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Ovarian CancerPhase 1/2NCT02571725

PARP-inhibition and CTLA-4 Blockade in BRCA-deficient Ovarian Cancer

A Phase 1/2 study testing Olaparib and Tremelimumab in people with Ovarian Cancer and Fallopian Tube Cancer, run by New Mexico Cancer Research Alliance at 5 sites in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Of the approximately 21,000 cases of ovarian cancer diagnosed annually in the U.S, ten percent are attributed to hereditary syndromes, most commonly the result of mutations in the breast cancer susceptibility genes 1 or 2 (BRCA1 or BRCA2). Read more about this study

Who is it for?
Ages 18 years and older, women only
What is being tested?
Olaparib and Tremelimumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
5 sitesUnited States
Study dates
23 Feb 2016to 15 Jul 2027
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients must have recurrent epithelial ovarian, fallopian tube, or primary peritoneal carcinoma for which standard curative measures do not exist.
  • Patients must have a confirmed germline mutation in the BRCA1 or BRCA2 gene
  • Patients must have measurable disease as defined by World Health Organization (WHO) criteria: at least 1 lesion that can be accurately measured in at least 1 dimension (longest diameter to be recorded). Each lesion must be >1.0cm when measured by CT, MRI, or caliper measurement by clinical exam; or >2.0cm when measured by chest x-ray. Lymph nodes must be >1.5cm in short axis when measured by CT or MRI
  • Patients with platinum-sensitive or platinum-resistant disease are eligible
  • Patients must have received at least 1 prior course of platinum-based chemotherapy for the management of primary disease including carboplatin, cisplatin, or another platinum compound
  • There are no restrictions on the total number of prior regimens patients may have received
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  • Gynecologic Oncology Group (GOG) performance status of 0, 1, or 2
  • Adequate organ and marrow function as defined below:
  • Absolute neutrophil count (ANC) >1,500/mcl
  • Platelets > 100,000/mcl
  • Creatinine < 1.5x the institutional upper limit of normal (ULN)
  • Bilirubin < 1.5x ULN
  • Aspartate aminotransferase and Alanine aminotransferase < 3x ULN
  • Alkaline phosphatase < 2.5x ULN
  • Women of child-bearing potential must have a negative pregnancy test prior to study entry and agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 180 days following completion of therapy
  • Ability to understand and the willingness to sign a written informed consent document
  • Patients must meet pre-entry requirements as specified

Who cannot join

  • Recovery from effects of recent surgery, radiotherapy, or chemotherapy must be demonstrated
  • Patients should be free of active infection requiring antibiotic therapy (except for uncomplicated urinary tract infections)
  • Hormonal therapy directed at treatment for the cancer must be discontinued at least 1 week prior to enrollment. Hormone replacement therapy for symptom management is permitted.
  • Any other therapy directed at treating the cancer including chemotherapy, biologic/targeted agents, and immunologic agents, must be discontinued at least 3 weeks prior to enrollment.
  • Any prior radiation therapy must be discontinued at least 4 weeks prior to enrollment.
  • A history of autoimmune disorders other than vitiligo (e.g., psoriasis, extensive atopic dermatitis, asthma, inflammatory bowel disease, multiple sclerosis, uveitis, vasculitis), chronic inflammatory condition, or any condition requiring concurrent use of any systemic immunosuppressants or steroids for any reason are excluded from the study. Any patient with an allo-transplant of any kind would be excluded as well, including xenograft heart valve. Mild, intermittent asthma requiring only occasional beta-agonist inhaler use or mild localized eczema will not be excluded.
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  • Chronic use of immune-suppressive drugs (i.e., systemic corticosteroids used in the management of cancer or non-cancer related illnesses, e.g., COPD).
  • Known HIV-positive patients and those with other acquired/inherited immunodeficiencies are ineligible due the possibility of affecting the response to tremelimumab, and the higher risk of active opportunistic infections.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to olaparib or tremelimumab, or other agents used in study.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Concomitant use of known potent cytochrome P450 isoform 3A4 (CYP3A4) inhibitors
  • Persistent toxicities (> Common Terminology Criteria for Adverse Event (CTCAE) grade 2) caused by prior cancer therapy, excluding alopecia
  • Must not be pregnant or nursing as the potential of this regimen to harm nursing infants has not been evaluated.
  • Patients who are receiving any other investigational agent
  • For Phase 2, the inclusion/exclusion criteria above apply. In addition, the following exclusion criteria apply:
  • Resting electrocardiogram with corrected QT interval (QTc) >470msec on two or more time points within a 24hr period, or a family history of long QT syndrome
  • Patients who have previously received anti-CTLA-4 antibody therapy

Trial locations and contacts

5 sites in 1 country.

5 sites in 1 country

United States5 sites
  • Southwest Gynecologic Oncology Associates

    Albuquerque, New Mexico, 87106

  • University of New Mexico Comprehensive Cancer Center

    Albuquerque, New Mexico, 87131

  • University of Virginia Cancer Center

    Charlottesville, Virginia, 22903

  • The Ohio State University

    Columbus, Ohio, 43210

  • Moffitt Cancer Center

    Tampa, Florida, 33612

Other trials in United States

About this study

Official title: A Phase 1-2 Study of the Combination of Olaparib and Tremelimumab, in BRCA1 and BRCA2 Mutation Carriers With Recurrent Ovarian Cancer

Of the approximately 21,000 cases of ovarian cancer diagnosed annually in the U.S, ten percent are attributed to hereditary syndromes, most commonly the result of mutations in the breast cancer susceptibility genes 1 or 2 (BRCA1 or BRCA2). Mutation in these genes results in the inability to repair double-stranded breaks in DNA. Treating these tumors with poly(adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitors results in the specific killing of BRCA negative cells by blocking a second DNA-repair mechanism. Treatment of ovarian cancer patients with PARP inhibitors has resulted in improved progression free survival (PFS), but not overall survival (OS). It's not completely understood why this is the case, but some preclinical studies using ovarian cancer models in mice have suggested that combining PARP inhibitors with immune system modulators like T cell checkpoint inhibitors improves long-term survival.

Therefore, the purpose of this study is to evaluate the safety and efficacy of a combination of a PARP inhibitor (Olaparib) with a T cell checkpoint inhibitor (the anti-CTLA-4 antibody Tremelimumab) in women with recurrent BRCA mutation-associated ovarian cancer.

Read the detailed description

The mechanism of action of Olaparib, a potent inhibitor of mammalian PARP-1, PARP-2, and PARP-3, has been proposed to involve the trapping of inactivated PARP onto single-stranded breaks preventing their repair and generating a potential block for cellular DNA replication. In tumors with homologous recombination deficiency, such as those with BRCA mutations, single agent treatment with Olaparib can lead to cell death and tumor regressions by a process known as synthetic lethality.

Tremelimumab is a human monoclonal immunoglobulin G2 (IgG2) antibody specific for human cytotoxic T lymphocyte-associated antigen 4 (CTLA-4), a co-inhibitory receptor expressed on activated T cells. Tremelimumab has been shown to block the inhibitory signal mediated by interaction of human CTLA-4 on activated T cells with B7-1 and B7-2 on antigen-presenting cells. This is thought to maintain T cell activation in the tumor microenvironment and promote the establishment of tumor-specific immune responses.

Like melanoma, ovarian cancer is associated with significant tumor heterogeneity, and is also a rational target for immune therapy. Although antitumor effects have been observed in patients with epithelial ovarian cancer in response to anti-CTLA-4 antibody treatment, evidence of clinical disease regression has not been demonstrated. Based on data indicating that a subset of ovarian cancers associated with germline mutations in BRCA1/2 genes may be more immunogenic, we hypothesized that BRCA-negative tumors would be particularly vulnerable to checkpoint blockade, and that immune priming with targeted cytotoxic therapy using a PARP-inhibitor would sensitize ovarian tumors to immune therapy and optimize patient survival. We have demonstrated this in pre-clinical models of high grade BRCA1-negative ovarian cancer.

Based on significant therapeutic benefit demonstrated in pre-clinical models, this clinical trial evaluates the combination of Olaparib and Tremelimumab in women with recurrent BRCA-deficient ovarian cancers.

Being tested
Olaparib, Tremelimumab
Keywords
Ovarian cancer, Fallopian tube cancer, Peritoneal cancer, PARP, BRCA, Immunotherapy, Olaparib, Tremelimumab, CTLA4
Medical subject headings
Ovarian Neoplasms, Fallopian Tube Neoplasms, Peritoneal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • OlaparibDrug

    Also called AZD-2281, Lynparza

    Olaparib starts concomitantly with the first dose of Tremelimumab

  • TremelimumabDrug

    Also called CP-675,206

    3 to 6 patients will be treated at 10 mg/kg depending on RLT observed in the first 3 patients. If 0 out of 3 or 1 out of 6 patients experienced a RLT at 10 mg/kg, then this dose will be considered at the recommended phase 2 dose (RP2D). If 2 out of 6 patients experience RLT at this dose within 56 days, then dose reductions as detailed in the Arm description will be carried out.

Study groups in NCT02571725
Study groupRoleWhat they receive
Olaparib and TremelimumabExperimentalEach cycle is 28 days: Olaparib at 300 mg, orally, twice daily + Tremelimumab at 10 mg/kg, intravenously, every 4 weeks for the first 6 doses, then every 12 weeks until disease progression or unacceptable toxicity. * If 1 of the first 3 patients experiences a regimen-limiting toxicity (RLT), 3 more patients will be treated with 10 mg/kg Tremelimumab in Phase 1. If 2 or more of 6 patients experience RLT, then 6 mg/kg Tremelimumab will be tested * If at 6 mg/kg, 1 or more of 3 patients experience RLT, 3 patients will be treated at 3 mg/kg Tremelimumab * If at 3 mg/kg, 1 or more patients experience RLT, the study will be discontinued for safety purposes In Phase 2, patients will receive doses of Olaparib and Tremelimumab determined in the Phase 1 portion as described above, based on tolerability.
Receives: Drug: Olaparib; Drug: Tremelimumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Phase 1: Recommended Phase 2 Dose (RP2D)

    The RP2D will be based on determination of the regimen-limiting toxicity (RLT), i.e., toxicity induced by the immunological agent that limits the administration of the backbone therapy (Olaparib).

    RLT is defined as the following toxicities occurring during the first two cycles (56 days) of treatment (with the combination of Olaparib and Tremelimumab):

    • Any grade 4 non-hematological toxicity that is treatment-related with the exception of alopecia, nausea and vomiting or lymphopenia.
    • Any grade 3 non hematological toxicity that is treatment related that results in delay of Olaparib by greater than 4 weeks.
    • Delay in starting the second cycle by more than 2 weeks due to toxicity attributable to Tremelimumab.

    The RP2D of Tremelimumab is one that does not induce RLT in more than 1 of 6 patients.

    Measured: Within 56 days of first treatment (up to 2 years)

  2. Phase 2: Objective response rate (ORR)

    Patients will be followed both clinically and radiographically every 12 weeks. Responses will be assessed using immune-related response criteria (irRC) (Wolchock et al 2009) in which tumor volume measurements are assessed along with the emergence of new measurable lesions. Each net percentage change in tumor burden accounts for the size and growth kinetics of both old and new lesions as they appear. The sum of the product of the diameters for all index lesions identified prior to enrollment is the immune-related sum of products of diameters (irSPD). Complete Response (CR), Disappearance of all tumor lesions; Partial Response (PR), >=50% decrease relative to the baseline irSPD. ORR = proportion of patients whose best overall response is either CR or PR.

    Measured: 2 years

Secondary outcomes (1)
  1. Phase 2: Progression free survival (PFS)

    PFS is defined as the time between the first dose of study therapy and the earliest of progression or death. Patients will be followed both clinically and radiographically every 12 weeks. Responses will be assessed using immune-related response criteria (irRC) (Wolchock et al 2009) in which tumor volume measurements are assessed along with the emergence of new measurable lesions. Each net percentage change in tumor burden accounts for the size and growth kinetics of both old and new lesions as they appear. The sum of the product of the diameters for all index lesions identified prior to enrollment is the immune-related sum of products of diameters (irSPD). New lesions alone do not qualify as progressive disease. Progressive disease is >= 25% increase in the irSPD (based on irSPD of all index lesions and any measurable new lesions) over the nadir irSPD, or the occurrence of any new measurable lesions if the SPD nadir is "0."

    Measured: 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Oct 2015 (estimated)
  2. Study start23 Feb 2016
  3. Primary completion2 Dec 2020
  4. Study completion15 Jul 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02571725
Sponsor's protocol ID
INST 1419
Status last verified
May 2025
First submitted
6 Oct 2015
Last updated
23 May 2025
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Olaparib and Tremelimumab in people with Ovarian Cancer and Fallopian Tube Cancer, run by New Mexico Cancer Research Alliance at 5 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 17 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 23 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Phase 1: Recommended Phase 2 Dose (RP2D) (time frame: Within 56 days of first treatment (up to 2 years)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 May 2025.

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