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Trial record 17 of 533 for:    "Primary Peritoneal Carcinoma"

Study of Relacorilant in Combination With Nab-Paclitaxel for Patients With Recurrent Platinum-Resistant Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

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ClinicalTrials.gov Identifier: NCT03776812
Recruitment Status : Recruiting
First Posted : December 17, 2018
Last Update Posted : October 15, 2019
Sponsor:
Information provided by (Responsible Party):
Corcept Therapeutics

Tracking Information
First Submitted Date  ICMJE December 13, 2018
First Posted Date  ICMJE December 17, 2018
Last Update Posted Date October 15, 2019
Actual Study Start Date  ICMJE January 28, 2019
Estimated Primary Completion Date March 2023   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: April 16, 2019)
Progression Free Survival (PFS) [ Time Frame: 12 months from enrollment of last subject ]
Time from randomization until the date first documented of progressive disease (PD) by RECIST v1.1 (as determined by the Investigator at the local site), or death due to any cause, whichever occurs first
Original Primary Outcome Measures  ICMJE
 (submitted: December 13, 2018)
Progression Free Survival [ Time Frame: 12 months from enrollment of last subject ]
Time from randomization until the earliest date of progressive disease (PD) by RECIST v1.1, as determined by the Investigator at the local site, or death from any cause, whichever occurs first
Change History Complete list of historical versions of study NCT03776812 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures  ICMJE
 (submitted: October 11, 2019)
  • Objective Response Rate (ORR) [ Time Frame: 12 months from enrollment of last subject ]
    Proportion of patients with measurable disease at baseline who attain complete response (CR) or partial response (PR) by RECIST v1.1 (confirmation not required).
  • Duration of Response (DoR) [ Time Frame: 12 months from enrollment of last subject ]
    Time from when response (CR or PR) was first documented to first objectively documented PD or death (whichever occurs first)
  • Response according to Gynecological Cancer Intergroup criteria (GCIG) [ Time Frame: 12 months from enrollment of last subject ]
    Overall response per Gynecological Cancer Intergroup criteria (GCIG)
  • Best Overall Response (BoR) [ Time Frame: 12 months from enrollment of last subject ]
    Best response recorded from the date of randomization until PD/recurrence (or death)
  • Progression Free Rate (PFR) [ Time Frame: 12 months from enrollment of last subject ]
    Proportion of patients who have not progressed at 6 and 12 months
  • Progression Free Survival in patients who crossover to continuous treatment at time of PD [ Time Frame: 12 months from enrollment of last subject ]
    Time from randomization until the earliest date of progressive disease (PD) by RECIST v1.1, as determined by the Investigator at the local site, or death from any cause, whichever occurs first
  • Overall Response Rate in patients who crossover to continuous treatment at time of PD [ Time Frame: 12 months from enrollment of last subject ]
    Proportion of patients with measurable disease at baseline who attain confirmed complete response (CR) or partial response (PR) by RECIST v1.1
  • Duration of Response in patients who crossover to continuous treatment at time of PD [ Time Frame: 12 months from enrollment of last subject ]
    Time from when response (CR or PR) was first documented to first objectively documented PD or death (whichever occurs first)
  • Best Overall Response in patients who crossover to continuous treatment at time of PD [ Time Frame: 12 months from enrollment of last subject ]
    Proportion of patients with measurable disease at baseline who attain CR or PR by RECIST v1.1
  • Cancer Antigen (CA)-125 Response [ Time Frame: 12 months from enrollment of last subject ]
    CA-125 response will be assessed per GCIG criteria defined as >/=50% reduction in CA-125 from a pre-treatment sample and maintained for >/- 28 days in patients with a pre-treatment sample that is at least twice the upper limit of the reference range and within 2 weeks before starting the treatment. In addition, patients who have a CA-125 response and whose CA-125 level falls to within the reference range will be classified as CA-125 complete responders.
  • Overall survival [ Time Frame: 12 months from enrollment of last subject ]
    Time from randomization to death by any cause
  • Combined Response according to RECIST v1.1 + GCIG criteria [ Time Frame: 12 months from enrollment of last subject ]
    To assess combined response by RECIST 1.1 with GCIG criteria
Original Secondary Outcome Measures  ICMJE
 (submitted: December 13, 2018)
  • Overall Response Rate [ Time Frame: 12 months from enrollment of last subject ]
    Proportion of patients with measurable disease at baseline who attain confirmed complete response (CR) or partial response (PR) by RECIST v1.1
  • Duration of Response [ Time Frame: 12 months from enrollment of last subject ]
    Time from when response (CR or PR) was first documented to first objectively documented PD or death (whichever occurs first)
  • Response according to Gynecological Cancer Intergroup (GCIG) criteria [ Time Frame: 12 months from enrollment of last subject ]
    Overall response per CGIC criteria
  • Best Overall Response [ Time Frame: 12 months from enrollment of last subject ]
    Proportion of patients with measurable disease at baseline who attain CR or PR by RECIST v1.1
  • Progression Free Rate [ Time Frame: 12 months from enrollment of last subject ]
    Proportion of patients who have not progressed at 6 and 12 months
  • Progression Free Survival in patients who crossover to intermittent or continuous treatment at time of PD [ Time Frame: 12 months from enrollment of last subject ]
    Time from randomization until the earliest date of progressive disease (PD) by RECIST v1.1, as determined by the Investigator at the local site, or death from any cause, whichever occurs first
  • Overall Response Rate in patients who crossover to intermittent or continuous treatment at time of PD [ Time Frame: 12 months from enrollment of last subject ]
    Proportion of patients with measurable disease at baseline who attain confirmed complete response (CR) or partial response (PR) by RECIST v1.1
  • Duration of Response in patients who crossover to intermittent or continuous treatment at time of PD [ Time Frame: 12 months from enrollment of last subject ]
    Time from when response (CR or PR) was first documented to first objectively documented PD or death (whichever occurs first)
  • Best Overall Response in patients who crossover to intermittent or continuous treatment at time of PD [ Time Frame: 12 months from enrollment of last subject ]
    Proportion of patients with measurable disease at baseline who attain CR or PR by RECIST v1.1
  • CA-125 Response [ Time Frame: 12 months from enrollment of last subject ]
    CA-125 response will be assessed per GCIC criteria defined as >/=50% reduction in CA-125 from a pre-treatment sample and maintained for >/- 28 days in patients with a pre-treatment sample that is at least twice the upper limit of the reference range and within 2 weeks before starting the treatment
  • Overall survival [ Time Frame: 12 months from enrollment of last subject ]
    Time from randomization to death by any cause
  • Combined Response according to RECIST v1.1 + GCIG criteria [ Time Frame: 12 months from enrollment of last subject ]
    To assess combined response by RECIST 1.1 with GCIC criteria
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Study of Relacorilant in Combination With Nab-Paclitaxel for Patients With Recurrent Platinum-Resistant Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
Official Title  ICMJE A Phase 2, Randomized, Open-Label, 3-arm Study of Relacorilant in Combination With Nab-Paclitaxel for Patients With Recurrent Platinum-Resistant Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
Brief Summary This is a Phase 2, open-label, randomized, 3-arm study to evaluate progression-free survival (PFS) in patients with recurrent platinum-resistant ovarian, fallopian tube, or primary peritoneal cancer treated with intermittent or continuous regimens of relacorilant in combination with nab-paclitaxel compared with patients treated with nab-paclitaxel alone.
Detailed Description

Relacorilant is a small molecule antagonist of the glucocorticoid receptor (GR). The goals of this study are to evaluate the efficacy of relacorilant either administered daily (continuous) or on the day prior, the day of, and the day after chemotherapy (intermittent) in combination with nab-paclitaxel in the treatment of platinum-resistant ovarian, fallopian tube, or primary peritoneal cancers compared with nab-paclitaxel alone. The safety, pharmacokinetics (PK), and pharmacodynamic profile of relacorilant in combination with nab-paclitaxel will also be assessed.

Eligible patients will be randomized 1:1:1 to one of the following three treatment arms. Patient randomization will be stratified by treatment-free interval from most recent taxane (relapsed within 6 months vs >6 months) and presence of ascites (yes vs no).

  • Arm A (Continuous relacorilant): Relacorilant starting at 100mg, administered orally, once daily every day in combination with nab-paclitaxel on Days 1, 8, and 15 of each 28-day cycle.
  • Arm B (Intermittent relacorilant): Relacorilant 150mg, administered orally, on the day before (excluding Cycle 1, Day -1), the day of, and the day after nab-paclitaxel, in combination with nab-paclitaxel on Days 1, 8, and 15 of each 28-day cycle.
  • Arm C (Comparator): Nab-paclitaxel on Days 1, 8, and 15 of each 28-day cycle.

Patients will remain on study treatment until reaching a protocol-defined event of disease progression (PD), experiencing unmanageable toxicity, or until other treatment discontinuation criteria are met. All patients will be followed for progression, subsequent therapies and survival. Patients in Arm C who experience unequivocal PD per RECIST v1.1 will be given the opportunity to receive relacorilant in combination with nab-paclitaxel after discussion with the Medical Monitor.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Recurrent Ovarian Cancer
  • Recurrent Fallopian Tube Carcinoma
  • Recurrent Primary Peritoneal Carcinoma
Intervention  ICMJE
  • Drug: Relacorilant, 100mg QD
    Relacorilant is supplied as capsules for oral dosing
    Other Name: CORT125134
  • Drug: Nab-paclitaxel, 80mg/m^2
    Nab-paclitaxel is administered as IV infusion over 30-40 minutes on Days 1, 8, and 15 of each 28-day cycle
    Other Name: Abraxane
  • Drug: Nab-paclitaxel, 100mg/m^2
    Nab-paclitaxel is administered as IV infusion over 30-40 minutes on Days 1, 8, and 15 of each 28-day cycle
    Other Name: Abraxane
  • Drug: Relacorilant, 150mg QD
    Relacorilant is supplied as capsules for oral dosing
    Other Name: CORT125134
Study Arms  ICMJE
  • Experimental: Continuous Relacorilant Dosing
    Patients will be treated with relacorilant, administered orally, once daily every day in combination with nab-paclitaxel on Days 1, 8, and 15 of each 28-day cycle.
    Interventions:
    • Drug: Relacorilant, 100mg QD
    • Drug: Nab-paclitaxel, 80mg/m^2
  • Experimental: Intermittent Relacorilant Dosing
    Patients will be treated with relacorilant, administered orally, on the day before (excluding Cycle 1, Day -1), the day of, and the day after nab-paclitaxel, in combination with nab-paclitaxel on Days 1, 8, and 15 of each 28-day cycle.
    Interventions:
    • Drug: Nab-paclitaxel, 80mg/m^2
    • Drug: Relacorilant, 150mg QD
  • Active Comparator: Nab-paclitaxel Comparator
    Patients will receive nab-paclitaxel on Days 1, 8, and 15 of each 28-day cycle.
    Intervention: Drug: Nab-paclitaxel, 100mg/m^2
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: December 13, 2018)
177
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE March 2023
Estimated Primary Completion Date March 2023   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Signed and dated IRB/IEC-approved informed consent form (ICF) prior to study-specific screening procedures.
  • Female patients aged ≥ 18 years old at time of consent.
  • Histologic diagnosis of high grade serous or endometrioid epithelial ovarian, primary peritoneal, or fallopian tube cancer or ovarian carcinosarcoma. Clear cell, mucinous and borderline histologic subtypes are excluded.
  • Received at least one line of therapy with progression within 6 months after platinum-based therapy, persistent disease at the completion of primary platinum-therapy, or PD during platinum-based therapy. Patients with primary platinum resistance (progression after first-line chemotherapy) are considered eligible.
  • Measurable or non-measurable disease by RECIST v1.1:
  • Previously irradiated lesions are not allowed as measurable disease, unless there is documented evidence of progression in the lesions.
  • To be eligible with non-measurable disease, patients must have evaluable disease with CA 125 at least twice the upper limit of reference range (of CA-125 ≥ 70 U/mL), along with radiographically evaluable disease by CT/MRI.
  • Availability and consent to provide tumor tissue for GR immunohistochemistry (archival or recent biopsy).
  • Up to 2 prior chemotherapeutic or myelosuppressive regimens for recurrent disease (not including maintenance therapy such as single-agent bevacizumab).
  • Appropriate to treat with nab-paclitaxel, in the opinion of the Investigator.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
  • Adequate organ and bone marrow function meeting the following criteria at the Screening Visit:

    • Absolute neutrophil count (ANC) ≥ 1,500 cells/mm3.
    • Platelet count ≥ 100,000/mm3.
    • Hemoglobin ≥ 9 g/dL.
    • AST or ALT ≤ 2.5 × upper limit of normal (ULN) (or ≤ 5 × ULN in the context of liver metastasis).
    • Total bilirubin ≤ 1.5 × ULN.
    • Serum creatinine ≤ 1 × ULN; creatinine clearance ≥ 50 mL/min/1.73 m2 for patients with creatinine levels above institutional normal.
    • Albumin ≥ 3 g/dL (≥ 30 g/L) .
  • If patient has undergone surgery of the gastrointestinal or hepatobiliary tract, adequate absorption as evidenced by: albumin ≥ 3.0 g/dL, controlled pancreatic insufficiency (if present), and lack of malabsorption.
  • Able to swallow and retain oral medication and does not have uncontrolled emesis.
  • Able to comply with protocol requirements.
  • Negative pregnancy test for patients of childbearing potential. Patients of childbearing potential must use appropriate precautions to avoid pregnancy, defined as of non-childbearing potential (ie, postmenopausal or permanently sterilized) or using highly effective contraception with low user-dependency, for at least 3 months after the last dose of study drug. A woman is postmenopausal if it is more than 12 months since her last menstruation, without an alternative medical cause. Accepted methods of permanent sterilization methods are hysterectomy, bilateral salpingectomy and/or bilateral oophorectomy. Accepted methods of highly effective contraception with low user-dependency are:

    • An IUD, provided that the subject has tolerated its use for at least 3 months before the first dose of study medication and undertakes not to have it removed for 1 month after the last dose.
    • Abstinence from heterosexual intercourse, when it is in line with the subject's preferred and usual lifestyle. Periodic abstinence and withdrawal are NOT acceptable.
    • Vasectomized partner provided that the partner is the sole sexual partner of the trial participant and that the vasectomized partner has received medical assessment of the surgical success.
    • Oral hormonal contraceptives are NOT permitted.

Exclusion Criteria:

  • Clinically relevant toxicity from prior systemic anticancer therapies or radiotherapy that in the opinion of the Investigator has not resolved to Grade 1 or less prior to randomization.
  • Any major surgery within 4 weeks prior to randomization. If subject received major surgery including (curative or palliative surgery), they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy.
  • Treatment with the following prior to randomization:

    • Concurrent treatment with other anticancer therapy including other chemotherapy, immunotherapy, radiotherapy, chemo-embolization, targeted therapy, an investigational agent or the non-approved use of a drug or device within 28 days before the first dose of study drug.
    • Hormonal anticancer therapies within 7 days of the first dose of study drug.
    • Systemic, inhaled, or prescription strength topical corticosteroids within 21 days of the first dose of study drug. Short courses (≤ 5 days) for non-cancer-related reasons are allowed if clinically required (such as prophylaxis for CT).
  • Received radiation to more than 25% of marrow-bearing areas.
  • Toxicities of prior therapies (except alopecia) that have not resolved to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0 ≤ Grade 1.
  • Requirement for treatment with chronic or frequently used oral corticosteroids for medical conditions or illnesses (e.g., rheumatoid arthritis, immunosuppression after organ transplantation).
  • History of severe hypersensitivity or severe reaction to either study drug.
  • Peripheral neuropathy from any cause > Grade 1.
  • Pregnant or lactating patients or patients expecting to conceive children within the projected duration of the trial, starting with screening visit through 90 days after the last dose of trial treatment.
  • Human immunodeficiency virus or current chronic/active infection with hepatitis C virus or hepatitis B virus, including:

    • Patients with chronic or active hepatitis B as diagnosed by serologic tests are excluded from the study. In equivocal cases, hepatitis B or C polymerase chain reaction may be performed and must be negative for enrollment.
  • Patient has a clinically significant uncontrolled condition(s) or which in the opinion of the Investigator may confound the results of the trial or interfere with the patient's participation, including but not limited to:

    • Unstable angina pectoris, angioplasty, cardiac stenting, or myocardial infarction 6 months before study entry.
    • Uncontrolled hypertension (sustained systolic blood pressure > 150 mmHg or diastolic pressure > 100 mmHg despite optimal management). Patients will be considered eligible if hypertension is treated and controlled during Screening.
    • Active infection that requires parenteral antibiotics.
    • Bowel obstruction or gastric outlet obstruction.
    • Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
  • Untreated parenchymal central nervous system metastases.
  • Any other concurrent cancer or a history of another invasive malignancy within the last 3 years that has a likelihood of recurrence of > 30% within the next 5 years. Adequately treated non-melanoma skin cancers or non-muscle invasive urothelial cancer or other tumors curatively treated with no evidence of disease are permissible.
  • Drugs with a narrow therapeutic ratio that are highly dependent on CYP3A for clearance should be avoided. Caution should be exercised when co-administering known inhibitors of CYP3A with relacorilant. Medicines/food known to strongly inhibit CYP3A should be avoided.
  • Concurrent treatment on other investigational treatment studies for the treatment of ovarian, fallopian tube, or primary peritoneal cancer.
  • Has received a live vaccine within 30 days of planned start of study therapy. Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however intranasal influenza vaccines (e.g., Flu-Mist®) are live attenuated vaccines, and are not allowed.
Sex/Gender  ICMJE
Sexes Eligible for Study: Female
Gender Based Eligibility: Yes
Gender Eligibility Description: Only patients with recurrent ovarian, primary peritoneal, or fallopian tube cancer will be considered for this study
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Corcept Therapeutics 650-327-3270 clinicalstudies@corcept.com
Listed Location Countries  ICMJE Belgium,   United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03776812
Other Study ID Numbers  ICMJE CORT125134-552
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Corcept Therapeutics
Study Sponsor  ICMJE Corcept Therapeutics
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Study Director: Stacie Shepherd, MD, PhD Corcept Therapeutics
PRS Account Corcept Therapeutics
Verification Date October 2019

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP