A Study of Targeted Agents for Patients With Recurrent or Persistent Endometrial Cancer (EndoMAP)

December 22, 2023 updated by: Alliance Foundation Trials, LLC.

A Phase IB/II Multi-Cohort Study of Targeted Agents and/or Immunotherapy With Atezolizumab for Patients With Recurrent or Persistent Endometrial Cancer

This is a Phase IB/II multi-cohort study designed to evaluate the efficacy and safety of targeted agents with or without cancer immune checkpoint therapy with atezolizumab in participant with recurrent and/or persistent endometrial cancer. The main protocol provides a platform for genomic screening with homogeneous basic eligibility criteria in order to direct study participants into biomarker-matched study cohorts consisting of testing targeted agents.

Study Overview

Detailed Description

This is a Phase IB/II multi-cohort study designed to evaluate the efficacy and safety of targeted agents with or without cancer immune checkpoint therapy with atezolizumab in participants with recurrent and/or persistent endometrial cancer.

This biomarker-driven study provides a platform whereby participants with persistent/recurrent endometrial cancer will be placed into study cohorts evaluating targeted agents selected on the basis of the tumor's specific genomic profile. Prospective participants with persistent and/or recurrent endometrial cancer will be prescreened within 60 days of treatment assignment to have a tumor tissue sample submitted for next-generation sequencing (NGS) using FoundationOne® companion diagnostic (CDx) testing prior to entering screening. If a participant has FoundationOne® CDx testing within five years of enrollment, the previous tumor tissue may be re-analyzed for use in the study.

Depending on the cohort assignment per the tumor's biomarker profile, participants will be assigned to the AFT-50A Protocol (atezolizumab+targeted agent) or the AFT-50B Protocol (non-atezolizumab targeted agents). The current study cohorts are as follows:

AFT-50A Cohorts

  • Atezolizumab + Bevacizumab doublet
  • Atezolizumab + Ipatasertib doublet
  • Atezolizumab + Talazoparib doublet
  • Atezolizumab + Trastuzumab emtansine (TDM-1) doublet
  • Atezolizumab + Tiragolumab doublet

AFT-50B Cohorts

  • Inavolisib + Letrozole doublet
  • Giredestrant + Abemaciclib doublet

It is anticipated that approximately 20 participants will be enrolled in each study cohort in AFT-50A and 24 participants in each study cohort in AFT-50B, unless otherwise specified for a given cohort due to statistical considerations. Each study cohort will open/close independently of other study cohorts. Once a study cohort reaches the prespecified number of participants, it will be closed to further enrollment, unless an expansion phase is planned.

The study is structured to allow for additional cohorts to be added as the study progresses. These additional study cohorts may be proposed by investigators, but requires approval by the Steering Committee in order to be added to the protocol.

Study Type

Interventional

Enrollment (Estimated)

148

Phase

  • Phase 2
  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • California
      • Duarte, California, United States, 91010
        • Recruiting
        • City of Hope Comprehensive Cancer Center
        • Contact:
          • Daphne Stewart
        • Principal Investigator:
          • Daphne Stewart, MD, MS
      • San Francisco, California, United States, 94143
        • Recruiting
        • UCSF Helen Diller Family Comprehensive Cancer Center
        • Contact:
          • Edwin Alvarez, MD
        • Principal Investigator:
          • Edwin Alvarez, MD
    • District of Columbia
      • Washington, District of Columbia, United States, 20007
        • Recruiting
        • Medstar Georgetown Cancer Institute
        • Principal Investigator:
          • Ebony Hoskins, MD
        • Contact:
          • Ebony Hoskins, MD
    • Florida
      • Miami Beach, Florida, United States, 33140
        • Recruiting
        • Mount Sinai Comprehensive Cancer Center
        • Principal Investigator:
          • Brian Slomovitz, MD
        • Contact:
          • Brian Slomovitz, MD
    • Illinois
      • Chicago, Illinois, United States, 60637
        • Recruiting
        • University of Chicago
        • Contact:
          • John Moroney, MD
        • Principal Investigator:
          • John Moroney, MD
    • Kansas
      • Westwood, Kansas, United States, 66205
        • Recruiting
        • University of Kansas Cancer Center
        • Principal Investigator:
          • Andrea Jewell, MD
        • Contact:
          • Andrea Jewell, MD
    • Massachusetts
      • Boston, Massachusetts, United States, 02125
        • Recruiting
        • Dana Farber Cancer Institute
        • Contact:
          • Joyce Liu, MD, MPH
        • Principal Investigator:
          • Joyce Liu, MD, MPH
    • Minnesota
      • Minneapolis, Minnesota, United States, 55455
        • Recruiting
        • University of Minnesota
        • Contact:
          • Britt Erickson, MD
        • Principal Investigator:
          • Britt Erickson, MD
    • Missouri
      • Saint Louis, Missouri, United States, 63110
        • Recruiting
        • Washington University School of Medicine Siteman Cancer Center
        • Contact:
          • Premal Thaker, MD, MS
        • Principal Investigator:
          • Premal Thaker, MD, MS
    • Nebraska
      • Omaha, Nebraska, United States, 68114
        • Recruiting
        • Nebraska Methodist Hospital
        • Principal Investigator:
          • Brent Tierney, MD
        • Contact:
          • Brent Tierney, MD
    • New Jersey
      • Englewood, New Jersey, United States, 07631
        • Active, not recruiting
        • Englewood Health
      • Morristown, New Jersey, United States, 07960
        • Recruiting
        • Atlantic Health Systems/Morristown Medical Center
        • Contact:
          • Nana Tchabo, MD
        • Principal Investigator:
          • Nana Tchabo, MD
    • New York
      • Buffalo, New York, United States, 14263
        • Recruiting
        • Roswell Park
        • Contact:
          • Peter Frederick, MD
        • Principal Investigator:
          • Peter Frederick, MD
      • New York, New York, United States, 10065
        • Recruiting
        • Weill Cornell Medicine
        • Contact:
          • Evelyn Cantillo, MD, MPH
        • Principal Investigator:
          • Evelyn Cantillo, MD, MPH
    • North Carolina
      • Durham, North Carolina, United States, 27710
        • Recruiting
        • Duke University Cancer Center
        • Contact:
          • Angeles Alvarez Secord, MD
        • Principal Investigator:
          • Angeles Alvarez Secord, MD
    • Oklahoma
      • Oklahoma City, Oklahoma, United States, 73104
        • Recruiting
        • University of Oklahoma Health Stephenson Cancer Center
        • Principal Investigator:
          • Debra Richardson, MD
        • Contact:
          • Debra Richardson, MD
    • Oregon
      • Portland, Oregon, United States, 97213
        • Recruiting
        • Providence Portland Cancer Institute
        • Contact:
          • Christopher Darus, MD
        • Principal Investigator:
          • Christopher Darus, MD
    • Pennsylvania
      • Pittsburgh, Pennsylvania, United States, 15261
        • Recruiting
        • University of Pittsburgh Medical Center
        • Contact:
          • Alexander B. Olawaiye, MD
        • Principal Investigator:
          • Alexander B Olawaiye, MD
    • Rhode Island
      • Providence, Rhode Island, United States, 02903
        • Recruiting
        • Lifespan - Rhode Island Hospital
        • Contact:
          • Don Dizon, MD
        • Principal Investigator:
          • Don Dizon, MD
    • Tennessee
      • Memphis, Tennessee, United States, 38120
        • Recruiting
        • Baptist Memorial Hospital
        • Contact:
          • David Engle, MD
        • Principal Investigator:
          • David Engle, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Key Inclusion Criteria:

  • Recurrent or persistent endometrial carcinoma which has progressed or recurred after at least 1, but no more than 2, prior lines of therapy. Prior hormonal therapies (e.g., tamoxifen, aromatase inhibitors) will not count toward the prior regimen limit. Chemotherapy given in conjunction with radiotherapy as a radiosensitizer will be counted as a systemic therapeutic regimen.
  • Measurable disease per RECIST 1.1
  • Availability of a representative tumor specimen that is suitable for determination of biomarker status via central testing (F1CDx) OR If a patient has a prior F1CDx report from 1 September 2019 or later, those NGS results can be used to determine biomarker status as long as the tumor tissue used in the report was obtained within 5 years prior to prescreening and appropriate signed consent is obtained from the patient.
  • Life expectancy > 12 weeks
  • Recovery from effects of recent radiotherapy, surgery, or chemotherapy

Key Exclusion Criteria:

  • Endometrial tumors with the following histologies: squamous carcinomas, sarcomas
  • Other invasive malignancies within the last 5 years, except for non-melanoma skin cancer with no evidence of disease within the past 5 years AND localized breast cancer with previous adjuvant chemotherapy treatment for breast cancer completed > 5 years ago
  • Synchronous primary invasive ovarian or cervical cancer
  • Have an active or history of autoimmune disease or immune deficiency
  • Have a history of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis based on a screening chest computed tomography (CT) scan
  • Active tuberculosis
  • Severe infections within 4 weeks
  • Have received therapeutic oral or IV antibiotic medication within 2 weeks, except prophylactic antibiotic medication
  • Have significant cardiovascular disease
  • Are administered treatment with a live attenuated vaccine within 4 weeks, or anticipation of need for such a vaccine during the course of the study
  • Have prior allogeneic bone marrow transplantation or solid organ transplant
  • Prior treatment with T-cell costimulating or immune checkpoint blockade therapies including, but not limited to, CD137 agonists, anti-PD-1, anti-PD-L1, and anti-CTLA-4 therapeutic antibodies
  • History of treatment with systemic immunostimulatory agents (including but not limited to interferons, interleukin-2) within 4 weeks or 5 half-lives of the drug, whichever is longer, prior to initiation of study treatment
  • History of treatment with systemic immunosuppressive medications within 2 weeks except acute, low-dose, systemic immunosuppressant medications, corticosteroids for chronic obstructive pulmonary disease and asthma, or mineralocorticoids and low-dose corticosteroids for participants with orthostatic hypotension or adrenocortical insufficiency
  • Have a history or clinical evidence of any untreated CNS disease, seizures not controlled with standard medical therapy, or history of cerebrovascular accident (stroke), transient ischemic attack or subarachnoid hemorrhage within 6 months

Note: Additional study cohort specific inclusion and exclusion criteria may apply based on cohort assignment.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Atezolizumab and Bevacizumab Cohort
Following the submission of tumor tissue for the FoundationOne® companion diagnostic (F1CDx) test, participants with no specified gene signatures will be enrolled in this cohort. Twenty participants will be enrolled. Once twenty participants are enrolled, the cohort will be closed to further enrollment. Participants in this study cohort will commence treatment as specified on Day 1 of each cycle.
Atezolizumab will be given to participants intravenously at a dosage of 1680 mg on day 1 of each 28-day cycle.
Other Names:
  • Tecentriq
  • L01XC32
Bevacizumab will be given to participants intravenously at a dosage of 10mg per participant kilogram every 2 weeks of the 28-day cycle.
Other Names:
  • Avastin
  • L01XC07
Experimental: Atezolizumab and Ipatasertib Cohort
Following the submission of tumor tissue for the FoundationOne® companion diagnostic (F1CDx) test, participants with PIK3CA/AKT1/PTEN-altered tumors will be enrolled in this cohort. Twenty participants will be enrolled. Once twenty participants are enrolled, the cohort will be closed to further enrollment. Participants in this study cohort will commence treatment as specified on Day 1 of each cycle.
Atezolizumab will be given to participants intravenously at a dosage of 1680 mg on day 1 of each 28-day cycle.
Other Names:
  • Tecentriq
  • L01XC32
Ipatasertib will be given as an orally at a dosage of 400 mg once daily for 21 days of each 28-day cycle.
Other Names:
  • GDC-0068
  • RG7440
Experimental: Atezolizumab and Talazoparib Cohort
Following the submission of tumor tissue for the FoundationOne® companion diagnostic (F1CDx) test, participants with tumors that have a ≥16%genomic loss of heterozygosity (LOH) will be assigned to this cohort. Twenty participants will be enrolled. Once twenty participants are enrolled, the cohort will be closed to further enrollment. Participants in this study cohort will commence treatment as specified on Day 1 of each cycle.
Atezolizumab will be given to participants intravenously at a dosage of 1680 mg on day 1 of each 28-day cycle.
Other Names:
  • Tecentriq
  • L01XC32
Talazoparib will be given in an orally at a dosage of 1 mg once daily for each day of the 28-day cycle.
Other Names:
  • Talzenna
  • L01XX60
Experimental: Atezolizumab and Trastuzumab emtansine (TDM-1) Cohort
Following the submission of tumor tissue for the FoundationOne® companion diagnostic (F1CDx) test, participants with tumors that with an amplification of ERBB2/HER2 will be assigned to this cohort. Twenty participants will be enrolled. Once twenty participants are enrolled, the cohort will be closed to further enrollment. Participants in this study cohort will commence treatment as specified on Day 1 of each cycle.
Trastuzumab emtansine be given to participants intravenously at a dosage of 3.6 mg per participant kilogram, on day 1 of each 21-day cycle.
Other Names:
  • Kadcyla
  • T-DM1
Atezolizumab will be given to participants intravenously at a dosage of 1200 mg on day 1 of each 21-day cycle.
Other Names:
  • Tecentriq
  • L01XC32
Experimental: Atezolizumab and Tiragolumab Cohort
Following the submission of tumor tissue for the FoundationOne® companion diagnostic (F1CDx) test, participants with tumor type MSI-H and/or tTMB >=10 mut/mb will be assigned to this cohort. Twenty participants will be enrolled initially. Once twenty participants are enrolled, the cohort may be expanded if a positive signal is shown. Participants in this study cohort will commence treatment as specified on Day 1 of each cycle.
Atezolizumab will be given to participants intravenously at a dosage of 1680 mg on day 1 of each 28-day cycle.
Other Names:
  • Tecentriq
  • L01XC32
Tiragolumab will be given to participants intravenously at a dosage of 840 mg on day 1 of each 28-day cycle.
Experimental: Inavolisib and Letrozole Cohort
Following the submission of tumor tissue for the FoundationOne® companion diagnostic (F1CDx) test, participants with tumors that with PIK3CA activating mutations in the absence of PTEN loss-of-function alterations or AKT1 activating mutations will be assigned to this cohort. Twenty-four participants will be enrolled. Once twenty-four participants are enrolled, the cohort will be closed to further enrollment. Participants in this study cohort will commence treatment as specified on Day 1 of each cycle.
Inavolisib will be given in an orally at a dosage of 9 mg once daily for each day of the 28-day cycle.
Other Names:
  • GDC-0077
Letrozole will be given orally at a dosage of 2.5 mg once daily for each day of the 28-day cycle.
Other Names:
  • Femara
Experimental: Giredestrant and Abemaciclib
Following the submission of tumor tissue for the FoundationOne® companion diagnostic (F1CDx) test, participants with tumors that are RB1 intact with a local grade 1-2 estrogne receptor positive (ER+) are assigned to this cohort. Twenty-four participants will be enrolled. Once twenty-four participants are enrolled, the cohort will be closed to further enrollment. Participants in this study cohort will commence treatment as specified on Day 1 of each cycle.
Giredestrant will be given orally at a dosage of 30 mg once daily for each day of the 28-day cycle.
Other Names:
  • GDC-9545
Giredestrant will be given orally at a dosage of 150 mg twice daily for each day of the 28-day cycle.
Other Names:
  • Verzenio

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Investigator-assessed overall response rate (ORR) of each biomarker cohort
Time Frame: 48 Months
AFT-50A Protocol: Overall response rate for each biomarker cohort is defined as the proportion of participants achieving a complete (CR) or partial (PR) response on two consecutive occasions at least 4 weeks apart, as determined by the investigator from AFT50A Protocol: Tumor assessments per RECIST v1.1.
48 Months
The proportion of participants in each biomarker cohort who remain alive and progression-free for at least 6 months
Time Frame: 6 Months
AFT-50B Protocol: Progression free survival rate at 6 months is defined as the proportion of participants who have not experienced disease progression or death from any cause at 6 months, as determined by the investigator according to RECIST v1.1
6 Months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Relative proportion of participants in each biomarker cohort who remain progression-free for at least 6 months compared to that from historical control studies
Time Frame: 6 Months per cohort
AFT-50A Protocol: PFS rate at 6 months is defined as the proportion of participants who have not experienced disease progression or death from any cause at 6 months, as determined by the investigator according to RECIST v1.1
6 Months per cohort
Investigator assessed disease-control rate of each biomarker cohort
Time Frame: 48 Months
AFT-50A Protocol: Disease-control rate is defined as the proportion of participants achieving either stable disease, complete response, or partial response.
48 Months
Duration of response for participants in each biomarker cohort who achieve a complete or partial response.
Time Frame: 48 Months
AFT-50A Protocol: Duration of response is defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST v1.1.
48 Months
Overall survival (OS) rates of participants in each biomarker cohort after 24 months
Time Frame: 24 Months per cohort
AFT-50A Protocol: 24-month overall survival rate is defined as the proportion of participants who have not experienced death from any cause at 24 months.
24 Months per cohort
Investigator assessed disease-control rate of each biomarker cohort
Time Frame: 48 Months
AFT-50B Protocol: Disease control rate is defined as the proportion of participants achieving either stable disease, complete response, or partial response at any time.
48 Months
Duration of response for participants in each biomarker cohort who achieve a confirmed response (complete or partial)
Time Frame: 48 Months
AFT-50B Protocol: Duration of response is defined as the time from the first occurrence of a documented objective response (complete or partial) to disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST v1.1
48 Months
Overall survival rates of participants in each biomarker cohort
Time Frame: 24 Months
AFT-50B Protocol: 24-month overall survival rate is defined as the proportion of participants who have not experienced death from any cause at 24 months.
24 Months

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Safety of each biomarker cohort: adverse events
Time Frame: 48 Months
AFT-50A Protocol: The incidence and severity of adverse events, with severity determined according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0), as well as summaries of changes in clinically relevant laboratory test results, changes in vital signs, and study treatment exposures for each biomarker cohort
48 Months
The safety of each biomarker cohort: Adverse Events
Time Frame: 48 Months
AFT-50B Protocol: The incidence and severity of adverse events, with severity determined according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0). Summaries of changes in clinically relevant laboratory test results, changes in vital signs, and study treatment exposures for each biomarker cohort
48 Months
Assess exploratory biomarkers in tumor tissue and peripheral blood, and their association with other molecular characteristics, disease status and/or participant response to study treatment
Time Frame: 48 Months
AFT-50A and AFT-50B Protocols: Association of exploratory biomarkers with clinical outcomes, including but not limited to molecular analysis of tumor tissue and peripheral blood, as well as cytokine/chemokine and cellular analysis of peripheral blood.
48 Months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 20, 2021

Primary Completion (Estimated)

October 1, 2025

Study Completion (Estimated)

October 1, 2026

Study Registration Dates

First Submitted

July 22, 2020

First Submitted That Met QC Criteria

July 23, 2020

First Posted (Actual)

July 24, 2020

Study Record Updates

Last Update Posted (Actual)

December 26, 2023

Last Update Submitted That Met QC Criteria

December 22, 2023

Last Verified

December 1, 2023

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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