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奥拉帕利联合卡铂/紫杉醇新辅助化疗治疗不可切除的卵巢癌:一项 II 期、开放标签、多中心研究(NUVOLA 试验)。

Neoadjuvant chemoteraphy in unresectable ovarian cancer with olaparib and weekly carboplatin plus paclitaxel: a phase II, open label multicenter study (NUVOLA trial).

机构信息

Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

出版信息

Int J Gynecol Cancer. 2021 Aug;31(8):1175-1178. doi: 10.1136/ijgc-2021-002727. Epub 2021 Jun 15.

Abstract

BACKGROUND

Neoadjuvant chemotherapy with interval debulking surgery represents an alternative treatment for advanced ovarian cancer. Currently, there are few data about the use of poly adenosine diphosphate-ribose polymerase inhibitors in the neoadjuvant setting.

PRIMARY OBJECTIVE

To evaluate whether the administration of olaparib in combination with standard chemotherapy in the neoadjuvant setting can improve tumor response.

STUDY HYPOTHESIS

The addition of a poly adenosine diphosphate-ribose polymerase inhibitor to standard chemotherapy will achieve a higher response rate in BRCA mutated patients compared with standard chemotherapy TRIAL DESIGN: This is a multicenter, phase II, single arm, open label trial. Eligible patients will receive three cycles of weekly carboplatin plus paclitaxel, and intermittent olaparib administration. Responding patients will undergo an interval debulking surgery with pathological evaluation of response to chemotherapy.

MAJOR ELIGIBILITY CRITERIA

Patients must have histologically confirmed International Federation of Gynecology and Obstetrics stages III-IV primary ovarian, peritoneal, or fallopian tube cancers, high grade serous or endometrioid histology, not suitable for primary cytoreductive surgery with a documented BRCA1 or BRCA2 germline and/or somatic mutation.

PRIMARY ENDPOINT

Rate of complete pathological response after three cycles of the experimental chemotherapy regimen.

SAMPLE SIZE

A total of 35 patients will be enrolled in the study.

ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS

Expected complete 42 accrual in January 2022, with presentation of results by June 2022.

TRIAL REGISTRATION NUMBER

NCT04261465.

摘要

背景

新辅助化疗联合间隔减瘤术是治疗晚期卵巢癌的一种替代方法。目前,关于聚腺苷二磷酸核糖聚合酶抑制剂在新辅助治疗中的应用数据较少。

主要目的

评估奥拉帕利联合标准化疗在新辅助治疗中是否能提高肿瘤反应率。

研究假设

聚腺苷二磷酸核糖聚合酶抑制剂联合标准化疗在 BRCA 突变患者中的反应率将高于标准化疗。

试验设计

这是一项多中心、Ⅱ期、单臂、开放标签试验。符合条件的患者将接受三个周期的每周卡铂加紫杉醇,以及间歇性奥拉帕利治疗。有反应的患者将接受间隔减瘤术,并对化疗的反应进行病理评估。

主要入选标准

患者必须有组织学证实的国际妇产科联合会(FIGO)分期为 III-IV 期的原发性卵巢、腹膜或输卵管癌,高级别浆液性或子宫内膜样组织学,不适合行初次细胞减瘤术,有 BRCA1 或 BRCA2 种系和/或体细胞突变的记录。

主要终点

在三个周期的实验化疗方案后完全病理缓解的比例。

样本量

研究共纳入 35 例患者。

预计完成入组和报告结果的日期

预计 2022 年 1 月完成 42 例入组,2022 年 6 月报告结果。

试验注册号

NCT04261465。

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