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Brief Title: FOCUS: PCC + Bevacizumab + CA4P Versus PCC + Bevacizumab + Placebo for Subjects With Platinum Resistant Ovarian Cancer
Official Title: FOCUS: A Multicenter, Multinational, Double-Blind, 2-Arm, Randomized, Phase 2/3, Study of Physician's Choice Chemotherapy ([PCC] Weekly Paclitaxel or Pegylated Liposomal Doxorubicin [PLD]) Plus Bevacizumab and CA4P Versus PCC Plus Bevacizumab and Placebo for Subjects With Platinum-Resistant, Recurrent Epithelial Ovarian, Primary Peritoneal or Fallopian Tube Cancer
Study ID: NCT02641639
Brief Summary: This is a multicenter, multinational, randomized, double-blind, 2-arm, parallel-group, Phase 2/3 study to evaluate the efficacy and safety of PCC plus bevacizumab and CA4P versus PCC plus bevacizumab and placebo in subjects with platinum-resistant ovarian cancers (prOC). Subjects with platinum-resistant, recurrent, epithelial ovarian, primary peritoneal or fallopian tube cancer will be randomized 1:1 to receive PCC plus bevacizumab and CA4P or PCC plus bevacizumab and placebo. Subjects will be stratified by selected chemotherapy (PLD vs. paclitaxel), platinum free interval (\< 3 vs. 3 to 6 months from last platinum therapy to subsequent progression), and line of therapy (2nd vs. 3rd). This is a 2-part study, consisting of a Phase 2, exploratory study (Part 1) followed by a Phase 3, pivotal study (Part 2). Both parts of the study will have similar overall design. Approximately 80 subjects will be randomized into Part 1 and approximately 356 subjects will be randomized into Part 2.
Detailed Description: This is a multicenter, multinational, randomized, double-blind, 2-arm, parallel-group, Phase 2/3 study to evaluate the efficacy and safety of PCC plus bevacizumab and CA4P versus PCC plus bevacizumab and placebo in subjects with platinum-resistant ovarian cancers (prOC). Subjects with platinum-resistant, recurrent, epithelial ovarian, primary peritoneal or fallopian tube cancer will be randomized 1:1 to receive PCC plus bevacizumab and CA4P or PCC plus bevacizumab and placebo. Subjects will be stratified by selected chemotherapy (PLD vs. paclitaxel), platinum free interval (\< 3 vs. 3 to 6 months from last platinum therapy to subsequent progression), and line of therapy (2nd vs. 3rd). This is a 2-part study, consisting of a Phase 2, exploratory study (Part 1) followed by a Phase 3, pivotal study (Part 2). Both parts of the study will have similar overall design. Approximately 80 subjects will be randomized into Part 1 and approximately 356 subjects will be randomized into Part 2. All subjects randomized will receive bevacizumab 10 mg/kg intravenously (IV) on Days 1 and 15, repeated every 4 weeks (q4wk) and PCC with paclitaxel 80 mg/m2 IV on Days 1, 8, 15 and 22, repeated q4wk, or paclitaxel 80 mg/m2 IV on Days 1, 8, 15, repeated q4wk or PLD 40 mg/m2 IV on Day 1, repeated q4wk. Subjects in the Treatment Arm will also receive CA4P 60 mg/m2 on the same day as bevacizumab (Days 1 and 15, repeated q4wk), while subjects in the Control Arm will receive placebo on those days. Order of dosing will follow the guidance listed below during this study when bevacizumab and CA4P / Placebo are dosed the same day as PCC, * Bevacizumab followed by CA4P / Placebo followed after 1-3 hours by paclitaxel, * PLD followed by bevacizumab followed by CA4P / Placebo Subjects will continue randomized treatment until disease progression, unacceptable toxicity, investigator decision, withdrawal of consent, or sponsor discontinues study for any reason. Subjects will undergo tumor assessments (RECIST) at baseline and every 8 weeks and CA-125 levels at baseline and every 4 weeks. The primary endpoint is PFS. Secondary endpoints include ORR, OS, proportion of subjects who remain progression free at 6, 9, and 12 months, and safety. Endpoints will be compared between the Treatment Arm and the Control arm. The study duration is estimated to last approximately 3 years. This study will have 2 parts with the same overall design. Part 1 will enroll up to approximately 80 subjects and will include multiple interim analyses to test the safety and efficacy assumptions in this specific subject population. Upon meeting certain efficacy criteria in Part 1, the protocol will be amended and additional sites added in order to enroll an additional 356 subjects into Part 2 of the study. Subjects enrolled in Part 2 will be analyzed separately and used as a stand-alone confirmatory efficacy study.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: FEMALE
Healthy Volunteers: No
University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, United States
Mitchell Cancer Institute - USA Health System, Mobile, Alabama, United States
Arizona Oncology Associates, PC - HAL, Phoenix, Arizona, United States
Arizona Oncology Associates, PC - HOPE, Tucson, Arizona, United States
University of Arizona Cancer Center, Tucson, Arizona, United States
Oncology Institute of Hope and Innovation, Lynwood, California, United States
University of California Irvine, Orange, California, United States
California Pacific Medical Center, Research Institute, San Francisco, California, United States
Sansum Clinic, Santa Barbara, California, United States
Rocky Mountain Cancer Centers, LLP, Lakewood, Colorado, United States
Hartford Health Care Cancer Institute; Affiliate Memorial Sloan Kettering, Hartford, Connecticut, United States
Stamford Hospital - Bennett Cancer Center, Stamford, Connecticut, United States
Sylvester Comprehensive Cancer Center University of Miami, Miami, Florida, United States
Baptist Health Medical Group Oncology, LLC, Miami, Florida, United States
Moffitt Cancer Center, Tampa, Florida, United States
Augusta University, Augusta, Georgia, United States
Maine Medical Center, Scarborough, Maine, United States
Mercy Medical Center; The Institute for Cancer Care, Baltimore, Maryland, United States
HCA Midwest Division - Sarah Cannon Cancer Institute, Kansas City, Missouri, United States
Memorial Sloan Kettering Cancer Center, New York, New York, United States
Gabrail Cancer Center, Canton, Ohio, United States
Oklahoma Heath Sciences Center - Stephenson Cancer Center, Oklahoma City, Oklahoma, United States
Tulsa Cancer Institute, Tulsa, Oklahoma, United States
OHSU Center for Women's Health & Knight Cancer Institute, Portland, Oregon, United States
Willamette Valley Cancer Institute, Springfield, Oregon, United States
Lehigh Valley Hospital, John and Dorothy Morgan Cancer Center; Affiliate Memorial Sloan Kettering, Allentown, Pennsylvania, United States
The Western Pennsylvania Hospital, Pittsburgh, Pennsylvania, United States
Gibbs Cancer Center & Research Institute Spartanburg Medical Center, Spartanburg, South Carolina, United States
Texas Oncology, P.A., Austin, Texas, United States
Texas Oncology, Bedford, Texas, United States
Dallas County Hospital District d/b/a Parkland Health and Hospital System, Dallas, Texas, United States
Simmons Comprehensive Cancer Center; UT Southwestern Medical Center, Dallas, Texas, United States
Texas Oncology, P.A., Dallas, Texas, United States
Texas Oncology San Antonio, San Antonio, Texas, United States
Texas Oncology, P.A., The Woodlands, Texas, United States
Texas Oncology, P.A., Tyler, Texas, United States
UZ Leuven, Leuven, , Belgium
Universitätsklinikum Erlangen, Erlangen, , Germany
Universitätsklinikum Essen (AöR) Klinik für Frauenheilkunde und Geburtshilfe, Essen, , Germany
Universitäts-Frauenklinik Dept. für Frauengesundheit, Tubingen, , Germany
Name: Harish Dave, MD
Affiliation: Medical Monitor
Role: STUDY_DIRECTOR