- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT04729387
Alpelisib Plus Olaparib i platinaresistent/refraktär, höggradig serös äggstockscancer, utan detekterad bakterielinje BRCA-mutation
EPIK-O: En fas III, multicenter, randomiserad (1:1), öppen, aktivt kontrollerad, studie för att bedöma effektiviteten och säkerheten av Alpelisib (BYL719) i kombination med Olaparib jämfört med cytotoxisk kemoterapi med enstaka medel , hos deltagare utan detekterad bakterielinje BRCA-mutation, platinaresistent eller refraktär, höggradig serös äggstockscancer
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
Den här studien kommer att inkludera vuxna kvinnor med platinaresistent eller refraktär höggradig serös äggstockscancer, utan BRCA-mutation i könsceller. Deltagarna kommer att randomiseras i ett 1:1-förhållande till antingen alpelisib plus olaparib eller cytotoxisk kemoterapi med enstaka medel (paclitaxel eller PLD) i denna öppna, aktivt kontrollerade studie.
Deltagarna kommer att fortsätta att få studiebehandling tills sjukdomsprogression, oacceptabel toxicitet som utesluter ytterligare behandling eller tills studiebehandlingen avbryts av någon annan anledning. Efter avslutad behandling kommer alla deltagare att gå in i uppföljningsperioden efter behandlingen, som består av ett säkerhetsuppföljningsbesök och ett 9 veckors postprogressionsbesök. När de har slutfört uppföljningen efter behandlingen kommer deltagarna att gå in i överlevnadsuppföljningsperioden.
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 3
Kontakter och platser
Studieorter
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Buenos Aires, Argentina, C1012AAR
- Novartis Investigative Site
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Caba, Argentina, C1015ABO
- Novartis Investigative Site
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Buenos Aires
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CABA, Buenos Aires, Argentina, C1125ABD
- Novartis Investigative Site
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Sydney, Australien, 2031
- Novartis Investigative Site
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South Australia
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Bedford Park, South Australia, Australien, 5041
- Novartis Investigative Site
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Victoria
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Shepparton, Victoria, Australien, 3630
- Novartis Investigative Site
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Brussels, Belgien, 1000
- Novartis Investigative Site
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Leuven, Belgien, 3000
- Novartis Investigative Site
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Namur, Belgien, 5000
- Novartis Investigative Site
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Minas Gerais
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Belo Horizonte, Minas Gerais, Brasilien, 30130-100
- Novartis Investigative Site
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São Paulo
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São Paulo, São Paulo, Brasilien, 04014-002
- Novartis Investigative Site
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Herlev, Danmark, DK-2730
- Novartis Investigative Site
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Odense C, Danmark, 5000
- Novartis Investigative Site
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Kuopio, Finland, FIN-70211
- Novartis Investigative Site
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Tampere, Finland, FIN-33521
- Novartis Investigative Site
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Turku, Finland, FIN 20521
- Novartis Investigative Site
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Besançon, Frankrike, 25030
- Novartis Investigative Site
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Lyon, Frankrike, 69373
- Novartis Investigative Site
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Paris, Frankrike, 75012
- Novartis Investigative Site
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Pierre-Bénite, Frankrike, 69495
- Novartis Investigative Site
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Villejuif, Frankrike, 94800
- Novartis Investigative Site
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Arizona
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Phoenix, Arizona, Förenta staterna, 85016
- Arizona Oncology Associates
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Phoenix, Arizona, Förenta staterna, 85016
- HonorHealth
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Florida
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Fort Myers, Florida, Förenta staterna, 33901
- Florida Cancer Specialists
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West Palm Beach, Florida, Förenta staterna, 33401
- Florida Cancer Specialists
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Maryland
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Silver Spring, Maryland, Förenta staterna, 20904
- Maryland Oncology Hematology P A
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Massachusetts
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Boston, Massachusetts, Förenta staterna, 02114
- Massachusetts General Hospital
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Boston, Massachusetts, Förenta staterna, 02115
- Dana Farber Cancer Institute
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New York
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New York, New York, Förenta staterna, 10065
- Memorial Sloan Kettering Cancer Ctr
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Ohio
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Cincinnati, Ohio, Förenta staterna, 45267
- University of Cincinnati
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Cincinnati, Ohio, Förenta staterna, 45242
- Oncology Hematology Care Inc
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South Dakota
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Sioux Falls, South Dakota, Förenta staterna, 57106
- Avera Cancer Institute
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Tennessee
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Nashville, Tennessee, Förenta staterna, 37203
- Tennessee Oncology
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Texas
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Amarillo, Texas, Förenta staterna, 79124
- Texas Oncology
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Bedford, Texas, Förenta staterna, 76022
- Texas Oncology P A
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San Antonio, Texas, Förenta staterna, 78217
- Texas Oncology P A
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Tyler, Texas, Förenta staterna, 75702
- Texas Oncology Northeast Texas
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Milan, Italien, 20141
- Novartis Investigative Site
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Naples, Italien, 80131
- Novartis Investigative Site
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BO
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Bologna, BO, Italien, 40138
- Novartis Investigative Site
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FI
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Florence, FI, Italien, 50134
- Novartis Investigative Site
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MI
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Milan, MI, Italien, 20133
- Novartis Investigative Site
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RM
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Roma, RM, Italien, 00168
- Novartis Investigative Site
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VI
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Vicenza, VI, Italien, 36100
- Novartis Investigative Site
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Alberta
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Calgary, Alberta, Kanada, T2N 5G2
- Novartis Investigative Site
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British Columbia
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Vancouver, British Columbia, Kanada, V5Z 4E6
- Novartis Investigative Site
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Ontario
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London, Ontario, Kanada, N6A 5W9
- Novartis Investigative Site
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Toronto, Ontario, Kanada, M4N 3M5
- Novartis Investigative Site
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Beijing, Kina, 100036
- Novartis Investigative Site
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Jinan, Kina, 250012
- Novartis Investigative Site
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Shanghai, Kina, 200032
- Novartis Investigative Site
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Tianjin, Kina, 300480
- Novartis Investigative Site
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Sichuan
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Chengdu, Sichuan, Kina, 610041
- Novartis Investigative Site
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Kuala Lumpur, Malaysia, 59100
- Novartis Investigative Site
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Kuala Lumpur
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Kuala Lumpur, Kuala Lumpur, Malaysia, 50586
- Novartis Investigative Site
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Sabah
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Kota Kinabalu, Sabah, Malaysia, 88996
- Novartis Investigative Site
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Sarawak
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Kuching, Sarawak, Malaysia, 93586
- Novartis Investigative Site
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Mexico City, Mexiko, 04700
- Novartis Investigative Site
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Nuevo León
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Monterrey, Nuevo León, Mexiko, 64460
- Novartis Investigative Site
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Eindhoven, Nederländerna, 5623 EJ
- Novartis Investigative Site
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Loures, Portugal, 2674-514
- Novartis Investigative Site
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Porto, Portugal, 4200-072
- Novartis Investigative Site
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Arkhangelsk, Ryssland, 163045
- Novartis Investigative Site
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Singapore, Singapore, 119074
- Novartis Investigative Site
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Singapore, Singapore, 168583
- Novartis Investigative Site
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Bratislava, Slovakien, 83310
- Novartis Investigative Site
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Barcelona, Spanien, 08035
- Novartis Investigative Site
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Barcelona, Spanien, 08036
- Novartis Investigative Site
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Córdoba, Spanien, 14004
- Novartis Investigative Site
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Madrid, Spanien, 28034
- Novartis Investigative Site
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Valencia, Spanien, 46010
- Novartis Investigative Site
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Navarre
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Pamplona, Navarre, Spanien, 31008
- Novartis Investigative Site
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Glasgow, Storbritannien, G12 0YN
- Novartis Investigative Site
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London, Storbritannien, SE1 9RT
- Novartis Investigative Site
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Manchester, Storbritannien, M20 2BX
- Novartis Investigative Site
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Seoul, Sydkorea, 03080
- Novartis Investigative Site
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Seoul, Sydkorea, 03722
- Novartis Investigative Site
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Taichung, Taiwan, 407219
- Novartis Investigative Site
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Taipei, Taiwan, 10002
- Novartis Investigative Site
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Taipei, Taiwan, 11217
- Novartis Investigative Site
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Nový Jičín, Tjeckien, 741 01
- Novartis Investigative Site
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Prague, Tjeckien, 128 08
- Novartis Investigative Site
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Poruba
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Ostrava, Poruba, Tjeckien, 708 52
- Novartis Investigative Site
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Ankara, Turkiet (Türkiye), 06520
- Novartis Investigative Site
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Karsiyaka
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Izmir, Karsiyaka, Turkiet (Türkiye), 35575
- Novartis Investigative Site
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Sihhiye-Altindag
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Ankara, Sihhiye-Altindag, Turkiet (Türkiye), 06230
- Novartis Investigative Site
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Yuregir
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Adana, Yuregir, Turkiet (Türkiye), 01230
- Novartis Investigative Site
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Berlin, Tyskland, 13353
- Novartis Investigative Site
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Essen, Tyskland, 45136
- Novartis Investigative Site
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Baden-Wurttemberg
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Mannheim, Baden-Wurttemberg, Tyskland, 68305
- Novartis Investigative Site
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Saxony
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Dresden, Saxony, Tyskland, 01307
- Novartis Investigative Site
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Graz, Österrike, 8036
- Novartis Investigative Site
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Tyrol
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Innsbruck, Tyrol, Österrike, 6020
- Novartis Investigative Site
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Beskrivning
Inklusionskriterier:
- Deltagaren har histologiskt bekräftad diagnos av höggradig serös eller höggradig endometrioid äggstockscancer, äggledarecancer eller primär peritonealcancer
- Mätbar sjukdom, d.v.s. minst en mätbar lesion per RECIST 1.1-kriterier (en lesion på ett tidigare bestrålat ställe får endast räknas som en målskada om det finns tydliga tecken på progression sedan bestrålningen)
- Om det inte finns någon mätbar sjukdom, bör sjukdomen kunna bedömas enligt Gynecologic Cancer Intergroup-kriterier (GCIC) för CA-125
- Deltagaren har ingen BRCA1/2-mutation i könscellerna enligt en FDA-godkänd analys.
- Deltagaren har prestandastatusen 0 eller 1 för Eastern Cooperative Oncology Group (ECOG).
- Deltagaren har platinaresistent (progression inom en till sex månader efter avslutad platinabaserad behandling) eller platinarefraktär sjukdom (progression under behandlingen eller inom 4 veckor efter den sista dosen), där platinabaserad behandling inte är ett alternativ, enligt GCIG 5th Ovarian Cancer Consensus Consensus Definitioner. Den platinabaserade kemoterapiregimen behöver inte nödvändigtvis vara den sista behandlingen som deltagaren fick innan studiestarten.
- Deltagaren måste ha erhållit minst en men högst tre tidigare systemiska behandlingsregimer och för vilka kemoterapi med ett läkemedel är lämplig som nästa behandlingslinje.
- Deltagaren har tillräcklig benmärgs- och organfunktion
Exklusions kriterier:
- Deltagaren har tidigare fått behandling med någon PI3K-, mTOR- eller AKT-hämmare.
- Deltagaren använder samtidigt annan anti-cancerterapi
- Deltagaren är i ett tillstånd av tunn- eller tjocktarmsobstruktion eller har annan försämring av gastrointestinal (GI) funktion eller GI-sjukdom
- Deltagaren har opererats inom 14 dagar innan studieläkemedlet påbörjades eller har inte återhämtat sig från allvarliga biverkningar
- Deltagaren har inte återhämtat sig från alla toxiciteter 5 relaterade till tidigare anticancerterapier till baseline eller NCI CTCAE Version 4.03 Grad ≤1. Undantag från detta kriterium: deltagare med vilken grad av alopeci som helst får delta i studien.
- Deltagare med nedsatt leverfunktion och Child Pugh poäng B eller C
- Deltagaren har fått strålbehandling ≤ 4 veckor eller begränsad fältstrålning för palliation ≤2 veckor före randomisering, och som inte har återhämtat sig till baseline, grad 1 eller bättre från relaterade biverkningar av sådan terapi (med undantag för alopeci).
- Deltagaren har en känd överkänslighet mot något av studieläkemedlen eller hjälpämnena
Andra inkluderings-/exkluderingskriterier kan gälla
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
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Experimentell: Alpelisib+olaparib
Alpelisib (200 mg once daily after food) and Olaparib (200 mg twice daily) were both administered orally on a continuous dosing schedule starting on Cycle 1 Day 1 in a 28-day cycle.
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Alpelisib was administered at 200 mg orally once daily following food on a continuous dosing schedule starting on Cycle 1 Day 1 in a 28-day cycle
Andra namn:
Olaparib was administered at 200 mg orally twice daily irrespective of meals on a continuous dosing schedule starting on Cycle 1 Day 1 in a 28-day cycle.
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Aktiv komparator: Paclitaxel or Pegylated liposomal doxorubicin
Paclitaxel (80 mg/m²) was administered as a weekly intravenous infusion on Days 1, 8, 15, and 22 of each 28-day cycle, or Pegylated liposomal doxorubicin (40-50 mg/m² at physician discretion) was administered as an intravenous infusion once every 28 days starting on Cycle 1 Day 1.
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Paclitaxel (80 mg/m²) was administered as a weekly intravenous infusion on Days 1, 8, 15, and 22 of each 28-day cycle.
Pegylated liposomal doxorubicin (40-50 mg/m² at physician discretion) was administered as an intravenous infusion once every 28 days starting on Cycle 1 Day 1.
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
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Progression Free Survival (PFS) Based on Blinded Independent Review Committee (BIRC) Assessment Using RECIST 1.1 Criteria
Tidsram: From randomization until the date of the first documented progression or death due to any cause, whichever comes first, assessed up to approximately 21 months
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Progression-free survival (PFS) was defined as the time from randomization to the first documented disease progression or death from any cause, as determined by blinded independent review committee (BIRC) assessment. Participants without an event were censored at the date of their last adequate tumor assessment. Clinical deterioration without objective radiologic evidence was not considered disease progression in the primary efficacy analysis. Disease progression was defined according to Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1, as a ≥20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (including baseline), with an absolute increase of at least 5 mm, the appearance of one or more new lesions, or unequivocal progression of non-target lesions. |
From randomization until the date of the first documented progression or death due to any cause, whichever comes first, assessed up to approximately 21 months
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
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Overall Survival
Tidsram: From randomization until death, assessed up to approximately 44 months
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Overall survival (OS) is defined as the time from date of randomization to date of death due to any cause.
If a participant is not known to have died, then OS will be censored at the latest date the participant was known to be alive
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From randomization until death, assessed up to approximately 44 months
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Overall Response Rate (ORR) With Confirmed Response Based on BIRC Assessment According to RECIST 1.1 Criteria
Tidsram: Up to approximately 21 months
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Overall Response Rate (ORR) was defined as the proportion of participants with best overall response (BOR) of complete response (CR) or partial response (PR) by blinded independent review committee (BIRC) assessment as per RECIST 1.1 criteria:
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Up to approximately 21 months
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Clinical Benefit Rate (CBR) With Confirmed Response Based on BIRC Assessment According to RECIST 1.1
Tidsram: Up to approximately 21 months
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Clinical benefit rate (CBR) with confirmed response was defined as the percentage of participants whose best overall response was a confirmed CR or PR, or stable disease (SD) maintained for at least 24 weeks.
CR, PR, and SD were determined by BIRC according to RECIST 1.1 criteria.
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Up to approximately 21 months
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Time to Response (TTR) Based on BIRC Assessment and According to RECIST 1.1
Tidsram: From the date of randomization to the first documented response, assessed through Month 12
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Time to response (TTR) was defined as the interval from randomization to the first documented occurrence of either complete response (CR) or partial response (PR), which was subsequently confirmed (using the date of initial response, not the confirmation date).
CR and PR were determined based on tumor response data assessed by BIRC according to RECIST 1.1 criteria.
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From the date of randomization to the first documented response, assessed through Month 12
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Duration of Response (DOR) With Confirmed Response Based on BIRC Assessment and According to RECIST 1.1
Tidsram: From first documented response to first documented progression or death, assessed up to approximately 21 months
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Duration of response (DOR) with confirmed response was calculated only for participants whose best overall response was a confirmed complete response (CR) or confirmed partial response (PR), based on tumor response data assessed by BIRC according to RECIST 1.1.
The start date was the date of the first documented CR or PR (i.e., the initial response date, not the confirmation date), and the end date was the date of first documented disease progression or death due to underlying cancer.
Participants without progression or cancer-related death were censored at the date of their last adequate tumor assessment.
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From first documented response to first documented progression or death, assessed up to approximately 21 months
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Time to Definitive Deterioration of the Eastern Cooperative Oncology Group (ECOG) Performance Status (PS)
Tidsram: Up to approximately 18 months
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Performance status (PS) was evaluated using the ECOG scale, which comprises six grades (0 to 5), where 0 represents fully active and 5 represents death.
Time to definitive deterioration in ECOG PS was defined as the interval from randomization to the date when ECOG PS worsened by at least one category from baseline and remained worsened.
Deterioration was considered definitive if there was no subsequent improvement to the baseline category or better.
Participants were censored if no definitive deterioration occurred before the earlier of: (i) the analysis cut-off date or (ii) initiation of a new anti-neoplastic therapy.
The censoring date was the date of the last PS assessment prior to the cut-off or start of new therapy.
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Up to approximately 18 months
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Number of Participants With Dose Interruptions and Dose Reductions
Tidsram: From randomization until end of treatment, assessed up to approximately 18 months
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The number of participants with dose reductions/interruptions was assessed and summarized by study treatment.
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From randomization until end of treatment, assessed up to approximately 18 months
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Dose Intensity for Alpelisib and Olaparib
Tidsram: From randomization until end of treatment, assessed up to approximately 18 months
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Dose intensity was computed as the ratio of actual cumulative dose received to actual duration of exposure and summarized by study treatment.
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From randomization until end of treatment, assessed up to approximately 18 months
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Dose Intensity for Paclitaxel
Tidsram: From randomization until end of treatment, assessed up to approximately 18 months
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Dose intensity was computed as the ratio of actual cumulative dose received to actual duration of exposure and summarized by study treatment.
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From randomization until end of treatment, assessed up to approximately 18 months
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Dose Intensity for Pegylated Liposomal Doxorubicin
Tidsram: From randomization until end of treatment, assessed up to approximately 18 months
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Dose intensity was computed as the ratio of actual cumulative dose received to actual duration of exposure and summarized by study treatment.
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From randomization until end of treatment, assessed up to approximately 18 months
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Area Under the Curve Calculated to the End of a Dosing Interval (Tau) at Steady-state (AUCtau) of Alpelisib and Olaparib
Tidsram: Day 8 Cycle 1 (pre-dose, 1, 2, 3, 4, 6, 8 and 24 hours post dose), Day 1 on Cycle 2, 4 and 8 (pre-dose)
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The AUCtau will be assessed to characterize the pharmacokinetics of alpelisib when administered in combination of olaparib
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Day 8 Cycle 1 (pre-dose, 1, 2, 3, 4, 6, 8 and 24 hours post dose), Day 1 on Cycle 2, 4 and 8 (pre-dose)
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Area Under the Curve From Time Zero to the Last Measurable Concentration Sampling Time (AUClast)of Alpelisib and Olaparib
Tidsram: Day 8 Cycle 1 (pre-dose, 1, 2, 3, 4, 6, 8 and 24 hours post dose), Day 1 on Cycle 2, 4 and 8 (pre-dose)
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The AUClast will be assessed to characterize the pharmacokinetics of alpelisib when administered in combination of olaparib
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Day 8 Cycle 1 (pre-dose, 1, 2, 3, 4, 6, 8 and 24 hours post dose), Day 1 on Cycle 2, 4 and 8 (pre-dose)
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Maximum Concentration (Cmax) of Alpelisib and Olaparib
Tidsram: Day 8 Cycle 1 (pre-dose, 1, 2, 3, 4, 6, 8 and 24 hours post dose), Day 1 on Cycle 2, 4 and 8 (pre-dose)
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The Cmax will be assessed to characterize the pharmacokinetics of alpelisib when administered in combination of olaparib
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Day 8 Cycle 1 (pre-dose, 1, 2, 3, 4, 6, 8 and 24 hours post dose), Day 1 on Cycle 2, 4 and 8 (pre-dose)
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Time to Reach Maximum Concentration (Tmax) of Alpelisib and Olaparib
Tidsram: Day 8 Cycle 1 (pre-dose, 1, 2, 3, 4, 6, 8 and 24 hours post dose), Day 1 on Cycle 2, 4 and 8 (pre-dose)
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The Tmax will be assessed to characterize the pharmacokinetics of alpelisib when administered in combination of olaparib
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Day 8 Cycle 1 (pre-dose, 1, 2, 3, 4, 6, 8 and 24 hours post dose), Day 1 on Cycle 2, 4 and 8 (pre-dose)
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Time to Definitive Deterioration by 10% in FACT-O Trial Outcomes Index (TOI) Score
Tidsram: Baseline, up to 15 months
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The Functional Assessment of Cancer Therapy-Ovarian (FACT O) is a validated instrument that evaluates quality of life in patients with ovarian cancer.
The Trial Outcome Index (TOI) of the FACT-O combines Physical Well Being (PWB), Functional Well Being (FWB), and the Ovarian Cancer Subscale (OCS), and its scores range from 0 to 100, with higher scores indicating better quality of life and physical/functional status.
Time to definitive deterioration by 10% in FACT O TOI is defined as the time from randomization to the first occurrence of at least a 10% worsening from baseline with no subsequent improvement above this threshold, or death.
Participants without an event before analysis cut off or before starting another anticancer therapy were censored at their last adequate assessment.
Time to deterioration was estimated using the Kaplan-Meier method.
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Baseline, up to 15 months
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Samarbetspartners och utredare
Sponsor
Utredare
- Studierektor: Novartis Pharmaceuticals, Novartis Pharmaceuticals
Publikationer och användbara länkar
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- Urogenitala sjukdomar
- Genitala sjukdomar
- Sjukdomar i det endokrina systemet
- Urogenitala neoplasmer
- Neoplasmer efter plats
- Neoplasmer
- Kvinnliga urogenitala sjukdomar
- Kvinnliga urogenitala sjukdomar och graviditetskomplikationer
- Genitala sjukdomar, kvinnor
- Neoplasmer i endokrina körtel
- Ovariella sjukdomar
- Adnexala sjukdomar
- Genitala neoplasmer, hona
- Gonadal sjukdomar
- Ovariella neoplasmer
- Organiska kemikalier
- Kolväten
- Cykloparaffiner
- Kolväten, alicyklisk
- Kolväten, cykliska
- Terpener
- Taxoids
- Cyklodekaner
- Gentare
- Paklitaxel
- liposomal doxorubicin
- olaparib
- Alpelisib
Andra studie-ID-nummer
- CBYL719K12301
- 2024-510782-42-00 (Registeridentifierare: EU CT Number)
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
IPD-planbeskrivning
Novartis har åtagit sig att dela med kvalificerade externa forskare, tillgång till data på patientnivå och stödjande kliniska dokument från kvalificerade studier. Dessa förfrågningar granskas och godkänns av en oberoende granskningspanel på grundval av vetenskapliga meriter. All data som tillhandahålls är anonymiserad för att respektera integriteten för patienter som har deltagit i prövningen i enlighet med tillämpliga lagar och förordningar.
Tillgängligheten av denna testdata är enligt kriterierna och processen som beskrivs på www.clinicalstudydatarequest.com
Läkemedels- och apparatinformation, studiedokument
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