This study will evaluate the role of addition of an anti-angiogenic agent (Nintedanib/placebo) to conventional combination chemotherapy as concomitant and maintenance treatment in primary advanced or with first relapse of endometrial cancer.
This multicenter, prospective, double-blind, placebo-controlled, randomised phase 2 study is evaluating combination chemotherapy with nintedanib in patients with primary advanced stage (3C2 \& 4), or with first relapse of endometrial cancer. Patients are stratified according to: 1. Stage of disease (stage 3C2 vs. stage 4 vs. recurrent disease) 2. Prior adjuvant chemotherapy (yes/no) 3. Disease status (Measurable disease vs. non-measurable /RECIST 1.1) Patients are randomized to one of the two treatment arms 1:1 randomization: * Arm A: Paclitaxel and Carboplatin (6 courses) and Nintedanib (until PD). (Experimental arm) * Arm B: Paclitaxel and Carboplatin (6 courses) and Placebo (until PD) (Control Arm) Primary endpoint is PFS. 148 patients to be enrolled.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
146
Arm A: Nintedanib: 200mg orally twice daily d 2-21 q 21 days x 6 courses; afterwards daily dosing, until PD Arm B: Placebo: orally twice daily d 2-21 q 21 days x 6 courses; afterwards daily dosing, until PD In both arms: 6 courses of standard carboplatin and paclitaxel: Carboplatin AUC 5 iv every 21 days; Paclitaxel 175mg/m2 iv every 21 days. Both drugs are continued for maximum six courses or until unacceptable toxicity
PFS: Difference in months of Median Progression-Free Survival in experimental arm versus comparator arm
Superiority of Nintedanib arm vs. placebo arm by median PFS increase of 4 months (from 10 months to 14 months) HR: 1.4; power80%; one-sided alpha: 15%. Inclusion period 18 months. Median PFS matures after 14 months of end inclusion
Time frame: 36 months
PFS in the sub-populations as described under stratification factors
To be measured (in months) and reported
Time frame: 32 months
PFS after consecutive treatment (PFS2). To be measured (in months) and reported
PFS2 is defined along the same timelines as PFS but accounts for the time from randomization to progression or death by any cause on any subsequent line of anticancer therapy.
Time frame: 48 months
Disease Specific Survival (DSS)
To be measured (in months) and reported
Time frame: 48 months
TSST (Time to Second Subsequent Therapy)
To be measured (in months) and reported
Time frame: 48 months
TFST (Time to First Subsequent Therapy)
To be measured (in months) and reported
Time frame: 48 months
Overall Survival (OS)
To be measured (in months) and reported
Time frame: 48 months
Response Rate (RR).
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Onze Lieve Vrouwziekenhuis
Aalst, Belgium
Cliniques universitaires Saint-Luc
Brussels, Belgium
Antwerp University Hospital
Edegem, Belgium
Ghent University Hospital
Ghent, Belgium
University Hospitals Leuven
Leuven, Belgium
Odense Universitetshospital
Odense, Fyn, Denmark
Aalborg Universitetshospital
Aalborg, Jylland, Denmark
Vejle Sygehus
Vejle, Jylland, Denmark
Rigshospitalet
Copenhagen, Region Sjælland, Denmark
Kuopio University Hospital
Kuopio, Finland
...and 27 more locations
To be measured (CRs \& PRs in %) and reported
Time frame: 32 months
Disease Control Rate (DCR)
Disease Control Rate (DCR = Complete Response, Partial Response or Stable Disease for at least 12 weeks). To be measured (CRs, PRs \& SDs in %) and reported
Time frame: 32 months
Patient Related Outcomes (PROs)
Patient questionnaire results to be presented as as narrative (1-10 scale)
Time frame: 48 months
Number of patients with Grade 3 through Grade 5 Adverse Events that are related to study drug.
NCI CTCAE Version 4.0
Time frame: 36 months
Compliance in the two treatment arms
Percentage of missed dosages during the treatment
Time frame: 32 months