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AVE0005 (VEGF Trap) in Patients With Recurrent Symptomatic Malignant Ascites

A Multicenter, Open-label, Single-arm Study of the Efficacy and Safety of Intravenous AVE0005 (VEGF Trap) Administered Every 2 Weeks in Advanced Ovarian Cancer Patients With Recurrent Symptomatic Malignant Ascites

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00396591
Enrollment
16
Registered
2006-11-07
Start date
2006-10-31
Completion date
2008-11-30
Last updated
2013-01-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Ovarian Neoplasms

Keywords

Ovarian cancer, malignant ascites, angiogenesis, angiogenesis inhibition, VEGF-Trap fusion recombinant protein

Brief summary

The primary objective of this study was to compare the time between paracenteses before and after administration of Aflibercept (ziv-aflibercept, AVE0005, VEGF trap, ZALTRAP®) in ovarian cancer participants with symptomatic malignant ascites. The secondary objectives were to further assess efficacy and safety of Aflibercept treatment, and the exploratory objectives were to assess pharmacokinetics, immunogenicity and health-related quality of life.

Detailed description

The study consisted of: * A 30-day screening phase prior to Day 1 * Day 1 registration and pre-treatment paracentesis * Aflibercept administration within 1-day of registration * Two-week study treatment cycles (for efficacy data, the cut-off date was 6 months post-registration * A 60-day post-treatment follow-up phase During the study, participants were treated with Aflibercept study treatment through the duration of the study unless they met one the following criteria for discontinuation: * Participant (or legal representative) chose to withdraw from treatment * The investigator or sponsor thought that continuation of the study would be detrimental to the participants well-being * Participant had intercurrent illness that prevented further administration of investigational product (IP) * Participant had more than 2 IP dose reductions * Participant had unacceptable adverse events (AEs) * Participant had arterial thromboembolic events, including cerebrovascular accidents, myocardial infarctions, transient ischemic attacks, new onset angina, or worsening of preexisting angina * Participant required surgical intervention for intestinal obstruction or gastrointestinal perforation

Interventions

4.0 mg/kg administered intravenously (IV) once every 2 weeks

Sponsors

Regeneron Pharmaceuticals
CollaboratorINDUSTRY
Sanofi
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Participants that met the following criteria were eligible. Inclusion Criteria: * Symptomatic malignant ascites resulting from advanced ovarian epithelial cancer (including fallopian tube and primary peritoneal adenocarcinoma) that required at least 3 previous therapeutic paracenteses at a frequency of 1 to 4 paracenteses per month for management. * Platinum resistant disease defined by relapse or progression of disease during or after treatment, or drug intolerance. * Topotecan- and/or liposomal doxorubicin-resistant disease defined by relapse or progression of disease during or after treatment, or drug intolerance.

Exclusion criteria

* Peritoneovenous or other type of shunt that was placed for the management of ascites * Prior treatment with a VEGF or VEGF receptor inhibitor * Uncontrolled hypertension The above information is not intended to contain all considerations relevant to participation in a clinical trial.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With a Repeat Paracentesis Response (RPR)up to 2 years post-registrationRPR was defined as at least a two-fold increase in the time to repeat paracentesis (TRP) as compared to the average duration of the 2 intervals between the 3 most recent paracenteses prior to study registration (ie, the baseline interval of paracentesis). Percentage of participants with a repeat paracentesis response were the number of participants with RPR / number of total participants \* 100.

Secondary

MeasureTime frameDescription
60-day Frequency of Paracentesis (FOP)up to 60 days post-registrationFOP was the total number of paracenteses performed within the first 60 days postregistration. For participants who had withdrawn after registration but prior to the 60-day cutoff date, the withdrawal would have been regarded as a paracentesis event and the 60-day FOP normalized and calculated as the nearest integer of the value corresponding to 60 × number of paracenteses / x, where x represents the number of days on study.
Progression-free Survival (PFS) Timeup to 6 months post-registrationAccording to the Response Evaluation Criteria in Solid Tumors \[RECIST\], progression was at least a 20% increase in the sum of the longest diameter (LD) of tumors, compared to smallest sum LD recorded since treatment started, or the appearance of one or more new tumors. PFS time was interval from the date of registration to the date of tumor progression or death from any cause, whichever was earlier. Median PFS time was estimated from Kaplan-Meier Plots. If participants were alive and progression-free at 6 months postregistration, they were censored for PFS.
Time to Repeat Paracentesis (TRP)up to 6 months from registrationTRP is the number of days between the date of registration and the date of the first postregistration paracentesis. Median TRP was estimated from Kaplan-Meier curves. For participants who did not undergo a postregistration paracentesis while on study, TRP was censored at the end of the treatment period (last dose + 1 cycle), at the last visit known without repeat paracentesis, at 6 months postregistration, or at death, whichever was earlier.
Number of Participants With a Positive Anti-drug Antibody Responseup to 60 days after the last dose of treatmentAnti-drug antibodies in participant's serum were measured using 2 different methods * an Enzyme Linked Immunosorbent Assay (ELISA) in which the lower limit of detection (LLOD) was 238.4 ng/mL; and * an Electrochemiluminescence-based, Bridging Assay in which the validated LLOD was about 5.4 ng/mL in the absence of aflibercept and about 25.2 ng/mL in the presence of 20 μg/mL of aflibercept. Participants with detectable anti-drug antibodies by either method were considered to have a positive anti-drug antibody response.
Safety - Number of Participants With Adverse Events (AE)up to 60 days after last dose of treatment (approximately 2 years), or until TEAE was resolved or stabilizedAll AEs regardless of seriousness or relationship to study treatment, spanning from the first administration of study treatment until 60 days after the last administration of study treatment, were recorded, and followed until resolution or stabilization. The number of participants with all treatment emergent adverse events (TEAE), serious adverse events (SAE), TEAE leading to death, and TEAE leading to permanent treatment discontinuation are reported.
Overall Survival (OS) Timeup to 6 months post-registrationOS time was the time interval between the date of registration to the date of death from any cause. Median OS was estimated from Kaplan-Meier curves. Participants who died after efficacy data cutoff date (6 months postregistration) were censored at the data cutoff date.

Countries

Italy, Sweden, United States

Participant flow

Recruitment details

17 participants were screened for this study, of which 16 participants were enrolled.

Participants by arm

ArmCount
Aflibercept
Participants with advanced ovarian epithelial cancer treated with 4.0 mg/kg Aflibercept every 2 weeks until a criterion for treatment discontinuation was met
16
Total16

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event2
Overall StudyDisease Progression13
Overall StudyParticipant request1

Baseline characteristics

CharacteristicAflibercept
Age Continuous59.3 years
STANDARD_DEVIATION 8.9
Age, Customized
<65 years
11 participants
Age, Customized
>=65 years
5 participants
Baseline interval of paracentesis16.5 days
STANDARD_DEVIATION 7.8
Eastern Cooperative Oncology Group (ECOG) performance status score
ECOG Score = 0
3 participants
Eastern Cooperative Oncology Group (ECOG) performance status score
ECOG Score = 1
10 participants
Eastern Cooperative Oncology Group (ECOG) performance status score
ECOG Score = 2
3 participants
Histology
Clear cell (mesonephroid)
1 Participants
Histology
Endometrioid
3 Participants
Histology
Missing data
2 Participants
Histology
Other
1 Participants
Histology
Serous
9 Participants
Histology grade
Moderately differentiated
1 Participants
Histology grade
Poorly differentiated
10 Participants
Histology grade
Unknown
5 Participants
Primary tumor site - Ovaries16 Participants
Prior anticancer surgeries,
No
1 Participants
Prior anticancer surgeries,
Yes
15 Participants
Race/Ethnicity, Customized
Caucasian
16 Participants
Sex: Female, Male
Female
16 Participants
Sex: Female, Male
Male
0 Participants
Time since initial cancer diagnosis2.8 Years
STANDARD_DEVIATION 1.7

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
16 / 16
serious
Total, serious adverse events
15 / 16

Outcome results

Primary

Percentage of Participants With a Repeat Paracentesis Response (RPR)

RPR was defined as at least a two-fold increase in the time to repeat paracentesis (TRP) as compared to the average duration of the 2 intervals between the 3 most recent paracenteses prior to study registration (ie, the baseline interval of paracentesis). Percentage of participants with a repeat paracentesis response were the number of participants with RPR / number of total participants \* 100.

Time frame: up to 2 years post-registration

ArmMeasureValue (NUMBER)
AfliberceptPercentage of Participants With a Repeat Paracentesis Response (RPR)62.5 percentage of participants
Secondary

60-day Frequency of Paracentesis (FOP)

FOP was the total number of paracenteses performed within the first 60 days postregistration. For participants who had withdrawn after registration but prior to the 60-day cutoff date, the withdrawal would have been regarded as a paracentesis event and the 60-day FOP normalized and calculated as the nearest integer of the value corresponding to 60 × number of paracenteses / x, where x represents the number of days on study.

Time frame: up to 60 days post-registration

ArmMeasureValue (MEAN)Dispersion
Aflibercept60-day Frequency of Paracentesis (FOP)1.5 paracentesesStandard Deviation 1.6
Secondary

Number of Participants With a Positive Anti-drug Antibody Response

Anti-drug antibodies in participant's serum were measured using 2 different methods * an Enzyme Linked Immunosorbent Assay (ELISA) in which the lower limit of detection (LLOD) was 238.4 ng/mL; and * an Electrochemiluminescence-based, Bridging Assay in which the validated LLOD was about 5.4 ng/mL in the absence of aflibercept and about 25.2 ng/mL in the presence of 20 μg/mL of aflibercept. Participants with detectable anti-drug antibodies by either method were considered to have a positive anti-drug antibody response.

Time frame: up to 60 days after the last dose of treatment

Population: Participants who received at least part of 1 dose of aflibercept and had evaluable blood samples

ArmMeasureValue (NUMBER)
AfliberceptNumber of Participants With a Positive Anti-drug Antibody Response0 participants
Secondary

Overall Survival (OS) Time

OS time was the time interval between the date of registration to the date of death from any cause. Median OS was estimated from Kaplan-Meier curves. Participants who died after efficacy data cutoff date (6 months postregistration) were censored at the data cutoff date.

Time frame: up to 6 months post-registration

Population: All participants were analyzed. 5 participants who died after efficacy data cutoff date (6 months postregistration) were censored at the data cutoff date.

ArmMeasureValue (MEDIAN)
AfliberceptOverall Survival (OS) Time92.0 days
Secondary

Progression-free Survival (PFS) Time

According to the Response Evaluation Criteria in Solid Tumors \[RECIST\], progression was at least a 20% increase in the sum of the longest diameter (LD) of tumors, compared to smallest sum LD recorded since treatment started, or the appearance of one or more new tumors. PFS time was interval from the date of registration to the date of tumor progression or death from any cause, whichever was earlier. Median PFS time was estimated from Kaplan-Meier Plots. If participants were alive and progression-free at 6 months postregistration, they were censored for PFS.

Time frame: up to 6 months post-registration

Population: Participants with a PFS event (tumor progression or death) were analyzed.

ArmMeasureValue (MEDIAN)
AfliberceptProgression-free Survival (PFS) Time59.5 days
Secondary

Safety - Number of Participants With Adverse Events (AE)

All AEs regardless of seriousness or relationship to study treatment, spanning from the first administration of study treatment until 60 days after the last administration of study treatment, were recorded, and followed until resolution or stabilization. The number of participants with all treatment emergent adverse events (TEAE), serious adverse events (SAE), TEAE leading to death, and TEAE leading to permanent treatment discontinuation are reported.

Time frame: up to 60 days after last dose of treatment (approximately 2 years), or until TEAE was resolved or stabilized

Population: All participants who received at least part of 1 dose of the study treatment.

ArmMeasureGroupValue (NUMBER)
AfliberceptSafety - Number of Participants With Adverse Events (AE)With at least one TEAE16 participants
AfliberceptSafety - Number of Participants With Adverse Events (AE)With at least one serious TEAE15 participants
AfliberceptSafety - Number of Participants With Adverse Events (AE)With a TEAE leading to death8 participants
AfliberceptSafety - Number of Participants With Adverse Events (AE)With a TEAE resulting in discontinuation2 participants
Secondary

Time to Repeat Paracentesis (TRP)

TRP is the number of days between the date of registration and the date of the first postregistration paracentesis. Median TRP was estimated from Kaplan-Meier curves. For participants who did not undergo a postregistration paracentesis while on study, TRP was censored at the end of the treatment period (last dose + 1 cycle), at the last visit known without repeat paracentesis, at 6 months postregistration, or at death, whichever was earlier.

Time frame: up to 6 months from registration

Population: All participants were analyzed. 8 had one or more paracentesis events. Participants with no paracentesis events were censored at the end of the treatment period (last dose + 1 cycle).

ArmMeasureValue (MEDIAN)
AfliberceptTime to Repeat Paracentesis (TRP)76.0 days

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026