Sacituzumab Govitecan联合Bevacizumab对比常规化疗(卡铂、聚乙二醇化脂质体多柔比星和Bevacizumab)用于治疗PARP抑制剂维持治疗后复发性铂敏感卵巢癌
A Randomized Phase II Trial of Sacituzumab Govitecan-HZIY (SG) and Bevacizumab Versus Standard of Care Carboplatin, Pegylated Liposomal Doxorubicin (PLD) and Bevacizumab in Patients With Platinum-Sensitive Ovarian Cancer That Has Progressed on Prior Maintenance PARP Inhibitor Therapy
This phase II trial compares the effect of sacituzumab govitecan and bevacizumab to standard care (carboplatin, pegylated liposomal doxorubicin, and bevacizumab) in patients with ovarian cancer that has come back after an initial response to platinum therapy (platinum-sensitive), that has progressed after poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor maintenance therapy (recurrent), and that has a mutation in the BRCA1 or BRCA2 genes or is homologous recombination deficient. Sacituzumab govitecan is a monoclonal antibody, called sacituzumab, linked to a drug called govitecan. Sacituzumab is a form of targeted therapy because it attaches to specific molecules (receptors) on the surface of cancer cells, known as TROP2 receptors, and delivers govitecan to kill them. Bevacizumab is in a class of medications called antiangiogenic agents. It works by stopping the formation of blood vessels that bring oxygen and nutrients to tumor. This may slow the growth and spread of tumor cells. Carboplatin is in a class of medications known as platinum-containing compounds. Carboplatin works by killing, stopping or slowing the growth of cancer cells. Doxorubicin is in a class of medications called anthracyclines. Doxorubicin damages the cell's deoxyribonucleic acid (DNA) and may kill cancer cells. It also blocks a certain enzyme needed for cell division and DNA repair. Liposomal doxorubicin is a form of the anticancer drug doxorubicin that is contained inside very tiny, fat-like particles. Liposomal doxorubicin may have fewer side effects and work better than other forms of the drug. Giving sacituzumab govitecan and bevacizumab may kill more tumor cells than standard care (carboplatin, pegylated liposomal doxorubicin, and bevacizumab) in patients with recurrent platinum-sensitive ovarian cancers that have BRCA1/2 mutations or homologous recombination deficiency.
研究概览
地位
条件
详细说明
PRIMARY OBJECTIVE:
I. To assess the clinical activity of sacituzumab govitecan (sacituzumab govitecan-hziy [SG]) and bevacizumab (or an anti-VEGF antibody biosimilar) compared to standard of care carboplatin, pegylated liposomal doxorubicin hydrochloride (pegylated liposomal doxorubicin [PLD]) and bevacizumab (or an anti-VEGF antibody biosimilar), as measured by progression-free survival, in patients with platinum-sensitive ovarian cancer that has progressed while receiving first-line PARP inhibitor maintenance therapy.
SECONDARY OBJECTIVES:
I. To assess additional measures of clinical activity of SG and bevacizumab compared to standard of care carboplatin, PLD and bevacizumab in patients with recurrent platinum-sensitive ovarian cancer, as measured by the overall response rate, duration of response, and overall survival.
II. To assess the safety of SG and bevacizumab in patients with recurrent platinum-sensitive ovarian cancer.
III. To assess the effect of SG and bevacizumab on overall survival in recurrent platinum-sensitive ovarian cancer.
EXPLORATORY OBJECTIVES:
I. To correlate clinical activity of SG and bevacizumab with TROP2 expression and tumor-specific cell-free deoxyribonucleic acid (cfDNA).
II. To assess time to first subsequent therapy or death (TFST). III. To assess time to second subsequent therapy or death (TSST).
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients receive carboplatin intravenously (IV) on day 1, PLD IV on day 1 (or gemcitabine IV on days 1 and 8), and bevacizumab (or anti-VEGF antibody biosimilar) IV on days 1 and 15 of each cycle. Cycles repeat every 21 days for 6-10 cycles in the absence of disease progression or unacceptable toxicity. After 6-10 cycles, patients proceed to maintenance therapy.
ARM II: Patients receive SG IV over 1-3 hours on days 1 and 8 and bevacizumab (or anti-VEGF antibody biosimilar) IV on day 1 of each cycle. Cycles repeat every 21 days for 6-10 cycles in the absence of disease progression or unacceptable toxicity. After 6-10 cycles, patients proceed to maintenance therapy.
MAINTENANCE: Patients receive bevacizumab (or anti-VEGF antibody biosimilar) IV on day 1 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Patients in Arm I also undergo echocardiography (ECHO) or multigated acquisition scan (MUGA) at screening and all patients undergo computed tomography (CT) and/or magnetic resonance imaging (MRI) and collection of blood samples throughout the trial.
After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.
研究类型
注册 (估计的)
阶段
- 阶段2
联系人和位置
学习地点
-
-
Arkansas
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Fayetteville、Arkansas、美国、72703
- 招聘中
- Highlands Oncology Group - Fayetteville
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接触:
- Site Public Contact
- 电话号码:479-872-8100
- 邮箱:research@hogonc.com
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首席研究员:
- Ewa M. Matczak
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Rogers、Arkansas、美国、72758
- 招聘中
- Highlands Oncology Group - Rogers
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接触:
- Site Public Contact
- 电话号码:479-872-8130
- 邮箱:research@hogonc.com
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首席研究员:
- Ewa M. Matczak
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Springdale、Arkansas、美国、72762
- 招聘中
- Highlands Oncology Group
-
接触:
- Site Public Contact
- 电话号码:479-872-8130
- 邮箱:research@hogonc.com
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首席研究员:
- Ewa M. Matczak
-
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Idaho
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Coeur d'Alene、Idaho、美国、83814
- 招聘中
- Kootenai Health - Coeur d'Alene
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首席研究员:
- John M. Schallenkamp
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接触:
- Site Public Contact
- 电话号码:406-969-6060
- 邮箱:mccinfo@mtcancer.org
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Post Falls、Idaho、美国、83854
- 招聘中
- Kootenai Clinic Cancer Services - Post Falls
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首席研究员:
- John M. Schallenkamp
-
接触:
- Site Public Contact
- 电话号码:406-969-6060
- 邮箱:mccinfo@mtcancer.org
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Sandpoint、Idaho、美国、83864
- 招聘中
- Kootenai Clinic Cancer Services - Sandpoint
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首席研究员:
- John M. Schallenkamp
-
接触:
- Site Public Contact
- 电话号码:406-969-6060
- 邮箱:mccinfo@mtcancer.org
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Illinois
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Danville、Illinois、美国、61832
- 招聘中
- Carle at The Riverfront
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首席研究员:
- Kendrith M. Rowland
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接触:
- Site Public Contact
- 电话号码:800-446-5532
- 邮箱:Research@Carle.com
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Effingham、Illinois、美国、62401
- 招聘中
- Carle Physician Group-Effingham
-
接触:
- Site Public Contact
- 电话号码:800-446-5532
- 邮箱:Research@carle.com
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首席研究员:
- Kendrith M. Rowland
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Mattoon、Illinois、美国、61938
- 招聘中
- Carle Physician Group-Mattoon/Charleston
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接触:
- Site Public Contact
- 电话号码:800-446-5532
- 邮箱:Research@carle.com
-
首席研究员:
- Kendrith M. Rowland
-
Normal、Illinois、美国、61761
- 招聘中
- Carle BroMenn Medical Center
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首席研究员:
- Kendrith M. Rowland
-
接触:
- Site Public Contact
- 电话号码:800-446-5532
- 邮箱:Research@Carle.com
-
Normal、Illinois、美国、61761
- 招聘中
- Carle Cancer Institute Normal
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首席研究员:
- Kendrith M. Rowland
-
接触:
- Site Public Contact
- 电话号码:800-446-5532
- 邮箱:Research@Carle.com
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Urbana、Illinois、美国、61801
- 招聘中
- Carle Cancer Center
-
接触:
- Site Public Contact
- 电话号码:800-446-5532
- 邮箱:Research@carle.com
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首席研究员:
- Kendrith M. Rowland
-
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Iowa
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Cedar Rapids、Iowa、美国、52403
- 招聘中
- Mercy Hospital
-
接触:
- Site Public Contact
- 电话号码:319-365-4673
-
首席研究员:
- Deborah W. Wilbur
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Cedar Rapids、Iowa、美国、52403
- 招聘中
- Oncology Associates at Mercy Medical Center
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首席研究员:
- Deborah W. Wilbur
-
接触:
- Site Public Contact
- 电话号码:319-363-2690
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Missouri
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Springfield、Missouri、美国、65804
- 招聘中
- Mercy Hospital Springfield
-
首席研究员:
- Jay W. Carlson
-
接触:
- Site Public Contact
- 电话号码:417-269-4520
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Montana
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Anaconda、Montana、美国、59711
- 招聘中
- Community Hospital of Anaconda
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首席研究员:
- John M. Schallenkamp
-
接触:
- Site Public Contact
- 电话号码:406-969-6060
- 邮箱:mccinfo@mtcancer.org
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Billings、Montana、美国、59101
- 招聘中
- Billings Clinic Cancer Center
-
首席研究员:
- John M. Schallenkamp
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接触:
- Site Public Contact
- 电话号码:800-996-2663
- 邮箱:research@billingsclinic.org
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Great Falls、Montana、美国、59405
- 招聘中
- Benefis Sletten Cancer Institute
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首席研究员:
- John M. Schallenkamp
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接触:
- Site Public Contact
- 电话号码:406-969-6060
- 邮箱:mccinfo@mtcancer.org
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Kalispell、Montana、美国、59901
- 招聘中
- Logan Health Medical Center
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首席研究员:
- John M. Schallenkamp
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接触:
- Site Public Contact
- 电话号码:406-969-6060
- 邮箱:mccinfo@mtcancer.org
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Missoula、Montana、美国、59804
- 招聘中
- Community Medical Center
-
首席研究员:
- John M. Schallenkamp
-
接触:
- Site Public Contact
- 电话号码:406-969-6060
- 邮箱:mccinfo@mtcancer.org
-
-
New Jersey
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Long Branch、New Jersey、美国、07740
- 招聘中
- Monmouth Medical Center
-
接触:
- Site Public Contact
- 电话号码:732-923-6564
- 邮箱:mary.danish@rwjbh.org
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首席研究员:
- Eugenia Girda
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New Brunswick、New Jersey、美国、08903
- 招聘中
- Rutgers Cancer Institute of New Jersey
-
接触:
- Site Public Contact
- 电话号码:732-235-7356
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首席研究员:
- Eugenia Girda
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Oklahoma
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Oklahoma City、Oklahoma、美国、73104
- 招聘中
- University of Oklahoma Health Sciences Center
-
接触:
- Site Public Contact
- 电话号码:405-271-8777
- 邮箱:ou-clinical-trials@ouhsc.edu
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首席研究员:
- Grace Duininck
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
-
Patients must have histologic diagnosis of high grade serous or endometrioid epithelial ovarian cancer
- Ovarian cancer = fallopian tube, ovarian, and primary peritoneal cancer
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Disease must be platinum sensitive, as defined by progression documented ≥ 6 months (182 days) from the last receipt of platinum
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Disease must have progressed during first line maintenance PARP inhibitor (PARPi) for advanced ovarian cancer. NO intervening therapies between progression on PARPi and study registration are permitted
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Disease must be germline or somatic BRCA1 or BRCA2 mutated or homologous recombination deficiency test positive
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Disease must be measurable or non-measurable as defined by Response Evaluation Criteria in Solid Tumors (RECIST) version (v.) 1.1
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Secondary or cytoreductive surgery, after start of treatment on this trial, and prior to documentation of disease progression, is NOT permitted
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No previous receipt of any topoisomerase-I inhibiting agents
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No investigational agents within 4 weeks of study registration
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No current treatment with any other (non-study) cytotoxic chemotherapy, targeted therapy, biologic therapy, immunotherapy or endocrine therapy for the treatment of the disease under the current study
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Last dose of PARP inhibitor treatment must be ≥ 3 weeks before study registration
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Patients with treated brain metastases are eligible if follow-up brain imaging 4 weeks after CNS-directed therapy shows no evidence of disease progression. Patients with brain metastases must have follow up imaging demonstrating no evidence of disease progression and that the disease is stable off of steroids
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Age ≥ 18
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Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2
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Not pregnant and not nursing
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Absolute neutrophil count (ANC) ≥ 1,500 cells/mm^3
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Platelets ≥ 100,000 cells/mm^3
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Hemoglobin ≥ 9 g/dl (Note: The use of transfusion or other intervention to achieve hemoglobin [Hgb] ≥ 9 g/dl is acceptable)
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Creatinine clearance (CrCL) of ≥ 30 mL/min by the Cockcroft-Gault formula
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Urinalysis with ≤ 1+ protein and/or urine protein < 1.0 g/24 hours (hrs)
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Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (patients with known Gilbert's disease who have bilirubin level ≤ 3 x institutional ULN may be enrolled)
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Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 x institutional ULN
-
Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association functional classification. To be eligible for this trial, patients should be class 2B or better
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No active infection requiring parenteral antibiotics
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No non-healing wound, ulcer, or bone fracture
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No current evidence of intra-abdominal abscess, abdominal/pelvic fistula (not diverted), gastrointestinal perforation, gastrointestinal (GI) obstruction, and/or need for drainage nasogastric or gastrostomy tube
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No clinically significant bleeding within 28 days prior to registration
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No uncontrolled hypertension, defined as systolic ≥ 160 mm Hg or diastolic ≥ 100 mm Hg
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Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities > grade 1) with the following exceptions:
- Patients with grade 2 or lower neuropathy, any grade alopecia, well controlled hypertension, thyroid disease controlled with therapy, and history of thromboembolic disease on anticoagulation are eligible
- Patients with laboratory-based grade 2 or higher adverse events (AEs) that meet the criteria outlined above are eligible
-
No major surgery within 3 weeks prior to study registration
-
Patients who underwent major surgery must have recovered adequately from any toxicity and/or complications from surgery prior to study registration
-
No strong inhibitors or inducers of UGT1A1
-
No history of allergic reaction to the study agent(s), compounds of similar chemical or biologic composition to the study agent(s) (or any of its excipients)
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
有源比较器:Arm I (carboplatin, PLD, bevacizumab)
Patients receive carboplatin IV on day 1, PLD IV on day 1 (or gemcitabine IV on days 1 and 8), and bevacizumab (or anti-VEGF antibody biosimilar) IV on days 1 and 15 of each cycle. Cycles repeat every 21 days for 6-10 cycles in the absence of disease progression or unacceptable toxicity. After 6-10 cycles, patients proceed to maintenance therapy. MAINTENANCE: Patients receive bevacizumab (or anti-VEGF antibody biosimilar) IV on day 1 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients also undergo ECHO or MUGA at screening and undergo CT and/or MRI and collection of blood samples throughout the trial. |
Given IV
其他名称:
Given IV
其他名称:
Undergo CT
其他名称:
Undergo MRI
其他名称:
Undergo ECHO
其他名称:
Undergo MUGA
其他名称:
Undergo collection of blood samples
其他名称:
Given IV
其他名称:
Given IV
其他名称:
Given IV
其他名称:
|
|
实验性的:Arm II (SG, bevacizumab)
Patients receive SG IV over 1-3 hours on days 1 and 8 and bevacizumab (or anti-VEGF antibody biosimilar) IV on day 1 of each cycle. Cycles repeat every 21 days for 6-10 cycles in the absence of disease progression or unacceptable toxicity. After 6-10 cycles, patients proceed to maintenance therapy. MAINTENANCE: Patients receive bevacizumab (or anti-VEGF antibody biosimilar) IV on day 1 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and/or MRI and collection of blood samples throughout the trial. |
Given IV
其他名称:
Undergo CT
其他名称:
Undergo MRI
其他名称:
Undergo collection of blood samples
其他名称:
Given IV
其他名称:
Given IV
其他名称:
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Progression-free survival
大体时间:From randomization to either progressive disease or death from any cause, assessed up to 5 years
|
The primary analysis will compare progression-free survival between Arm II and Arm I using a stratified log-rank test. The corresponding hazard ratio will be estimated from a stratified Cox regression model. The treatment hazard ratio estimate and its 95% confidence interval will be estimated using proportional hazards models specified to be consistent with the logrank tests. |
From randomization to either progressive disease or death from any cause, assessed up to 5 years
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Objective response rate (ORR)
大体时间:Within 12 months of starting maintenance therapy
|
The ORR is the percentage of evaluable patients who achieve a complete response (CR) or partial response (PR) within 12 months of starting maintenance therapy. The analysis will be based on physician-assessed responses according to Response Evaluation Criteria in Solid Tumors 1.1 criteria. Comparisons of ORR between the experimental and reference groups will use a multivariable logistic regression model, stratified by the randomization factors, to estimate the odds ratio. A 95% Jeffries confidence interval will also be calculated for the ORR in each treatment arm. |
Within 12 months of starting maintenance therapy
|
|
Duration of response (DOR)
大体时间:From the first documented response (CR or PR) until disease progression or death, assessed up to 5 years
|
DOR will be visualized using Kaplan-Meier curves, and the treatment groups will be compared with a stratified log-rank test. A stratified Cox proportional hazards model will be used to estimate the hazard ratio for progression or death between the groups. |
From the first documented response (CR or PR) until disease progression or death, assessed up to 5 years
|
|
Incidence of adverse events
大体时间:Up to 5 years
|
The nature, frequency, and degree of toxicity will be tabulated at the System Organ Class and adverse event-specific term levels using Common Terminology Criteria for Adverse Events version 5.0. Each patient will be represented according to the maximum grade observed for each term. Tabulations will show the number and percentage of patients by maximum grade, within the treatment group received, regardless of the randomized treatment assignment. |
Up to 5 years
|
|
Overall survival
大体时间:From randomization to death from any cause, assessed up to 5 years
|
Estimates of treatment effect will be interpreted descriptively with associated confidence intervals, without formal hypothesis testing. |
From randomization to death from any cause, assessed up to 5 years
|
其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
TROP2 expression
大体时间:Up to 5 years
|
TROP2 expression will be correlated with clinical activity of sacituzumab govitecan (SG) and bevacizumab to assess how the clinical effect of the randomized treatment is modified by TROP2 expression. Will formally test the interaction between the biomarker and the treatment assignment to assess whether this is a predictive biomarker. A logistic regression model will be used to test the treatment-by-TROP2 interaction on the odds of achieving a response. The odds ratio for the treatment effect will be estimated within each TROP2 subgroup. A Cox proportional hazards model will be fitted with main effects for treatment, TROP2 status, and a treatment-by-TROP2 interaction term. A statistically significant interaction term would suggest TROP2 is a predictive biomarker. The treatment effect will be estimated and displayed on a forest plot for TROP2-high and TROP2-low subgroups. Kaplan-Meier curves for PFS will be plotted for each treatment arm within each TROP2 subgroup. |
Up to 5 years
|
|
Cell-free deoxyribonucleic acid (cfDNA)
大体时间:Up to 5 years
|
cfDNA expression will be correlated with clinical activity of SG and bevacizumab to assess how the clinical effect of the randomized treatment is modified by cfDNA expression. Will formally test the interaction between the biomarker and the treatment assignment to assess whether this is a predictive biomarker. |
Up to 5 years
|
|
Time to first subsequent therapy or death (TFST)
大体时间:From randomization to the earliest occurrence of either first subsequent therapy or death, assessed up to 5 years
|
TFST distributions by randomized treatment assignment in the intent to treat population will be visualized using Kaplan-Meier curves. The effect of treatment assignment on TFST will be estimated using a Cox proportional hazards model, stratified by the randomization factors. Hazard ratio estimates and 95% confidence intervals will be reported to quantify the treatment effect. Treatment effects within strata will be presented in a forest plot. |
From randomization to the earliest occurrence of either first subsequent therapy or death, assessed up to 5 years
|
|
Time to second subsequent therapy or death (TSST)
大体时间:From randomization to the earliest occurrence of either second subsequent therapy or death, assessed up to 5 years
|
TSST distributions by randomized treatment assignment in the intent to treat population will be visualized using Kaplan-Meier curves. The effect of treatment assignment on TSST will be estimated using a Cox proportional hazards model, stratified by the randomization factors. Hazard ratio estimates and 95% confidence intervals will be reported to quantify the treatment effect. Treatment effects within strata will be presented in a forest plot. |
From randomization to the earliest occurrence of either second subsequent therapy or death, assessed up to 5 years
|
合作者和调查者
调查人员
- 首席研究员:Rebecca L Porter、NRG Oncology
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
- 氨基酸,肽和蛋白质
- 蛋白质
- 硫化合物
- 有机化学品
- 杂环化合物,1形
- 杂环化合物
- 调查技术
- 临床实验室技术
- 诊断技术和程序
- 诊断
- 碳氢化合物
- 碳氢化合物,循环
- 碳水化合物
- 多环芳烃
- 碳氢化合物,芳香族
- 多环化合物
- 糖苷
- 抗体,单克隆,人源化
- 抗体,单克隆
- 抗体
- 免疫球蛋白
- 免疫蛋白
- 血蛋白
- 血清球蛋白
- 球蛋白
- 无机化学物质
- 协调配合物
- 脱氧胞苷
- 胞苷
- 嘧啶核苷
- 嘧啶
- 化学技术,分析
- 频谱分析
- 蒽环类动物
- 萘烯
- 氨基糖苷
- 免疫球蛋白同种型
- 硫化物
- 阴离子
- 离子
- 电解质
- 硫化氢
- Daunorubicin
- 贝伐单抗
- 吉西他滨
- 卡铂
- 阿霉素
- 免疫球蛋白G
- 标本处理
- 磁共振光谱
- 二硫化物
- 脂质体阿霉素
- sacituzumab govitecan
其他研究编号
- NCI-2026-01998
- U10CA180868 (美国 NIH 拨款/合同)
- NCI-2026-01998 (注册表标识符:CTRP (Clinical Trial Reporting Program))
- NRG-GY038 (其他标识符:CTEP)
- NRG-GY038 (其他标识符:NRG Oncology)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
IPD 计划说明
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.
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
在美国制造并从美国出口的产品
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.