A Phase 2 interventional study of Pimasertib once daily and Pimasertib placebo in Ovarian Cancer, sponsored by EMD Serono. Completed at 34 sites in 7 countries. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-12-12.
Sponsored by EMD Serono · Phase 2, Interventional, and Treatment
This is a double blind, randomized, placebo-controlled, 2-arm, Phase 2 trial investigating the efficacy and safety of combination therapy of pimasertib plus SAR245409 and pimasertib placebo administered once per day compared to pimasertib administered twice per day plus SAR245409 placebo administered once per day in participants with previously treated unresectable low-grade serous ovarian or peritoneal carcinoma or serous borderline ovarian or peritoneal tumors.
2,695 studies on the registry are indexed under Ovarian Neoplasms; 727 are open to participants now.
This study's enrollment of 65 is close to the median of 60 across 2,030 interventional studies indexed under Ovarian Neoplasms.
Browse Ovarian Neoplasms studies →EMD Serono is the lead sponsor of 88 studies on the registry; none are open to participants now.
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Exclusion Criteria:
Drug: Pimasertib once daily · Drug: Pimasertib placebo · Drug: SAR245409
Drug: SAR245409 placebo · Drug: Pimasertib twice daily
Pimasertib administered as oral capsule at a dose of 60 milligram (mg) once daily until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.
Placebo matching Pimasertib administered once daily in evening until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.
Placebo matching SAR245409 administered once daily in morning until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.
SAR245409 administered as oral capsule at a dose of 70 milligram (mg) once daily until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.
Pimasertib administered as oral capsule at a dose of 60 milligram (mg) twice daily until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.
Objective Tumor Response
Objective tumor response was defined as the presence of at least one Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to more than (\<) 10 millimeter (mm). Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
Time frame: From randomization until disease progression or death assessed every 8 weeks up to week 32, and thereafter every 12 weeks up to 52 months
Progression-Free Survival
PFS defined as time from randomization to first documentation of objective tumor progression.CR:Disappearance of all target lesions.Any pathological lymph nodes(whether target or non-target)must have reduction in short axis to\<10 mm.PR:At least 30% decrease in sum of diameters of target lesions,taking as reference baseline sum diameters.PD:At least a 20% increase in sum of diameters of target lesions,taking as reference smallest sum on study.In addition to relative increase of 20%,the sum also demonstrate absolute increase of at least 5 mm.SD:Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD,taking as reference smallest sum diameters while on study. PFS calculated as(Months)=first event date minus randomization or first dose date plus 1.Median PFS was computed using Kaplan-Meier estimates (product-limit estimates) and was presented with 95% confidence interval.The confidence intervals for median was calculated according to Brookmeyer and Crowley.
Time frame: Time from randomization until first observation of progressive disease or death, assessed up to 52 months
Percentage of Participants With Disease Control
Disease control as per RECIST v.1.1 was defined as the proportion of participants with stable disease (SD), for at least 16 weeks, PR or CR according to RECIST v1.1 criteria. SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. PD: At least a 20% increase in sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters). CR: Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm.
Time frame: Randomization until disease progression or death assessed every 8 weeks up to week 32, and thereafter every 12 weeks up to 52 months
Overall Survival
Overall survival (OS) was defined as the time (in months) from randomization to death. Data has been presented in terms of number participants who died and number of censored participants.
Time frame: Time from randomization until death, assessed up to 52 months
Health Related Quality of Life (HrQoL) Assessed Using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30)
EORTC QLQ-C30 is a 30-item questionnaire comprising of five functional scales (physical, role, cognitive, emotional, and social), three symptom scales (fatigue, pain, and nausea/vomiting), six single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial impact), and a global quality of life (QoL) scale summarized from two 7-point scales (overall QoL and overall general health). Each of the multi-item scales includes a different set of items - no item occurs in more than one scale. All of the scales and the individual single-items ranged in score from 0 to 100. A high scale score represents a higher response level. High score for a functional scale represents a high / healthy level of functioning, a high score for the global health status / QoL represents a high QoL, but a high score for a symptom scale/item represents a high level of symptomatology/problems.
Time frame: Baseline up to disease progression or withdrawal, assessed up to 52 months
Health Related Quality of Life (HrQoL) Assessed Using European Organization for Research and Treatment of Cancer (EORTC) Ovarian-Specific Module Quality of Life Questionnaire Ovarian Cancer Module (QLQ-OV28)
EORTC QLQ-OV28 assesses disease and treatment-related symptoms of ovarian cancer. The 28-item module comprises of 6 symptom scales (abdominal/gastrointestinal symptoms, peripheral neuropathy, other chemotherapy side-effects, hormonal symptoms, body image, attitude to disease and treatment), and sexual functioning. All of the scales and the individual single-items ranged in score from 0 to 100. Higher scores indicate a better quality of life.
Time frame: Baseline up to disease progression or withdrawal, assessed up to 52 months
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, TEAEs Leading to Discontinuation of Treatment and Death
TEAEs, Serious TEAEs and AEs were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 4.0. An adverse event was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. A Serious Adverse Event was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent are events between first dose of study drug and up to data cut-off that were absent before treatment or that worsened relative to pretreatment state.
Time frame: First dose of study drug up to 52 months
Maximum Plasma Concentration (Cmax) After Dose of Pimasertib and SAR245409
Time frame: Pre-dose Hour 0.5, 1.5, 4.5 8 post dose on Day 15, 29, 43
Area Under the Curve (AUC) After Dose of Pimasertib and SAR245409
Time frame: Pre-dose Hour 0.5, 1.5, 4.5 8 post dose on Day 15, 29, 43
Molecular Alterations in MAPK and/or PI3K Signaling Pathway Components/Modulators in Tumor Tissue and Blood
Time frame: Screening visit (day -28 to 1)
First/last participants (informed consent): Sep 2013/Oct 2014. Clinical data cut off: Jan 2018.
| Milestone | Pimasertib (Once Daily) Plus SAR245409 | Pimasertib (Twice Daily) Plus SAR245409 Placebo |
|---|---|---|
| Started | 32 | 33 |
| Completed | 32 | 33 |
| Not completed | 0 | 0 |
Objective tumor response was defined as the presence of at least one Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to more than (\<) 10 millimeter (mm). Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
| percentage of participants | Pimasertib (Once Daily) Plus SAR245409 | Pimasertib (Twice Daily) Plus SAR245409 Placebo |
|---|---|---|
| Objective Tumor Response | 12.5 (3.5 to 29.0) | 12.1 (3.4 to 28.2) |
PFS defined as time from randomization to first documentation of objective tumor progression.CR:Disappearance of all target lesions.Any pathological lymph nodes(whether target or non-target)must have reduction in short axis to\<10 mm.PR:At least 30% decrease in sum of diameters of target lesions,taking as reference baseline sum diameters.PD:At least a 20% increase in sum of diameters of target lesions,taking as reference smallest sum on study.In addition to relative increase of 20%,the sum also demonstrate absolute increase of at least 5 mm.SD:Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD,taking as reference smallest sum diameters while on study. PFS calculated as(Months)=first event date minus randomization or first dose date plus 1.Median PFS was computed using Kaplan-Meier estimates (product-limit estimates) and was presented with 95% confidence interval.The confidence intervals for median was calculated according to Brookmeyer and Crowley.
| months | Pimasertib (Once Daily) Plus SAR245409 | Pimasertib (Twice Daily) Plus SAR245409 Placebo |
|---|---|---|
| Progression-Free Survival | 9.99 (3.42 to 15.21) | 12.71 (4.21 to NA) |
Disease control as per RECIST v.1.1 was defined as the proportion of participants with stable disease (SD), for at least 16 weeks, PR or CR according to RECIST v1.1 criteria. SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. PD: At least a 20% increase in sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters). CR: Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm.
| percentage of participants | Pimasertib (Once Daily) Plus SAR245409 | Pimasertib (Twice Daily) Plus SAR245409 Placebo |
|---|---|---|
| Percentage of Participants With Disease Control | 50.0 (31.9 to 68.1) | 39.4 (22.9 to 57.9) |
Overall survival (OS) was defined as the time (in months) from randomization to death. Data has been presented in terms of number participants who died and number of censored participants.
| Participants | Pimasertib (Once Daily) Plus SAR245409 | Pimasertib (Twice Daily) Plus SAR245409 Placebo |
|---|---|---|
| Number of deaths | 8 | 6 |
| Number for censored | 24 | 27 |
EORTC QLQ-C30 is a 30-item questionnaire comprising of five functional scales (physical, role, cognitive, emotional, and social), three symptom scales (fatigue, pain, and nausea/vomiting), six single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial impact), and a global quality of life (QoL) scale summarized from two 7-point scales (overall QoL and overall general health). Each of the multi-item scales includes a different set of items - no item occurs in more than one scale. All of the scales and the individual single-items ranged in score from 0 to 100. A high scale score represents a higher response level. High score for a functional scale represents a high / healthy level of functioning, a high score for the global health status / QoL represents a high QoL, but a high score for a symptom scale/item represents a high level of symptomatology/problems.
No measurements were reported for this outcome.
EORTC QLQ-OV28 assesses disease and treatment-related symptoms of ovarian cancer. The 28-item module comprises of 6 symptom scales (abdominal/gastrointestinal symptoms, peripheral neuropathy, other chemotherapy side-effects, hormonal symptoms, body image, attitude to disease and treatment), and sexual functioning. All of the scales and the individual single-items ranged in score from 0 to 100. Higher scores indicate a better quality of life.
No measurements were reported for this outcome.
TEAEs, Serious TEAEs and AEs were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 4.0. An adverse event was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. A Serious Adverse Event was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent are events between first dose of study drug and up to data cut-off that were absent before treatment or that worsened relative to pretreatment state.
| Participants | Pimasertib (Once Daily) Plus SAR245409 | Pimasertib (Twice Daily) Plus SAR245409 Placebo |
|---|---|---|
| TEAE | 32 | 32 |
| Serious TEAE | 16 | 18 |
| TEAE leading to discontinuation of study treatment | 16 | 12 |
| Death | 2 | 3 |
No measurements were reported for this outcome.
No measurements were reported for this outcome.
No measurements were reported for this outcome.
Collected over First dose of study drug up to 52 months. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Pimasertib (Once Daily) Plus SAR245409 | — | 16/32 (50%) | 32/32 (100%) |
| Pimasertib (Twice Daily) Plus SAR245409 Placebo | — | 18/32 (56.3%) | 32/32 (100%) |
| Event | Pimasertib (Once Daily) Plus SAR245409 | Pimasertib (Twice Daily) Plus SAR245409 Placebo |
|---|---|---|
| DiarrhoeaGastrointestinal disorders | 1/32 | 4/32 |
| PyrexiaGeneral disorders | 3/32 | 2/32 |
| DehydrationMetabolism and nutrition disorders | 0/32 | 3/32 |
| NauseaGastrointestinal disorders | 2/32 | 2/32 |
| Intestinal obstructionGastrointestinal disorders | 1/32 | 2/32 |
| Small intestinal obstructionGastrointestinal disorders | 2/32 | 2/32 |
| AscitesGastrointestinal disorders | 0/32 | 2/32 |
| VomitingGastrointestinal disorders | 2/32 | 0/32 |
| Blood creatine phosphokinase increasedInvestigations | 2/32 | 1/32 |
| DyspnoeaRespiratory, thoracic and mediastinal disorders | 0/32 | 2/32 |
| Event | Pimasertib (Once Daily) Plus SAR245409 | Pimasertib (Twice Daily) Plus SAR245409 Placebo |
|---|---|---|
| DiarrhoeaGastrointestinal disorders | 26/32 | 26/32 |
| NauseaGastrointestinal disorders | 22/32 | 13/32 |
| FatigueGeneral disorders | 19/32 | 14/32 |
| Blood creatine phosphokinase increasedInvestigations | 19/32 | 19/32 |
| Dermatitis acneiformSkin and subcutaneous tissue disorders | 12/32 | 19/32 |
| Vision blurredEye disorders | 16/32 | 11/32 |
| VomitingGastrointestinal disorders | 16/32 | 14/32 |
| Oedema peripheralGeneral disorders | 11/32 | 15/32 |
| StomatitisGastrointestinal disorders | 13/32 | 9/32 |
| AlopeciaSkin and subcutaneous tissue disorders | 12/32 | 4/32 |
Intent-to Treat (ITT) analysis set included all participant who were randomized.
| Age, Continuous(years) | Pimasertib (Once Daily) Plus SAR245409 | Pimasertib (Twice Daily) Plus SAR245409 Placebo | Total |
|---|---|---|---|
| Mean | 47.3 ± 14.07 | 50.6 ± 16.39 | 49.0 ± 15.26 |
| Sex: Female, Male(Participants) | Pimasertib (Once Daily) Plus SAR245409 | Pimasertib (Twice Daily) Plus SAR245409 Placebo | Total |
|---|---|---|---|
| Female | 32 | 33 | 65 |
| Male | 0 | 0 | 0 |
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