Background: The study aims to address the challenge of accurately identifying patients with ovarian cancer who would benefit from poly-ADP ribose inhibitors (PARPi) as first-line maintenance therapy. While BRCA1/2-mutated epithelial ovarian cancer (EOC) patients have shown significant benefits from PARPi treatment, the efficacy in homologous recombination deficient (HRD) patients remains inconclusive. Current assays used to estimate HR status do not effectively differentiate between patients who benefit most from PARPi and those who do not, making it inefficient to treat all patients. There is a need for a more accurate HR status testing method to optimize PARPi benefit. This study aims to assess the performance of the VHIO-CARD-300 test in determining HR status compared to SOPHiA DDM™ Dx HRD Solution. Summary: The study is a prospective, non-randomized trial designed to evaluate the concordance of the VHIO-CARD-300 test in establishing HR status compared to SOPHiA DDM™ Dx HRD Solution. Additionally, it aims to assess the association between HRD status determined by the VHIO-CARD-300 test and treatment efficacy. Patients with advanced FIGO stage III-IV high grade serous or endometrioid ovarian, fallopian tube, or peritoneal cancer will be invited to participate. Those eligible will undergo testing with both VHIO-CARD-300 and SOPHiA DDM™ Dx HRD Solution. Patients classified as HRD positive will receive olaparib in combination with bevacizumab, while others will receive bevacizumab alone. Treatment will be administered according to approved doses, with follow-up evaluations conducted until RECIST progression.
This non-randomized, open-label phase II trial seeks to enhance our understanding of HRD status in patients with advanced ovarian, fallopian tube, or peritoneal cancer. Following standard first-line treatment, participants will be assessed for HRD status using the VHIO-CARD-300 test and SOPHiA DDM™ Dx HRD Solution. Those identified as HRD-positive will receive olaparib in combination with bevacizumab, while others will receive bevacizumab alone as per standard care. The study aims to determine the concordance between the two HRD tests, evaluate the efficacy of the olaparib-bevacizumab combination, and assess safety and tolerability. Efficacy outcomes will be evaluated using RECIST criteria, with a minimum follow-up of 30 months post-enrollment. Secondary objectives include examining treatment accuracy, association with efficacy outcomes, and analyzing discrepant cases. Overall, this trial aims to provide valuable insights into personalized treatment approaches for patients with advanced ovarian cancer.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
100
Bevacizumab dosing is at 15 mg/kg every 3 weeks as an intravenous infusion.
Olaparib dosing is oral at 300 mg twice daily
Vall d'Hebron Institute of Oncology
Barcelona, Spain
RECRUITINGConcordance in HRD status identification between VHIO-CARD-300 test and SOPHiA DDM™ Dx HRD Solution
The primary outcome measure description would outline the method used to evaluate the agreement in HRD status identification between the VHIO-CARD-300 test and SOPHiA DDM™ Dx HRD Solution. This would include details on how HRD status is determined and compared between the two tests, along with any statistical analyses employed to measure the level of agreement.
Time frame: Through study completion, an average of 1.5 years
Performance Assessment of VHIO-CARD-300 Test for HR Status Identification
This secondary outcome measure focuses on evaluating the performance of the VHIO-CARD-300 test as a diagnostic tool for identifying HR status. The assessment will include determining the sensitivity, specificity, and predictive positive and negative values of the VHIO-CARD-300 test, with the SOPHiA DDM™ Dx HRD Solution serving as the reference standard.
Time frame: Through study completion, an average of 1.5 years
Association Between VHIO-CARD-300 Test Groups and Efficacy Outcomes(i.e., HRD positive and HRD negative) and efficacy outcomes.
To assess the relationship between the HRD positive and HRD negative groups identified by the VHIO-CARD-300 test and treatment efficacy outcomes.
Time frame: Through study completion, an average of 1.5 years
Analysis of Progression-Free Survival (PFS) and Overall Survival (OS) in Discrepant HRD Cases
This outcome measure aims to assess the efficacy outcomes in cases where there is a discrepancy between the results obtained from the VHIO-CARD-300 test and the SOPHiA DDM™ Dx HRD Solution. Specifically, it focuses on cases where a patient is classified as HRD positive by one test but HRD negative by the other, and vice versa. The primary efficacy endpoints, progression-free survival (PFS) and overall survival (OS), will be analyzed in these discrepant cases to evaluate the impact of the discordant results on clinical outcomes
Time frame: Through study completion, an average of 1.5 years
Safety and Tolerability of Olaparib Plus Bevacizumab
Assessment of adverse events (AEs) graded by the National Cancer Institute (NCI) CTCAE v5.0, serious adverse events (SAEs), abnormal vital signs, abnormal ECG results, and evaluation of laboratory parameters
Time frame: Through study completion, an average of 1.5 years
To evaluate the failure rate for the VHIOCARD-300 test and SOPHiA DD Dx HRD Solution.
Percentage of inconclusive results will be estimated for each test
Time frame: Through study completion, an average of 1.5 years
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