Tutkimus lääkkeen darolutamidin testaamiseksi yhdessä lääkkeiden leuprolidiasetaatin ja eksemestaanin kanssa potilailla, joilla on toistuvia munasarjasolukasvareita
Vaiheen II tutkimus androgeenireseptorin (AR) estämisestä darolutamidilla yhdessä leuprolidiasetaatin ja eksemestaanin kanssa uusiutuvassa aikuistyypin munasarjasolukasvaimessa
This phase II trial tests how well darolutamide in combination with leuprolide acetate and exemestane works in treating patients with ovarian granulosa cell tumors that have come back after a period of improvement (recurrent). Darolutamide is in a class of medications called androgen receptor inhibitors. It works by blocking the effects of androgen (a male reproductive hormone) to stop the growth and spread of tumor cells. Leuprolide acetate is in a class of medications called gonadotropin-releasing hormone agonists. It works by decreasing the amount of certain hormones in the body. Exemestane is in a class of medications called aromatase inhibitors which has anti-estrogen and anticancer activities. Exemestane binds to and inhibits the enzyme aromatase, thereby blocking the conversion of androgens to estrogens. This lowers estrogen levels in the blood circulation causing the tumor cells to grow more slowly or stop growing completely. The combination of darolutamide, leuprolide acetate, and exemestane may be an effective approach to shrinking or stabilizing recurrent ovarian granulosa cell tumors or preventing them from coming back.
Tutkimuksen yleiskatsaus
Tila
Tila
Ehdot
Ehdot
Interventio / Hoito
Interventio / Hoito
Yksityiskohtainen kuvaus
PRIMARY OBJECTIVE:
I. To determine the objective response rate of darolutamide, leuprolide acetate, and exemestane in recurrent adult-type granulosa cell tumors of the ovary (AGCT).
SECONDARY OBJECTIVES:
I. To determine duration of response of darolutamide, leuprolide acetate, and exemestane in recurrent adult-type granulosa cell tumors of the ovary (AGCT).
II. To determine progression-free survival of darolutamide, leuprolide acetate, and exemestane when used in recurrent adult-type granulosa cell tumors of ovary (AGCT).
III. To determine overall survival of darolutamide, leuprolide acetate, and exemestane when used in recurrent adult-type granulosa cell tumors of ovary (AGCT).
IV. To elucidate the toxicities of darolutamide, leuprolide acetate, and exemestane when used in recurrent adult-type granulosa cell tumors of ovary (AGCT).
EXPLORATORY OBJECTIVE:
I. To determine biomarkers predictive of response to darolutamide, leuprolide acetate, and exemestane.
OUTLINE:
Patients receive exemestane orally (PO) once daily (QD) and darolutamide PO twice daily (BID) starting on days -14 to -7 prior to cycle 1, day 1 (C1D1) and then on days 1-28 of each cycle. Patients receive leuprolide acetate intramuscularly (IM) on day 1 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo chest computed tomography (CT) or chest x-ray and CT, magnetic resonance imaging (MRI), or positron emission tomography (PET)/CT as well as blood sample collection throughout the study. Patients undergo collection of archived tissue during screening.
Upon completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.
Opintotyyppi
Opintotyyppi
Ilmoittautuminen (Todellinen)
Ilmoittautuminen
Vaihe
Vaihe
- Vaihe 2
Yhteystiedot ja paikat
Opiskelupaikat
-
-
California
-
Los Angeles, California, Yhdysvallat, 90048
- Cedars-Sinai Medical Center
-
-
Delaware
-
Newark, Delaware, Yhdysvallat, 19713
- Helen F Graham Cancer Center
-
Newark, Delaware, Yhdysvallat, 19713
- Medical Oncology Hematology Consultants PA
-
-
Idaho
-
Boise, Idaho, Yhdysvallat, 83706
- Saint Alphonsus Cancer Care Center-Boise
-
Caldwell, Idaho, Yhdysvallat, 83605
- Saint Alphonsus Cancer Care Center-Caldwell
-
Coeur d'Alene, Idaho, Yhdysvallat, 83814
- Kootenai Health - Coeur d'Alene
-
Nampa, Idaho, Yhdysvallat, 83687
- Saint Alphonsus Cancer Care Center-Nampa
-
Post Falls, Idaho, Yhdysvallat, 83854
- Kootenai Clinic Cancer Services - Post Falls
-
Sandpoint, Idaho, Yhdysvallat, 83864
- Kootenai Clinic Cancer Services - Sandpoint
-
-
Illinois
-
Chicago, Illinois, Yhdysvallat, 60611
- Northwestern University
-
Danville, Illinois, Yhdysvallat, 61832
- Carle at The Riverfront
-
DeKalb, Illinois, Yhdysvallat, 60115
- Northwestern Medicine Cancer Center Kishwaukee
-
Effingham, Illinois, Yhdysvallat, 62401
- Carle Physician Group-Effingham
-
Geneva, Illinois, Yhdysvallat, 60134
- Northwestern Medicine Cancer Center Delnor
-
Grayslake, Illinois, Yhdysvallat, 60030
- Northwestern Medicine Grayslake Outpatient Center
-
Lake Forest, Illinois, Yhdysvallat, 60045
- Northwestern Medicine Lake Forest Hospital
-
Mattoon, Illinois, Yhdysvallat, 61938
- Carle Physician Group-Mattoon/Charleston
-
Orland Park, Illinois, Yhdysvallat, 60462
- Northwestern Medicine Orland Park
-
Urbana, Illinois, Yhdysvallat, 61801
- Carle Cancer Center
-
Warrenville, Illinois, Yhdysvallat, 60555
- Northwestern Medicine Cancer Center Warrenville
-
-
Indiana
-
Indianapolis, Indiana, Yhdysvallat, 46260
- Ascension Saint Vincent Indianapolis Hospital
-
-
Iowa
-
Iowa City, Iowa, Yhdysvallat, 52242
- University of Iowa/Holden Comprehensive Cancer Center
-
-
Maine
-
Scarborough, Maine, Yhdysvallat, 04074
- MaineHealth Maine Medical Center- Scarborough
-
-
Michigan
-
Ann Arbor, Michigan, Yhdysvallat, 48109
- University of Michigan Rogel Cancer Center
-
Ann Arbor, Michigan, Yhdysvallat, 48106
- Trinity Health Saint Joseph Mercy Hospital Ann Arbor
-
Battle Creek, Michigan, Yhdysvallat, 49017
- Bronson Battle Creek
-
Brighton, Michigan, Yhdysvallat, 48114
- Trinity Health IHA Medical Group Hematology Oncology - Brighton
-
Canton, Michigan, Yhdysvallat, 48188
- Trinity Health IHA Medical Group Hematology Oncology - Canton
-
Chelsea, Michigan, Yhdysvallat, 48118
- Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
-
Flint, Michigan, Yhdysvallat, 48503
- Hurley Medical Center
-
Flint, Michigan, Yhdysvallat, 48503
- Genesee Hematology Oncology PC
-
Flint, Michigan, Yhdysvallat, 48503
- Genesys Hurley Cancer Institute
-
Flint, Michigan, Yhdysvallat, 48503
- Cancer Hematology Centers - Flint
-
Grand Rapids, Michigan, Yhdysvallat, 49503
- Trinity Health Grand Rapids Hospital
-
Grand Rapids, Michigan, Yhdysvallat, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
-
Kalamazoo, Michigan, Yhdysvallat, 49007
- West Michigan Cancer Center
-
Kalamazoo, Michigan, Yhdysvallat, 49007
- Bronson Methodist Hospital
-
Kalamazoo, Michigan, Yhdysvallat, 49009
- Beacon Kalamazoo Cancer Center
-
Livonia, Michigan, Yhdysvallat, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
-
Muskegon, Michigan, Yhdysvallat, 49444
- Trinity Health Muskegon Hospital
-
Norton Shores, Michigan, Yhdysvallat, 49444
- Cancer and Hematology Centers of Western Michigan - Norton Shores
-
Reed City, Michigan, Yhdysvallat, 49677
- Corewell Health Reed City Hospital
-
Saint Joseph, Michigan, Yhdysvallat, 49085
- Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
-
Traverse City, Michigan, Yhdysvallat, 49684
- Munson Medical Center
-
Wyoming, Michigan, Yhdysvallat, 49519
- University of Michigan Health - West
-
Ypsilanti, Michigan, Yhdysvallat, 48197
- Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
-
-
Missouri
-
St Louis, Missouri, Yhdysvallat, 63141
- Mercy Hospital Saint Louis
-
-
Montana
-
Anaconda, Montana, Yhdysvallat, 59711
- Community Hospital of Anaconda
-
Billings, Montana, Yhdysvallat, 59101
- Billings Clinic Cancer Center
-
Bozeman, Montana, Yhdysvallat, 59715
- Bozeman Health Deaconess Hospital
-
Great Falls, Montana, Yhdysvallat, 59405
- Benefis Sletten Cancer Institute
-
Missoula, Montana, Yhdysvallat, 59804
- Community Medical Center
-
-
Nebraska
-
Omaha, Nebraska, Yhdysvallat, 68198
- University of Nebraska Medical Center
-
-
North Carolina
-
Charlotte, North Carolina, Yhdysvallat, 28203
- Carolinas Medical Center/Levine Cancer Institute
-
Concord, North Carolina, Yhdysvallat, 28025
- Atrium Health Cabarrus/LCI-Concord
-
-
Ohio
-
Centerville, Ohio, Yhdysvallat, 45459
- Miami Valley Hospital South
-
Cleveland, Ohio, Yhdysvallat, 44195
- Cleveland Clinic Foundation
-
Sylvania, Ohio, Yhdysvallat, 43560
- ProMedica Flower Hospital
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Yhdysvallat, 73104
- University of Oklahoma Health Sciences Center
-
-
Oregon
-
Ontario, Oregon, Yhdysvallat, 97914
- Saint Alphonsus Cancer Care Center-Ontario
-
Portland, Oregon, Yhdysvallat, 97210
- Legacy Good Samaritan Hospital and Medical Center
-
Tualatin, Oregon, Yhdysvallat, 97062
- Legacy Meridian Park Hospital
-
-
Washington
-
Vancouver, Washington, Yhdysvallat, 98686
- Legacy Salmon Creek Hospital
-
-
West Virginia
-
Charleston, West Virginia, Yhdysvallat, 25304
- West Virginia University Charleston Division
-
-
Wisconsin
-
Appleton, Wisconsin, Yhdysvallat, 54911
- ThedaCare Regional Cancer Center
-
Milwaukee, Wisconsin, Yhdysvallat, 53226
- Medical College of Wisconsin
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
-
Physicians should consider the following when evaluating if the patient is appropriate for this protocol:
-
Patients must have adequate health that permits completion of the study requirements and required follow up
-
For patients with known human immunodeficiency virus (HIV), hepatitis B virus (HBV), and/or hepatitis C virus (HCV) infection:
- HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
- For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated
- Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
-
Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
-
In addition:
-
The effects of the combination of darolutamide, leuprolide acetate, and exemestane on the developing human fetus are unknown. For this reason, and because androgen receptor inhibitor agents as well as other therapeutic agents used in this trial are known to be teratogenic, participants of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) during study therapy and for 1 month following the completion of study therapy. Should a participant become pregnant or suspect pregnancy while participating in this study, they should inform their treating physician immediately
- Submission of tissue is required. Investigators should check with their pathology department regarding release of tissue before approaching patients about participation in the trial
- Histologically confirmed diagnosis of recurrent adult-type granulosa cell tumor
- Patient must have measurable disease. Measurable disease is defined in the protocol per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. Measurable disease is defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded). Each lesion must be ≥ 10 mm when measured by CT or MRI. Lymph nodes must be ≥ 15 mm in short axis when measured by CT or MRI
- Patient must have had ≥1 treatment regimen
- Subject must have progressed on an aromatase inhibitor (letrozole, exemestane, anastrozole) in a prior treatment line
- Age ≥ 18 years
- Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2
- Not pregnant and not nursing
- Absolute neutrophil count (ANC) ≥ 1,500 cells/mm^3
- Platelets ≥ 100,000 cells/mm^3
- Hemoglobin ≥ 8 g/dl
- Creatinine clearance (CrCL) of ≥ 30 mL/min by the Cockcroft-Gault formula
- Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (patients with known Gilbert's disease who have bilirubin level ≤ 3 x ULN may be enrolled)
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 1.5 x institutional ULN
- Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better
- No active infection requiring parenteral antibiotics
- Patients with current evidence of intra-abdominal abscess, abdominal/pelvic fistula (not diverted), gastrointestinal perforation, gastrointestinal (GI) obstruction, and/or need for drainage nasogastric or gastrostomy tube
- The patient or a legally authorized representative must provide study-specific informed consent prior to study entry and, for patients treated in the United States (U.S.), authorization permitting release of personal health information
Exclusion Criteria:
- Prior treatment with AR inhibitors
- Known hypersensitivity to the study drugs or their ingredients
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Ei käytössä
- Inventiomalli: Yksittäinen ryhmätehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseiden lukumäärä
Aseet ja interventiot
Osallistujaryhmä / ArmOsallistujaryhmä / Arm |
Interventio / HoitoInterventio / Hoito |
|---|---|
|
Kokeellinen: Treatment (exemestane, darolutamide, leuprolide acetate)
Patients receive exemestane PO QD and darolutamide PO BID starting on days -14 to -7 prior to C1D1 and then on days 1-28 of each cycle. Patients receive leuprolide acetate IM on day 1 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo chest CT or chest x-ray and CT, MRI, or PET/CT as well as blood sample collection throughout the study. Patients undergo collection of archived tissue during screening. |
Given PO
Muut nimet:
Undergo MRI
Muut nimet:
Undergo PET/CT
Muut nimet:
Undergo chest x-ray
Muut nimet:
Undergo CT and/or PET/CT
Muut nimet:
Given PO
Muut nimet:
Undergo archived tissue and blood sample collection
Muut nimet:
Given IM
Muut nimet:
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Objective Response Rate (ORR)
Aikaikkuna: Within 9 months of initiating study treatment
|
Defined as a complete response (CR) or partial response (PR) as assessed by Response Evaluation Criteria in Solid Tumors version 1.1 criteria. Exact 95% confidence limits, accounting for interim analysis, will be provided in the final report. |
Within 9 months of initiating study treatment
|
Toissijaiset tulostoimenpiteet
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Duration of Response
Aikaikkuna: Within 9 months of initiating study treatment
|
The duration of overall response is measured from the time measurement criteria are first met for CR or PR (whichever is first recorded) until the first date that recurrence or progressive disease is objectively documented. Only one patient experienced a partial response (PR) within the 9-month response window. Therefore the 95% confidence interval for the duration of response was not estimated. |
Within 9 months of initiating study treatment
|
|
Progression-free Survival (PFS)
Aikaikkuna: up to 22 months
|
Progression-free survival (PFS) is defined as the duration of time from study entry to time of progression or death, whichever occurs first, or date of last contact with known progression-free status if neither progression nor death has occurred. Patients with no follow-up will be censored 1 day after enrollment. Will be graphed using Kaplan-Meier methods. Median PFS will be estimated with corresponding 95% confidence intervals. |
up to 22 months
|
|
Overall Survival (OS)
Aikaikkuna: up to 22 months
|
Overall survival is defined as the duration of time from study entry to time of death or the date of last contact. Patients with no follow-up will be censored 1 day after enrollment. Will be graphed using Kaplan-Meier methods. Median OS will be estimated with corresponding 95% confidence intervals. The OS was not reached due to the study early termination for futility. Thus the death rate was reported instead of survival time. |
up to 22 months
|
|
Incidence of Adverse Events
Aikaikkuna: Adverse Events were assessed up to 9 months, All Cause Mortality was assessed up to 22 months.
|
Common Terminology Criteria for Adverse Events version 5 will be used to grade and categorize adverse events. Safety will be assessed beginning with the initial dose of any treatment. Descriptive statistics, including frequencies of maximum grade of adverse events by term and category will be reported. Adverse events categorized as grade 5 will be individually reported. |
Adverse Events were assessed up to 9 months, All Cause Mortality was assessed up to 22 months.
|
Yhteistyökumppanit ja tutkijat
Sponsori
Sponsori
Yhteistyökumppanit
Yhteistyökumppanit
Tutkijat
Tutkijat
- Päätutkija: Elizabeth Hopp, NRG Oncology
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Erfani H, Martynova A, Matsuzaki S, Matsuo K, Roman LD, Sood AK, Kurnit KC, Westin SN. Androgen receptor as a therapeutic target in endometrial cancer: a narrative review. Int J Gynecol Cancer. 2026 Jun;36(6):104698. doi: 10.1016/j.ijgc.2026.104698. Epub 2026 Apr 11.
- Hopp EE, Enserro D, Campos S, Chitiyo V, Huang G, Lankes H, Crane EK, Hoekstra A, Siedel J, Richardson DL, Aghajanian C, Rader JS, Covens A. A phase II study of androgen receptor inhibition by darolutamide in combination with leuprolide acetate and exemestane in recurrent adult-type ovarian granulosa cell tumor. Gynecol Oncol. 2026 Aug 10;212:98-105. doi: 10.1016/j.ygyno.2026.07.017. Online ahead of print.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Ensisijainen valmistuminen
Opintojen valmistuminen (Todellinen)
Opintojen valmistuminen
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Ensimmäinen Lähetetty
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin päivitys julkaistu
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
- Munasarjan granulosa -solukasvain
- Hormonit
- Hormonit, hormonikorvikkeet ja hormoniantagonistit
- Aivolisäkkeen vapauttavat hormonit
- Hypotalamuksen hormonit
- Peptidihormonit
- Neuropeptidit
- Peptidit
- Aminohapot, peptidit ja proteiinit
- Oligopeptidit
- Hermokudosproteiinit
- Proteiinit
- Tutkintatekniikat
- Kliiniset laboratoriotekniikat
- Diagnostiikkatekniikat ja menettelyt
- Diagnoosi
- Fyysiset ilmiöt
- Kemian tekniikat, analyyttiset
- Spektrianalyysi
- Sähkömagneettiset ilmiöt
- Magneettiset ilmiöt
- Sähkömagneettinen säteily
- Säteily
- Säteily, ionisoiva
- Gonadotropiinia vapauttava hormoni
- Leuprolidi
- luprolidiasetaattigeelivarasto
- darolutamidi
- Näytteenkäsittely
- Magneettiresonanssispektroskopia
- Röntgenkuva
- exemestane
Muut tutkimustunnusnumerot
Muut tutkimustunnusnumerot
- NCI-2023-06524
- U10CA180868 (Yhdysvaltain NIH-apuraha/sopimus)
- NCI-2023-06524 (Rekisterin tunniste: CTRP (Clinical Trial Reporting Program))
- NRG-GY033 (Muu tunniste: CTEP)
- NRG-GY033 (Muu tunniste: NRG Oncology)
Yksittäisten osallistujien tietojen suunnitelma (IPD)
Aiotko jakaa yksittäisten osallistujien tietoja (IPD)?
IPD-suunnitelman kuvaus
NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.
Lääke- ja laitetiedot, tutkimusasiakirjat
Tutkii yhdysvaltalaista FDA sääntelemää lääkevalmistetta
Tutkii yhdysvaltalaista FDA sääntelemää laitetuotetta
Nämä tiedot haettiin suoraan verkkosivustolta clinicaltrials.gov ilman muutoksia. Jos sinulla on pyyntöjä muuttaa, poistaa tai päivittää tutkimustietojasi, ota yhteyttä register@clinicaltrials.gov. Heti kun muutos on otettu käyttöön osoitteessa clinicaltrials.gov, se päivitetään automaattisesti myös verkkosivustollemme .