Title

Olaparib Treatment in BRCA Mutated Ovarian Cancer Patients After Complete or Partial Response to Platinum Chemotherapy
Phase III Randomised, Double Blind, Placebo Controlled Study of Olaparib Maintenance Monotherapy in Platinum Sensitive Relapsed BRCA Mutated Ovarian Cancer Patients With a Complete or Partial Response Following Platinum Based Chemotherapy
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    olaparib ...
  • Study Participants

    327
A Phase III, randomised, double-blind, placebo-controlled, multi-centre study to assess the efficacy of olaparib maintenance monotherapy in relapsed high grade serous ovarian cancer (HGSOC) patients (including patients with primary peritoneal and / or fallopian tube cancer) or high grade endometrioid cancer with BRCA mutations (documented mutation in BRCA1 or BRCA2 that is predicted to be deleterious or suspected deleterious (known or predicted to be detrimental/lead to loss of function)) who have responded following platinum based chemotherapy.
Comparison of olaparib against a placebo in patients with ovarian cancer whose cancer has already improved by taking platinum based chemotherapy. The patients must also have a fault in their DNA which codes for the BRCA protein. The BRCA protein helps mend broken DNA in the cells of the body; if this protein doesn't work properly it can increase the chance of getting cancer. The aim of this study is to see whether patients taking olaparib tablets last longer until their cancer gets worse, compared to those taking the placebo tablet. The study is also looking to see if there is an overall improvement to how long the patients survive whilst taking olaparib tablets compared to the placebo tablets; and the quality of their life whilst living with ovarian cancer.
Study Started
Sep 03
2013
Primary Completion
Sep 19
2016
Study Completion
Dec 29
2023
Anticipated
Results Posted
Feb 07
2018
Last Update
Oct 23
2023

Drug Olaparib 300mg tablets

300mg Olaparib or placebo tablets taken orally twice daily until objective radiological disease progression as per RECIST as assessed by the investigator (or as long as in the investigator's opinion they are benefiting from treatment and they do not meet any other discontinuation criteria). Dose reduction to 250mg and subsequently 200mg is permitted following confirmation of toxicity.

Drug Placebo to match olaparib 300mg

300mg Olaparib or placebo tablets taken orally twice daily until objective radiological disease progression as per RECIST as assessed by the investigator (or as long as in the investigator's opinion they are benefiting from treatment and they do not meet any other discontinuation criteria). Dose reduction to 250mg and subsequently 200mg is permitted following confirmation of toxicity.

Olaparib 300mg tablets Experimental

Taken orally twice daily

Placebo tablets Placebo Comparator

Taken orally twice daily

Criteria

Inclusion Criteria:

Patients must be ≥ 18 years of age.

Female patients with histologically diagnosed relapsed high grade serous ovarian cancer (including primary peritoneal and / or fallopian tube cancer) or high grade endometrioid cancer.
Documented mutation in BRCA1 or BRCA2 that is predicted to be deleterious or suspected deleterious (known or predicted to be detrimental/lead to loss of function).
Patients who have received at least 2 previous lines of platinum containing therapy prior to randomisation

For the penultimate chemotherapy course prior to enrolment on the study:

• Patient defined as platinum sensitive after this treatment; defined as disease progression greater than 6 months after completion of their last dose of platinum chemotherapy

For the last chemotherapy course immediately prior to randomisation on the study:

Patients must be, in the opinion of the investigator, in response (partial or complete radiological response), or may have no evidence of disease (if optimal cytoreductive surgery was conducted prior to chemotherapy), and no evidence of a rising CA-125, following completion of this chemotherapy course
Patient must have received a platinum based chemotherapy regimen (e.g. carboplatin or cisplatin) and have received at least 4 cycles of treatment
Patients must be randomized within 8 weeks of their last dose of chemotherapy
Maintenance treatment is allowed at the end of the penultimate platinum regimen, including bevacizumab

Exclusion Criteria:

Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site).
BRCA 1 and/or BRCA2 mutations that are considered to be non detrimental (e.g., "Variants of uncertain clinical significance" or "Variant of unknown significance" or "Variant, favor polymorphism" or "benign polymorphism" etc.)
Patients who have had drainage of their ascites during the final 2 cycles of their last chemotherapy regimen prior to enrolment on the study.

Summary

Olaparib 300 Tablets (Global Cohort)

Placebo Tablets (Global Cohort)

Olaparib 300 Tablets (China Cohort)

Placebo Tablets (China Cohort)

All Events

Event Type Organ System Event Term Olaparib 300 Tablets (Global Cohort) Placebo Tablets (Global Cohort) Olaparib 300 Tablets (China Cohort) Placebo Tablets (China Cohort)

Progression Free Survival (PFS) Using Investigator Assessment According to Modified Response Evaluation Criteria In Solid Tumours (RECIST 1.1)

To determine the efficacy by progression free survival (PFS) (using investigator assessment according to modified Response Evaluation Criteria In Solid Tumours (RECIST 1.1)) of olaparib maintenance monotherapy compared to placebo in BRCA mutated relapsed ovarian cancer patients who are in complete or partial response following platinum based chemotherapy.

Olaparib 300mg Tablets (Global Cohort)

19.1
Months (Median)
95% Confidence Interval: 16.3 to 25.7

Placebo Tablets (Global Cohort)

5.5
Months (Median)
95% Confidence Interval: 5.2 to 5.8

Olaparib 300mg Tablets (China Cohort)

13.8
Months (Median)
95% Confidence Interval: 6.5 to 16.6

Placebo Tablets (China Cohort)

5.5
Months (Median)
95% Confidence Interval: 2.7

Efficacy in Patients Following Platinum Based Chemotherapy by Assessment of Overall Survival

To determine the efficacy of olaparib maintenance monotherapy compared to placebo in BRCA mutated relapsed ovarian cancer patients who are in complete or partial response following platinum based chemotherapy by assessment of overall survival (OS).

Olaparib 300mg Tablets (Global Cohort)

51.7
Months (Median)
95% Confidence Interval: 41.5 to 59.1

Placebo Tablets (Global Cohort)

38.8
Months (Median)
95% Confidence Interval: 31.4 to 48.6

Olaparib 300mg Tablets (China Cohort)

41.7
Months (Median)
95% Confidence Interval: 17.6

Placebo Tablets (China Cohort)

36.4
Months (Median)
95% Confidence Interval: 13.2

Efficacy in Patients Following Platinum Based Chemotherapy by Assessment of Time to Earliest Progression by RECIST or Cancer Antigen (CA-125) or Death

To determine the efficacy of olaparib maintenance monotherapy compared to placebo in BRCA mutated relapsed ovarian cancer patients who are in complete or partial response following platinum based chemotherapy by assessment of time to earliest progression by RECIST or CA-125 or death.

Olaparib 300mg Tablets (Global Cohort)

16.9
Months (Median)
95% Confidence Interval: 14.6 to 22.3

Placebo Tablets (Global Cohort)

4.9
Months (Median)
95% Confidence Interval: 3.7 to 5.6

Olaparib 300mg Tablets (China Cohort)

12.9
Months (Median)
95% Confidence Interval: 5.9 to 14.0

Placebo Tablets (China Cohort)

3.7
Months (Median)
95% Confidence Interval: 1.0 to 7.4

Efficacy in Patients Following Platinum Based Chemotherapy by Assessment of Time From Randomization to Second Progression

To determine the efficacy of olaparib maintenance monotherapy compared to placebo in BRCA mutated relapsed ovarian cancer patients who are in complete response or partial response following first line platinum based chemotherapy by assessment of time from randomization up to second progression

Olaparib 300mg Tablets (Global Cohort)

Placebo Tablets (Global Cohort)

18.4
Months (Median)
95% Confidence Interval: 15.4 to 22.8

Olaparib 300mg Tablets (China Cohort)

Placebo Tablets (China Cohort)

17.3
Months (Median)
95% Confidence Interval: 6.0 to 17.3

Change From Baseline in Health-Related Quality of Life (HRQoL) as Assessed by the the Trial Outcome Index (TOI) of the Functional Assessment of Cancer Therapy - Ovarian (FACT-O)

To compare the effects of olaparib maintenance monotherapy compared to placebo on Health-related Quality of Life (HRQoL) as assessed by the trial outcome index (TOI) of the Functional Assessment of Cancer Therapy - Ovarian (FACT-O) in BRCA mutated relapsed ovarian cancer patients who are in complete or partial response following platinum based chemotherapy. The TOI ranges from 0-100 and a higher score indicates a higher HRQoL.

Olaparib 300mg Tablets (Global Cohort)

-2.9
Change in TOI over 12 months (Least Squares Mean)
95% Confidence Interval: -4.131 to -1.673

Placebo Tablets (Global Cohort)

-2.87
Change in TOI over 12 months (Least Squares Mean)
95% Confidence Interval: -4.643 to -1.097

Efficacy of Olaparib by Time to First Subsequent Therapy or Death (TFST)

To determine the efficacy of olaparib maintenance monotherapy compared to placebo in BRCA mutated high risk advanced ovarian cancer patients who are in clinical complete response or partial response following first line platinum based chemotherapy by assessment of time from randomization to first subsequent therapy or death (TFST).

Olaparib 300mg Tablets (Global Cohort)

27.4
Months (Median)
95% Confidence Interval: 22.6 to 31.1

Placebo Tablets (Global Cohort)

7.2
Months (Median)
95% Confidence Interval: 6.3 to 8.5

Olaparib 300mg Tablets (China Cohort)

13.9
Months (Median)
95% Confidence Interval: 9.1 to 15.9

Placebo Tablets (China Cohort)

5.5
Months (Median)
95% Confidence Interval: 1.4 to 18.4

Efficacy of Olaparib by Time to Second Subsequent Therapy or Death (TSST)

To determine the efficacy of olaparib maintenance monotherapy compared to placebo in BRCA mutated high risk advanced ovarian cancer patients who are in clinical complete response or partial response following first line platinum based chemotherapy by assessment of time from randomization to second subsequent therapy or death (TSST).

Placebo Tablets (Global Cohort)

18.9
Months (Median)
95% Confidence Interval: 15.5 to 21.5

Olaparib 300mg Tablets (ChinaCohort)

19.0
Months (Median)
95% Confidence Interval: 10.1 to 32.8

Placebo Tablets (China Cohort)

26.4
Months (Median)
95% Confidence Interval: 6.3 to 36.0

Olaparib 300mg Tablets (Global Cohort)

35.8
Months (Median)
95% Confidence Interval: 29.4 to 43.9

Efficacy of Olaparib by Time From Randomization to Study Treatment Discontinuation or Death (TDT)

To determine the efficacy of olaparib maintenance monotherapy compared to placebo in BRCA mutated high risk advanced ovarian cancer patients who are in clinical complete response or partial response following first line platinum based chemotherapy by assessment of time from randomization to study treatment discontinuation or death (TDT).

Olaparib 300mg Tablets (Global Cohort)

19.4
Months (Median)
95% Confidence Interval: 14.9 to 25.9

Placebo Tablets (Global Cohort)

5.6
Months (Median)
95% Confidence Interval: 5.0 to 6.8

Olaparib 300mg Tablets (China Cohort)

13.4
Months (Median)
95% Confidence Interval: 6.3 to 16.5

Placebo Tablets (China Cohort)

4.7
Months (Median)
95% Confidence Interval: 1.3 to 11.1

Efficacy in Patients With a Deleterious or Suspected Deleterious Variant in Either of the BRCA Genes by Assessment of PFS.

To assess efficacy of olaparib in patients identified as having a deleterious or suspected deleterious variant in either of the BRCA genes using variants identified with current and future BRCA mutation assays (gene sequencing and large rearrangement analysis).

Olaparib 300mg Tablets (Global Cohort)

19.3
Months (Median)
95% Confidence Interval: 16.5 to 27.3

Placebo Tablets (Global Cohort)

5.5
Months (Median)
95% Confidence Interval: 5.0 to 5.8

To Determine the Exposure to Olaparib by Pharmacokinetic Analysis

To determine the exposure to olaparib in patients receiving olaparib maintenance monotherapy

Olaparib 300mg Tablets

Day 1 - 1 hour

3.26
mcg/mL (Geometric Mean)
Geometric Coefficient of Variation: 312.2

Day 15 - 1 hour

5.12
mcg/mL (Geometric Mean)
Geometric Coefficient of Variation: 61.8

Day 15 - Pre-dose

0.92
mcg/mL (Geometric Mean)
Geometric Coefficient of Variation: 95.5

Day 1 - Pre-dose

Day 29 - Pre-dose

0.94
mcg/mL (Geometric Mean)
Geometric Coefficient of Variation: 179.0

Total

327
Participants

Age, Continuous

Age, Continuous

Age, Customized

Age, Customized

Ethnicity (NIH/OMB)

Ethnicity (NIH/OMB)

Race/Ethnicity, Customized

Race/Ethnicity, Customized

Sex: Female, Male

Sex: Female, Male

Overall Study

Olaparib 300mg Tablets (Global Cohort)

Placebo Tablets (Global Cohort)

Olaparib 300mg Tablets (China Cohort)

Placebo Tablets (China Cohort)

Drop/Withdrawal Reasons

Olaparib 300mg Tablets (Global Cohort)

Placebo Tablets (Global Cohort)

Olaparib 300mg Tablets (China Cohort)

Placebo Tablets (China Cohort)