Clinical Trial Page

Clinical Trial Results:
NGR012: A phase II study of NGR-hTNF administered in combination with doxorubicin every 3 weeks in patients affected by advanced or metastatic ovarian cancer

Summary
EudraCT number
2007-000004-33
Trial protocol
IT  
Global end of trial date
17 Dec 2015

Results information
Results version number
v1(current)
This version publication date
26 Jan 2020
First version publication date
26 Jan 2020
Other versions

Trial information

Close Top of page
Trial identification
Sponsor protocol code
NGR012
Additional study identifiers
ISRCTN number
-
US NCT number
-
WHO universal trial number (UTN)
-
Sponsors
Sponsor organisation name
MolMed S.p.A.
Sponsor organisation address
Via Olgettina, 58, Milan, Italy, 20132
Public contact
MolMed S.p.A., Clinical Development, 0039 0221277234, clinical.operations@molmed.com
Scientific contact
MolMed S.p.A., Clinical Development, 0039 0221277234, clinical.operations@molmed.com
Paediatric regulatory details
Is trial part of an agreed paediatric investigation plan (PIP)
No
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
No
Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
No
Results analysis stage
Analysis stage
Final
Date of interim/final analysis
12 Dec 2019
Is this the analysis of the primary completion data?
No
Global end of trial reached?
Yes
Global end of trial date
17 Dec 2015
Was the trial ended prematurely?
No
General information about the trial
Main objective of the trial
Antitumor activity defined as response rate according to RECIST criteria
Protection of trial subjects
The study was conducted in accordance with the ethical principles that have their origins in the Declaration of Helsinki. The study was performed in compliance with Good Clinical Practices (CPMP/ICH/135/95), and the essential documents are archived as required by the applicable regulatory requirements. The study and any amendments were reviewed by an Independent Ethics Committees or Institutional Review Boards.
Background therapy
Patients affected by advanced or metastatic ovarian cancer previously treated with platinum regimens (cis or carboplatin) plus paclitaxel and with documented progression disease within 6 months from last chemotherapy administered (refractory/resistant population) or in progression disease after 6 months from last chemotherapy (platinum regimens plus paclitaxel) administered.
Evidence for comparator
-
Actual start date of recruitment
01 Dec 2008
Long term follow-up planned
No
Independent data monitoring committee (IDMC) involvement?
No
Population of trial subjects
Number of subjects enrolled per country
Country: Number of subjects enrolled
Italy: 37
Worldwide total number of subjects
37
EEA total number of subjects
37
Number of subjects enrolled per age group
In utero
0
Preterm newborn - gestational age
0
Newborns (0-27 days)
0
Infants and toddlers (28 days-23 months)
0
Children (2-11 years)
0
Adolescents (12-17 years)
0
Adults (18-64 years)
17
From 65 to 84 years
20
85 years and over
0

Subject disposition

Close Top of page
Recruitment
Recruitment details
Study period: First patient enrolled: 01 December 2008; Last patient completed: 17 December 2015; Study centres: 2 investigational study sites in Italy.

Pre-assignment
Screening details
Totally 37 consented and screened patients received at least one dose of study medication and were included in the Safety population (SAF set).

Period 1
Period 1 title
Overall period
Is this the baseline period?
Yes
Allocation method
Non-randomised - controlled
Blinding used
Not blinded

Arms
Arm title
NGR-hTNF + doxorubicin
Arm description
Patients received 60 minutes intravenous NGR-hTNF infusion every 3 weeks at dose of 0.8 μg/m2 before of a dose of doxorubicin 60 mg/m2 as 15 minutes infusion. At reaching of a cumulative dose of doxorubicin of 550 mg/m2, a continuation of treatment (if patient was showing an objective response or is in stable disease) with single agent NGR-hTNF at dose of 0.8 μg/m2 every 3 weeks was allowed.
Arm type
Experimental

Investigational medicinal product name
NGR-hTNF
Investigational medicinal product code
Other name
Pharmaceutical forms
Concentrate for solution for infusion
Routes of administration
Intravenous use
Dosage and administration details
Patients received 60 minutes intravenous NGR-hTNF infusion every 3 weeks at dose of 0.8 μg/m2 before of a dose of doxorubicin 60 mg/m2 as 15 minutes infusion. At reaching of a cumulative dose of doxorubicin of 550 mg/m2, a continuation of treatment (if patient was showing an objective response or is in stable disease) with single agent NGR-hTNF at dose of 0.8 μg/m2 every 3 weeks was allowed.

Investigational medicinal product name
Doxorubicin
Investigational medicinal product code
Other name
Pharmaceutical forms
Concentrate for solution for infusion
Routes of administration
Intravenous use
Dosage and administration details
Patients received 60 minutes intravenous NGR-hTNF infusion every 3 weeks at dose of 0.8 μg/m2 before of a dose of doxorubicin 60 mg/m2 as 15 minutes infusion. At reaching of a cumulative dose of doxorubicin of 550 mg/m2, a continuation of treatment (if patient was showing an objective response or is in stable disease) with single agent NGR-hTNF at dose of 0.8 μg/m2 every 3 weeks was allowed.

Number of subjects in period 1
NGR-hTNF + doxorubicin
Started
37
Completed
26
Not completed
11
     Physician decision
2
     Adverse event, non-fatal
1
     Consent withdrawn by subject
8

Baseline characteristics

Close Top of page
Baseline characteristics reporting groups
Reporting group title
NGR-hTNF + doxorubicin
Reporting group description
Patients received 60 minutes intravenous NGR-hTNF infusion every 3 weeks at dose of 0.8 μg/m2 before of a dose of doxorubicin 60 mg/m2 as 15 minutes infusion. At reaching of a cumulative dose of doxorubicin of 550 mg/m2, a continuation of treatment (if patient was showing an objective response or is in stable disease) with single agent NGR-hTNF at dose of 0.8 μg/m2 every 3 weeks was allowed.

Reporting group values
NGR-hTNF + doxorubicin Total
Number of subjects
37 37
Age categorical
Units: Subjects
    In utero
0 0
    Preterm newborn infants (gestational age < 37 wks)
0 0
    Newborns (0-27 days)
0 0
    Infants and toddlers (28 days-23 months)
0 0
    Children (2-11 years)
0 0
    Adolescents (12-17 years)
0 0
    Adults (18-64 years)
17 17
    From 65-84 years
20 20
    85 years and over
0 0
Age continuous
Units: years
    median (full range (min-max))
57.0 (35 to 72) -
Gender categorical
Units: Subjects
    Female
37 37
    Male
0 0

End points

Close Top of page
End points reporting groups
Reporting group title
NGR-hTNF + doxorubicin
Reporting group description
Patients received 60 minutes intravenous NGR-hTNF infusion every 3 weeks at dose of 0.8 μg/m2 before of a dose of doxorubicin 60 mg/m2 as 15 minutes infusion. At reaching of a cumulative dose of doxorubicin of 550 mg/m2, a continuation of treatment (if patient was showing an objective response or is in stable disease) with single agent NGR-hTNF at dose of 0.8 μg/m2 every 3 weeks was allowed.

Primary: Response rate (RR)

Close Top of page
End point title
Response rate (RR) [1]
End point description
The primary endpoint of the study was antitumor activity defined as response rate according to RECIST criteria. Response rate was defined as the percentage of patients having as best response throughout the study a CR or a PR: (CR + PR)/n. of patients in ENR population.
End point type
Primary
End point timeframe
The response rate was measured during the whole study.
Notes
[1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
Justification: The study was conducted using Simon’s two-stage design method for the primary efficacy end point. Since 7 responses (complete or partial) were observed among the 37 patients, the study was to be considered to have a positive result.
End point values
NGR-hTNF + doxorubicin
Number of subjects analysed
37
Units: Percentage of patients
    number (confidence interval 95%)
18.9 (8.0 to 35.2)
No statistical analyses for this end point

Secondary: Progression-free survival (PFS)

Close Top of page
End point title
Progression-free survival (PFS)
End point description
Progression-free survival (PFS), defined as the time from baseline CT-scan date until the first observation of disease progression, or death due to any cause, or the last date the patient was known to be progression free or alive.
End point type
Secondary
End point timeframe
Progression-free survival (PFS) was measured during the whole study/at each cycle.
End point values
NGR-hTNF + doxorubicin
Number of subjects analysed
37
Units: months
    median (confidence interval 95%)
4.7 (3.1 to 6.3)
No statistical analyses for this end point

Secondary: Overall survival

Close Top of page
End point title
Overall survival
End point description
Overall Survival (OS), defined as the time from baseline until the date of death from any cause or the last date the patient was known to be alive.
End point type
Secondary
End point timeframe
Patiens were followed for survival after documented disease progression or after discontinuation before disease progression (every 12 weeks)
End point values
NGR-hTNF + doxorubicin
Number of subjects analysed
37
Units: Months
    median (confidence interval 95%)
13.9 (9.3 to 17.3)
No statistical analyses for this end point

Secondary: Tumor marker CA125 detection

Close Top of page
End point title
Tumor marker CA125 detection
End point description
Changes from baseline of tumor marker CA125.
End point type
Secondary
End point timeframe
The level of tumor marker CA125 was measured before the treatment (within 14 days prior treatment) and during the treatment (every 2 cycles).
End point values
NGR-hTNF + doxorubicin
Number of subjects analysed
37
Units: U/ml
    median (full range (min-max))
1.8 (-1833.8 to 745.8)
No statistical analyses for this end point

Adverse events

Close Top of page
Adverse events information
Timeframe for reporting adverse events
All adverse events and serious adverse events occurring after initiation of trial treatment will be recorded for 28 days after completion of the last treatment cycle. All serious adverse events related to the study drug will be recorded indefinitely.
Assessment type
Systematic
Dictionary used for adverse event reporting
Dictionary name
MedDRA
Dictionary version
19.1
Reporting groups
Reporting group title
NGR-hTNF + doxorubicin
Reporting group description
Patients received 60 minutes intravenous NGR-hTNF infusion every 3 weeks at dose of 0.8 μg/m2 before of a dose of doxorubicin 60 mg/m2 as 15 minutes infusion. At reaching of a cumulative dose of doxorubicin of 550 mg/m2, a continuation of treatment (if patient was showing an objective response or is in stable disease) with single agent NGR-hTNF at dose of 0.8 μg/m2 every 3 weeks was allowed.

Serious adverse events
NGR-hTNF + doxorubicin
Total subjects affected by serious adverse events
     subjects affected / exposed
7 / 37 (18.92%)
     number of deaths (all causes)
0
     number of deaths resulting from adverse events
0
Respiratory, thoracic and mediastinal disorders
Pulmonary Embolism
     subjects affected / exposed
1 / 37 (2.70%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Blood and lymphatic system disorders
Anaemia
     subjects affected / exposed
2 / 37 (5.41%)
     occurrences causally related to treatment / all
2 / 2
     deaths causally related to treatment / all
0 / 0
General disorders and administration site conditions
Infusion Site Extravasation
     subjects affected / exposed
1 / 37 (2.70%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Gastrointestinal disorders
Constipation
     subjects affected / exposed
1 / 37 (2.70%)
     occurrences causally related to treatment / all
1 / 1
     deaths causally related to treatment / all
0 / 0
Nausea
     subjects affected / exposed
1 / 37 (2.70%)
     occurrences causally related to treatment / all
1 / 1
     deaths causally related to treatment / all
0 / 0
Reproductive system and breast disorders
Pelvic Pain
     subjects affected / exposed
1 / 37 (2.70%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Frequency threshold for reporting non-serious adverse events: 5%
Non-serious adverse events
NGR-hTNF + doxorubicin
Total subjects affected by non serious adverse events
     subjects affected / exposed
37 / 37 (100.00%)
Investigations
Alanine Aminotransferase Increased
     subjects affected / exposed
4 / 37 (10.81%)
     occurrences all number
4
Aspartate Aminotransferase Increased
     subjects affected / exposed
3 / 37 (8.11%)
     occurrences all number
3
Gamma-Glutamyltransferase Increased
     subjects affected / exposed
3 / 37 (8.11%)
     occurrences all number
3
Respiratory, thoracic and mediastinal disorders
Dyspnoea
     subjects affected / exposed
3 / 37 (8.11%)
     occurrences all number
3
Cough
     subjects affected / exposed
2 / 37 (5.41%)
     occurrences all number
2
Immune system disorders
Contrast Media Allergy
     subjects affected / exposed
2 / 37 (5.41%)
     occurrences all number
2
Blood and lymphatic system disorders
Leukopenia
     subjects affected / exposed
31 / 37 (83.78%)
     occurrences all number
84
Anaemia
     subjects affected / exposed
29 / 37 (78.38%)
     occurrences all number
34
Neutropenia
     subjects affected / exposed
29 / 37 (78.38%)
     occurrences all number
73
Thrombocytosis
     subjects affected / exposed
8 / 37 (21.62%)
     occurrences all number
8
Thrombocytopenia
     subjects affected / exposed
5 / 37 (13.51%)
     occurrences all number
8
Nervous system disorders
Paraesthesia
     subjects affected / exposed
15 / 37 (40.54%)
     occurrences all number
18
Headache
     subjects affected / exposed
8 / 37 (21.62%)
     occurrences all number
12
General disorders and administration site conditions
Asthenia
     subjects affected / exposed
33 / 37 (89.19%)
     occurrences all number
37
Chills
     subjects affected / exposed
24 / 37 (64.86%)
     occurrences all number
40
Pyrexia
     subjects affected / exposed
4 / 37 (10.81%)
     occurrences all number
5
Gastrointestinal disorders
Nausea
     subjects affected / exposed
29 / 37 (78.38%)
     occurrences all number
45
Vomiting
     subjects affected / exposed
24 / 37 (64.86%)
     occurrences all number
43
Constipation
     subjects affected / exposed
23 / 37 (62.16%)
     occurrences all number
32
Stomatitis
     subjects affected / exposed
19 / 37 (51.35%)
     occurrences all number
19
Diarrhoea
     subjects affected / exposed
7 / 37 (18.92%)
     occurrences all number
8
Metabolism and nutrition disorders
Hypoalbuminaemia
     subjects affected / exposed
3 / 37 (8.11%)
     occurrences all number
3
Hypocalcaemia
     subjects affected / exposed
3 / 37 (8.11%)
     occurrences all number
3
Infections and infestations
Urinary Tract Infection
     subjects affected / exposed
3 / 37 (8.11%)
     occurrences all number
3
Herpes Zoster
     subjects affected / exposed
2 / 37 (5.41%)
     occurrences all number
2

More information

Close Top of page

Substantial protocol amendments (globally)

Were there any global substantial amendments to the protocol? Yes
Date
Amendment
05 May 2008
Summary of changes: - The reference name of the sponsor was changed; - The introduction was modified according to the availability of results of new studies; - The production process of the study drug has been changed, and therefore the protocol has been modified for the sections regarding pharmaceutical form, labelling, mode of dispensing and returning, and other details on study drug; - Plan of visits schedule of assessments has been changed; - Criteria for evaluation of relationship of adverse events have been modified; - Other minor changes.

Interruptions (globally)

Were there any global interruptions to the trial? No

Limitations and caveats

Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
None reported
3
Subscribe