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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04729387
Registration number
NCT04729387
Ethics application status
Date submitted
25/01/2021
Date registered
28/01/2021
Titles & IDs
Public title
Alpelisib Plus Olaparib in Platinum-resistant/Refractory, High-grade Serous Ovarian Cancer, With no Germline BRCA Mutation Detected
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Scientific title
EPIK-O: A Phase III, Multi-center, Randomized (1:1), Open-label, Active-controlled, Study to Assess the Efficacy and Safety of Alpelisib (BYL719) in Combination With Olaparib as Compared to Single Agent Cytotoxic Chemotherapy, in Participants With no Germline BRCA Mutation Detected, Platinum-resistant or Refractory, High-grade Serous Ovarian Cancer
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Secondary ID [1]
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2019-004682-40
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Secondary ID [2]
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CBYL719K12301
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Ovarian Cancer
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Condition category
Condition code
Cancer
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Ovarian and primary peritoneal
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Alpelisib
Treatment: Drugs - Olaparib
Treatment: Drugs - Paclitaxel
Treatment: Drugs - Pegylated liposomal doxorubicin (PLD)
Experimental: Alpelisib+olaparib - Alpelisib 200 mg orally once daily and olaparib 200 mg orally twice daily on a continuous dosing schedule.
Active comparator: Paclitaxel or PLD - Investigator's choice of one of 2 single agent cytotoxic chemotherapies: Paclitaxel 80 mg/m2 intravenously weekly or Pegylated liposomal Doxorubicin (PLD) 40-50 mg/m2 (physician discretion) intravenously every 28 days.
Treatment: Drugs: Alpelisib
Alpelisib will be 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
Treatment: Drugs: Olaparib
Olaparib will be 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.
Treatment: Drugs: Paclitaxel
Paclitaxel will be administered at 80 mg/m2 as an intravenous infusion weekly during a 28-day treatment cycle, starting on Cycle 1 Day 1, and on Day 8, Day 15 and Day 22 of every cycle thereafter
Treatment: Drugs: Pegylated liposomal doxorubicin (PLD)
PLD will be administered at 40-50 mg/m2 (physician discretion) as an intravenous infusion once every 28-days in a 28 day treatment cycle, starting on Cycle 1 Day 1
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Progression Free Survival (PFS) based on Blinded Independent Review Committee (BIRC) assessment using RECIST 1.1 criteria
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Assessment method [1]
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PFS is defined as the time from the date of randomization to the date of the first documented progression (based on RECIST 1.1 criteria) or death due to any cause. If a participant has not had an event, PFS will be censored at the date of the last adequate tumor assessment
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Timepoint [1]
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From randomization until the date of the first documented progression or death due to any cause, whichever comes first, assessed up to approximately 23 months
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Secondary outcome [1]
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Overall survival
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Assessment method [1]
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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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Timepoint [1]
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From randomization until death, assessed up to approximately 44 months
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Secondary outcome [2]
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Number of participants with dose interruptions and dose reductions
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Assessment method [2]
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Tolerability measured by the number of participants who have dose interruptions and dose reductions
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Timepoint [2]
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From randomization until end of treatment, assessed up to approximately 18 months
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Secondary outcome [3]
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Dose intensity
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Assessment method [3]
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Tolerability measured by the dose intensity of study drug. Dose intensity will be computed as the ratio of actual cumulative dose received and actual duration of exposure.
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Timepoint [3]
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From randomization until end of treatment, assessed up to approximately 18 months
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Secondary outcome [4]
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Time to definitive deterioration of the Eastern Cooperative Oncology Group (ECOG) performance status (PS)
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Assessment method [4]
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PS will be assessed using ECOG scale. The scale consists of 6 grades (from 0 to 5) where 0 implies fully active and 5 implies dead. Time to definitive deterioration in ECOG PS is defined as the time from the date of randomization to the date when ECOG PS has definitively deteriorated by at least one category compared with baseline. Deterioration is considered definitive if there is no subsequent improvement in ECOG PS back to the baseline category or above.
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Timepoint [4]
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Up to approximately 18 months
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Secondary outcome [5]
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Overall Response Rate (ORR) with confirmed response based on BIRC assessment according to RECIST 1.1 criteria
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Assessment method [5]
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ORR with confirmed response is defined as the proportion of participants with best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR), as per BIRC assessment according to RECIST 1.1
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Timepoint [5]
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Up to approximately 23 months
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Secondary outcome [6]
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Clinical benefit rate (CBR) with confirmed response based on BIRC assessment according to RECIST 1.1
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Assessment method [6]
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Clinical benefit rate (CBR) with confirmed response is defined as the proportion of participants with a best overall response of confirmed CR or PR, or stable disease (SD) lasting for a duration of at least 24 weeks. CR, PR and SD are defined as per BIRC assessment according to RECIST 1.1
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Timepoint [6]
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Up to approximately 23 months
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Secondary outcome [7]
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Time to response (TTR) based on BIRC assessment and according to RECIST 1.1
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Assessment method [7]
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TTR is defined as the time from the date of randomization to the first documented response of either complete response (CR) or partial response (PR) based on tumor response data as per BIRC assessment and according to RECIST 1.1
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Timepoint [7]
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From the date of randomization to the first documented response, assessed up to approximately 23 months
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Secondary outcome [8]
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Duration of response (DOR) with confirmed response based on BIRC assessment and according to RECIST 1.1
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Assessment method [8]
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DOR with confirmed response only applies to participants whose best overall response is confirmed CR or confirmed PR according to RECIST 1.1 based on tumor response data per BIRC assessment. The start date is the date of first documented response of CR or PR and the end date is defined as the date of the first documented progression or death due to underlying cancer
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Timepoint [8]
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From first documented response to first documented progression or death, assessed up to approximately 23 months
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Secondary outcome [9]
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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
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Assessment method [9]
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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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Timepoint [9]
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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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Secondary outcome [10]
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Area under the curve from time zero to the last measurable concentration sampling time (AUClast)of alpelisib and olaparib
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Assessment method [10]
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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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Timepoint [10]
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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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Secondary outcome [11]
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Maximum Concentration (Cmax) of alpelisib and olaparib
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Assessment method [11]
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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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Timepoint [11]
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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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Secondary outcome [12]
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Time to reach maximum concentration (Tmax) of alpelisib and olaparib
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Assessment method [12]
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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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Timepoint [12]
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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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Secondary outcome [13]
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Change from baseline in Function Assessment of Cancer Therapy-Ovarian Trial Outcome Index (FACT-O TOI)
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Assessment method [13]
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Health-related quality of life will be assessed by the Trial Outcome Index (TOI) of the Function Assessment of Cancer Therapy - Ovarian (FACT-O). The TOI is an index driven from FACT-O summarizing patients' physical and functional well-being as well as ovarian cancer-specific symptoms driven from FACT-O. The FACT-O TOI score ranges from 0 to 100 with higher scores indicating better quality of life.
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Timepoint [13]
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From baseline up to approximately 44 months
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Eligibility
Key inclusion criteria
* Participant has histologically confirmed diagnosis of high-grade serous or high-grade endometrioid ovarian cancer, fallopian tube cancer, or primary peritoneal cancer
* Measurable disease, i.e., at least one measurable lesion per RECIST 1.1 criteria (a lesion at a previously irradiated site may only be counted as a target lesion if there is clear sign of progression since the irradiation)
* If no measurable disease is present, the disease should be assessable by Gynecologic Cancer Intergroup criteria (GCIC) for CA-125
* Participant has no germline BRCA1/2 mutation as determined by an FDA approved assay.
* Participant has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
* Participant has platinum-resistant (progression within one to six months after completing platinum-based therapy) or platinum refractory disease (progression during treatment or within 4 weeks after the last dose), where platinum-based therapy is not an option, according to the GCIG 5th Ovarian Cancer Consensus Conference definitions. The platinum-based chemotherapy regimen does not necessarily need to be the last regimen the participant received prior to study entry.
* Participant must have received at least one but no more than three prior systemic treatment regimens and for whom single-agent chemotherapy is appropriate as the next line of treatment.
* Participant has adequate bone marrow and organ function
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Participant has received prior treatment with any PI3K, mTOR or AKT inhibitor.
* Participant is concurrently using other anti-cancer therapy
* Participant is in a state of small or large bowel obstruction or has other impairment of gastrointestinal (GI) function or GI disease
* Participant has had surgery within 14 days prior to starting study drug or has not recovered from major side effects
* Participant has not recovered from all toxicities 5 related to prior anticancer therapies to baseline or NCI CTCAE Version 4.03 Grade =1. Exception to this criterion: participants with any grade of alopecia are allowed to enter the study.
* Participants with liver impairment and Child Pugh score B or C
* Participant has received radiotherapy = 4 weeks or limited field radiation for palliation =2 weeks prior to randomization, and who has not recovered to baseline, grade 1 or better from related side effects of such therapy (with the exception of alopecia).
* Participant has a known hypersensitivity to any of the study drugs or excipients
Other inclusion/exclusion criteria may apply
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
2/07/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
31/01/2026
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Actual
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Sample size
Target
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Accrual to date
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Final
358
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Recruitment in Australia
Recruitment state(s)
NSW,SA,VIC
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Recruitment hospital [1]
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Novartis Investigative Site - Randwick
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Recruitment hospital [2]
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Novartis Investigative Site - Bedford Park
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Recruitment hospital [3]
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Novartis Investigative Site - Shepparton
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Recruitment postcode(s) [1]
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2031 - Randwick
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Recruitment postcode(s) [2]
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5041 - Bedford Park
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Recruitment postcode(s) [3]
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3630 - Shepparton
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Recruitment outside Australia
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BO
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Adana
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Izmir
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London
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Manchester
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Novartis Pharmaceuticals
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The objective of this study is to assess the efficacy and safety of the combination of alpelisib and olaparib compared with single agent cytotoxic chemotherapy in patients with platinum resistant or refractory high-grade serous ovarian cancer, with no germline BRCA mutation detected.
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Trial website
https://clinicaltrials.gov/study/NCT04729387
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Trial related presentations / publications
Konstantinopoulos PA, Gonzalez-Martin A, Cruz FM, Friedlander M, Glasspool R, Lorusso D, Marth C, Monk BJ, Kim JW, Hinson P, Ajipa O, Pretre V, Han Y, Matulonis UA. EPIK-O/ENGOT-OV61: alpelisib plus olaparib vs cytotoxic chemotherapy in high-grade serous ovarian cancer (phase III study). Future Oncol. 2022 Oct;18(31):3481-3492. doi: 10.2217/fon-2022-0666. Epub 2022 Sep 6.
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Public notes
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Contacts
Principal investigator
Name
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.
This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
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When will data be available (start and end dates)?
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Available to whom?
Query!
Available for what types of analyses?
Query!
How or where can data be obtained?
Query!
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04729387