors (irRECIST) criteria
    -Overall survival (OS)
    -Safety and tolerability of all treatments
    -Health related quality of life (HRQoL)
    -Time to first subsequent therapy (TFST)
    -Time to second subsequent therapy (TSST)
    -Time from treatment randomization to the earliest date of assessment of progression on the next anticancer therapy following study treatment or death by any cause (PFS2)
    -Objective response rate (ORR) per RECIST v.1.1 and irRECIST criteria
    -Pathologic complete response (pCR) rate, per Investigator assessment, in patients undergoing interval debulking surgery (IDS)
    -Duration of response (DOR) per RECIST v.1.1 and irRECIST criteria
    -Disease control rate (DCR) per RECIST v.1.1 and irRECIST criteria
    -Maintenance progression free survival (MPFS) per RECIST v.1.1 and irRECIST criteria
    Per le pazienti PD-L1 positive e per tutte le pazienti:
    - BICR ha determinato la PFS secondo i criteri RECIST v1.1 -PFS secondo irRECIST -Sopravvivenza complessiva (OS) -Sicurezza e tollerabilità di tutti i trattamenti -Qualità della vita correlata alla salute (HRQoL) -Tempo alla prima terapia successiva (TFST) -Tempo alla seconda terapia successiva (TSST) -Tempo dalla randomizzazione del trattamento alla prima data di valutazione della progressione durante la terapia antitumorale successiva al trattamento dello studio, oppure al decesso da qualsiasi causa (PFS2) -Tasso di risposta obiettiva (ORR) secondo i criteri RECIST v.1.1 e irRECIST -Tasso di risposta completa patologica (pCR), come da valutazione dello Sperimentatore, nelle pazienti sottoposte a citoriduzione chirurgica di intervallo (IDS) -Durata della risposta (DOR) secondo i criteri RECIST v.1.1 e irRECIST -Tasso di controllo della malattia (DCR) secondo i criteri RECIST v.1.1 e irRECIST (si prega di far rif. alla sinossi)
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Patients must be female, >=18 years of age, able to understand the study procedures, and agree to participate in the study by providing written informed consent.
    2. Patients with a histologically confirmed diagnosis of high-grade nonmucinous epithelial ovarian (serous, endometrioid, clear cell, carcinosarcoma, and mixed pathologies), fallopian tube, or primary peritoneal cancer that is Stage III or IV according to the FIGO or tumor, node and metastasis staging criteria [ie, American Joint Committee on Cancer].
    3. All patients with Stage IV disease are eligible. This includes those with inoperable disease, those who undergo PDS (CC0 or macroscopic disease), or those for whom NACT is planned.
    4. Patients with Stage III are eligible if they meet one or more of the following criteria:
    a. Stage IIIC patients CC0 resection if they meet the following criteria: aggregate >= 5 cm extra-pelvic disease during PDS as assessed by the Investigator.
    b. All patients with inoperable Stage III disease.
    c. All Stage III patients with macroscopic residual tumor (per Investigator judgement) following PDS.
    d. All Stage III patients for whom NACT is planned.
    5. Patient must provide a blood sample for ctDNA HRR testing at Pre-Screening or Screening.
    6. Patient must provide sufficient tumor tissue sample (a minimum of 1 FFPE block at Pre-Screening or Screening for PD-L1, homologous recombination deficiency [HRD] testing).
    7. Patients of childbearing potential must have a negative serum or urine pregnancy test (beta human chorionic gonadotropin) within 3 days prior to receiving the first dose of study treatment.
    8. Patients must be postmenopausal, free from menses for >1 year, surgically sterilized, or willing to use highly effective contraception to prevent pregnancy or must agree to abstain from activities that could result in pregnancy throughout the study, starting with enrollment through 180 days after the last dose of study treatment.
    9. Patients must have adequate organ function, defined as follows (Note: CBC test should be obtained without transfusion or receipt of stimulating factors within 2 weeks before obtaining Screening blood sample):
    a. Absolute neutrophil count >=1,500/µL
    b. Platelet count >=100,000/µL
    c. Hemoglobin >=9 g/dL
    d. Serum creatinine <=1.5 × upper limit of normal (ULN) or calculated creatinine clearance >=60 mL/min using the Cockcroft Gault equation
    e. Total bilirubin <=1.5 × ULN or direct bilirubin <=1.5 × ULN
    f. Aspartate aminotransferase and alanine aminotransferase (ALT) <=2.5 × ULN unless liver metastases are present, in which case they must be <=5 × ULN
    10. Patients must have an ECOG score of 0 or 1.
    11. Patients must have normal blood pressure (BP) or adequately treated and controlled hypertension (systolic BP <=140 mmHg and/or diastolic BP <=90 mmHg).
    12. Patients must agree to complete HRQoL questionnaires throughout the study.
    13. Patients must be able to take oral medication.
    1.Le pazienti devono essere donne di età >=18 anni, in grado di comprendere le procedure dello studio e di accettare di partecipare allo studio fornendo consenso informato scritto.
    2. Pazienti con diagnosi istologicamente confermata di tumore epiteliale ovarico nonmucinoso di alto grado (sieroso, endometrioide, a cellule chiare, carcinosarcoma e patologie miste), delle tube di Falloppio o peritoneale primario in stadio III o IV secondo i criteri di stadiazione della International Federation of Gynecology and Obstetrics (Federazione internazionale di ginecologia e ostetricia) o del sistema tumore, linfonodi e metastasi (ovvero, il sistema dell’American Joint Committee on Cancer [Comitato americano congiunto sul cancro]).
    3. Tutte le pazienti con malattia in stadio IV sono considerate idonee, incluse le pazienti con malattia inoperabile, le pazienti sottoposte a PDS (CC0 o malattia macroscopica) o le pazienti candidate a NACT.
    4. Le pazienti con malattia in stadio III sono considerate idonee se soddisfano uno o più dei seguenti criteri:
    a. Pazienti in stadio IIIC con resezione CC0 se soddisfano i seguenti criteri: malattia extra-pelvica complessiva >=5 cm durante la PDS, come valutato dallo sperimentatore.
    b. Tutte le pazienti con malattia in stadio III inoperabile.
    c. Tutte le pazienti in stadio III con tumore residuo macroscopico (secondo il giudizio dello sperimentatore) dopo PDS.
    d. Tutte le pazienti in stadio III candidate a NACT.
    5. Al pre-screening o allo screening, le pazienti devono fornire un campione di sangue per l’analisi dello stato HRR del ctDNA.
    6. Le pazienti devono fornire un campione di tessuto tumorale sufficiente (almeno 1 blocco FFPE al pre-screening o allo screening per PD-L1 per l’analisi del deficit di ricombinazione omologa [HRD]).
    7. Le pazienti in età fertile devono presentare un test di gravidanza sul siero o sulle urine (dosaggio della beta gonadotropina corionica umana) negativo entro 3 giorni prima di ricevere la prima dose di trattamento dello studio.
    8. Le pazienti devono essere in post-menopausa, amenorroiche da >1 anno, chirurgicamente sterili o disposte a utilizzare una contraccezione altamente efficace per evitare la gravidanza, oppure devono accettare di astenersi da attività che potrebbero portare alla gravidanza per tutta la durata dello studio, a partire dall’arruolamento fino a 180 giorni dopo l’ultima dose di trattamento dello studio.
    9. Le pazienti devono presentare una funzionalità d’organo adeguata, definita come segue (Nota: l’esame CBC deve essere ottenuto senza trasfusioni o trattamento con fattori di stimolazione entro 2 settimane prima del prelievo del campione di sangue dello screening):
    a. Conta assoluta dei neutrofili (ANC) >=1500/µl
    b. Conta piastrinica >=100.000/µl
    c. Emoglobina >=9 g/dl
    d. Creatinina sierica <=1,5 volte il limite superiore della norma (ULN) o clearance della creatinina calcolata >=60 ml/min in base all’equazione di Cockcroft-Gault
    e. Bilirubina totale <=1,5 × l’ULN o bilirubina diretta <=1,5 × l’ULN
    f. Aspartato aminotransferasi e alanina aminotransferasi (ALT) <=2,5 × l’ULN salvo che in presenza di metastasi epatiche, nel qual caso devono essere <=5 × l’ULN
    10. Le pazienti devono presentare un punteggio ECOG di 0 o 1.
    11. Le pazienti devono presentare una pressione sanguigna (PS) nella norma o un’ipertensione adeguatamente trattata e controllata (PS sistolica <=140 mmHg e/o PS diastolica <=90 mmHg).
    12. Le pazienti devono accettare di compilare questionari di HRQoL per tutta la durata dello studio.
    13. Le pazienti devono essere in grado di assumere farmaci per via orale.
    E.4Principal exclusion criteria
    1. Patient has mucinous, germ cell, transitional cell, or undifferentiated tumor.
    2. Patient has low grade or Grade 1 epithelial ovarian cancer.
    3. Stage III patient with R0 resection after PDS (ie, no macroscopic residual disease, unless inclusion criterion #4a is met).
    4. Patient has not adequately recovered from prior major surgery.
    5. Patient has a known condition, therapy, or laboratory abnormality that might confound the study results or interfere with the patient's participation for the full duration of the study treatment in the opinion of the Investigator.
    6. Patient is pregnant or is expecting to conceive children while receiving study drug or for up to 180 days after the last dose of study drug. Patient is breastfeeding or is expecting to breastfeed within 30 days of receiving the final dose of study drug (women should not breastfeed or store breastmilk for use, during niraparib treatment and for 30 days after receiving the final dose of study treatment).
    7. Patient has known active central nervous system metastases, carcinomatous meningitis, or both.
    8. Patient has clinically significant cardiovascular disease (eg, significant cardiac conduction abnormalities, uncontrolled hypertension, myocardial infarction, uncontrolled cardiac arrhythmia or unstable angina <6 months to enrollment, New York Heart Association Grade 2 or greater congestive heart failure, serious cardiac arrhythmia requiring medication, Grade 2 or greater peripheral vascular disease, and history of cerebrovascular accident within 6 months).
    9. Patient has a bowel obstruction by clinical symptoms or CT scan, subocclusive mesenteric disease, abdominal or gastrointestinal fistula, gastrointestinal perforation, or intra abdominal abscess.
    10. Patient initiating bevacizumab as SOC has proteinuria as demonstrated by urine protein:creatinine ratio >=1.0 at Screening or urine dipstick for proteinuria >=2 (patients discovered to have >=2 proteinuria on dipstick at baseline should undergo a 24 hour urine collection and must demonstrate <2 g of protein in 24 hours to be eligible).
    11. Patient has any known history or current diagnosis of MDS or AML.
    12. Patient has been diagnosed and/or treated with any therapy for invasive cancer <5 years from study enrollment, completed adjuvant chemotherapy and/or targeted therapy (eg, trastuzumab) less than 3 years from enrollment, or completed adjuvant hormonal therapy less than 4 weeks from enrollment. Patients with definitively treated non invasive malignancies such as cervical carcinoma in situ, ductal carcinoma in situ, Grade 1 or 2, Stage I endometrial cancer, or nonmelanomatous skin cancer are allowed.
    13. Patient is at increased bleeding risk due to concurrent conditions (eg, major injuries or major surgery within the past 28 days prior to start of study treatment and/or history of hemorrhagic stroke, transient ischemic attack, subarachnoid hemorrhage, or clinically significant hemorrhage within the past 3 months).
    14. Patient is immunocompromised. Patients with splenectomy are allowed. Patients with known human immunodeficiency virus (HIV) are allowed if they meet all criteria as listed in the protocol.
    15. Patient has known active hepatitis B (eg, hepatitis B surface antigen reactive) or hepatitis C (eg, hepatitis C virus ribonucleic acid [qualitative] is detected).
    16. Patient is considered a poor medical risk due to a serious, uncontrolled medical disorder, non malignant systemic disease, or uncontrolled infection.
    17. Patient has had investigational therapy administered within 4 weeks or within a time interval less than at least 5 half lives of the investigational agent, whichever is longer, prior to the first scheduled day of dosing in this study.
    (for the complete list of exclusion criteria please refer to the attached Protocol synopsis)
    1. La paziente presenta un tumore mucinoso, a cellule germinali, a cellule transizionali o indifferenziato.
    2. La paziente presenta un tumore epiteliale ovarico di basso grado o di grado 1.
    3. Paziente in stadio III con resezione R0 dopo PDS (ovvero, nessuna malattia residua macroscopica, a meno che non sia soddisfatto il criterio di inclusione n. 4a).
    4. La paziente non si è adeguatamente ripresa dal precedente intervento chirurgico maggiore.
    5. Condizione, terapia o anomalia di laboratorio nota che, a giudizio dello sperimentatore, potrebbe confondere i risultati dello studio o interferire con la partecipazione della paziente per tutta la durata del trattamento dello studio.
    6. La paziente è in stato di gravidanza o intende concepire un figlio durante il trattamento con il farmaco dello studio o fino a 180 giorni dopo l’ultima dose di farmaco dello studio. La paziente sta allattando al seno o prevede di allattare al seno entro 30 giorni dall’ultima dose di farmaco dello studio (le donne non devono allattare al seno o conservare il proprio latte per l’uso durante il trattamento con niraparib e per 30 giorni dopo l’ultima dose di trattamento dello studio).
    7. La paziente presenta metastasi attive note al sistema nervoso centrale, meningite carcinomatosa o entrambe.
    8. La paziente presenta una malattia cardiovascolare clinicamente significativa (per es., anomalie significative della conduzione cardiaca, ipertensione non controllata, infarto del miocardio, aritmia cardiaca non controllata o angina instabile <6 mesi prima dell’arruolamento, insufficienza cardiaca congestizia di grado 2 o superiore secondo la classificazione della New York Heart Association [Associazione dei cardiologi di New York], grave aritmia cardiaca con necessità di terapia farmacologica, vasculopatia periferica di grado 2 o superiore e anamnesi di accidente cerebrovascolare entro 6 mesi).
    9. La paziente presenta occlusione intestinale in base ai sintomi clinici o all’esame TC, malattia mesenterica subocclusiva, fistola addominale o gastrointestinale, perforazione gastrointestinale o ascesso intraddominale.
    10. La paziente che ha iniziato bevacizumab come terapia standard presenta proteinuria, come dimostrato da un rapporto proteinuria: creatininuria >=1,0 allo screening o da una proteinuria >=2 allo stick urine (le pazienti in cui viene riscontrata una proteinuria >=2 allo stick eseguito al basale devono effettuare una raccolta delle urine delle 24 ore e dimostrare <2 g di proteine nelle 24 ore per essere considerate idonee).
    11. La paziente presenta qualsiasi anamnesi nota o diagnosi attuale di SMD o LMA.
    12. La paziente ha ricevuto una diagnosi di tumore invasivo e/o è stata trattata con qualsiasi terapia per tumore invasivo <5 anni prima dell’arruolamento nello studio, ha completato la chemioterapia adiuvante e/o la terapia mirata (per es., trastuzumab) meno di 3 anni prima dell’arruolamento o ha completato la terapia ormonale adiuvante meno di 4 settimane prima dell’arruolamento. Sono ammesse le pazienti con malignità non invasive trattate in modo definitivo, per es. carcinoma cervicale in situ, carcinoma duttale in situ, tumore endometriale in stadio I di grado 1 o 2 o tumore cutaneo non melanomatoso.
    13. La paziente è ad aumentato rischio di sanguinamento a causa di condizioni concomitanti (per es., lesioni gravi o intervento chirurgico maggiore entro gli ultimi 28 giorni prima dell’avvio del trattamento dello studio e/o anamnesi di ictus emorragico, attacco ischemico transitorio, emorragia subaracnoidea o emorragia clinicamente significativa entro gli ultimi 3 mesi).
    14. La paziente è immunocompromessa. Sono ammesse le pazienti con anamnesi di splenectomia. Le pazienti con infezione nota da virus dell’immunodeficienza umana (HIV) possono partecipare se soddisfano tutti i criteri elencati nel protocollo.
    (per l'elenco completo dei criteri di esclusione si prega di far rifermento alla Sintesi del protocollo allegata)
    E.5 End points
    E.5.1Primary end point(s)
    This study has dual primary efficacy endpoints: PFS in PD-L1 positive patients and PFS in all patients.
    PFS, defined as the time from the date of treatment randomization to the date of first documentation of progression or death by any cause in the absence of progression, whichever occurs first.
    Questo studio prevede due endpoint primari di efficacia: la PFS nelle pazienti PD-L1 positive e la PFS in tutte le pazienti.
    L’endpoint primario di efficacia della PFS è definito come l’intervallo di tempo dalla data di randomizzazione del trattamento alla data della prima documentazione di progressione o al decesso da qualsiasi causa in assenza di progressione, a seconda di quale evento si verifichi prima.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Date of first documentation of progression or death by any cause in the absence of progression, whichever occurs first.
    Data della prima documentazione di progressione o morte per qualsiasi causa in assenza di progressione, a seconda di quale si verifica prima.
    E.5.2Secondary end point(s)
    1. Progression-free survival
    2. Overall survival
    3. Health-related quality of life
    4. Time to first subsequent therapy
    5. Time to second subsequent therapy
    6. Progression-free survival 2
    7. Objective response rate
    8. Pathologic complete response
    9. Duration of response
    10. Disease control rate
    11. Maintenance progression-free survival
    1. Sopravvivenza libera da progressione
    2. Sopravvivenza globale
    3. Qualità della vita correlata alla salute
    4. Tempo alla prima terapia successiva
    5. Tempo per la seconda terapia successiva
    6. Sopravvivenza libera da progressione 2
    7. Tasso di risposta obiettiva
    8. risposta completa patologica
    9. Durata della risposta
    10. Tasso di controllo della malattia
    11. Mantenimento della sopravvivenza libera da progressione
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. Date of first documentation of progression or death by any cause in the absence of progression, whichever occurs first. 2. Date of death. 3. Study visits, including follow up. 4. Date of first subsequent therapy. 5. Date of second subsequent therapy. 6. The earlier date of assessment of progression on the next anticancer therapy following study treatment or death by any cause. 7. End of study. 8. End of study. 9. First documentation of PD or death by any cause in the absence of progression. 10. End of study. 11. Date of first documentation of progression or death by any cause in the absence of progression, whichever occurs first.
    1. Data della prima documentazione di progressione o morte per qualsiasi causa in assenza di progressione, a seconda di quale si verifica prima. 2. Data di morte. 3. Visite di studio, incluso il follow up. 4. Data della prima terapia successiva. 5. Data della seconda terapia successiva. 6. La precedente data di valutazione della progressione sulla successiva terapia antitumorale dopo trattamento in studio o morte per qualsiasi causa. 7. Fine dello studio. 8. Fine dello studio. 9. Prima documentazione di PD o morte per qualsiasi causa in assenza di progressione. 10. Fine dello studio. 11. Data della prima documentazione di progressione o morte per qualsiasi causa in assenza di progressione, a seconda di quale si verifica prima.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    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.8.4.1Number of sites anticipated in Member State concerned10
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA138
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Belarus
    Canada
    Israel
    Ukraine
    United States
    Belgium
    Czechia
    Denmark
    Finland
    France
    Germany
    Greece
    Italy
    Netherlands
    Norway
    Poland
    Romania
    Spain
    United Kingdom
    E.8.7Trial 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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years6
    E.8.9.1In the Member State concerned months5
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years6
    E.8.9.2In all countries concerned by the trial months5
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 365
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 863
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male No
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state80
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 755
    F.4.2.2In the whole clinical trial 1228
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Follow-up period for telephone assessment of survival status every 90 days (±14 days)
    Follow-up periodico al telefono per la valutazione dello stato di sopravvivenza ogni 90 giorni (± 14 giorni)
    G. Investigator Networks to be involved in the Trial
    G.4 Investigator Network to be involved in the Trial: 1
    G.4.1Name of Organisation GINECO
    G.4.3.4Network Country France
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2018-09-19
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-09-26
    P. End of Trial
    P.End of Trial StatusOngoing
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