Title

Efficacy Multicentre Trial of ImmunoTherapy Vaccination With Abagovomab to Treat Ovarian Cancer Patients
A Randomised,Double Blind, Placebo Controlled, Multicentre Trial of Abagovomab Maintenance Therapy in Patients With Epithelial Ovarian Cancer After Complete Response to First Line Chemotherapy
  • Phase

    Phase 2/Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    Abagovomab ...
  • Study Participants

    888
The purpose of this study is to evaluate the benefit of vaccination with Abagovomab, an experimental immunotherapy in ovarian cancer patients. The benefit will be evaluated in terms of time the remission status is kept as well as prolongation of life expectancy.
Standard initial treatment of ovarian cancer patients includes both surgery and chemotherapy which in the vast majority of cases achieves the disappearance of ovarian cancer lesions. This status, called "clinical remission" which means having no evidence of cancer on CT scan or physical examination needs to be carefully follow up in order to confirm the maintenance of the remission status or to early detect if the cancer grows again and then start a new chemotherapy. At present, no approved therapies exist for the maintenance treatment of patients who achieved the clinical remission.

This trial aims to evaluate if the repeated vaccination with Abagovomab creates an immunoresponse which is able to fight the cancer cells thus keeping the remission status as long as possible and help patients live disease-free and longer.

Patients who achieve the remission status after chemotherapy will be screened for study participation and if they meet the criteria for inclusion they will start to receive a single subcutaneous injection every 2 weeks (for the first 4 doses - induction phase) and then every 4 weeks (maintenance phase). The duration of treatment is up to approximately 4 years or it will be stopped in case relapse occurs.

In order to evaluate the real benefit of vaccination, the experimental treatment includes Abagovomab (the active drug) or placebo (the vehicle only, without drug), with a double chance to receive Abagovomab. Assignment of Abagovomab or placebo will be done by a computerised system and nobody in the study will know which treatment has been allocated until study end.

Patients will be visited every 4 weeks and will undergo CT scan of pelvis and abdomen every 12 weeks in order to confirm the remission status or to early detect if relapse eventually occurs. This will be done in blind condition (i.e. without being aware which treatment the patient is going to receive) for the first part of the study which is expected to last four years. After then the overall status of patient will continue to be monitored by phone contact for additional five years.
Study Started
Dec 31
2006
Primary Completion
Dec 31
2010
Study Completion
Jun 30
2011
Results Posted
Nov 18
2011
Estimate
Last Update
Nov 24
2011
Estimate

Biological Abagovomab

2 mg/ml SC (subcutaneously)

Biological Placebo

2 mg/ml SC (subcutaneously)

Abagovomab Experimental

Placebo Placebo Comparator

Criteria

Inclusion Criteria:

At a maximum of 12 weeks after the last cycle of first line standard platinum/taxane intravenous (IV) or intraperitoneal (IP) chemotherapy, patients must fulfill all the following inclusion criteria:

Age >/= 18 years;
Properly executed written informed consent;
History of histological and CA125 (> 35 U/ml) confirmed diagnosis of stage III-IV epithelial ovarian, fallopian tube, or primary peritoneal cancer;
History of debulking surgery and 6-8 cycles of standard platinum/taxane based non-investigational IV-IP chemotherapy;
Complete clinical response defined as:
Normal physical examination;
No symptoms suggestive of persistent cancer;
No definite evidence of disease by computed tomography (CT) of the abdomen and pelvis within the previous 4 weeks;
Negative chest x-ray (or chest CT scan) within the previous 4 weeks;
Serum CA125 within the normal laboratory range.

Adequate hematologic, renal and hepatic function:

Absolute Neutrophil Count (ANC) >/=1.5 * 109/l;
Platelets >/= 75 * 109/l;
Haemoglobin >/= 6.2 mmol/l (>9.9 g/dl);
Serum creatinine </= 1.5 * ULN (Upper Limit of Normal);
Bilirubin </= 1.5 * ULN; AST, ALT, AP </= 2.5 * ULN.
Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) </= 2.

Exclusion Criteria:

Patients are ineligible to participate in the study, if any of the following criteria are present:

any other invasive malignancies, with the exception of non-melanoma skin cancer or cervical carcinoma in situ, within the last 5 years or whose previous cancer treatment contraindicates this protocol therapy;
known active autoimmune disease requiring chronic treatment with immunosuppressive agents (e.g., rheumatoid arthritis, ulcerative colitis, etc.);
known immune deficiency (e.g. HIV, hypogammaglobulinemia, etc.);
known infection with hepatitis B, or hepatitis C;
history of recent myocardial infarction (</= 6 months) or decompensated heart failure (New York Heart Association - NYHA class >/= III);
previous or concomitant use of any anti-cancer therapy other than the platinum-taxane based 1st line chemotherapy for ovarian cancer; any maintenance or consolidation therapy is not permitted after completion of standard front line chemotherapy.
concomitant use of any other investigational agent;
any prior investigational anti-cancer vaccine or monoclonal antibody;
known allergy to murine proteins;
any significant medical or psychiatric condition, drug or alcohol abuse that might prevent the patient from complying with all study procedures;
clinically significant active infection;
concomitant use of any immunosuppressive agent (e.g., steroids, cyclosporin, etc.);
major surgery within the previous 2 weeks;
radiotherapy within the previous 4 weeks;
any significant toxicity from prior chemotherapy;
unreliability or inability to follow protocol requirements;
potentially childbearing and not willing to use adequate contraceptive methods throughout the entire study period;
pregnancy.

Summary

Abagovomab

Placebo

All Events

Event Type Organ System Event Term Abagovomab Placebo

Recurrence Free Survival Evaluated by Clinical Event Adjudication Committee (CEAC)

The Recurrence free survival correspond to the time from date of randomization to documented disease recurrence or death. Disease recurrence is defined as the appearance of any lesion or development of tumor-related symptoms evaluated by medical examination and must be confirmed by a documented CT scan.

Abagovomab

403.0
days (Median)
95% Confidence Interval: 323.0 to 414.0

Placebo

402.0
days (Median)
95% Confidence Interval: 323.0 to 487.0

Overall Survival

2 years survival rate

Abagovomab

80.0
Percentage of participants

Placebo

79.0
Percentage of participants

Safety

Safety was analyzed in all patients who received at least 1 dose administration. Adverse event (AE) are defined as events which started on or after the first dose of study medication and on or before the date of the final study visit, or within 12 weeks of the last dose if the final study visit was not performed.

Abagovomab

Patients with at least 1 Adverse Drug Reaction ADR

507.0
participants

Patients with at least 1 Adverse Event (AE)

564.0
participants

Patients with at least 1 AE leading to withdrawal

93.0
participants

Patients with at least 1 AE resulted in death

8.0
participants

Patients with at least 1 Serious ADR (SADR)

10.0
participants

Patients with at least 1 Serious Adverse Event SAE

141.0
participants

Placebo

Patients with at least 1 Adverse Drug Reaction ADR

246.0
participants

Patients with at least 1 Adverse Event (AE)

278.0
participants

Patients with at least 1 AE leading to withdrawal

57.0
participants

Patients with at least 1 AE resulted in death

4.0
participants

Patients with at least 1 Serious ADR (SADR)

3.0
participants

Patients with at least 1 Serious Adverse Event SAE

72.0
participants

Time Course of Immunoresponse

Time course of immunologic parameters (anti-anti-idiotypic antibody - Ab3) will be assessed in all patients, by comparing levels at baseline (week 0), at week 10 after first dose administration and at end of treatment (at week 4 or week 12 after the last administered dose, as appropriate).

Abagovomab

Ab3 (baseline)

Ab3 (end of treatment)

493000.0
ng/ml (Median)
Full Range: 0.0 to 2720000.0

Ab3 (week 10)

63550.0
ng/ml (Median)
Full Range: 0.0 to 777000.0

Total

888
Participants

Age Continuous

56.3
years (Mean)
Standard Deviation: 10.53

Age, Categorical

Eastern Cooperative Oncology Group Performance Status (ECOG-PS)

Grade of histologic differentiation

Histology of ovarian tumor

International Federation of Gynecology and Obstetrics (FIGO) stage

Region of Enrollment

Serum CA-125 after 3rd chemotherapy cycle

Sex/Gender, Customized

Tumor size after debulking surgery

Overall Study

Abagovomab

Placebo