The purpose of this trial is to assess the effectiveness of TroVax® compared to placebo in extending the time to progression in patients with asymptomatic relapsed platinum resistant ovarian, fallopian tube or primary peritoneal cancer.The trial will also look at overall survival times and quality of life.
A significant number of patients with advanced ovarian cancer develop a "CA-125 relapse" without clinical symptoms and with a low volume disease on the CT scan. For this group of patients, no survival benefit has been demonstrated from early chemotherapy treatment and, on average, the time to start of chemotherapy is 5 months. Such patients could benefit from immunotherapy and the time to chemotherapy could potentially be prolonged. Multiple immunotherapy agents, such as anti-CA-125 antibodies and various vaccines, have been tested and, although there is plenty of evidence of immune response, this has not translated to a definitive clinical benefit and is not recommended in clinical practice 5T4 appears to be highly expressed in ovarian cancer and correlates with more advanced stage of disease and poorly differentiated tumours. TroVax®, the vaccine targeting 5T4, has an extensive record of safety and efficacy in humans and vaccination in patients with colorectal, renal, and prostate cancer resulted in immune cellular and humoral responses and signs of clinical benefit. We propose a trial of TroVax® vaccination in patients with CA-125-relapsed asymptomatic ovarian cancer to assess the clinical efficacy and immunological responses as outlined in this protocol. To allow for capture of any delayed response to immunotherapy, patients who progress on RECIST 1.1 criteria and who do not experience toxicity from treatment will continue on the vaccine/placebo injection until repeat imaging at 8 weeks in order for immune-related response criteria (irRC) to be evaluated in addition to RECIST 1.1 criteria (these patients as a standard of care would not receive any other therapeutic intervention).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
94
Pre-amendment 10: Patients will be randomised to receive either TroVax® 1 x 10↑9 TCID50/mL in 1mL (experimental arm) or matched placebo (control arm) on a 1:1 basis. A single dose will be given by intramuscular injection during the following weeks: 2, 4, 7, 10, 13, 19, 25, 31, 37, 43 and 49. No further treatment will be given beyond week 49.Treatment will be stopped early if confirmed progression or unacceptable toxicity. Post-amendment 10: Patients will be registered to receive TroVax 1 x 10↑9 TCID50/mL in 1mL only. A single dose will be given by intramuscular injection during the following weeks: 2, 4, 7, 10, 13, 19 and 25. No further treatment will be given beyond week 25.Treatment will be stopped early if confirmed progression or unacceptable toxicity.
Pre-amendment 10: Matched placebo will be administered as above. Post-amendment 10: TRI-70 onwards received TroVax only.
Leeds Teaching Hospitals NHS Trust
Leeds, West Yorkshire, United Kingdom
The Clatterbridge Cancer Centre NHS Foundation Trust
Bebington, Wirral, United Kingdom
Brighton and Sussex NHS Foundation Trust
Brighton, United Kingdom
Progression
Protocol-defined progression
Time frame: At 25 weeks
Immune-related response criteria (irRC)
irRC will be used to identify any delayed response.Patients will remain on treatment until irRc has confirmed progression (in the absence of unacceptable toxicity or the need for urgent chemotherapy).
Time frame: 8 weeks post evidence of progression by RECIST 1.1
Progression-free survival
Time frame: Time from randomisation/registration to clinical intervention or confirmed evidence of progression or death, assessed for up to 2 years
Time to clinical intervention
Time frame: Time from randomisation/registration to clinical intervention or death, assessed for up to 2 years
Incidence of clinical intervention
Time frame: At 25 weeks from randomisation/registration
CA-125 doubling time
To investigate CA-125 doubling time as an independent prognostic factor.
Time frame: Assessed at treatment visits for up to 2 years from randomisation/registration.
Overall survival
Time frame: Time between randomisation/registration and death assessed for up to 4 years
Quality of Life
Patient reported outcome and health-related quality of life measured by standardised questionnaires (EORTC QLQ C-30, EORTC QLQ OV-28)
Time frame: For up to 2 years following randomisation/registration or until progression
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
University Hospitals of Bristol NHS Foundation Trust
Bristol, United Kingdom
Velindre NHS Trust
Cardiff, United Kingdom
Beatson West of Scotland Cancer Centre
Glasgow, United Kingdom
Royal Surrey County Hospital NHS Foundation Trust
Guildford, United Kingdom
University College London Hospitals NHS Foundation Trust
London, United Kingdom
The Christie NHS Foundation Trust
Manchester, United Kingdom
Nottingham University Hospitals NHS Trust
Nottingham, United Kingdom
...and 2 more locations