Trial Review

The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/study/NCT03603184




Registration number
NCT03603184
Ethics application status
Date submitted
21/05/2018
Date registered
27/07/2018
Date last updated
13/03/2024

Titles & IDs
Public title
Atezolizumab Trial in Endometrial Cancer - AtTEnd
Scientific title
Phase III Double-blind Randomized Placebo Controlled Trial of Atezolizumab in Combination With Paclitaxel and Carboplatin in Women With Advanced/Recurrent Endometrial Cancer
Secondary ID [1] 0 0
IRFMN-EN-7556
Universal Trial Number (UTN)
Trial acronym
AtTEnd
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Endometrial Cancer 0 0
Condition category
Condition code
Cancer 0 0 0 0
Womb (Uterine or endometrial cancer)

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Atezolizumab
Treatment: Drugs - Placebos
Treatment: Drugs - Paclitaxel
Treatment: Drugs - Carboplatin

Experimental: Experimental arm - paclitaxel 175 mg/m2 + carboplatin AUC 5 or 6 will be administered every 21 days for 6-8 cycles or PD. Atezolizumab will be administered as I.V. infusion at a fixed dose of 1200 mg, every 21 days until objective radiological disease progression as assessed by the investigator if they do not meet any other discontinuation criteria (patient refusal, toxicity). Patients who are clinically stable at initial RECIST v 1.1 - defined progression - should continue on treatment until the next imaging assessment that should be =4 weeks and no longer than 8 weeks later.

Placebo comparator: Control arm - paclitaxel 175 mg/m2 + carboplatin AUC 5 or AUC 6 will be administered every 21 days for 6-8 cycles or PD. Placebo will be administered as I.V. infusion every 21 days until objective radiological disease progression as assessed by the investigator if they do not meet any other discontinuation criteria (patient refusal, toxicity). Patients who are clinically stable at initial RECIST v 1.1 - defined progression - should continue on treatment until the next imaging assessment that should be =4 weeks and no longer than 8 weeks later.


Treatment: Drugs: Atezolizumab
Atezolizumab will be administered as I.V. infusion at a fixed dose of 1200 mg, every 21 days until objective radiological disease progression as assessed by the investigator if they do not meet any other discontinuation criteria (patient refusal, toxicity).

Treatment: Drugs: Placebos
Placebo will be administered as I.V. infusion every 21 days until objective radiological disease progression as assessed by the investigator if they do not meet any other discontinuation criteria (patient refusal, toxicity).

Treatment: Drugs: Paclitaxel
Paclitaxel 175 mg/m2 will be administered every 21 days for 6-8 cycles or until progression of disease.

Treatment: Drugs: Carboplatin
Carboplatin AUC 5 or AUC 6 will be administered every 21 days for 6-8 cycles or until progression of disease.
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
PFS in the MSI
Timepoint [1] 0 0
Up to 18 months after the last patient enrolled
Primary outcome [2] 0 0
PFS
Timepoint [2] 0 0
Up to 18 months after the last patient enrolled
Primary outcome [3] 0 0
OS
Timepoint [3] 0 0
Up to two years after the last patient enrolled
Secondary outcome [1] 0 0
Objective response rate
Timepoint [1] 0 0
Up to three years after the last patient enrolled
Secondary outcome [2] 0 0
Duration of response
Timepoint [2] 0 0
Up to two years after the last patient enrolled
Secondary outcome [3] 0 0
Safety: Maximum toxicity grade
Timepoint [3] 0 0
Up to 30 days after the end of treatment
Secondary outcome [4] 0 0
Safety: Number of patients experiencing grade 3-4 toxicity for each toxicity
Timepoint [4] 0 0
Up to 30 days after the end of treatment
Secondary outcome [5] 0 0
Safety: Type, frequency and nature of SAEs
Timepoint [5] 0 0
Up to 30 days after the end of treatment
Secondary outcome [6] 0 0
Safety: Number of patients with at least a SAE
Timepoint [6] 0 0
Up to 30 days after the end of treatment
Secondary outcome [7] 0 0
Safety: Number of patients with at least a SADR
Timepoint [7] 0 0
Up to two years after the last patient enrolled
Secondary outcome [8] 0 0
Safety: Number of patients with at least a SUSAR
Timepoint [8] 0 0
Up to two years after the last patient enrolled
Secondary outcome [9] 0 0
Quality of life: EORTC QLQ-C30 questionnaire
Timepoint [9] 0 0
Up to two years after the last patient enrolled
Secondary outcome [10] 0 0
Quality of life: QLQ-EN24 questionnaire
Timepoint [10] 0 0
Up to two years after the last patient enrolled
Secondary outcome [11] 0 0
Quality of life: GP5 item
Timepoint [11] 0 0
Up to two years after the last patient enrolled
Secondary outcome [12] 0 0
Compliance: Number of administered cycles
Timepoint [12] 0 0
Up to two year after the last patient enrolled
Secondary outcome [13] 0 0
Compliance: Reasons for discontinuation and treatment modification
Timepoint [13] 0 0
Up to two year after the last patient enrolled
Secondary outcome [14] 0 0
Compliance: Dose intensity
Timepoint [14] 0 0
Up to two year after the last patient enrolled

Eligibility
Key inclusion criteria
I-1. Newly diagnosed, histologically-confirmed with residual disease after surgery either measurable or evaluable, or inoperable stage III-IV endometrial carcinoma/carcinosarcoma, after diagnostic biopsy, and naïve to first line systemic anti-cancer treatment. Recurrent endometrial cancer patients if not yet treated for recurrent disease.

I-2. Eastern Cooperative Oncology Group (ECOG) performance status 0-2 I-3. Age = 18 years I-4. Only one prior line of systemic platinum-based regimen is permitted if the platinum-free interval = 6 months. Such prior line is the up-front/adjuvant treatment which can be concurrent chemoradiation or concurrent chemoradiation followed by chemotherapy or only chemotherapy.

I-5. Patients with history of primary breast cancer may be eligible provided they completed their definitive anticancer treatment more than 3 years ago and they remain breast cancer disease free prior to start of study treatment.

I-6. Previous pelvic and outside pelvis radiation is allowed if completed more than 6 weeks ago.

I-7. Signed informed consent and ability to comply with treatment and follow-up.

I-8. Representative FFPE tumor sample or, only if unfeasible, at least 20 unstained slides from initial surgery or from diagnostic biopsy, in case surgery was not performed, available and sent to central laboratory for Micro Satellite (MS) determination prior to randomization.

I-9. Patients must have normal organ and bone marrow function :

1. Haemoglobin = 10.0 g/dL.
2. Absolute neutrophil count (ANC) = 1.5 x 109/L.
3. Platelet count = 100 x 109/L.
4. Total bilirubin = 1.5 x institutional upper limit of normal (ULN).
5. Aspartate aminotransferase /Serum Glutamic Oxaloacetic Transaminase (ASAT/SGOT)) and Alanine aminotransferase /Serum Glutamic Pyruvate Transaminase (ALAT/SGPT)) = 2.5 x ULN, unless liver metastases are present in which case they must be = 5 x ULN.
6. Serum creatinine = 1.5 x institutional ULN
Minimum age
18 Years
Maximum age
No limit
Sex
Females
Can healthy volunteers participate?
No
Key exclusion criteria
E-1. Other malignancy within the last 5 years except: adequately treated non-melanoma skin cancer, curatively treated in situ cancer of the cervix, ductal carcinoma in situ (DCIS) of the breast. Patients with a history of localized malignancy diagnosed over 5 years ago may be eligible provided they completed their adjuvant systemic therapy prior to randomization and that the patient remains free of recurrent or metastatic disease.

E-2. Patients with uterine leiomyosarcoma . E-3. Major surgery within 4 weeks of starting study treatment or patients who have not completely recovered from the effects of any major surgery.

E-4. Previous allogeneic bone marrow transplant or previous solid organ transplantation.

E-5. Administration of other simultaneous chemotherapy drugs, any other anticancer therapy or anti-neoplastic hormonal therapy, or simultaneous radiotherapy during the trial treatment period (hormonal replacement therapy is permitted).

E-6. Prior treatment with CD137 agonists or immune checkpoint blockade therapies, anti-PD1, or anti-PDL1 therapeutic antibodies or anti-CTLA4 .

E-7. Treatment with systemic immunostimulatory agents (including but not limited to interferon-alpha (IFN-a) and interleukin-2 (IL-2) within 4 weeks or five half-lives of the drug (whichever is shorter) prior to Cycle 1, Day 1.

E-8. Treatment with systemic corticosteroids or other systemic immunosuppressive medications (including but not limited to prednisone, dexamethasone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor [TNF] agents) within 2 weeks prior to Cycle 1, Day 1, or anticipated requirement for systemic immunosuppressive medications during the trial. However, please note that the use of inhaled corticosteroids for chronic obstructive pulmonary disease or for asthma is allowed, as well as the use of mineralocorticoids (e.g., fludrocortisones) and low-dose supplemental corticosteroids for adrenocortical insufficiency and for patients with orthostatic hypotension. The use of corticosteroids as premedication for paclitaxel-based regimen is allowed).

E-9. History of autoimmune disease, including but not limited to myasthenia gravis, myositis,autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with anti-phospholipid syndrome, Wegener's granulomatosis, Sjögren's syndrome, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis [please note: patients with a history of autoimmune hypothyroidism on a stable dose of thyroid replacement hormone are eligible; patients with controlled Type 1 diabetes mellitus on a stable insulin regimen are eligible; history of idiopathic pulmonary fibrosis (including pneumonitis), drug-induced pneumonitis, organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia) is permitted].

E-10. Immunocompromised patients, e.g., patients who are known to be serologically positive for human immunodeficiency virus (HIV).

E-11. Patients with active hepatitis B (defined as having a positive hepatitis B surface antigen [HBsAg] test at screening) or hepatitis C .

1. Patients with past hepatitis B virus (HBV) infection or resolved HBV infection (defined as having a negative HBsAg test and a positive total hepatitis B core antibody [HBcAb]) are eligible only if hepatitis B virus (HBV) DNA is negative. The HBV DNA test will be performed only for patients who have a positive total HBcAb test.
2. Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction (PCR) is negative for HCV RNA. The HCV RNA test will be performed only for patients who have a positive HCV antibody test.

E-12. Active tuberculosis (all patients will have tuberculin [PPD] skin test or Interferon-Gamma Releasing Assay [IGRA] done locally prior to inclusion to study) E-13. Signs or symptoms of infection within 2 weeks prior to Cycle 1, Day 1 E-14. Administration of a live, attenuated vaccine within 4 weeks prior to Cycle 1, Day 1 or anticipation that such a live attenuated vaccine will be required during the study. Influenza vaccination should be given during influenza season only (example approximately October to March in the Northern Hemisphere). Patients must not receive live, attenuated influenza vaccine.

E-15. Clinically significant (e.g. active) cardiovascular disease, including:

1. Myocardial infarction or unstable angina within = 6 months of randomization,
2. New York Heart Association (NYHA) = grade 2 congestive heart failure (CHF),
3. Poorly controlled cardiac arrhythmia despite medication (patients with rate controlled atrial fibrillation are eligible),
4. Peripheral vascular disease grade = 3 (e.g. symptomatic and interfering with activities of daily living [ADL] requiring repair or revision) E-16. Resting ECG with QTc > 470 msec on 2 or more time points within a 24 hour period or family history of long QT syndrome.

E-17. History or clinical suspicion of brain metastases or spinal cord compression. CT/MRI of the brain is mandatory (within 4 weeks prior to randomization) in case of suspected brain metastases. Spinal MRI is mandatory (within 4 weeks prior to randomization) in any case of suspected central nervous system (CNS) involvement .

E-18. History or evidence upon neurological examination of central nervous system (CNS) disease, unless asymptomatic and adequately treated with standard medical therapy.

E-19. Evidence of any other disease, metabolic dysfunction, physical examination finding or laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or puts the patient at high risk for treatment related complications.

E-20. Women of childbearing potential (<2 years after last menstruation) not willing to use highly-effective means of contraception.

E-21. Pregnant or lactating women. E-22. History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins.

E-23. Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells or to any component of the atezolizumab formulation.

E-24. Known hypersensitivity reaction or allergy to drugs chemically related to carboplatin, paclitaxel, or their excipients that contraindicates the subject's participation

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s


The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Active, not recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
2/10/2018
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
1/05/2025
Actual
Sample size
Target
550
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
Royal Adelaide hospital - Adelaide
Recruitment hospital [2] 0 0
Border Medical Oncology Research Unit - Albury
Recruitment hospital [3] 0 0
Icon Cancer Centre - Auchenflower
Recruitment hospital [4] 0 0
Pindara Private Hospital - Benowa
Recruitment hospital [5] 0 0
Box Hill Hospital - Box Hill
Recruitment hospital [6] 0 0
Frankston Hospital - Frankston
Recruitment hospital [7] 0 0
Gosford Hospital - Gosford
Recruitment hospital [8] 0 0
Royal Brisbane and Women's Hospital - Herston
Recruitment hospital [9] 0 0
Royal Hobart Hospital - Hobart
Recruitment hospital [10] 0 0
Liverpool Hospital - Liverpool
Recruitment hospital [11] 0 0
Northern Cancer Institute - Saint Leonards
Recruitment hospital [12] 0 0
Darling Downs Hospital and Health Service - Toowoomba Hospital - Toowoomba
Recruitment hospital [13] 0 0
Calvary Mater Newcastle - Waratah
Recruitment hospital [14] 0 0
Wollongong Hospital - Wollongong
Recruitment postcode(s) [1] 0 0
- Adelaide
Recruitment postcode(s) [2] 0 0
- Albury
Recruitment postcode(s) [3] 0 0
- Auchenflower
Recruitment postcode(s) [4] 0 0
- Benowa
Recruitment postcode(s) [5] 0 0
- Box Hill
Recruitment postcode(s) [6] 0 0
- Frankston
Recruitment postcode(s) [7] 0 0
- Gosford
Recruitment postcode(s) [8] 0 0
- Herston
Recruitment postcode(s) [9] 0 0
- Hobart
Recruitment postcode(s) [10] 0 0
- Liverpool
Recruitment postcode(s) [11] 0 0
- Saint Leonards
Recruitment postcode(s) [12] 0 0
- Toowoomba
Recruitment postcode(s) [13] 0 0
- Waratah
Recruitment postcode(s) [14] 0 0
- Wollongong
Recruitment outside Australia
Country [1] 0 0
Austria
State/province [1] 0 0
Graz
Country [2] 0 0
Austria
State/province [2] 0 0
Innsbruck
Country [3] 0 0
Germany
State/province [3] 0 0
Berlin
Country [4] 0 0
Germany
State/province [4] 0 0
Essen
Country [5] 0 0
Germany
State/province [5] 0 0
Mannheim
Country [6] 0 0
Germany
State/province [6] 0 0
Muenchen
Country [7] 0 0
Italy
State/province [7] 0 0
Alessandria
Country [8] 0 0
Italy
State/province [8] 0 0
Bologna
Country [9] 0 0
Italy
State/province [9] 0 0
Bolzano
Country [10] 0 0
Italy
State/province [10] 0 0
Brescia
Country [11] 0 0
Italy
State/province [11] 0 0
Cagliari
Country [12] 0 0
Italy
State/province [12] 0 0
Firenze
Country [13] 0 0
Italy
State/province [13] 0 0
Lecco
Country [14] 0 0
Italy
State/province [14] 0 0
Lucca
Country [15] 0 0
Italy
State/province [15] 0 0
Milan
Country [16] 0 0
Italy
State/province [16] 0 0
Monza
Country [17] 0 0
Italy
State/province [17] 0 0
Padova
Country [18] 0 0
Italy
State/province [18] 0 0
Parma
Country [19] 0 0
Italy
State/province [19] 0 0
Pisa
Country [20] 0 0
Italy
State/province [20] 0 0
Reggio Emilia
Country [21] 0 0
Italy
State/province [21] 0 0
Rimini
Country [22] 0 0
Italy
State/province [22] 0 0
Roma
Country [23] 0 0
Italy
State/province [23] 0 0
Sondrio
Country [24] 0 0
Italy
State/province [24] 0 0
Sora
Country [25] 0 0
Italy
State/province [25] 0 0
Torino
Country [26] 0 0
Italy
State/province [26] 0 0
Vercelli
Country [27] 0 0
Japan
State/province [27] 0 0
Aomori
Country [28] 0 0
Japan
State/province [28] 0 0
Chiba
Country [29] 0 0
Japan
State/province [29] 0 0
Ehime
Country [30] 0 0
Japan
State/province [30] 0 0
Fukuoka
Country [31] 0 0
Japan
State/province [31] 0 0
Hokkaido
Country [32] 0 0
Japan
State/province [32] 0 0
Miyagi
Country [33] 0 0
Japan
State/province [33] 0 0
Niigata
Country [34] 0 0
Japan
State/province [34] 0 0
Osaka
Country [35] 0 0
Japan
State/province [35] 0 0
Shizuoka
Country [36] 0 0
Japan
State/province [36] 0 0
Tokyo
Country [37] 0 0
Korea, Republic of
State/province [37] 0 0
Daegu
Country [38] 0 0
Korea, Republic of
State/province [38] 0 0
Gyeonggi-do
Country [39] 0 0
Korea, Republic of
State/province [39] 0 0
Incheon
Country [40] 0 0
Korea, Republic of
State/province [40] 0 0
Seoul
Country [41] 0 0
New Zealand
State/province [41] 0 0
Auckland
Country [42] 0 0
Spain
State/province [42] 0 0
Barcelona
Country [43] 0 0
Spain
State/province [43] 0 0
Girona
Country [44] 0 0
Spain
State/province [44] 0 0
Hospitalet de Llobregat
Country [45] 0 0
Spain
State/province [45] 0 0
Madrid
Country [46] 0 0
Spain
State/province [46] 0 0
Oviedo
Country [47] 0 0
Spain
State/province [47] 0 0
Santiago De Compostela
Country [48] 0 0
Spain
State/province [48] 0 0
Zaragoza
Country [49] 0 0
Switzerland
State/province [49] 0 0
Baden
Country [50] 0 0
Switzerland
State/province [50] 0 0
Basel
Country [51] 0 0
Switzerland
State/province [51] 0 0
Bellinzona
Country [52] 0 0
Switzerland
State/province [52] 0 0
Bern
Country [53] 0 0
Switzerland
State/province [53] 0 0
Luzern
Country [54] 0 0
Switzerland
State/province [54] 0 0
Münsterlingen
Country [55] 0 0
Switzerland
State/province [55] 0 0
Winterthur
Country [56] 0 0
Switzerland
State/province [56] 0 0
Zürich
Country [57] 0 0
Taiwan
State/province [57] 0 0
Kaohsiung City
Country [58] 0 0
Taiwan
State/province [58] 0 0
Taoyuan City
Country [59] 0 0
United Kingdom
State/province [59] 0 0
Derby
Country [60] 0 0
United Kingdom
State/province [60] 0 0
Exeter
Country [61] 0 0
United Kingdom
State/province [61] 0 0
Glasgow
Country [62] 0 0
United Kingdom
State/province [62] 0 0
London
Country [63] 0 0
United Kingdom
State/province [63] 0 0
Manchester
Country [64] 0 0
United Kingdom
State/province [64] 0 0
Nottingham
Country [65] 0 0
United Kingdom
State/province [65] 0 0
Plymouth

Funding & Sponsors
Primary sponsor type
Other
Name
Mario Negri Institute for Pharmacological Research
Address
Country
Other collaborator category [1] 0 0
Commercial sector/industry
Name [1] 0 0
Hoffmann-La Roche
Address [1] 0 0
Country [1] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Nicoletta Colombo, MD
Address 0 0
Istituto Europeo di Oncologia (IEO) - Milan
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

No information has been provided regarding IPD availability


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/NCT03603184