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Testing av Olaparib og Temozolomid versus den vanlige behandlingen for uterin leiomyosarkom etter at kjemoterapi har sluttet å virke

30. september 2026 oppdatert av: National Cancer Institute (NCI)

En randomisert fase 2/3-studie av Olaparib Plus Temozolomid versus Investigators Choice for behandling av pasienter med avansert uterint leiomyosarkom etter progresjon på tidligere kjemoterapi

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.

Studieoversikt

Status

Aktiv, ikke rekrutterende

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Faktiske)

74

Fase

  • Fase 2
  • Fase 3

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Fremgangsmåte: Magnetic Resonance Imaging

Undergo MRI

Andre navn:
  • MR
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medisinsk bildebehandling, magnetisk resonans / kjernemagnetisk resonans
  • MR Imaging
  • MR-skanning
  • NMR-avbildning
  • NMRI
  • Kjernemagnetisk resonansavbildning
  • Magnetisk resonanstomografi (MR)
  • sMRI
  • Magnetisk resonansavbildning (prosedyre)
  • MR-er
  • Strukturell MR
Legemiddel: Temozolomide

Given PO

Andre navn:
  • Temodar
  • SCH 52365
  • Temodal
  • Temcad
  • Metazolastone
  • RP-46161
  • Temomedac
  • TMZ
  • CCRG-81045
  • Imidazo[5,1-d]-1,2,3,5-tetrazin-8-karboksamid, 3,4-dihydro-3-metyl-4-okso-
  • M & B 39831
  • M og B 39831
  • Gliotem
  • Temizol
Fremgangsmåte: Multigated Acquisition Scan

Undergo MUGA

Andre navn:
  • Skanning av blodbasseng
  • Likevektsradionuklidangiografi
  • Gated Blood Pool Imaging
  • MUGA
  • Radionuklid ventrikulografi
  • RNVG
  • SYMA-skanning
  • Synchronized Multigated Acquisition Scanning
  • MUGA Scan
  • Multi-Gated Acquisition Scan
  • Radionuklid ventrikulogramskanning
  • Gated Heart Pool Scan
  • RNV Scan
Fremgangsmåte: Biospecimen Collection

Undergo collection of blood samples

Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling
Fremgangsmåte: Computed Tomography

Undergo CT scan

Andre navn:
  • CT
  • KATT
  • CAT-skanning
  • Beregnet aksial tomografi
  • Datastyrt aksialtomografi
  • Datastyrt tomografi
  • CT skann
  • tomografi
  • Datastyrt aksial tomografi (prosedyre)
  • Datastyrt tomografi (CT) skanning
  • Diagnostisk CAT -skanning
  • Diagnostisk CAT -skannertype
Legemiddel: Olaparib

Given PO

Andre navn:
  • Lynparza
  • AZD 2281
  • AZD-2281
  • AZD2281
  • KU-0059436
  • PARP-hemmer AZD2281
  • KU0059436
  • Olanib
  • Olaparix
  • KU 0059436
Fremgangsmåte: Bone Scan

Undergo bone scan

Andre navn:
  • Benscintigrafi
Fremgangsmåte: Transthoracic Echocardiography Test

Undergo TTE

Andre navn:
  • TTE
  • Transthoracic ekkokardiografi
Aktiv komparator: 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.
Fremgangsmåte: Magnetic Resonance Imaging

Undergo MRI

Andre navn:
  • MR
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medisinsk bildebehandling, magnetisk resonans / kjernemagnetisk resonans
  • MR Imaging
  • MR-skanning
  • NMR-avbildning
  • NMRI
  • Kjernemagnetisk resonansavbildning
  • Magnetisk resonanstomografi (MR)
  • sMRI
  • Magnetisk resonansavbildning (prosedyre)
  • MR-er
  • Strukturell MR
Fremgangsmåte: Multigated Acquisition Scan

Undergo MUGA

Andre navn:
  • Skanning av blodbasseng
  • Likevektsradionuklidangiografi
  • Gated Blood Pool Imaging
  • MUGA
  • Radionuklid ventrikulografi
  • RNVG
  • SYMA-skanning
  • Synchronized Multigated Acquisition Scanning
  • MUGA Scan
  • Multi-Gated Acquisition Scan
  • Radionuklid ventrikulogramskanning
  • Gated Heart Pool Scan
  • RNV Scan
Fremgangsmåte: Biospecimen Collection

Undergo collection of blood samples

Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling
Fremgangsmåte: Computed Tomography

Undergo CT scan

Andre navn:
  • CT
  • KATT
  • CAT-skanning
  • Beregnet aksial tomografi
  • Datastyrt aksialtomografi
  • Datastyrt tomografi
  • CT skann
  • tomografi
  • Datastyrt aksial tomografi (prosedyre)
  • Datastyrt tomografi (CT) skanning
  • Diagnostisk CAT -skanning
  • Diagnostisk CAT -skannertype
Fremgangsmåte: Bone Scan

Undergo bone scan

Andre navn:
  • Benscintigrafi
Fremgangsmåte: Transthoracic Echocardiography Test

Undergo TTE

Andre navn:
  • TTE
  • Transthoracic ekkokardiografi
Legemiddel: Pazopanib

Given PO

Andre navn:
  • GW786034
Legemiddel: Trabectedin

Given IV

Andre navn:
  • Yondelis
  • Ekteinascidin
  • Ecteinascidin 743
  • ET-743
  • ET 743
  • ET743

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Progression Free Survival (PFS) (Phase II)
Tidsramme: 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)
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Overall Response Rate
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

National Cancer Institute (NCI)

Etterforskere

  • Hovedetterforsker: Matthew Ingham, Alliance for Clinical Trials in Oncology

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

30. mars 2023

Primær fullføring (Faktiske)

13. august 2024

Studiet fullført (Antatt)

30. januar 2027

Datoer for studieregistrering

Først innsendt

22. juni 2022

Først innsendt som oppfylte QC-kriteriene

22. juni 2022

Først lagt ut (Faktiske)

27. juni 2022

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

1. oktober 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

30. september 2026

Sist bekreftet

1. juli 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • NCI-2022-05065
  • U10CA180821 (U.S. NIH-stipend/kontrakt)
  • NCI-2022-05065 (Registeridentifikator: CTRP (Clinical Trial Reporting Program))
  • A092104 (Annen identifikator: CTEP)
  • A092104 (Annen identifikator: Alliance for Clinical Trials in Oncology)

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

IPD-planbeskrivelse

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.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Ja

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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