- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT06169124
Studio per testare il farmaco Darolutamide insieme ai farmaci Leuprolide acetato ed Exemestane in pazienti con tumori ricorrenti a cellule della granulosa ovarica
Uno studio di fase II sull'inibizione del recettore degli androgeni (AR) da parte di darolutamide in combinazione con leuprolide acetato ed exemestane nel tumore ricorrente a cellule della granulosa ovarica di tipo adulto
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.
Panoramica dello studio
Stato
Descrizione dettagliata
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.
Tipo di studio
Iscrizione (Effettivo)
Fase
- Fase 2
Contatti e Sedi
Luoghi di studio
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California
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Los Angeles, California, Stati Uniti, 90048
- Cedars-Sinai Medical Center
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Delaware
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Newark, Delaware, Stati Uniti, 19713
- Helen F Graham Cancer Center
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Newark, Delaware, Stati Uniti, 19713
- Medical Oncology Hematology Consultants PA
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Idaho
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Boise, Idaho, Stati Uniti, 83706
- Saint Alphonsus Cancer Care Center-Boise
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Caldwell, Idaho, Stati Uniti, 83605
- Saint Alphonsus Cancer Care Center-Caldwell
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Coeur d'Alene, Idaho, Stati Uniti, 83814
- Kootenai Health - Coeur d'Alene
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Nampa, Idaho, Stati Uniti, 83687
- Saint Alphonsus Cancer Care Center-Nampa
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Post Falls, Idaho, Stati Uniti, 83854
- Kootenai Clinic Cancer Services - Post Falls
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Sandpoint, Idaho, Stati Uniti, 83864
- Kootenai Clinic Cancer Services - Sandpoint
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Illinois
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Chicago, Illinois, Stati Uniti, 60611
- Northwestern University
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Danville, Illinois, Stati Uniti, 61832
- Carle at The Riverfront
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DeKalb, Illinois, Stati Uniti, 60115
- Northwestern Medicine Cancer Center Kishwaukee
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Effingham, Illinois, Stati Uniti, 62401
- Carle Physician Group-Effingham
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Geneva, Illinois, Stati Uniti, 60134
- Northwestern Medicine Cancer Center Delnor
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Grayslake, Illinois, Stati Uniti, 60030
- Northwestern Medicine Grayslake Outpatient Center
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Lake Forest, Illinois, Stati Uniti, 60045
- Northwestern Medicine Lake Forest Hospital
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Mattoon, Illinois, Stati Uniti, 61938
- Carle Physician Group-Mattoon/Charleston
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Orland Park, Illinois, Stati Uniti, 60462
- Northwestern Medicine Orland Park
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Urbana, Illinois, Stati Uniti, 61801
- Carle Cancer Center
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Warrenville, Illinois, Stati Uniti, 60555
- Northwestern Medicine Cancer Center Warrenville
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Indiana
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Indianapolis, Indiana, Stati Uniti, 46260
- Ascension Saint Vincent Indianapolis Hospital
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Iowa
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Iowa City, Iowa, Stati Uniti, 52242
- University of Iowa/Holden Comprehensive Cancer Center
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Maine
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Scarborough, Maine, Stati Uniti, 04074
- MaineHealth Maine Medical Center- Scarborough
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Michigan
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Ann Arbor, Michigan, Stati Uniti, 48109
- University of Michigan Rogel Cancer Center
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Ann Arbor, Michigan, Stati Uniti, 48106
- Trinity Health Saint Joseph Mercy Hospital Ann Arbor
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Battle Creek, Michigan, Stati Uniti, 49017
- Bronson Battle Creek
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Brighton, Michigan, Stati Uniti, 48114
- Trinity Health IHA Medical Group Hematology Oncology - Brighton
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Canton, Michigan, Stati Uniti, 48188
- Trinity Health IHA Medical Group Hematology Oncology - Canton
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Chelsea, Michigan, Stati Uniti, 48118
- Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
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Flint, Michigan, Stati Uniti, 48503
- Hurley Medical Center
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Flint, Michigan, Stati Uniti, 48503
- Genesee Hematology Oncology PC
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Flint, Michigan, Stati Uniti, 48503
- Genesys Hurley Cancer Institute
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Flint, Michigan, Stati Uniti, 48503
- Cancer Hematology Centers - Flint
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Grand Rapids, Michigan, Stati Uniti, 49503
- Trinity Health Grand Rapids Hospital
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Grand Rapids, Michigan, Stati Uniti, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
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Kalamazoo, Michigan, Stati Uniti, 49007
- West Michigan Cancer Center
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Kalamazoo, Michigan, Stati Uniti, 49007
- Bronson Methodist Hospital
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Kalamazoo, Michigan, Stati Uniti, 49009
- Beacon Kalamazoo Cancer Center
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Livonia, Michigan, Stati Uniti, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
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Muskegon, Michigan, Stati Uniti, 49444
- Trinity Health Muskegon Hospital
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Norton Shores, Michigan, Stati Uniti, 49444
- Cancer and Hematology Centers of Western Michigan - Norton Shores
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Reed City, Michigan, Stati Uniti, 49677
- Corewell Health Reed City Hospital
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Saint Joseph, Michigan, Stati Uniti, 49085
- Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
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Traverse City, Michigan, Stati Uniti, 49684
- Munson Medical Center
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Wyoming, Michigan, Stati Uniti, 49519
- University of Michigan Health - West
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Ypsilanti, Michigan, Stati Uniti, 48197
- Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
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Missouri
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St Louis, Missouri, Stati Uniti, 63141
- Mercy Hospital Saint Louis
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Montana
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Anaconda, Montana, Stati Uniti, 59711
- Community Hospital of Anaconda
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Billings, Montana, Stati Uniti, 59101
- Billings Clinic Cancer Center
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Bozeman, Montana, Stati Uniti, 59715
- Bozeman Health Deaconess Hospital
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Great Falls, Montana, Stati Uniti, 59405
- Benefis Sletten Cancer Institute
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Missoula, Montana, Stati Uniti, 59804
- Community Medical Center
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Nebraska
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Omaha, Nebraska, Stati Uniti, 68198
- University of Nebraska Medical Center
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North Carolina
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Charlotte, North Carolina, Stati Uniti, 28203
- Carolinas Medical Center/Levine Cancer Institute
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Concord, North Carolina, Stati Uniti, 28025
- Atrium Health Cabarrus/LCI-Concord
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Ohio
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Centerville, Ohio, Stati Uniti, 45459
- Miami Valley Hospital South
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Cleveland, Ohio, Stati Uniti, 44195
- Cleveland Clinic Foundation
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Sylvania, Ohio, Stati Uniti, 43560
- ProMedica Flower Hospital
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Oklahoma
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Oklahoma City, Oklahoma, Stati Uniti, 73104
- University of Oklahoma Health Sciences Center
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Oregon
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Ontario, Oregon, Stati Uniti, 97914
- Saint Alphonsus Cancer Care Center-Ontario
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Portland, Oregon, Stati Uniti, 97210
- Legacy Good Samaritan Hospital and Medical Center
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Tualatin, Oregon, Stati Uniti, 97062
- Legacy Meridian Park Hospital
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Washington
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Vancouver, Washington, Stati Uniti, 98686
- Legacy Salmon Creek Hospital
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West Virginia
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Charleston, West Virginia, Stati Uniti, 25304
- West Virginia University Charleston Division
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Wisconsin
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Appleton, Wisconsin, Stati Uniti, 54911
- ThedaCare Regional Cancer Center
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Milwaukee, Wisconsin, Stati Uniti, 53226
- Medical College of Wisconsin
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
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Physicians should consider the following when evaluating if the patient is appropriate for this protocol:
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Patients must have adequate health that permits completion of the study requirements and required follow up
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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
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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
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In addition:
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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
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
|
Sperimentale: 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
Altri nomi:
Undergo MRI
Altri nomi:
Undergo PET/CT
Altri nomi:
Undergo chest x-ray
Altri nomi:
Undergo CT and/or PET/CT
Altri nomi:
Given PO
Altri nomi:
Undergo archived tissue and blood sample collection
Altri nomi:
Given IM
Altri nomi:
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Objective Response Rate (ORR)
Lasso di tempo: Within 9 months of initiating study treatment
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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
|
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Duration of Response
Lasso di tempo: 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)
Lasso di tempo: 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)
Lasso di tempo: up to 22 months
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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
|
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Incidence of Adverse Events
Lasso di tempo: 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.
|
Collaboratori e investigatori
Sponsor
Collaboratori
Investigatori
- Investigatore principale: Elizabeth Hopp, NRG Oncology
Pubblicazioni e link utili
Pubblicazioni generali
- 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.
Studiare le date dei record
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Inizio studio (Effettivo)
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Tumore a cellule granulosa dell'ovaio
- Ormoni
- Ormoni, sostituti ormonali e antagonisti ormonali
- Ormoni a rilascio di ormoni ipofisari
- Ormoni ipotalamici
- Ormoni peptidici
- Neuropeptidi
- Peptidi
- Aminoacidi, peptidi e proteine
- Oligopeptidi
- Proteine del tessuto nervoso
- Proteine
- Tecniche investigative
- Tecniche di laboratorio clinico
- Tecniche e procedure diagnostiche
- Diagnosi
- Fenomeni fisici
- Tecniche di chimica, analitiche
- Analisi dello spettro
- Fenomeni elettromagnetici
- Fenomeni magnetici
- Radiazioni elettromagnetiche
- Radiazione
- Radiazione, ionizzante
- Ormone a rilascio di gonadotropina
- Leuprolide
- deposito gel di acetato di luprolide
- Daroutamide
- Gestione dei campioni
- Spettroscopia di risonanza magnetica
- Raggi X.
- Esemestane
Altri numeri di identificazione dello studio
- NCI-2023-06524
- U10CA180868 (Sovvenzione/contratto NIH degli Stati Uniti)
- NCI-2023-06524 (Identificatore di registro: CTRP (Clinical Trial Reporting Program))
- NRG-GY033 (Altro identificatore: CTEP)
- NRG-GY033 (Altro identificatore: NRG Oncology)
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Descrizione del piano IPD
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Informazioni su farmaci e dispositivi, documenti di studio
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