Ovarian Cancer
Conditions
Keywords
Serous,, Ovarian cancer,, PARP,, BRCA1,, BRCA2,, Poly(ADP ribose) polymerases,, Platinum sensitive,, Homologous Recombination Deficiency (HRD)
Brief summary
The primary purpose of this study to determine if AZD2281 is effective and well tolerated in maintaining the improvement in your cancer after previous platinum-based chemotherapy
Interventions
Tablets Oral BID
matching placebo bid
Sponsors
Study design
Eligibility
Inclusion criteria
* Female patients with histologically diagnosed serous ovarian cancer or recurrent serous ovarian cancer. * Patients must have completed at least 2 previous courses of platinum containing therapy; the patient must have been platinum sensitive to the penultimate chemo regimen. * For the last chemotherapy course prior to enrolment on the study, patients must have demonstrated an objective stable maintained response (partial or complete response) and this response needs to be maintained until completion of chemotherapy. * Patients must be treated on the study within 8 wks of completion of their final dose of the platinum containing regimen.
Exclusion criteria
* Previous treatment with PARP inhibitors including AZD2281 * Patients with low grade ovarian carcinoma. * Patients who have had drainage of their ascites during the final 2 cycles of their last chemotherapy regimen prior to enrolment on the study * Patients receiving any chemotherapy, radiotherapy (except for palliative reasons), within 2 weeks from the last dose prior to study entry (or a longer period depending on the defined characteristics of the agents used).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Progression Free Survival (PFS) (According to Response Evaluation Criteria in Solid Tumours [RECIST]) | Radiologic scans performed at baseline then every 12 weeks (+/- 1 week) for the first 60 weeks, then every 24 weeks (+/-1 week) thereafter, assessed maximum up to 14 months. | PFS was defined as the time from randomisation to the earlier date of radiological progression (per RECIST criteria) or death by any cause in the absence of objective progression. \[Full analysis set (FAS)\] |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Objective Response Rate (ORR) (According to RECIST) | Radiologic scans performed at baseline then every 12 weeks (+/- 1 week) for the first 60 weeks, then every 24 weeks (+/-1 week) thereafter, assessed maximum up to 14 months. | For each treatment group, the ORR was the number of Complete Response (CR) and Partial Response (PR) divided by the number of patients in the group in the FAS with measurable disease at baseline (displayed as a percentage below). Evaluable for response set |
| Disease Control Rate | Assessed at 24 weeks. Radiologic scans performed at baseline, week 12 (+/- 1 week) and week 24 (+/- 1 week). | Disease control rate was defined as the percentage of patients who have at least 1 confirmed visit response of CR or PR or have demonstrated SD or NED for at least 23 weeks (ie, 24 weeks +/- 1 week) prior to any evidence of progression. \[FAS\] |
| Duration of Response | Radiologic scans performed at baseline then every 12 weeks (+/- 1 week) for the first 60 weeks, then every 24 weeks (+/-1 week) thereafter, assessed maximum up to 14 months. | Duration of response = time from assessment prior to timepoint where PR or CR confirmed (i.e. initial assessment of PR/CR), until earliest date of objective progression or death. \[Responding patients only\]. There were insufficient responses to enable conclusions to be drawn. |
| Percentage Change From Baseline in Tumour Size at Week 24 | Radiologic scans performed at baseline then every 12 weeks (+/- 1week) for the first 60 weeks, then every 24 weeks (+/-1 week) thereafter, assessed maximum up to 14 months. | Percentage change from baseline to Week 24 in target tumour size. |
| Best Percentage Change in Cancer Antigen 125 (CA-125) Levels | CA-125 was measured at baseline then every 28 days on treatment, assessed maximum up to 14 months. | Best percentage change from baseline in CA-125 level |
| Best Objective Response | Radiologic scans performed at baseline then every 12 weeks (+/- 1week) for the first 60 weeks, then every 24 weeks (+/- 1 week) thereafter, assessed maximum up to 14 months. | Best overall response from radiologic assessments. \[FAS\] |
| RECIST and CA-125 Response Separately and Combined | Radiologic scans performed at baseline then every 12 weeks (+/- 1week) for the first 60 weeks, then every 24 weeks (+/- 1 week) thereafter and monthly for CA-125 measurements, assessed maximum up to 14 months. | RECIST and CA-125 response separately and combined \[Patients evaluable for either CA-125 response or RECIST response\] |
| Overall Survival (OS) | Follow up every 12 weeks post progression, assessed maximum up to 90 months. | OS = time from randomisation to date of death from any cause. Patients who had not died at time of analysis were censored at last date patient was known to be alive. |
| Improvement Rate for FACT-O Symptom Index (FOSI) | Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months. | The percentage of patients with an improvement in FOSI. Improvement was defined as a change from baseline of greater than or equal to +3. \[Evaluable for FOSI set\] |
| Improvement Rate for Trial Outcome Index (TOI) | Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months. | The percentage of patients with an improvement in TOI. Improvement was defined as a change from baseline of greater than or equal to +7. \[Evaluable for TOI set\] |
| Improvement Rate for Total Functional Analysis of Cancer Therapy - Ovarian (FACT-O) | Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months. | The percentage of patients with an improvement in total FACT-O. Improvement was defined as a change from baseline of greater than or equal to +9. \[Evaluable for FACT-O set\] |
| FACT-O Symptom Index (FOSI) Time to Worsening | Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months. | The time to worsening was compared between treatments for each of the TOI, FOSI and total FACT-O. \[Evaluable for FOSI set\] |
| Trial Outcome Index(TOI)Time to Worsening | Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months. | The time to worsening was compared between treatments for each of the TOI, FOSI and total FACT-O. \[Evaluable for TOI set\] |
| Functional Analysis of Cancer Therapy - Ovarian (FACT-O) Time to Worsening | Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months. | The time to worsening was compared between treatments for each of the TOI, FOSI and total FACT-O. \[Evaluable for FACT-O set\] |
| Time to Earlier of CA-125 or RECIST Progression | Radiologic scans performed at baseline then every 12 weeks (+/- 1 week) for the first 60 weeks, then every 24 weeks (+/- 1 week) thereafter and monthly for CA-125 measurements, assessed maximum up to 14 months. | Time from randomisation to the earlier date of radiological progression (per RECIST criteria) or CA-125 or death by any cause in the absence of objective progression. \[FAS\] |
Countries
Australia, Austria, Belgium, Canada, Czechia, Estonia, France, Germany, Israel, Netherlands, Poland, Romania, Russia, Spain, Ukraine, United Kingdom, United States
Participant flow
Recruitment details
The first patient was enrolled on 28 August 2008 and the last patient was enrolled on 9 February 2010. Patients were enrolled at 82 centres in 16 countries. Of the 326 patients enrolled, 265 were randomized
Pre-assignment details
It was planned that 250 women with advanced platinum sensitive serous ovarian cancer who had received 2 or more previous platinum-containing regimens and demonstrated an objective stable maintained response in the last platinum regimen prior to enrolment were to receive olaparib 400 mg bd or matching placebo in a 1:1 ratio. 265 randomised.
Participants by arm
| Arm | Count |
|---|---|
| Olaparib 400 mg bd AZD2281 olaparib (AZD2281) 400 mg oral capsules twice daily | 136 |
| Placebo bd olaparib matching placebo oral capsules twice daily | 129 |
| Total | 265 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Death | 98 | 112 |
| Overall Study | Lost to Follow-up | 2 | 3 |
| Overall Study | Protocol Violation | 1 | 0 |
| Overall Study | Voluntary Discontinuation of Patient | 7 | 3 |
Baseline characteristics
| Characteristic | Placebo bd | Total | Olaparib 400 mg bd |
|---|---|---|---|
| Age, Continuous | 58.5 years STANDARD_DEVIATION 9.89 | 58.7 years STANDARD_DEVIATION 10.43 | 58.9 years STANDARD_DEVIATION 10.95 |
| Objective response Complete response | 63 Participants | 120 Participants | 57 Participants |
| Objective response Partial response | 66 Participants | 145 Participants | 79 Participants |
| Sex: Female, Male Female | 129 Participants | 265 Participants | 136 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
| Time to progression >12 months | 75 participants | 158 participants | 83 participants |
| Time to progression >6 to 12 months | 54 participants | 107 participants | 53 participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 129 / 136 | 111 / 128 |
| serious Total, serious adverse events | 31 / 136 | 11 / 128 |
Outcome results
Progression Free Survival (PFS) (According to Response Evaluation Criteria in Solid Tumours [RECIST])
PFS was defined as the time from randomisation to the earlier date of radiological progression (per RECIST criteria) or death by any cause in the absence of objective progression. \[Full analysis set (FAS)\]
Time frame: Radiologic scans performed at baseline then every 12 weeks (+/- 1 week) for the first 60 weeks, then every 24 weeks (+/-1 week) thereafter, assessed maximum up to 14 months.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Olaparib 400 mg bd | Progression Free Survival (PFS) (According to Response Evaluation Criteria in Solid Tumours [RECIST]) | 8.4 Months |
| Placebo bd | Progression Free Survival (PFS) (According to Response Evaluation Criteria in Solid Tumours [RECIST]) | 4.8 Months |
Best Objective Response
Best overall response from radiologic assessments. \[FAS\]
Time frame: Radiologic scans performed at baseline then every 12 weeks (+/- 1week) for the first 60 weeks, then every 24 weeks (+/- 1 week) thereafter, assessed maximum up to 14 months.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Olaparib 400 mg bd | Best Objective Response | Complete Response | 0 Participants |
| Olaparib 400 mg bd | Best Objective Response | Partial Response | 7 Participants |
| Olaparib 400 mg bd | Best Objective Response | No evidence of disease | 49 Participants |
| Olaparib 400 mg bd | Best Objective Response | Stable Disease >= 11 weeks | 46 Participants |
| Olaparib 400 mg bd | Best Objective Response | Disease Progression | 24 Participants |
| Olaparib 400 mg bd | Best Objective Response | Not Evaluable | 10 Participants |
| Placebo bd | Best Objective Response | Disease Progression | 55 Participants |
| Placebo bd | Best Objective Response | Complete Response | 0 Participants |
| Placebo bd | Best Objective Response | Stable Disease >= 11 weeks | 25 Participants |
| Placebo bd | Best Objective Response | Partial Response | 2 Participants |
| Placebo bd | Best Objective Response | Not Evaluable | 5 Participants |
| Placebo bd | Best Objective Response | No evidence of disease | 42 Participants |
Best Percentage Change in Cancer Antigen 125 (CA-125) Levels
Best percentage change from baseline in CA-125 level
Time frame: CA-125 was measured at baseline then every 28 days on treatment, assessed maximum up to 14 months.
Population: A subset of the FAS with baseline and at least 1 follow-up value of CA-125
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Olaparib 400 mg bd | Best Percentage Change in Cancer Antigen 125 (CA-125) Levels | -16.67 percentage of change |
| Placebo bd | Best Percentage Change in Cancer Antigen 125 (CA-125) Levels | 0.00 percentage of change |
Disease Control Rate
Disease control rate was defined as the percentage of patients who have at least 1 confirmed visit response of CR or PR or have demonstrated SD or NED for at least 23 weeks (ie, 24 weeks +/- 1 week) prior to any evidence of progression. \[FAS\]
Time frame: Assessed at 24 weeks. Radiologic scans performed at baseline, week 12 (+/- 1 week) and week 24 (+/- 1 week).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Olaparib 400 mg bd | Disease Control Rate | 53.7 percentage of participants |
| Placebo bd | Disease Control Rate | 25.6 percentage of participants |
Duration of Response
Duration of response = time from assessment prior to timepoint where PR or CR confirmed (i.e. initial assessment of PR/CR), until earliest date of objective progression or death. \[Responding patients only\]. There were insufficient responses to enable conclusions to be drawn.
Time frame: Radiologic scans performed at baseline then every 12 weeks (+/- 1 week) for the first 60 weeks, then every 24 weeks (+/-1 week) thereafter, assessed maximum up to 14 months.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Olaparib 400 mg bd | Duration of Response | 4.2 Months |
| Placebo bd | Duration of Response | 2.3 Months |
FACT-O Symptom Index (FOSI) Time to Worsening
The time to worsening was compared between treatments for each of the TOI, FOSI and total FACT-O. \[Evaluable for FOSI set\]
Time frame: Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Olaparib 400 mg bd | FACT-O Symptom Index (FOSI) Time to Worsening | 2.8 Months |
| Placebo bd | FACT-O Symptom Index (FOSI) Time to Worsening | 3.7 Months |
Functional Analysis of Cancer Therapy - Ovarian (FACT-O) Time to Worsening
The time to worsening was compared between treatments for each of the TOI, FOSI and total FACT-O. \[Evaluable for FACT-O set\]
Time frame: Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Olaparib 400 mg bd | Functional Analysis of Cancer Therapy - Ovarian (FACT-O) Time to Worsening | 2.8 Months |
| Placebo bd | Functional Analysis of Cancer Therapy - Ovarian (FACT-O) Time to Worsening | 4.6 Months |
Improvement Rate for FACT-O Symptom Index (FOSI)
The percentage of patients with an improvement in FOSI. Improvement was defined as a change from baseline of greater than or equal to +3. \[Evaluable for FOSI set\]
Time frame: Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months.
Population: Evaluable for FOSI set - A subset of the full analysis set which includes patients who have evaluable QoL/Symptom Endpoints at baseline
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Olaparib 400 mg bd | Improvement Rate for FACT-O Symptom Index (FOSI) | 17.1 percentage of evaluable participants |
| Placebo bd | Improvement Rate for FACT-O Symptom Index (FOSI) | 14.8 percentage of evaluable participants |
Improvement Rate for Total Functional Analysis of Cancer Therapy - Ovarian (FACT-O)
The percentage of patients with an improvement in total FACT-O. Improvement was defined as a change from baseline of greater than or equal to +9. \[Evaluable for FACT-O set\]
Time frame: Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months.
Population: Evaluable for Total Fact-O set - A subset of the full analysis set which includes patients who have evaluable QoL/Symptom Endpoints at baseline
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Olaparib 400 mg bd | Improvement Rate for Total Functional Analysis of Cancer Therapy - Ovarian (FACT-O) | 21.1 percentage of evaluable participants |
| Placebo bd | Improvement Rate for Total Functional Analysis of Cancer Therapy - Ovarian (FACT-O) | 18.9 percentage of evaluable participants |
Improvement Rate for Trial Outcome Index (TOI)
The percentage of patients with an improvement in TOI. Improvement was defined as a change from baseline of greater than or equal to +7. \[Evaluable for TOI set\]
Time frame: Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months.
Population: Evaluable for TOI - a subset of the full analysis set which includes patients who have evaluable QoL/Symptom Endpoints at baseline
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Olaparib 400 mg bd | Improvement Rate for Trial Outcome Index (TOI) | 20.0 percentage of evaluable participants |
| Placebo bd | Improvement Rate for Trial Outcome Index (TOI) | 18.0 percentage of evaluable participants |
Objective Response Rate (ORR) (According to RECIST)
For each treatment group, the ORR was the number of Complete Response (CR) and Partial Response (PR) divided by the number of patients in the group in the FAS with measurable disease at baseline (displayed as a percentage below). Evaluable for response set
Time frame: Radiologic scans performed at baseline then every 12 weeks (+/- 1 week) for the first 60 weeks, then every 24 weeks (+/-1 week) thereafter, assessed maximum up to 14 months.
Population: Evaluable for response set - A subset of the full analysis set which includes patients with measurable disease at baseline
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Olaparib 400 mg bd | Objective Response Rate (ORR) (According to RECIST) | 12.3 percentage of participants |
| Placebo bd | Objective Response Rate (ORR) (According to RECIST) | 4.2 percentage of participants |
Overall Survival (OS)
OS = time from randomisation to date of death from any cause. Patients who had not died at time of analysis were censored at last date patient was known to be alive.
Time frame: Follow up every 12 weeks post progression, assessed maximum up to 90 months.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Olaparib 400 mg bd | Overall Survival (OS) | 29.8 Months |
| Placebo bd | Overall Survival (OS) | 27.8 Months |
Percentage Change From Baseline in Tumour Size at Week 24
Percentage change from baseline to Week 24 in target tumour size.
Time frame: Radiologic scans performed at baseline then every 12 weeks (+/- 1week) for the first 60 weeks, then every 24 weeks (+/-1 week) thereafter, assessed maximum up to 14 months.
Population: Evaluable for response set - A subset of the full analysis set which includes patients with measurable disease at baseline.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Olaparib 400 mg bd | Percentage Change From Baseline in Tumour Size at Week 24 | -0.8 Percent change in tumour size |
| Placebo bd | Percentage Change From Baseline in Tumour Size at Week 24 | 26.4 Percent change in tumour size |
RECIST and CA-125 Response Separately and Combined
RECIST and CA-125 response separately and combined \[Patients evaluable for either CA-125 response or RECIST response\]
Time frame: Radiologic scans performed at baseline then every 12 weeks (+/- 1week) for the first 60 weeks, then every 24 weeks (+/- 1 week) thereafter and monthly for CA-125 measurements, assessed maximum up to 14 months.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Olaparib 400 mg bd | RECIST and CA-125 Response Separately and Combined | Confirmed RECIST Response | 7 Participants |
| Olaparib 400 mg bd | RECIST and CA-125 Response Separately and Combined | CA-125 Response | 1 Participants |
| Olaparib 400 mg bd | RECIST and CA-125 Response Separately and Combined | Unconfirmed RECIST response | 9 Participants |
| Olaparib 400 mg bd | RECIST and CA-125 Response Separately and Combined | Confirmed RECIST or CA-125 Response | 8 Participants |
| Olaparib 400 mg bd | RECIST and CA-125 Response Separately and Combined | RECIST Response | 16 Participants |
| Placebo bd | RECIST and CA-125 Response Separately and Combined | Confirmed RECIST or CA-125 Response | 3 Participants |
| Placebo bd | RECIST and CA-125 Response Separately and Combined | RECIST Response | 2 Participants |
| Placebo bd | RECIST and CA-125 Response Separately and Combined | Confirmed RECIST Response | 2 Participants |
| Placebo bd | RECIST and CA-125 Response Separately and Combined | Unconfirmed RECIST response | 0 Participants |
| Placebo bd | RECIST and CA-125 Response Separately and Combined | CA-125 Response | 1 Participants |
Time to Earlier of CA-125 or RECIST Progression
Time from randomisation to the earlier date of radiological progression (per RECIST criteria) or CA-125 or death by any cause in the absence of objective progression. \[FAS\]
Time frame: Radiologic scans performed at baseline then every 12 weeks (+/- 1 week) for the first 60 weeks, then every 24 weeks (+/- 1 week) thereafter and monthly for CA-125 measurements, assessed maximum up to 14 months.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Olaparib 400 mg bd | Time to Earlier of CA-125 or RECIST Progression | 8.3 Months |
| Placebo bd | Time to Earlier of CA-125 or RECIST Progression | 3.7 Months |
Trial Outcome Index(TOI)Time to Worsening
The time to worsening was compared between treatments for each of the TOI, FOSI and total FACT-O. \[Evaluable for TOI set\]
Time frame: Patient reported outcome questionnaire completed at baseline then every 28 days up to disease progression, assessed maximum up to 14 months.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Olaparib 400 mg bd | Trial Outcome Index(TOI)Time to Worsening | 3.8 Months |
| Placebo bd | Trial Outcome Index(TOI)Time to Worsening | 4.6 Months |