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A Study to Evaluate Dostarlimab Plus Carboplatin-paclitaxel Versus Placebo Plus Carboplatin-paclitaxel in Participants With Recurrent or Primary Advanced Endometrial Cancer (RUBY)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03981796
Recruitment Status : Recruiting
First Posted : June 11, 2019
Last Update Posted : November 10, 2020
Sponsor:
Collaborators:
European Network of Gynaecological Oncological Trial Groups (ENGOT)
Gynecologic Oncology Group
Information provided by (Responsible Party):
Tesaro, Inc.

Brief Summary:
Endometrial cancer accounts for greater than 90 percent (%) of all uterine cancer. The majority of participants with endometrial cancer are diagnosed in early stages (Stage I or II) and receive surgery with curative intent; however, approximately 20% are diagnosed with advanced or metastatic disease (Stage III or IV) for which a surgical cure is not possible. Paclitaxel in combination with carboplatin has been shown to be efficacious against a variety of different tumor types, including non-small-cell-lung-carcinoma (NSCLC), ovarian cancer, endometrial cancer, and head and neck cancer. This study will evaluate the efficacy and safety of dostarlimab in combination with carboplatin-paclitaxel, the standard of care for participants with recurrent or primary advanced endometrial cancer. This study consists of a Screening Period, Treatment Period, an End of Treatment (EOT) Visit, a Safety Follow-up Visit, and a Survival Assessment Period. Participants will be randomized in a 1:1 ratio to receive either dostarlimab plus carboplatin paclitaxel or placebo plus carboplatin-paclitaxel.

Condition or disease Intervention/treatment Phase
Neoplasms Biological: Dostarlimab Drug: Placebo Drug: Carboplatin-paclitaxel Phase 3

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 470 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Masking Description: The participant, Investigator, study staff, and the Sponsor study team and its representatives will be blinded to the assigned treatment.
Primary Purpose: Treatment
Official Title: A Phase 3, Randomized, Double-blind, Multicenter Study of Dostarlimab (TSR-042) Plus Carboplatin-paclitaxel Versus Placebo Plus Carboplatin-paclitaxel in Patients With Recurrent or Primary Advanced Endometrial Cancer (RUBY)
Actual Study Start Date : July 18, 2019
Estimated Primary Completion Date : October 11, 2021
Estimated Study Completion Date : February 16, 2026

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Active Comparator: Dostarlimab plus Carboplatin-paclitaxel
Participants will be administered dostarlimab 500 milligram (mg) every 3 weeks (Q3W) as 30-minute infusion intravenously (IV) from Cycle 1 (each cycle is 21 days) to Cycle 6 and dostarlimab 1000 mg every 6 weeks (Q6W) (Cycle 7 until progression of disease, toxicity, withdrawal of consent, Investigator's decision, or death, whichever occurs first); followed by Carboplatin 5 mg/milliliter (mL)/minute (min) and paclitaxel 175 mg per square meter (mg/m^2) Q3W as 30-minute infusion IV from Cycle 1 to Cycle 6.
Biological: Dostarlimab
Dostarlimab is a humanized monoclonal antibody that binds with high affinity to programmed cell death-1 (PD-1) resulting in inhibition of its binding to programmed death receptor ligands 1 and 2 (PD-L1 and PD-L2).
Other Name: TSR-042

Drug: Carboplatin-paclitaxel
Carboplatin in combination with paclitaxel is a chemotherapy treatment that has been shown to be efficacious against a variety of different tumor types.

Placebo Comparator: Placebo plus carboplatin-paclitaxel
Participants will be administered placebo Q3W as 30-minute infusion IV from Cycle 1 to Cycle 6 and placebo Q6W (Cycle 7 until progression of disease, toxicity, withdrawal of consent, Investigator's decision, or death, whichever occurs first); followed by carboplatin 5mg/mL/min and paclitaxel 175 mg/m^2 Q3W as 30-minute infusion IV from Cycle 1 to Cycle 6.
Drug: Placebo
Placebo will be available as IV dextrose solution with no active drug to mimic dostarlimab.

Drug: Carboplatin-paclitaxel
Carboplatin in combination with paclitaxel is a chemotherapy treatment that has been shown to be efficacious against a variety of different tumor types.




Primary Outcome Measures :
  1. Progression-Free Survival (PFS) - Investigator assessment [ Time Frame: Up to 6 years and 9 months ]
    PFS is defined as the time from the date of randomization to the earliest date of assessment of progression of disease (PD) or death by any cause in the absence of PD, whichever occurs first as per Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1 as determined by Investigator.


Secondary Outcome Measures :
  1. Progression free survival (PFS) - Blinded Independent Central Review (BICR) [ Time Frame: Up to 6 years and 9 months ]
    PFS is defined as the time from randomization to the earliest date of assessment of PD per RECIST v.1.1 based on BICR assessment or death by any cause in the absence of PD per RECIST v.1.1, whichever occurs first.

  2. Overall survival (OS) [ Time Frame: Up to 6 years and 9 months ]
    OS is defined as the time from randomization to the date of death by any cause.

  3. Objective response rate (ORR) [ Time Frame: Up to 6 years and 9 months ]
    ORR is defined as the proportion of participant with a best overall response (BOR) of CR or PR.

  4. Duration of response (DOR) [ Time Frame: Up to 6 years and 9 months ]
    DOR is defined as the time from first documentation of complete response (CR) or partial response (PR) until the time of first documentation of subsequent PD per RECIST v.1.1 based on Investigator assessment or death by any cause in the absence of PD per RECIST v.1.1, whichever occurs first.

  5. Disease control rate (DCR) [ Time Frame: Up to 6 years and 9 months ]
    DCR is defined as the proportion of participants who have achieved a BOR of CR, PR, or stable disease (SD) per RECIST v.1.1 based on Investigator assessment.

  6. Patient-reported outcomes (PROs) in the European Quality of Life scale, 5-Dimensions, 5-Levels (EQ-5D-5L) [ Time Frame: Up to 6 years and 9 months ]
    EQ-5D-5L is a validated questionnaire to assess the overall health-related quality of life in participants across diseases. EQ-5D-5L consists of a descriptive section of 5 questions, one related to each of: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Questions use a 5-point scale ("no problems", "slight problems", "moderate problems", "severe problems", "unable/extreme problems"). Scores are converted to an index value based on country-specific value sets, with a value of 0 representing "death" and 1 representing "perfect health"). The EQ-5D-5L also includes a visual-analogue scale of overall health on a 100-point scale (from "Worst imaginable health state" to "Best imaginable health state").

  7. Patient-reported outcomes (PROs) in the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30 [Core]) [ Time Frame: Up to 6 years and 9 months ]
    EORTC QLQ-C30 is validated questionnaire to assess overall health-related quality of life in participants with cancer and is composed of 30 questions including multi-item scales and single item measures. These include five functional scales (physical, role, emotional, cognitive and social), three symptom scales (fatigue, nausea/vomiting, and pain), a global health status/quality of life scale (GHS/QOL), and six single items (dyspnoea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). The QLQ-C30 employs a week recall period for all items and a 4-point scale for the functional and symptom scales/items with response categories "Not at all", "A little", "Quite a bit" and "Very much". The two items assessing GHS/QOL utilize a 7-point scale ranging from 1 ("Very Poor") to 7 ("Excellent"). Scores are averaged, and transformed to a 0-100 scale. A higher score on functional scales represents better function, and on symptom scales represents more severe symptoms.

  8. Patient-reported outcomes (PROs) in the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-EN24 [Endometrial Cancer Module]) [ Time Frame: Up to 6 years and 9 months ]
    EORTC QLQ-EN24 is a validated questionnaire to assess the overall health-related quality of life in participants with all stages of endometrial cancer, and consists of 24 questions including multi-item scales and single item measures. These include three functional scales (sexual interest, activity, and enjoyment), five symptom scales (lymphedema, urological symptoms, gastrointestinal symptoms, poor body image, and sexual/vaginal problems), and five single items (back/pelvis pain, tingling/numbness, muscular pain, hair loss, and taste change). Questions use a 4-point scale (from 1 'Not at All' to 4 'Very Much'). Scores are averaged, and transformed to a 0-100 scale; a higher score represents a more severe overall side effect of treatment.

  9. Number of participants with adverse events (AEs) and Serious adverse events (SAEs) [ Time Frame: Up to 6 years and 9 months ]
    An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of a study intervention, whether or not considered related to the study intervention. An SAE is any untoward medical occurrence that, at any dose: results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or any other situation according to medical or scientific judgment.

  10. Number of participants experiencing treatment-emergent adverse events (TEAEs) [ Time Frame: Up to 6 years and 9 months ]
    Any event that was not present prior to the initiation of study treatment or any event already present that worsens in either intensity or frequency following exposure to study treatment will be considered as TEAE.

  11. Change from Baseline in hematology parameter: Hemoglobin (Hb) (Grams per Liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical hematology parameters.

  12. Change from Baseline in Hematology Parameters: Basophils Count, Eosinophils Count, Lymphocytes Count, Monocytes Count, Neutrophils Count, white blood cell count (WBC), and Platelet Count (Giga cells per Liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical hematology parameters.

  13. Change from Baseline in hematology parameter: Mean corpuscle volume (MCV) (Femtoliters) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical hematology parameters.

  14. Change From Baseline in hematology parameter: activated partial thromboplastin time (aPTT) (Seconds) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical hematology parameters.

  15. Change FromBaseline in hematology parameter: International Normalized Ratio (INR) (Ratio) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical hematology parameters.

  16. Change from Baseline in Chemistry Parameters: Calcium, Glucose, Potassium, Sodium, Chloride, Blood urea nitrogen (Millimoles per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical chemistry parameters.

  17. Change from Baseline in Chemistry Parameters: Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP), Aspartate Aminotransferase (AST) (International units per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical chemistry parameters.

  18. Change from Baseline in Chemistry Parameters: Albumin, Total Protein (Grams per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical chemistry parameters.

  19. Change from Baseline in Chemistry Parameters: Creatinine, Total Bilirubin (Micromoles per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical chemistry parameters.

  20. Change From Baseline in Chemistry Parameters: Amylase, Lipase (Units per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical chemistry parameters.

  21. Change from Baseline in Chemistry parameter: Magnesium, Phosphate (Millimoles per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of clinical chemistry parameters.

  22. Change from Baseline in Urinalysis Parameter: Specific Gravity (Ratio) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Urine samples will be collected at indicated time points for the assessment of specific gravity. Urine specific gravity is a measure of the concentration of solutes in the urine and provides information on the kidney's ability to concentrate urine. The concentration of the excreted molecules determines the urine's specific gravity.

  23. Change from Baseline in Urinalysis parameter: Glucose (Millimoles per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Urine samples will be collected at indicated time points for the assessment of urinary glucose.

  24. Change from Baseline in Urinalysis parameter: Nitrite (Milligrams per deciliter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Urine samples will be collected at indicated time points for the assessment of urinary nitrite.

  25. Change from Baseline in Urinalysis parameter: Leukocyte esterase (White blood cells per high power field) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Urine samples will be collected at indicated time points for the assessment of urinary leukocyte esterase.

  26. Change from Baseline in Urinalysis parameter: Occult blood (10^9 cells per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Urine samples will be collected at indicated time points for the assessment of urinary occult blood.

  27. Change from Baseline in Urinalysis parameter: Protein (Grams per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Urine samples will be collected at indicated time points for the assessment of urinary protein.

  28. Change from Baseline in Urinalysis parameter: Bilirubin (Milligrams per deciliter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Urine samples will be collected at indicated time points for the assessment of urinary bilirubin.

  29. Change from Baseline in Urinalysis parameter: Ketones (Millimoles per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Urine samples will be collected at indicated time points for the assessment of urinary ketones.

  30. Change from Baseline in Thyroid Stimulating Harmone (TSH) (milliunits per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of thyroid parameter.

  31. Change from Baseline in Free T3 (Triiodothyronine) (picomoles per liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of thyroid parameter.

  32. Change from Baseline in Thyroxine (T4) (Picomole per Liter) [ Time Frame: Baseline (Day -1) and up to 6 years and 9 months ]
    Blood samples will be collected for the assessment of thyroid parameter.

  33. Number of participants with abnormal Vital Signs [ Time Frame: Up to 6 years and 9 months ]
    Number of participants with abnormal vital signs: systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate, temperature will be analyzed.

  34. Number of participants with abnormality in physical examinations [ Time Frame: Up to 6 years and 9 months ]
    A complete physical examination will include, assessments of the Skin, Cardiovascular, Respiratory, Gastrointestinal and Neurological systems. Brief physical examination will include, at a minimum, assessments of the skin, lungs, cardiovascular system, and abdomen.

  35. Number of participants with abnormal Electrocardiogram (ECG) [ Time Frame: Up to 6 years and 9 months ]
    Twelve lead ECG will be recorded in participants with supine or in a semi-recumbent position (about 30 degrees of elevation) and after approximately 2 minutes of rest.

  36. Number of participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Scores [ Time Frame: Up to 6 years and 9 months ]
    ECOG scores for the performance status are defined as follows: Score 0: Fully active, 1: restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, 2: ambulatory and capable of all self-care but unable to carry out any work activities, 3: capable of only limited self-care, 4: completely disabled, 5: dead.

  37. Number of participants Reporting the Intake of Concomitant Medication [ Time Frame: Up to 6 years and 9 months ]
    Any medication that the participant will take during the study other than the study treatments, including herbal and other nontraditional remedies, alternative anti-cancer treatment will be considered a concomitant medication.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Female participant is at least 18 years of age, able to understand the study procedures, and agrees to participate in the study by providing written informed consent.
  • Participant has histologically or cytologically proven endometrial cancer with recurrent or advanced disease.
  • Participant must provide adequate tumor tissue sample at Screening for microsatellite instability (MSI) status testing.
  • Participant must have primary Stage III or Stage IV disease or first recurrent endometrial cancer with a low potential for cure by radiation therapy or surgery alone or in combination and meet at least one of the following criteria; a) Participant has primary Stage IIIA to IIIC1 disease with presence of evaluable or measurable disease per RECIST v.1.1 based on Investigator's assessment. Lesions that are equivocal or can be representative of postoperational change should be biopsied and confirmed for the presence of tumor; b) Participant has primary Stage IIIC1 disease with carcinosarcoma, clear cell, serous, or mixed histology (containing >= 10% carcinosarcoma, clear cell, or serous histology) regardless of presence of evaluable or measurable disease on imaging; c) Participant has primary Stage IIIC2 or Stage IV disease; d) Participant has first recurrent disease and is chemotherapy naïve; e) Participant has received prior neo-adjuvant/adjuvant systemic chemotherapy and had a recurrence or PD >= 6 months after completing treatment (first recurrence only).
  • Participant has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Participant has adequate organ function as follows: a) Absolute neutrophil count >= 1,500 cells/micro Liters (mcL); b) Platelets >= 100,000 cells/mcL; c) Hemoglobin >= 9 grams per deciliter (g/dL) or >= 5.6 millimoles per Liter (mmol/L); d) Serum creatinine <= 1.5× upper limit of normal (ULN) or calculated creatinine clearance >= 50 milliliter per minute (mL/min) using the Cockcroft-Gault equation for participants with creatinine levels > 1.5× institutional ULN; e) Total bilirubin <= 1.5× ULN and direct bilirubin <= 1× ULN; f) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) <= 2.5× ULN unless liver metastases are present, in which case they must be <= 5× ULN; g) International normalized ratio or prothrombin time (PT) <=1.5× ULN and activated partial thromboplastin time <=1.5× ULN. Participants receiving anticoagulant therapy must have a PT or partial thromboplastin within the therapeutic range of intended use of anticoagulants.
  • Participant must have a negative serum pregnancy test within 72 hours of the first dose of study medication, unless they are of nonchildbearing potential. Nonchildbearing potential is defined as follows: a) Participant is >= 45 years of age and has not had menses for > 1 year; b) A follicle-stimulating hormone value in the postmenopausal range upon screening evaluation if amenorrheic for < 2 years without a hysterectomy and oophorectomy; c) Posthysterectomy, postbilateral oophorectomy, or posttubal ligation.
  • Participants of childbearing potential must agree to use 2 adequate methods of contraception with their partners starting with the screening visit through 180 days after the last dose of study treatment.

Exclusion Criteria:

  • Participant has received neo-adjuvant/adjuvant systemic chemotherapy for primary Stage III or IV disease and: a) has not had a recurrence or PD prior to entering the study OR b) has had a recurrence or PD within 6 months of completing chemotherapy treatment prior to entering the study.
  • Participant has had at least 1 recurrence of endometrial cancer.
  • Participant has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent.
  • Participant has received prior anticancer therapy (chemotherapy, targeted therapies, hormonal therapy, radiotherapy, or immunotherapy) within 21 days or < 5 times the half-life of the most recent therapy prior to Study Day 1, whichever is shorter.
  • Participant has a concomitant malignancy, or participant has a prior non-endometrial invasive malignancy who has been disease-free for < 3 years or who received any active treatment in the last 3 years for that malignancy. Non-melanoma skin cancer is allowed.
  • Participant has known uncontrolled central nervous system metastases, carcinomatosis meningitis, or both.
  • Participant has a known history of human immunodeficiency virus (HIV; HIV 1/2 antibodies).
  • Participant has known active hepatitis B (eg, hepatitis B surface antigen reactive) or hepatitis C (eg, hepatitis C virus ribonucleic acid [qualitative] is detected).
  • Participant has an active autoimmune disease that has required systemic treatment in the past 2 years. Replacement therapy is not considered a form of systemic therapy (eg, thyroid hormone or insulin).
  • Participant has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of systemic immunosuppressive therapy within 7 days prior to the first dose of study treatment.
  • Participant has not recovered (ie, to Grade <= 1 or to Baseline) from cytotoxic therapy induced AEs.
  • Participant has not recovered adequately from AEs or complications from any major surgery prior to starting therapy.
  • Participant has a known hypersensitivity to carboplatin, paclitaxel, or dostarlimab components or excipients.
  • Participant is currently participating and receiving study treatment or has participated in a study of an investigational agent and received study treatment or used an investigational device within 4 weeks of the first dose of treatment.
  • Participant is considered a poor medical risk due to a serious, uncontrolled medical disorder, nonmalignant systemic disease, or active infection requiring systemic therapy. Specific examples include, but are not limited to, active, noninfectious pneumonitis; uncontrolled ventricular arrhythmia; recent (within 90 days) myocardial infarction; uncontrolled major seizure disorder; unstable spinal cord compression; superior vena cava syndrome; or any psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study (including obtaining informed consent).
  • Participant is pregnant or breastfeeding or is expecting to conceive children within the projected duration of the study, starting with the screening visit through 180 days after the last dose of study treatment.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03981796


Contacts
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Contact: US GSK Clinical Trials Call Center 877-379-3718 GSKClinicalSupportHD@gsk.com
Contact: EU GSK Clinical Trials Call Center +44 (0) 20 89904466 GSKClinicalSupportHD@gsk.com

Locations
Show Show 135 study locations
Sponsors and Collaborators
Tesaro, Inc.
European Network of Gynaecological Oncological Trial Groups (ENGOT)
Gynecologic Oncology Group
Investigators
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Study Director: GSK Clinical Trials GlaxoSmithKline
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Responsible Party: Tesaro, Inc.
ClinicalTrials.gov Identifier: NCT03981796    
Other Study ID Numbers: 213361
ENGOT-EN6 ( Other Identifier: ENGOT )
GOG-3031 ( Other Identifier: GOG )
4010-03-001 ( Other Identifier: Tesaro )
First Posted: June 11, 2019    Key Record Dates
Last Update Posted: November 10, 2020
Last Verified: November 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Tesaro, Inc.:
Dostarlimab
Carboplatin
Paclitaxel
Endometrial cancer
TSR-042
Additional relevant MeSH terms:
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Endometrial Neoplasms
Uterine Neoplasms
Genital Neoplasms, Female
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Uterine Diseases
Paclitaxel
Carboplatin
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action