Epithelial Ovarian Cancer, Fallopian Tube Cancer, Ovarian Cancer, Peritoneal Cancer
Conditions
Keywords
ovarian cancer, fallopian tube cancer, primary peritoneal cancer, peritoneal cancer, platinum sensitive, relapsed disease, PARP Inhibitor, rucaparib, homologous recombination, homologous recombination deficiency, genomic scarring, loss of heterozygosity, CO-338, PF 01367338, AG 14699, platinum sensitive ovarian cancer, platinum sensitive fallopian tube cancer, platinum sensitive primary peritoneal cancer, platinum sensitive peritoneal cancer, gynecological cancer, Clovis, Clovis Oncology, ARIEL2, ARIEL 2, ARIEL3, ARIEL 3
Brief summary
The purpose of this study is to determine which patients with ovarian, fallopian tube, and primary peritoneal cancer will best respond to treatment with rucaparib.
Detailed description
Rucaparib is an orally available, small molecule inhibitor of poly-adenosine diphosphate \[ADP\] ribose polymerase (PARP) being developed for treatment of ovarian cancer associated with homologous recombination (HR) DNA repair deficiency (HRD). The safety and efficacy of rucaparib has been evaluated in several Phase 1 and Phase 2 studies. An oral formulation is the focus of current development efforts. Rucaparib is currently being investigated as monotherapy in patients with cancer associated with breast cancer susceptibility gene 1 (BRCA1) or BRCA2 mutations. Clinical data with PARP inhibitors indicate there is an ovarian cancer patient population beyond just those with germline BRCA (gBRCA) mutations that may benefit from treatment with a PARP inhibitor. This study will define a molecular signature of HRD in ovarian cancer that correlates with response to rucaparib and enables selection of appropriate ovarian cancer patients for treatment with rucaparib. The HRD signature will be based on an association between the extent of genomic scarring (a downstream consequence of HRD) in a patient's tumor and observed clinical benefit from rucaparib treatment. Genomic scarring can be assessed by quantifying the extent of loss of heterozygosity across the tumor genome (tumor genomic LOH). One of the main advantages of detecting tumor genomic LOH is that it can identify HRD tumors regardless of the underlying mechanisms, which include both known (i.e., BRCA mutations) and unknown genetic and other mechanisms. Once determined, this signature will be prospectively applied to ARIEL2 PART 2 and ARIEL3. This Phase 2 study (ARIEL2) will also compare archival versus recently collected tumor tissue in order to validate the use of archival tumor tissue for assessment of HRD status in ARIEL3. This study will include 2 parts: PART 1 (completed enrollment): Evaluation of HRD status and rucaparib efficacy in patients who received ≥1 prior platinum-based regimen and had platinum-sensitive disease PART 2 (completed enrollment): Evaluation of HRD status and rucaparib efficacy in patients who received at least 3 prior chemotherapy regimens
Interventions
600 mg BID
Sponsors
Study design
Eligibility
Inclusion criteria
The following eligibility criteria pertain to patients enrolling into PART 2 of the study: Inclusion: * Have a histologically confirmed diagnosis of high grade serous or Grade 2 or Grade 3 endometrioid epithelial ovarian, fallopian tube, or primary peritoneal cancer * Received at least 3 prior chemotherapy regimens. Non-chemotherapy regimens and maintenance therapies administered as single agent treatment will not count as a chemotherapy regimen * Relapsed/progressive disease as confirmed by CT scan * Have biopsiable and measurable disease. Note: biopsy is optional for patients known to harbor a deleterious gBRCA mutation * Have sufficient archival formalin-fixed paraffin-embedded (FFPE) tumor tissue available for planned analyses Exclusion: * History of prior cancers except for those that have been curatively treated, with no evidence of cancer currently (provided all chemotherapy was completed \>6 months prior and/or bone marrow transplant \>2 years prior to first dose of rucaparib). * Prior treatment with any PARP inhibitor * Symptomatic and/or untreated central nervous system metastases * Pre-existing duodenal stent and/or any other gastrointestinal disorder or defect that would, in the opinion of the Investigator, interfere with absorption of rucaparib * Hospitalization for bowel obstruction within 3 months prior to enrollment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD (Homologous Recombination Deficiency) Subgroups (Part 1 of Study) | Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years. | The primary efficacy endpoint of PFS is calculated as 1+ the number of days from the first dose of study drug to disease progression by RECIST (Response Evaluation Criteria in Solid Tumors), as determined by the investigator or death due to any cause, whichever occurs first. Progression is defined using RECIST v1.1, as at least a 20% increase in the sum of the longest diameter of target lesions, or a measureable increase in a non-target lesion, or the appearance of new lesions. |
| Objective Response Rate (ORR) by RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study) | Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years. | The confirmed response rate by RECIST v1.1 is defined as the percentage of patients with a confirmed complete response (CR) or partial response (PR) on subsequent tumor assessment at least 28 days after first response documentation. Complete response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial response (PR) is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Response Per RECIST v1.1 | Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years. | Duration of response (DOR) for any confirmed RECIST CR or PR measured from the date of the first occurrence of a response until the first occurrence of progressive disease (PD) per RECIST. For patients who continued treatment post-progression, the first date of progression was used for the analysis. Any patients with an ongoing response were censored at the date of the last post-baseline scan. Complete response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial response (PR) is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. |
| Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study) | Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years. | Progression-Free Survival (PFS) is calculated as 1+ the number of days from the first dose of study drug to disease progression by RECIST, as determined by the investigator or death due to any cause, whichever occurs first. Progression is defined using RECIST v1.1, as at least a 20% increase in the sum of the longest diameter of target lesions, or a measureable increase in a non-target lesion, or the appearance of new lesions. |
| Objective Response Rate (ORR) by RECIST v1.1 (Part 1 of Study) | Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years. | The confirmed response rate by RECIST v1.1 is defined as the percentage of patients with a confirmed CR or PR on subsequent tumor assessment at least 28 days after first response documentation. Complete response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial response (PR) is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. |
| Steady State Trough (Cmin) Level Rucaparib Concentrations | Cycle 1 Day 15 to Cycle 4 Day 1, or approximately 10 weeks | Per protocol, the secondary PK endpoint, trough (Cmin) concentrations of rucaparib were summarized with descriptive statistics overall and by cycle in all patients with at least one PK sample collected. Blood samples for trough level PK analysis of rucaparib were drawn at the following timepoints only: on Day 15 of Cycle 1 and on Day 1 of Cycles 2, 3, and 4. Data for other timepoints is not available. |
| Overall Survival (Part 2 of Study) | All patients in Part 2 were followed for survival, subsequent therapy, and secondary malignancy every 12 weeks until death, loss to follow-up, withdrawal of consent from study or study closure, whichever happened first, up to 7 years. | Overall survival (OS) is defined as the number of days from the date of first dose of study drug to the date of death (due to any cause). Patients without a known date of death will be censored on the date the patient was last known to be alive. |
| Objective Response Rate (ORR) by RECIST v1.1 and GCIG CA-125 Criteria | Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years. | The endpoint of ORR defined as the percentage of patients with a best response of CR or PR using RECIST v 1.1 or a response per Gynecologic Cancer InterGroup cancer antigen 125 (GCIG CA-125) criteria. Complete response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial response (PR) is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. A response to CA-125 has occurred if there is at least a 50% decrease from baseline: 1. in a sample collected after initiation of study treatment AND 2. that is confirmed in a subsequent sample collected ≥21 days after the prior sample. The absolute value of this confirmatory sample must be ≤110% of the prior sample. The date when the first sample with a 50% decrease from baseline is observed is the date of the CA-125 response. |
Countries
Australia, Canada, France, Spain, United Kingdom, United States
Participant flow
Recruitment details
491 subjects were recruited from 64 sites across 6 countries.
Participants by arm
| Arm | Count |
|---|---|
| tBRCA Patients with a deleterious BRCA mutation detected in their tumor. | 124 |
| Non-tBRCA LOH+ Patients without a BRCA mutation in their tumor, but have high LOH. | 155 |
| Non-tBRCA LOH- Patients without a BRCA mutation in their tumor, but have low LOH. | 177 |
| Non-tBRCA LOH Unknown Patients without a BRCA mutation in their tumor, and have unknown LOH due to missing results and/or failed test result(s). | 35 |
| Total | 491 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 | FG005 | FG006 | FG007 |
|---|---|---|---|---|---|---|---|---|---|
| Overall Study | Ongoing | 6 | 2 | 0 | 1 | 4 | 1 | 0 | 0 |
Baseline characteristics
| Characteristic | Non-tBRCA LOH- | tBRCA | Total | Non-tBRCA LOH Unknown | Non-tBRCA LOH+ |
|---|---|---|---|---|---|
| Age, Continuous Part 1 | 65 years | 58.5 years | 64.5 years | 69.5 years | 65 years |
| Age, Continuous Part 2 | 64 years | 60.5 years | 63 years | 62 years | 61 years |
| Number of Prior Chemotherapy Regimens Part 1 0 | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Number of Prior Chemotherapy Regimens Part 1 1 | 47 Participants | 17 Participants | 119 Participants | 10 Participants | 45 Participants |
| Number of Prior Chemotherapy Regimens Part 1 2 | 16 Participants | 14 Participants | 52 Participants | 1 Participants | 21 Participants |
| Number of Prior Chemotherapy Regimens Part 1 3 | 6 Participants | 4 Participants | 24 Participants | 1 Participants | 13 Participants |
| Number of Prior Chemotherapy Regimens Part 1 4 | 0 Participants | 4 Participants | 5 Participants | 0 Participants | 1 Participants |
| Number of Prior Chemotherapy Regimens Part 1 5 | 1 Participants | 1 Participants | 3 Participants | 0 Participants | 1 Participants |
| Number of Prior Chemotherapy Regimens Part 1 >5 | 0 Participants | 0 Participants | 1 Participants | 0 Participants | 1 Participants |
| Number of Prior Chemotherapy Regimens Part 2 0 | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Number of Prior Chemotherapy Regimens Part 2 1 | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Number of Prior Chemotherapy Regimens Part 2 2 | 1 Participants | 0 Participants | 2 Participants | 0 Participants | 1 Participants |
| Number of Prior Chemotherapy Regimens Part 2 3 | 73 Participants | 52 Participants | 186 Participants | 17 Participants | 44 Participants |
| Number of Prior Chemotherapy Regimens Part 2 4 | 31 Participants | 32 Participants | 97 Participants | 6 Participants | 28 Participants |
| Number of Prior Chemotherapy Regimens Part 2 5 | 2 Participants | 0 Participants | 2 Participants | 0 Participants | 0 Participants |
| Number of Prior Chemotherapy Regimens Part 2 >5 | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Number of Prior Platinum Regimens Part 1 0 | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Number of Prior Platinum Regimens Part 1 1 | 47 Participants | 17 Participants | 119 Participants | 10 Participants | 45 Participants |
| Number of Prior Platinum Regimens Part 1 2 | 16 Participants | 15 Participants | 57 Participants | 1 Participants | 25 Participants |
| Number of Prior Platinum Regimens Part 1 3 | 6 Participants | 6 Participants | 23 Participants | 1 Participants | 10 Participants |
| Number of Prior Platinum Regimens Part 1 >3 | 1 Participants | 2 Participants | 5 Participants | 0 Participants | 2 Participants |
| Number of Prior Platinum Regimens Part 2 0 | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Number of Prior Platinum Regimens Part 2 1 | 7 Participants | 2 Participants | 16 Participants | 3 Participants | 4 Participants |
| Number of Prior Platinum Regimens Part 2 2 | 55 Participants | 34 Participants | 127 Participants | 7 Participants | 31 Participants |
| Number of Prior Platinum Regimens Part 2 3 | 44 Participants | 40 Participants | 132 Participants | 12 Participants | 36 Participants |
| Number of Prior Platinum Regimens Part 2 >3 | 1 Participants | 8 Participants | 12 Participants | 1 Participants | 2 Participants |
| Platinum Sensitivity Status Part 1 Refractory | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Platinum Sensitivity Status Part 1 Resistant | 0 Participants | 0 Participants | 2 Participants | 1 Participants | 1 Participants |
| Platinum Sensitivity Status Part 1 Sensitive | 70 Participants | 40 Participants | 202 Participants | 11 Participants | 81 Participants |
| Platinum Sensitivity Status Part 2 Refractory | 18 Participants | 12 Participants | 48 Participants | 4 Participants | 14 Participants |
| Platinum Sensitivity Status Part 2 Resistant | 56 Participants | 41 Participants | 158 Participants | 15 Participants | 46 Participants |
| Platinum Sensitivity Status Part 2 Sensitive | 33 Participants | 31 Participants | 81 Participants | 4 Participants | 13 Participants |
| Race (NIH/OMB) Part 1 American Indian or Alaska Native | 0 Participants | 1 Participants | 1 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Part 1 Asian | 5 Participants | 3 Participants | 13 Participants | 1 Participants | 4 Participants |
| Race (NIH/OMB) Part 1 Black or African American | 1 Participants | 1 Participants | 5 Participants | 1 Participants | 2 Participants |
| Race (NIH/OMB) Part 1 More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Part 1 Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Part 1 Unknown or Not Reported | 8 Participants | 2 Participants | 19 Participants | 0 Participants | 9 Participants |
| Race (NIH/OMB) Part 1 White | 56 Participants | 33 Participants | 166 Participants | 10 Participants | 67 Participants |
| Race (NIH/OMB) Part 2 American Indian or Alaska Native | 0 Participants | 1 Participants | 1 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Part 2 Asian | 5 Participants | 5 Participants | 14 Participants | 0 Participants | 4 Participants |
| Race (NIH/OMB) Part 2 Black or African American | 0 Participants | 0 Participants | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Part 2 More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Part 2 Native Hawaiian or Other Pacific Islander | 1 Participants | 0 Participants | 1 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Part 2 Unknown or Not Reported | 19 Participants | 19 Participants | 65 Participants | 5 Participants | 22 Participants |
| Race (NIH/OMB) Part 2 White | 82 Participants | 59 Participants | 205 Participants | 18 Participants | 46 Participants |
| Sex: Female, Male Part 1 Female | 70 Participants | 40 Participants | 204 Participants | 12 Participants | 82 Participants |
| Sex: Female, Male Part 1 Male | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Part 2 Female | 107 Participants | 84 Participants | 287 Participants | 23 Participants | 73 Participants |
| Sex: Female, Male Part 2 Male | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 2 / 204 | 18 / 287 |
| other Total, other adverse events | 203 / 204 | 285 / 287 |
| serious Total, serious adverse events | 54 / 204 | 92 / 287 |
Outcome results
Objective Response Rate (ORR) by RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study)
The confirmed response rate by RECIST v1.1 is defined as the percentage of patients with a confirmed complete response (CR) or partial response (PR) on subsequent tumor assessment at least 28 days after first response documentation. Complete response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial response (PR) is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter.
Time frame: Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years.
Population: Safety population by HRD subgroups: Consist of all Part 2 patients who received at least one dose of rucaparib.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: tBRCA | Objective Response Rate (ORR) by RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study) | 31.0 percentage of participants |
| Part 1: Non-tBRCA LOH+ | Objective Response Rate (ORR) by RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study) | 6.8 percentage of participants |
| Part 1: Non-tBRCA LOH- | Objective Response Rate (ORR) by RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study) | 5.6 percentage of participants |
| Part 1: Non-tBRCA LOH Unknown | Objective Response Rate (ORR) by RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study) | 13.0 percentage of participants |
Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD (Homologous Recombination Deficiency) Subgroups (Part 1 of Study)
The primary efficacy endpoint of PFS is calculated as 1+ the number of days from the first dose of study drug to disease progression by RECIST (Response Evaluation Criteria in Solid Tumors), as determined by the investigator or death due to any cause, whichever occurs first. Progression is defined using RECIST v1.1, as at least a 20% increase in the sum of the longest diameter of target lesions, or a measureable increase in a non-target lesion, or the appearance of new lesions.
Time frame: Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years.
Population: Safety population by HRD subgroups: Consists of all Part 1 patients who received at least one dose of rucaparib.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part 1: tBRCA | Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD (Homologous Recombination Deficiency) Subgroups (Part 1 of Study) | 388 Days |
| Part 1: Non-tBRCA LOH+ | Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD (Homologous Recombination Deficiency) Subgroups (Part 1 of Study) | 174 Days |
| Part 1: Non-tBRCA LOH- | Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD (Homologous Recombination Deficiency) Subgroups (Part 1 of Study) | 160 Days |
| Part 1: Non-tBRCA LOH Unknown | Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD (Homologous Recombination Deficiency) Subgroups (Part 1 of Study) | 223 Days |
Duration of Response Per RECIST v1.1
Duration of response (DOR) for any confirmed RECIST CR or PR measured from the date of the first occurrence of a response until the first occurrence of progressive disease (PD) per RECIST. For patients who continued treatment post-progression, the first date of progression was used for the analysis. Any patients with an ongoing response were censored at the date of the last post-baseline scan. Complete response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial response (PR) is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter.
Time frame: Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years.
Population: Efficacy population by HRD subgroups. The overall number of patients analyzed includes only patients with confirmed RECIST CR or PR.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part 1: tBRCA | Duration of Response Per RECIST v1.1 | 281 Days |
| Part 1: Non-tBRCA LOH+ | Duration of Response Per RECIST v1.1 | 329 Days |
| Part 1: Non-tBRCA LOH- | Duration of Response Per RECIST v1.1 | 169 Days |
| Part 1: Non-tBRCA LOH Unknown | Duration of Response Per RECIST v1.1 | 225 Days |
| Part 2: tBRCA | Duration of Response Per RECIST v1.1 | 176 Days |
| Part 2: Non-tBRCA LOH+ | Duration of Response Per RECIST v1.1 | 282 Days |
| Part 2: Non-tBRCA LOH- | Duration of Response Per RECIST v1.1 | 314 Days |
| Part 2: Non-tBRCA LOH Unknown | Duration of Response Per RECIST v1.1 | 181 Days |
Objective Response Rate (ORR) by RECIST v1.1 and GCIG CA-125 Criteria
The endpoint of ORR defined as the percentage of patients with a best response of CR or PR using RECIST v 1.1 or a response per Gynecologic Cancer InterGroup cancer antigen 125 (GCIG CA-125) criteria. Complete response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial response (PR) is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. A response to CA-125 has occurred if there is at least a 50% decrease from baseline: 1. in a sample collected after initiation of study treatment AND 2. that is confirmed in a subsequent sample collected ≥21 days after the prior sample. The absolute value of this confirmatory sample must be ≤110% of the prior sample. The date when the first sample with a 50% decrease from baseline is observed is the date of the CA-125 response.
Time frame: Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years.
Population: Safety population by HRD subgroups: Consist of all Part 1 and Part 2 patients who received at least one dose of rucaparib.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: tBRCA | Objective Response Rate (ORR) by RECIST v1.1 and GCIG CA-125 Criteria | 87.5 percentage of patients |
| Part 1: Non-tBRCA LOH+ | Objective Response Rate (ORR) by RECIST v1.1 and GCIG CA-125 Criteria | 46.3 percentage of patients |
| Part 1: Non-tBRCA LOH- | Objective Response Rate (ORR) by RECIST v1.1 and GCIG CA-125 Criteria | 21.4 percentage of patients |
| Part 1: Non-tBRCA LOH Unknown | Objective Response Rate (ORR) by RECIST v1.1 and GCIG CA-125 Criteria | 50.0 percentage of patients |
| Part 2: tBRCA | Objective Response Rate (ORR) by RECIST v1.1 and GCIG CA-125 Criteria | 54.8 percentage of patients |
| Part 2: Non-tBRCA LOH+ | Objective Response Rate (ORR) by RECIST v1.1 and GCIG CA-125 Criteria | 12.3 percentage of patients |
| Part 2: Non-tBRCA LOH- | Objective Response Rate (ORR) by RECIST v1.1 and GCIG CA-125 Criteria | 13.1 percentage of patients |
| Part 2: Non-tBRCA LOH Unknown | Objective Response Rate (ORR) by RECIST v1.1 and GCIG CA-125 Criteria | 30.4 percentage of patients |
Objective Response Rate (ORR) by RECIST v1.1 (Part 1 of Study)
The confirmed response rate by RECIST v1.1 is defined as the percentage of patients with a confirmed CR or PR on subsequent tumor assessment at least 28 days after first response documentation. Complete response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial response (PR) is at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter.
Time frame: Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years.
Population: Safety population by HRD subgroups: Consist of all Part 1 patients who received at least one dose of rucaparib
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: tBRCA | Objective Response Rate (ORR) by RECIST v1.1 (Part 1 of Study) | 80.0 percentage of participants |
| Part 1: Non-tBRCA LOH+ | Objective Response Rate (ORR) by RECIST v1.1 (Part 1 of Study) | 28.0 percentage of participants |
| Part 1: Non-tBRCA LOH- | Objective Response Rate (ORR) by RECIST v1.1 (Part 1 of Study) | 10.0 percentage of participants |
| Part 1: Non-tBRCA LOH Unknown | Objective Response Rate (ORR) by RECIST v1.1 (Part 1 of Study) | 33.3 percentage of participants |
Overall Survival (Part 2 of Study)
Overall survival (OS) is defined as the number of days from the date of first dose of study drug to the date of death (due to any cause). Patients without a known date of death will be censored on the date the patient was last known to be alive.
Time frame: All patients in Part 2 were followed for survival, subsequent therapy, and secondary malignancy every 12 weeks until death, loss to follow-up, withdrawal of consent from study or study closure, whichever happened first, up to 7 years.
Population: Safety population by HRD subgroups: Consist of all Part 2 patients who received at least one dose of rucaparib.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part 1: tBRCA | Overall Survival (Part 2 of Study) | 22.7 Months |
| Part 1: Non-tBRCA LOH+ | Overall Survival (Part 2 of Study) | 14.7 Months |
| Part 1: Non-tBRCA LOH- | Overall Survival (Part 2 of Study) | 13.3 Months |
| Part 1: Non-tBRCA LOH Unknown | Overall Survival (Part 2 of Study) | 14.1 Months |
Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study)
Progression-Free Survival (PFS) is calculated as 1+ the number of days from the first dose of study drug to disease progression by RECIST, as determined by the investigator or death due to any cause, whichever occurs first. Progression is defined using RECIST v1.1, as at least a 20% increase in the sum of the longest diameter of target lesions, or a measureable increase in a non-target lesion, or the appearance of new lesions.
Time frame: Assessments every 8 weeks from C1D1 until disease progression, death or withdrawal of consent. After 18 months on study, assessments every 16 weeks. Total follow-up was up to approximately 3 years.
Population: Safety population by HRD subgroups: Consist of all Part 2 patients who received at least one dose of rucaparib.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part 1: tBRCA | Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study) | 223 Days |
| Part 1: Non-tBRCA LOH+ | Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study) | 57 Days |
| Part 1: Non-tBRCA LOH- | Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study) | 113 Days |
| Part 1: Non-tBRCA LOH Unknown | Progression-free Survival (PFS) According to RECIST v1.1 in Molecularly-defined HRD Subgroups (Part 2 of Study) | 110 Days |
Steady State Trough (Cmin) Level Rucaparib Concentrations
Per protocol, the secondary PK endpoint, trough (Cmin) concentrations of rucaparib were summarized with descriptive statistics overall and by cycle in all patients with at least one PK sample collected. Blood samples for trough level PK analysis of rucaparib were drawn at the following timepoints only: on Day 15 of Cycle 1 and on Day 1 of Cycles 2, 3, and 4. Data for other timepoints is not available.
Time frame: Cycle 1 Day 15 to Cycle 4 Day 1, or approximately 10 weeks
Population: All Part 1 and Part 2 patients with at least one PK sample collected
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Part 1: tBRCA | Steady State Trough (Cmin) Level Rucaparib Concentrations | Cycle 3 Day 1 | 1557.32 ng/mL | Standard Deviation 952.903 |
| Part 1: tBRCA | Steady State Trough (Cmin) Level Rucaparib Concentrations | Cycle 1 Day 15 | 2020.76 ng/mL | Standard Deviation 1145.164 |
| Part 1: tBRCA | Steady State Trough (Cmin) Level Rucaparib Concentrations | Cycle 4 Day 1 | 1530.41 ng/mL | Standard Deviation 765.94 |
| Part 1: tBRCA | Steady State Trough (Cmin) Level Rucaparib Concentrations | Cycle 2 Day 1 | 1652.27 ng/mL | Standard Deviation 935.503 |
| Part 1: Non-tBRCA LOH+ | Steady State Trough (Cmin) Level Rucaparib Concentrations | Cycle 4 Day 1 | 1629.14 ng/mL | Standard Deviation 1026.999 |
| Part 1: Non-tBRCA LOH+ | Steady State Trough (Cmin) Level Rucaparib Concentrations | Cycle 1 Day 15 | 2276.37 ng/mL | Standard Deviation 1587.586 |
| Part 1: Non-tBRCA LOH+ | Steady State Trough (Cmin) Level Rucaparib Concentrations | Cycle 3 Day 1 | 1552.09 ng/mL | Standard Deviation 1054.346 |
| Part 1: Non-tBRCA LOH+ | Steady State Trough (Cmin) Level Rucaparib Concentrations | Cycle 2 Day 1 | 1689.83 ng/mL | Standard Deviation 1039.953 |