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化学療法が効かなくなった後の子宮平滑筋肉腫に対するオラパリブとテモゾロミドと通常の治療法との比較試験

2026年9月30日 更新者：National Cancer Institute (NCI)

以前の化学療法で進行した子宮平滑筋肉腫患者の治療のためのオラパリブとテモゾロミドと治験責任医師の選択の無作為化第 2/3 相研究

This phase II/III trial compares the effect of the combination treatment with olaparib and temozolomide to trabectedin or pazopanib (two of the most common chemotherapy drugs used as usual approach) in patients with uterine leiomyosarcoma that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced) after initial chemotherapy has stopped working. The usual approach is defined as care most people get for advanced uterine leiomyosarcoma. Olaparib is a PARP inhibitor. PARP is a protein that helps repair damaged deoxyribonucleic acid (DNA). Blocking PARP may prevent tumor cells from repairing their damaged DNA, causing them to die. PARP inhibitors are a type of targeted therapy. Temozolomide is in a class of medications called alkylating agents. It works by slowing or stopping the growth of tumor cells in the body. The combination of olaparib and temozolomide may work better than the usual treatment in shrinking or stabilizing advanced uterine leiomyosarcoma after initial chemotherapy has stopped working.

調査の概要

状態

積極的、募集していない

条件

介入・治療

詳細な説明

PRIMARY OBJECTIVES:

I. To compare the progression free survival (PFS) of olaparib plus temozolomide (Arm 1) as compared to investigator's choice (trabectedin or pazopanib hydrochloride [pazopanib]) (Arm 2) for the treatment of patients with advanced uterine leiomyosarcoma (uLMS) who have received two or more prior lines of therapy as determined by investigator (local site) assessment. (Phase 2) II. To compare the overall survival (OS) of olaparib plus temozolomide (Arm 1) as compared to investigator's choice (trabectedin or pazopanib) (Arm 2) for the treatment of patients with advanced uLMS who have received two or more prior lines of therapy. (Phase 3)

SECONDARY OBJECTIVES:

I. To evaluate the safety and tolerability of each treatment by determining adverse events using Common Terminology Criteria for Adverse Events (CTCAE) version 5 and patient-reported toxicity using Patient-Reported Outcome (PRO)-CTCAE version 1 in and across each treatment arm. (Phase 2/3) II. To evaluate the objective response rate (ORR), duration of response (DOR) and disease control rate (DCR) in and across each treatment arm as determined by investigator assessment. (Phase 2/3)

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM 1: Patients receive temozolomide orally (PO) once daily (QD) on days 1-7 of each cycle and olaparib PO twice daily (BID) on days 1-7 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo computed tomography (CT) scan or magnetic resonance imaging (MRI) and/or bone scans throughout the trial. Patients also undergo collection of blood samples throughout the trial.

ARM 2: Patients receive trabectedin intravenously (IV) continuously over 24 hours on day 1 of each cycle or pazopanib PO QD on days 1-21 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan or MRI and/or bone scans throughout the trial. Patients also undergo transthoracic echocardiography (TTE) or multi-gated acquisition scan (MUGA) on study and as clinically indicated, as well as collection of blood samples throughout the trial.

After completion of study treatment, patients without disease progression are followed every 6 weeks until disease progression. After disease progression, patients are followed every 3 months for the first 2 years, then every 6 months thereafter until 5 years post-randomization or death, whichever comes first.

研究の種類

介入

入学 (実際)

74

段階

  • フェーズ2
  • フェーズ 3

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

  • アメリカ
    • Alabama
      • Birmingham、Alabama、アメリカ、35233
        • University of Alabama at Birmingham Cancer Center
    • Alaska
      • Anchorage、Alaska、アメリカ、99508
        • Alaska Women's Cancer Care
    • Arizona
      • Phoenix、Arizona、アメリカ、85054
        • Mayo Clinic Hospital in Arizona
    • California
      • Duarte、California、アメリカ、91010
        • City of Hope Comprehensive Cancer Center
      • Dublin、California、アメリカ、94568
        • Epic Care-Dublin
      • Emeryville、California、アメリカ、94608
        • Epic Care Partners in Cancer Care
      • Irvine、California、アメリカ、92618
        • City of Hope at Irvine Lennar
      • Martinez、California、アメリカ、94553-3156
        • Contra Costa Regional Medical Center
      • Walnut Creek、California、アメリカ、94597
        • Epic Care Cyberknife Center
    • Colorado
      • Aurora、Colorado、アメリカ、80045
        • UCHealth University of Colorado Hospital
      • Colorado Springs、Colorado、アメリカ、80909
        • UCHealth Memorial Hospital Central
      • Colorado Springs、Colorado、アメリカ、80920
        • Memorial Hospital North
      • Fort Collins、Colorado、アメリカ、80524
        • Poudre Valley Hospital
      • Fort Collins、Colorado、アメリカ、80528
        • Cancer Care and Hematology-Fort Collins
      • Greeley、Colorado、アメリカ、80631
        • UCHealth Greeley Hospital
      • Loveland、Colorado、アメリカ、80538
        • Medical Center of the Rockies
    • Connecticut
      • Derby、Connecticut、アメリカ、06418
        • Smilow Cancer Hospital-Derby Care Center
      • Fairfield、Connecticut、アメリカ、06824
        • Smilow Cancer Hospital Care Center-Fairfield
      • Glastonbury、Connecticut、アメリカ、06033
        • Smilow Cancer Hospital Care Center at Glastonbury
      • Greenwich、Connecticut、アメリカ、06830
        • Smilow Cancer Hospital Care Center at Greenwich
      • Guilford、Connecticut、アメリカ、06437
        • Smilow Cancer Hospital Care Center - Guilford
      • Hartford、Connecticut、アメリカ、06105
        • Smilow Cancer Hospital Care Center at Saint Francis
      • New Haven、Connecticut、アメリカ、06520
        • Yale University
      • North Haven、Connecticut、アメリカ、06473
        • Yale-New Haven Hospital North Haven Medical Center
      • Stamford、Connecticut、アメリカ、06902
        • Smilow Cancer Hospital Care Center at Long Ridge
      • Torrington、Connecticut、アメリカ、06790
        • Smilow Cancer Hospital-Torrington Care Center
      • Trumbull、Connecticut、アメリカ、06611
        • Smilow Cancer Hospital Care Center-Trumbull
      • Waterbury、Connecticut、アメリカ、06708
        • Smilow Cancer Hospital-Waterbury Care Center
      • Waterford、Connecticut、アメリカ、06385
        • Smilow Cancer Hospital Care Center - Waterford
    • District of Columbia
      • Washington D.C.、District of Columbia、アメリカ、20010
        • MedStar Washington Hospital Center
    • Florida
      • Deerfield Beach、Florida、アメリカ、33442
        • UM Sylvester Comprehensive Cancer Center at Deerfield Beach
      • Jacksonville、Florida、アメリカ、32224-9980
        • Mayo Clinic in Florida
      • Miami、Florida、アメリカ、33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Plantation、Florida、アメリカ、33324
        • UM Sylvester Comprehensive Cancer Center at Plantation
    • Georgia
      • Savannah、Georgia、アメリカ、31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
    • Idaho
      • Boise、Idaho、アメリカ、83712
        • Saint Luke's Cancer Institute - Boise
      • Fruitland、Idaho、アメリカ、83619
        • Saint Luke's Cancer Institute - Fruitland
      • Meridian、Idaho、アメリカ、83642
        • Saint Luke's Cancer Institute - Meridian
      • Nampa、Idaho、アメリカ、83687
        • Saint Luke's Cancer Institute - Nampa
      • Twin Falls、Idaho、アメリカ、83301
        • Saint Luke's Cancer Institute - Twin Falls
    • Illinois
      • Chicago、Illinois、アメリカ、60611
        • Northwestern University
      • Chicago、Illinois、アメリカ、60612
        • University of Illinois
      • Danville、Illinois、アメリカ、61832
        • Carle at The Riverfront
      • DeKalb、Illinois、アメリカ、60115
        • Northwestern Medicine Cancer Center Kishwaukee
      • Effingham、Illinois、アメリカ、62401
        • Carle Physician Group-Effingham
      • Evanston、Illinois、アメリカ、60201
        • NorthShore University HealthSystem-Evanston Hospital
      • Geneva、Illinois、アメリカ、60134
        • Northwestern Medicine Cancer Center Delnor
      • Glenview、Illinois、アメリカ、60026
        • NorthShore University HealthSystem-Glenbrook Hospital
      • Highland Park、Illinois、アメリカ、60035
        • NorthShore University HealthSystem-Highland Park Hospital
      • Lake Forest、Illinois、アメリカ、60045
        • Northwestern Medicine Lake Forest Hospital
      • Mattoon、Illinois、アメリカ、61938
        • Carle Physician Group-Mattoon/Charleston
      • Urbana、Illinois、アメリカ、61801
        • Carle Cancer Center
      • Warrenville、Illinois、アメリカ、60555
        • Northwestern Medicine Cancer Center Warrenville
    • Iowa
      • Ames、Iowa、アメリカ、50010
        • Mary Greeley Medical Center
      • Ames、Iowa、アメリカ、50010
        • McFarland Clinic - Ames
      • Boone、Iowa、アメリカ、50036
        • McFarland Clinic - Boone
      • Council Bluffs、Iowa、アメリカ、51503
        • Heartland Oncology and Hematology LLP
      • Des Moines、Iowa、アメリカ、50314
        • Mercy Medical Center - Des Moines
      • Fort Dodge、Iowa、アメリカ、50501
        • McFarland Clinic - Trinity Cancer Center
      • Iowa City、Iowa、アメリカ、52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Jefferson、Iowa、アメリカ、50129
        • McFarland Clinic - Jefferson
      • Marshalltown、Iowa、アメリカ、50158
        • McFarland Clinic - Marshalltown
    • Kentucky
      • Lexington、Kentucky、アメリカ、40503
        • Baptist Health Lexington
    • Louisiana
      • Baton Rouge、Louisiana、アメリカ、70817
        • Our Lady of the Lake Medical Oncology
      • New Orleans、Louisiana、アメリカ、70112
        • University Medical Center New Orleans
    • Maine
      • Scarborough、Maine、アメリカ、04074
        • MaineHealth Maine Medical Center- Scarborough
    • Massachusetts
      • Boston、Massachusetts、アメリカ、02215
        • Dana-Farber Cancer Institute
    • Michigan
      • Ann Arbor、Michigan、アメリカ、48109
        • University of Michigan Rogel Cancer Center
      • Battle Creek、Michigan、アメリカ、49017
        • Bronson Battle Creek
      • Grand Rapids、Michigan、アメリカ、49503
        • Trinity Health Grand Rapids Hospital
      • Grand Rapids、Michigan、アメリカ、49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • Kalamazoo、Michigan、アメリカ、49007
        • West Michigan Cancer Center
      • Kalamazoo、Michigan、アメリカ、49007
        • Bronson Methodist Hospital
      • Kalamazoo、Michigan、アメリカ、49009
        • Beacon Kalamazoo Cancer Center
      • Muskegon、Michigan、アメリカ、49444
        • Trinity Health Muskegon Hospital
      • Norton Shores、Michigan、アメリカ、49444
        • Cancer and Hematology Centers of Western Michigan - Norton Shores
      • Reed City、Michigan、アメリカ、49677
        • Corewell Health Reed City Hospital
      • Saint Joseph、Michigan、アメリカ、49085
        • Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
      • Traverse City、Michigan、アメリカ、49684
        • Munson Medical Center
      • Wyoming、Michigan、アメリカ、49519
        • University of Michigan Health - West
    • Minnesota
      • Coon Rapids、Minnesota、アメリカ、55433
        • Mercy Hospital
      • Edina、Minnesota、アメリカ、55435
        • Fairview Southdale Hospital
      • Minneapolis、Minnesota、アメリカ、55407
        • Abbott-Northwestern Hospital
      • Rochester、Minnesota、アメリカ、55905
        • Mayo Clinic in Rochester
      • Saint Louis Park、Minnesota、アメリカ、55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Paul、Minnesota、アメリカ、55101
        • Regions Hospital
      • Saint Paul、Minnesota、アメリカ、55102
        • United Hospital
    • Missouri
      • Creve Coeur、Missouri、アメリカ、63141
        • Siteman Cancer Center at West County Hospital
      • St Louis、Missouri、アメリカ、63110
        • Washington University School of Medicine
      • St Louis、Missouri、アメリカ、63129
        • Siteman Cancer Center-South County
      • St Louis、Missouri、アメリカ、63141
        • Mercy Hospital Saint Louis
    • Nebraska
      • Omaha、Nebraska、アメリカ、68114
        • Nebraska Methodist Hospital
      • Omaha、Nebraska、アメリカ、68114
        • Oncology Associates PC
      • Omaha、Nebraska、アメリカ、68114
        • Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
    • New Jersey
      • Basking Ridge、New Jersey、アメリカ、07920
        • Memorial Sloan Kettering Basking Ridge
      • Middletown、New Jersey、アメリカ、07748
        • Memorial Sloan Kettering Monmouth
      • Montvale、New Jersey、アメリカ、07645
        • Memorial Sloan Kettering Bergen
    • New York
      • Buffalo、New York、アメリカ、14263
        • Roswell Park Cancer Institute
      • Commack、New York、アメリカ、11725
        • Memorial Sloan Kettering Commack
      • Harrison、New York、アメリカ、10604
        • Memorial Sloan Kettering Westchester
      • Lake Success、New York、アメリカ、11042
        • Northwell Health/Center for Advanced Medicine
      • New York、New York、アメリカ、10065
        • Memorial Sloan Kettering Cancer Center
      • Uniondale、New York、アメリカ、11553
        • Memorial Sloan Kettering Nassau
    • North Carolina
      • Chapel Hill、North Carolina、アメリカ、27599
        • UNC Lineberger Comprehensive Cancer Center
      • Durham、North Carolina、アメリカ、27710
        • Duke University Medical Center
      • Greenville、North Carolina、アメリカ、27834
        • ECU Health Medical Center
    • Ohio
      • Avon、Ohio、アメリカ、44011
        • UH Seidman Cancer Center at UH Avon Health Center
      • Beachwood、Ohio、アメリカ、44122
        • UHHS-Chagrin Highlands Medical Center
      • Cleveland、Ohio、アメリカ、44106
        • Case Western Reserve University
      • Cleveland、Ohio、アメリカ、44195
        • Cleveland Clinic Foundation
      • Cleveland、Ohio、アメリカ、44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Mayfield Heights、Ohio、アメリカ、44124
        • Hillcrest Hospital Cancer Center
    • Oklahoma
      • Oklahoma City、Oklahoma、アメリカ、73104
        • University of Oklahoma Health Sciences Center
    • Oregon
      • Clackamas、Oregon、アメリカ、97015
        • Clackamas Radiation Oncology Center
      • Gresham、Oregon、アメリカ、97030
        • Legacy Mount Hood Medical Center
      • Newberg、Oregon、アメリカ、97132
        • Providence Newberg Medical Center
      • Oregon City、Oregon、アメリカ、97045
        • Providence Willamette Falls Medical Center
      • Portland、Oregon、アメリカ、97239
        • Oregon Health and Science University
      • Portland、Oregon、アメリカ、97210
        • Legacy Good Samaritan Hospital and Medical Center
      • Portland、Oregon、アメリカ、97213
        • Providence Portland Medical Center
      • Portland、Oregon、アメリカ、97225
        • Providence Saint Vincent Medical Center
      • Tualatin、Oregon、アメリカ、97062
        • Legacy Meridian Park Hospital
    • Pennsylvania
      • Philadelphia、Pennsylvania、アメリカ、19111
        • Fox Chase Cancer Center
      • Philadelphia、Pennsylvania、アメリカ、19107
        • Thomas Jefferson University Hospital
      • Willow Grove、Pennsylvania、アメリカ、19090
        • Asplundh Cancer Pavilion
    • Rhode Island
      • Providence、Rhode Island、アメリカ、02905
        • Women and Infants Hospital
      • Westerly、Rhode Island、アメリカ、02891
        • Smilow Cancer Hospital Care Center - Westerly
    • South Carolina
      • Bluffton、South Carolina、アメリカ、29910
        • Saint Joseph's/Candler - Bluffton Campus
      • Charleston、South Carolina、アメリカ、29425
        • Medical University of South Carolina
    • Tennessee
      • Nashville、Tennessee、アメリカ、37232
        • Vanderbilt University/Ingram Cancer Center
    • Virginia
      • Richmond、Virginia、アメリカ、23235
        • VCU Massey Cancer Center at Stony Point
      • Richmond、Virginia、アメリカ、23298
        • VCU Massey Comprehensive Cancer Center
    • Washington
      • Seattle、Washington、アメリカ、98195
        • University of Washington Medical Center - Montlake
      • Seattle、Washington、アメリカ、98109
        • Fred Hutchinson Cancer Center
      • Vancouver、Washington、アメリカ、98686
        • Legacy Salmon Creek Hospital
      • Vancouver、Washington、アメリカ、98684
        • Legacy Cancer Institute Medical Oncology and Day Treatment
    • West Virginia
      • Charleston、West Virginia、アメリカ、25304
        • Vandalia Health/CAMC Institute for Academic Medicine
    • Wisconsin
      • Eau Claire、Wisconsin、アメリカ、54701
        • Marshfield Medical Center-EC Cancer Center
      • Marshfield、Wisconsin、アメリカ、54449
        • Marshfield Medical Center-Marshfield
      • Milwaukee、Wisconsin、アメリカ、53226
        • Medical College of Wisconsin
      • Minocqua、Wisconsin、アメリカ、54548
        • Marshfield Medical Center - Minocqua
      • Rice Lake、Wisconsin、アメリカ、54868
        • Marshfield Medical Center-Rice Lake
      • Stevens Point、Wisconsin、アメリカ、54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Weston、Wisconsin、アメリカ、54476
        • Marshfield Medical Center - Weston
  • プエルトリコ
      • San Juan、プエルトリコ、00927
        • Centro Comprensivo de Cancer de UPR

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  • Histologically confirmed leiomyosarcoma of uterine origin, as established by the site institutional practice for pathology confirmation for research studies when enrolling the patient on study. Central pathology review will not occur.

  • Metastatic or locally advanced and surgically unresectable disease, in the opinion of the treating investigator.

  • Patients must have at least one lesion that is measurable per Response Evaluation Criteria in Solid Tumors (RECIST) version (v)1.1 criteria to be eligible for the study.

  • Not pregnant and not nursing, because this study involves agents that have known genotoxic, mutagenic and teratogenic effects. Therefore, for women of childbearing potential only, a negative pregnancy test done =< 7 days prior to registration is required

  • Age >= 18 years.

  • Eastern Cooperative Oncology Group (ECOG) Performance Status =< 2.

  • Patients must have had prior progression on, or intolerance to, at least two prior lines of systemic therapy for advanced uLMS, one of which was an anthracycline (anthracycline monotherapy or combination). Adjuvant chemotherapy will qualify as a prior line of treatment. Endocrine treatment will not qualify as a prior line of treatment.

  • Patients may not have received prior treatment with any PARP inhibitor, temozolomide or dacarbazine (IV analogue of temozolomide).

  • Patients may not have had prior treatment with BOTH of the agents included on the investigator's choice arm: trabectedin AND pazopanib. If the patient has had prior treatment with one of these agents, they are eligible; however, they must be assigned to the other agent for investigator's choice. That is, patients who have received prior pazopanib must be assigned to trabectedin, and patients who have received prior trabectedin must be assigned to pazopanib.

  • Patients must have recovered to baseline or =< grade 1 per CTCAE version 5.0 from toxicity related to any prior treatment, unless adverse events are clinically nonsignificant and/or stable on supportive therapy, with the exception of fatigue (which must be =< grade 2), alopecia and/or endocrinopathies related to prior immunotherapy which are controlled with hormone replacement.

  • Patients must have completed all prior anti-cancer treatment, including radiation, >= 28 days prior to registration.

  • Patients may have undergone major surgery (related or unrelated to their cancer diagnosis) >= 28 days of registration. Subjects with clinically relevant ongoing complications from prior surgery are not eligible.

  • Absolute neutrophil count (ANC) >= 1500/mm^3 (within =< 28 days prior to registration).

  • Platelet count >= 100,000/mm^3 (within =< 28 days prior to registration).

  • Creatinine =< 1.5 * upper limit of normal (ULN) (within =< 28 days prior to registration).

    • If creatinine > 1.5 * ULN, then creatinine clearance (CrCl) must be > 50 mL/min, per Cockcroft-Gault method.

  • Hemoglobin >= 9 g/dL (within =< 28 days prior to registration).

    • No transfusions =< 14 days before cycle 1 day 1 (C1D1).

  • Total bilirubin =< 1.5 x ULN (within =< 28 days prior to registration).

    • If documented Gilbert's: =< 2.0 x ULN.

  • Aspartate aminotransferase/alanine aminotransferase (AST/ALT) =< 3 x ULN (within =< 28 days prior to registration).

  • Patients may not have uncontrolled hypertension defined as a blood pressure (BP) > 150/90 on two consecutive assessments during the screening period. If a patient is found to have a BP > 150/90 on two consecutive assessments during the screening period, the patient may be started on an anti-hypertensive regimen, and will be considered eligible if two subsequent measurements are performed and the BP is =< 150/90. If BP is in range on the first measurement, no further measurements are needed.

  • Patients must demonstrate a QTcF (Fredericia formula) =< 470 msec on an electrocardiography (EKG) performed during screening. This criterion applies only to patients who will receive pazopanib if randomized to Arm 2. Repeat EKG testing during the screening period is allowed.

  • Patients may not have an uncontrolled ventricular arrhythmia or recent (within 3 months) myocardial infarction.

  • In addition to the above, 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, patients should be class 2B or better.

  • Patients may not have a history of active or unresolved: perforation, abscess or fistula within 28 days prior to registration (either clinically or radiographically).

  • Patients must not have myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) or a history of bone marrow biopsy findings at any time consistent with MDS and/or AML.

  • For patients with evidence of chronic hepatitis B (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.

  • HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial.

  • 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.

  • Patients with central nervous system (CNS)/leptomeningeal disease must have undergone definitive treatment, have no evidence of CNS progression on follow-up imaging performed at least 4 weeks after the CNS-directed therapy is completed, and be off all steroids, in order to be eligible.

  • Patients must not have an uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome, extensive interstitial bilateral lung disease on high resolution computed tomography (HRCT) scan or any other condition that would limit compliance with study requirements.

  • Patients must be able to swallow oral medications.

  • Patients may not require concomitant use of known strong CYP3A inhibitors (e.g., itraconazole, telithromycin, clarithromycin, protease inhibitors boosted with ritonavir or cobicistat, indinavir, saquinavir, nelfinavir, boceprevir, telaprevir) or moderate CYP3A inhibitors (e.g., ciprofloxacin, erythromycin, diltiazem, fluconazole, verapamil). The required washout period prior to starting study treatment is 2 weeks.

  • Patients may not require concomitant use of known strong (e.g., phenobarbital, enzalutamide, phenytoin, rifampicin, rifabutin, rifapentine, carbamazepine, nevirapine and St John's Wort) or moderate CYP3A inducers (e.g. bosentan, efavirenz, modafinil). The required washout period prior to starting study treatment is 5 weeks for enzalutamide or phenobarbital and 3 weeks for other agents.

  • In order to complete the mandatory patient-completed measure, participants must be able to speak and/or read English and Spanish. Non-English or non-Spanish readers may still participate in the study but are not required to complete the PRO-CTCAE side effect surveys.

  • For all patients, prior to randomization and as part of eligibility, the investigator must select the agent which the patient would receive if assigned to the investigator's choice arm, prior to randomization. The patient must meet all eligibility criteria for that agent during screening and prior to randomization.

  • Patients without central venous access must be willing to undergo placement of central venous access (i.e. port or peripherally inserted central catheter [PICC] line, per institutional practice) if assigned to the investigator's choice arm and if the investigator intends to treat the patient with trabectedin. The site must be able to place central venous access within 10 days of registration/randomization.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 主な目的：処理
  • 割り当て：ランダム化
  • 介入モデル：並列代入
  • マスキング：なし（オープンラベル）

武器と介入

参加者グループ / アーム
介入・治療
実験的：Arm 1 (olaparib, temozolomide)

Patients receive temozolomide PO QD on days 1-7 of each cycle and olaparib PO BID on days 1-7 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan or MRI and/or bone scans throughout the trial. Patients also undergo collection of blood samples throughout the trial.
手順：Magnetic Resonance Imaging

Undergo MRI

他の名前：
  • MRI
  • 磁気共鳴
  • 磁気共鳴画像スキャン
  • 医用画像、磁気共鳴 / 核磁気共鳴
  • 氏
  • MRイメージング
  • MRI スキャン
  • NMRイメージング
  • NMRI
  • 核磁気共鳴イメージング
  • 磁気共鳴画像法 (MRI)
  • sMRI
  • 磁気共鳴画像法（手順）
  • 構造MRI
薬：Temozolomide

Given PO

他の名前：
  • テモダール
  • SCH 52365
  • テモーダル
  • Temcad
  • メタゾラストン
  • RP-46161
  • テモメダク
  • TMZ
  • CCRG-81045
  • イミダゾ[5,1-d]-1,2,3,5-テトラジン-8-カルボキサミド、3,4-ジヒドロ-3-メチル-4-オキソ-
  • M&B 39831
  • エムアンドビー 39831
  • グリオテム
  • テミゾール
手順：Multigated Acquisition Scan

Undergo MUGA

他の名前：
  • 血液プールスキャン
  • 平衡放射性核種血管造影
  • ゲーテッド血液プールイメージング
  • ムガ
  • 放射性核種心室造影
  • RNVG
  • SYMAスキャン
  • 同期マルチゲート取得スキャン
  • ムガスキャン
  • マルチゲート取得スキャン
  • 放射性核種脳室造影スキャン
  • ゲーテッドハートプールスキャン
  • RNVスキャン
手順：Biospecimen Collection

Undergo collection of blood samples

他の名前：
  • 生物学的サンプルの収集
  • 採取された生体試料
  • 標本収集
  • サンプル収集
手順：Computed Tomography

Undergo CT scan

他の名前：
  • CT
  • 猫
  • CATスキャン
  • コンピューター断層撮影
  • コンピュータ化されたアキシャルトモグラフィー
  • CTスキャン
  • トモグラフィー
  • コンピューター断層撮影 (手順)
  • コンピューター断層撮影 (CT) スキャン
  • 診断CATスキャン
  • 診断CATスキャンサービスタイプ
薬：Olaparib

Given PO

他の名前：
  • リムパーザ
  • AZD2281
  • AZD-2281
  • KU-0059436
  • PARP阻害剤AZD2281
  • KU0059436
  • オラニブ
  • オラパリクス
  • KU 0059436
手順：Bone Scan

Undergo bone scan

他の名前：
  • 骨シンチグラフィー
手順：Transthoracic Echocardiography Test

Undergo TTE

他の名前：
  • TTE
  • 経胸壁心エコー検査
アクティブコンパレータ：Arm 2 (trabectedin, pazopanib)

Patients receive trabectedin IV continuously over 24 hours on day 1 of each cycle or pazopanib PO QD on days 1-21 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan or MRI and/or bone scans throughout the trial. Patients also undergo TTE or MUGA on study and as clinically indicated, as well as collection of blood samples throughout the trial.
手順：Magnetic Resonance Imaging

Undergo MRI

他の名前：
  • MRI
  • 磁気共鳴
  • 磁気共鳴画像スキャン
  • 医用画像、磁気共鳴 / 核磁気共鳴
  • 氏
  • MRイメージング
  • MRI スキャン
  • NMRイメージング
  • NMRI
  • 核磁気共鳴イメージング
  • 磁気共鳴画像法 (MRI)
  • sMRI
  • 磁気共鳴画像法（手順）
  • 構造MRI
手順：Multigated Acquisition Scan

Undergo MUGA

他の名前：
  • 血液プールスキャン
  • 平衡放射性核種血管造影
  • ゲーテッド血液プールイメージング
  • ムガ
  • 放射性核種心室造影
  • RNVG
  • SYMAスキャン
  • 同期マルチゲート取得スキャン
  • ムガスキャン
  • マルチゲート取得スキャン
  • 放射性核種脳室造影スキャン
  • ゲーテッドハートプールスキャン
  • RNVスキャン
手順：Biospecimen Collection

Undergo collection of blood samples

他の名前：
  • 生物学的サンプルの収集
  • 採取された生体試料
  • 標本収集
  • サンプル収集
手順：Computed Tomography

Undergo CT scan

他の名前：
  • CT
  • 猫
  • CATスキャン
  • コンピューター断層撮影
  • コンピュータ化されたアキシャルトモグラフィー
  • CTスキャン
  • トモグラフィー
  • コンピューター断層撮影 (手順)
  • コンピューター断層撮影 (CT) スキャン
  • 診断CATスキャン
  • 診断CATスキャンサービスタイプ
手順：Bone Scan

Undergo bone scan

他の名前：
  • 骨シンチグラフィー
手順：Transthoracic Echocardiography Test

Undergo TTE

他の名前：
  • TTE
  • 経胸壁心エコー検査
薬：Pazopanib

Given PO

他の名前：
  • GW786034
薬：Trabectedin

Given IV

他の名前：
  • ヨンデリス
  • エクテナサイジン
  • エクテナサイジン 743
  • ET-743
  • ET 743
  • ET743

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Progression Free Survival (PFS) (Phase II)
時間枠：Time between the date of randomization and the earliest of disease progression or death, assessed up to 1 year

Will be estimated using the Kaplan-Meier method, where the stratified log-rank test will be used to compare the distributions across the treatment arms. PFS rates at 1 year will also be reported, along with 95% confidence intervals. Univariable and multivariable Cox models stratified by the stratification factors used in the randomization will be assessed as well.
Time between the date of randomization and the earliest of disease progression or death, assessed up to 1 year
Overall Survival (OS) (Phase III)
時間枠：Time between the date of randomization and the date of death from any cause, assessed up to 5 years

Will be estimated using the Kaplan-Meier method, where the stratified log-rank test will be used to compare the distributions across the treatment arms. OS rates at 1 year, 2 years, and 5 years will also be reported, along with 95% confidence intervals. Univariable and multivariable Cox models stratified by the stratification factors used in the randomization will be assessed as well.
Time between the date of randomization and the date of death from any cause, assessed up to 5 years

二次結果の測定

結果測定
メジャーの説明
時間枠
Overall Response Rate
時間枠：Up to 5 years

Will be estimated by dividing the number of evaluable patients that achieve a confirmed response (partial response [PR] or better) by the total number of evaluable patients. This estimate will be calculated by arm and will also include a 95% confidence interval using the properties of the binomial distribution, and compared between the arms using a chi-square test.
Up to 5 years
Duration of Response (DOR)
時間枠：Time from first evidence of response until disease progression (or death), assessed up to 5 years

This analysis is restricted to those patients that achieved a confirmed response (PR or better). Patients that go off of study treatment prior to progression will have their DOR time censored at that time.
Time from first evidence of response until disease progression (or death), assessed up to 5 years
Disease Control Rate
時間枠：Up to 6 weeks

Will be estimated using the number of patients that achieve complete response, partial response, or stable disease at the 6 week assessment divided by all evaluable patients. This estimate will be calculated by arm and will also include a 95% confidence interval using the properties of the binomial distribution, and compared between the arms using a chi-square test.
Up to 6 weeks
Incidence of Adverse Events
時間枠：Up to 4 weeks after the end of study treatment

Adverse events will be recorded using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 for each patient. Frequency tables and summary statistics will be used and with the appropriate methods of evaluating categorical and continuous data. In addition, patient reported safety and tolerability will be assessed using Patient-Reported Outcomes (PRO)-CTCAE for a prespecified group of expected toxicities. PRO-CTCAE assessments will occur prior to registration and on day 1 of every cycle during treatment. Collection of PRO-CTCAE will be discontinued after cycle 11.
Up to 4 weeks after the end of study treatment

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

National Cancer Institute (NCI)

捜査官

  • 主任研究者：Matthew Ingham、Alliance for Clinical Trials in Oncology

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2023年3月30日

一次修了 (実際)

2024年8月13日

研究の完了 (推定)

2027年1月30日

試験登録日

最初に提出

2022年6月22日

QC基準を満たした最初の提出物

2022年6月22日

最初の投稿 (実際)

2022年6月27日

学習記録の更新

投稿された最後の更新 (実際)

2026年10月1日

QC基準を満たした最後の更新が送信されました

2026年9月30日

最終確認日

2026年7月1日

詳しくは

本研究に関する用語

追加の関連 MeSH 用語

その他の研究ID番号

  • NCI-2022-05065
  • U10CA180821 (米国 NIH グラント/契約)
  • NCI-2022-05065 (レジストリ識別子：CTRP (Clinical Trial Reporting Program))
  • A092104 (その他の識別子：CTEP)
  • A092104 (その他の識別子：Alliance for Clinical Trials in Oncology)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

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.

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

はい

米国FDA規制機器製品の研究

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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