ClinicalTrials.gg
RecruitingNCT07822646Updated Sep 16, 2026

A Phase 3 Study of Manganese-primed Immunochemotherapy in Patients With Advanced Ovarian Cancer

A Phase 3 interventional study of Manganese Chloride and Nab-paclitaxel in Ovarian Cancer, sponsored by Chinese PLA General Hospital. Recruiting at 6 sites in China. Open to female participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-16.

Sponsored by Chinese PLA General Hospital · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
120
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
Female
01

Study summary

Epithelial ovarian cancer is the most lethal gynecologic malignancy, and most patients eventually relapse and develop resistance to available therapies. Immune checkpoint inhibitors have shown limited overall efficacy in recurrent ovarian cancer, partly because of its immunosuppressive tumor microenvironment. Manganese (Mn2+) can activate the cGAS-STING pathway and may enhance antitumor immunity and the therapeutic effects of PD-1 blockade combined with chemotherapy. Following encouraging findings from an early-phase study, a randomized, single-blind, placebo-controlled phase II trial showed that the addition of manganese chloride to anti-PD-1 antibody, nab-paclitaxel, and cisplatin improved clinical outcomes compared with placebo, with an overall manageable safety profile. Based on these findings, this phase III trial is designed to confirm the efficacy and further evaluate the safety of Mn2+-primed immunochemotherapy in patients with advanced ovarian cancer.

02

Conditions studied

  • Ovarian Cancer

Keywords

  • Relapsed
  • Refractory
  • anti-PD-1 antibody
  • Manganese
  • Chemotherapy
03

In context

Ovarian Neoplasms

3,381 studies on the registry are indexed under Ovarian Neoplasms; 790 are open to participants now.

This study's planned enrollment of 120 is above the median of 54 across 2,548 interventional studies indexed under Ovarian Neoplasms.

Browse Ovarian Neoplasms studies →

Lead sponsor

Chinese PLA General Hospital is the lead sponsor of 570 studies on the registry; 207 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Patients with or cytologically confirmed epithelial ovarian cancer, primary fallopian tube cancer, or peritoneal cancer.
  2. Patients who have received at least two , including at least one platinum-based regimen.
  3. Patients who experienced disease progression during or within 6 months after completion of the most recent line of systemic therapy.

    Note: This most recent therapy is not required to be platinum-based and may be any systemic treatment (chemotherapy, targeted therapy, or other anticancer therapy).

  4. Patients with at least one .
  5. Patients who have received immunotherapy ( antibodies, anti-PD-L1 antibodies), or bevacizumab, are not restricted from enrollment.
  6. Expected survival of more than 6 months.
  7. Age over 18 years.
  8. Patient weight > 40 kg.
  9. performance status ≤ 2.
  10. Peripheral blood white blood cell count > 3.5×10 /L.
  11. Bone marrow reserve and liver and kidney function (the following laboratory tests should be performed before initial treatment to prove):

    • (ANC) ≥ 1,000/mm ;
    • > 80 g/dL;
    • count > 80,000/mm ;
    • /AST \< 3×;
    • Serum creatinine \< 3×ULN;
    • Total level \< 3×ULN.
  12. No significant hereditary diseases.
  13. Normal liver and kidney biochemical indicators.
  14. Completed the last systemic anticancer therapy at least 4 weeks prior to enrollment, with resolution of all treatment-related adverse events to grade ≤1 according to v5.0, with the exception of alopecia and other clinically insignificant toxicities deemed acceptable by the investigator.
  15. No treatment with paclitaxel (albumin-bound) plus platinum in the past 3 months.
  16. Voluntary participation and signing of , compliance with the trial treatment plan and visit schedule, and cooperation in observing adverse events and efficacy.

Exclusion criteria

Exclusion Criteria:

  1. (ANC) \< 1×10 /L or \< 80×10 /L or \< 80 g/dL (according to the normal values of the clinical trial center).
  2. Serum total levels higher than 3 times the upper limit of the reference range.
  3. , AST, or ALP levels higher than 3 times the upper limit of the reference range when there are no liver ; ALT, AST, or ALP levels higher than 5 times the upper limit of the reference range when there are liver metastases.
  4. Patients receiving known strong inhibitors (e.g., ketoconazole) or inducers (e.g., rifampicin or St. John's Wort) of , or strong inhibitors (e.g., gemfibrozil) or inducers of CYP2C8; patients receiving treatment with potent P-gp inhibitors or inducers, or patients who cannot stop treatment with these agents for 2 weeks before the start of the study.
  5. Subjects' bowel obstruction or requirement for bowel obstruction-related interventions within 3 weeks prior to first study drug administration; subjects with incomplete bowel obstruction who have returned to normal within 1 month before the first dose of the experimental drug can be included in the study after discussion by the researchers.
  6. Patients with severe or uncontrolled ascites, defined as either of the following: a) symptomatic ascites corresponding to ≥ Grade 2; b) history of therapeutic paracentesis for ascites within 3 weeks prior to enrollment.
  7. Organ failure:

    • Heart: Grade III or IV.
    • Liver: Grade C according to B liver function classification.
    • Kidney: Renal failure and uremia.
    • Lung: Severe respiratory failure symptoms.
    • Brain: Consciousness disorders.
  8. T-cell tumors such as T-cell lymphoma or T-cell leukemia.
  9. Major surgery within 4 weeks before enrollment, or planned major surgery during the study (excluding diagnostic surgery).
  10. antibody positive, or other acquired, congenital immunodeficiency diseases, or patients with a history of organ transplantation.
  11. History of Parkinson's disease or epilepsy, or occurrence of diseases that can induce seizures within 12 months before the study (including a history of , stroke, traumatic brain injury with consciousness disorders).
  12. CTCAE grade 2 infections that do not respond to treatment or active clinically serious infections with CTCAE > Grade 2.
  13. Patients with active virus (HBV) or virus (HCV) infection requiring treatment.
  14. Patients with a history of allergic reactions to study drug components or suspected allergies.
  15. Chronic diseases requiring immunotherapy or hormone therapy.
  16. Patients who have received any drug treatment within 30 days before the first dose of the trial drug.
  17. Subjects with symptoms of brain or .
  18. Subjects with a history of malignant tumors (non-study tumor) within 3 years before the first dose of the trial drug.
  19. History of the following diseases: interstitial lung disease, non-infectious pneumonia, or uncontrolled systemic diseases including diabetes, hypertension, pulmonary fibrosis, acute lung disease, abdominal infection, etc.
Terms in these criteria, in plain language(22)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
120 participants (estimated)

Study arms

  • Experimental
    Manganese primed anti-PD-1 plus nPP chemotherapy

    Subject received Manganese primed anti-PD-1 antibody, nab-paclitaxel and platinum chemotherapy every 3 weeks until achieving a second assessable complete response or progressive disease, development of unacceptable toxicity, or withdrawal of consent.

    Drug: Manganese Chloride · Drug: Nab-paclitaxel · Drug: Platinum chemotherapy · Drug: Anti-PD-1 antibody

  • Placebo comparator
    anti-PD-1 plus nPP chemotherapy

    Subject received placebo, anti-PD-1 antibody, nab-paclitaxel and platinum chemotherapy every 3 weeks until achieving a second assessable complete response or progressive disease, development of unacceptable toxicity, or withdrawal of consent.

    Drug: Nab-paclitaxel · Drug: Platinum chemotherapy · Drug: Anti-PD-1 antibody · Drug: Placebo

Interventions

  • Administered by inhalation at 0.4mg/kg twice per week in the first 3-week cycle, and then inhaled 0.4mg/kg twice in the first week of each 3-week cycle thereafter

  • Administered intravenously, 180-220mg/m2 on day 2 in a 3-week cycle (day 1 without Manganese priming)

  • DrugPlatinum chemotherapy

    Administered intravenously, Cisplatin (60-80mg/m2) or Carboplatin (area under the curve \[AUC\] 4-6 mg/ mL per min) on day 2 in a 3-week cycle (day 1 without Manganese priming)

  • Administered intravenously, 200mg on day 3 in a 3-week cycle (day 2 without Manganese priming)

  • DrugPlacebo

    Administered by inhalation twice per week in the first 3-week cycle, and then inhaled twice in the first week of each 3-week cycle thereafter

06

What researchers measure

Primary outcomes

  1. Progression-free survival (PFS)

    PFS time was measured from study entry to the first documentation of disease progression or death. Disease progression was determined per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.

    Time frame: 12 months

Secondary outcomes

  1. Overall survival (OS)

    OS time was measured from the study entry to the date of death.

    Time frame: 24 months

  2. Object response rate (ORR)

    ORR is defined as the proportion of subjects who achieved a partial response (PR) or complete response (CR) according to the RECIST V1.1.

    Time frame: 24 months

  3. Number of Subjects with treatment-related adverse events (AEs)

    Incidence, nature, and severity of adverse events graded according to the NCI CTCAE v5.0. AEs were considered to be treatment-related if they had started or worsened within the interval from first study drug administration until the follow-up visit.

    Time frame: 12 months

Other outcomes

  1. Number of participants with laboratory test abnormalities

    The laboratory tests of serum cytokines and chemokines will be performed on day 1 and 3 of each cycle, and the abnormality will be determined by the investigator.

    Time frame: 12 months

07

Study locations

3 of 6 sites recruiting
  • Department of Obstetrics and Gynecology, Seventh Medical Center, Chinese PLA General Hospital
    Beijing, Beijing Municipality 100007, China
    Recruiting
  • Department of Bio-therapeutic, First Medical Center, Chinese PLA General Hospital
    Beijing, Beijing Municipality 100853, China
    Recruiting
    • Weidong Han · Contacthanwdrsw@163.com · +86-010-66937463
    • Qian Mei · Sub investigator
    • Yan Zhang · Sub investigator
  • Department of Obstetrics and Gynecology, First Medical Center, Chinese PLA General Hospital
    Beijing, Beijing Municipality 100853, China
    Recruiting
    • Mingxia Ye · Contactymx298013@126.com · +86-15901229215
    • Mingxia Ye · Principal investigator
  • Peking University International Hospital
    Beijing, Beijing Municipality 102206, China
    Not yet recruiting
    • Yuanguang Meng · Contactmeng6512@vip.sina.com · +86-010-69006900
    • Yuanguang Meng · Principal investigator
  • Department of Obstetrics and Gynecology, North China University of Science and Technology Affiliated Hospital
    Tangshan, Hebei 063000, China
    Not yet recruiting
  • Department of Gynecologic Oncology, Shanxi Province Cancer Hospital
    Taiyuan, Shanxi 030013, China
    Not yet recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 16, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07822646
Responsible party
Han weidong (Principal Investigator, Chinese PLA General Hospital) — Principal investigator
First posted
Sep 16, 2026
Start date
Oct 12, 2026 (estimated)
Primary completion
Apr 12, 2029 (estimated)
Completion
Dec 20, 2030 (estimated)
Last update
Sep 16, 2026

Study contacts

Weidong Han
Contact
hanwdrsw@163.com
+86-01066937463

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Manganese chloride

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