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Platinum Resistant Ovarian CancerPhase 1NCT07772882

Study of Supplemental Arginine With Chemotherapy and Immunotherapy in Platinum Resistant Ovarian, Fallopian Tube, and Peritoneal Cancer

A Phase 1 study testing (Arginaid®) Oral Arginine, (R-Gene® 10) IV Arginine and Pembrolizumab in people with Platinum Resistant Ovarian Cancer and Fallopian Tube Cancers, run by Rebecca Arend at 1 site in United States.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This is an open-label, Phase 1 clinical study to evaluate the safety, tolerability, PK profiles, and clinical activity of IV and PO arginine supplementation + SOC chemoimmunotherapy regimens in participants with PROC. Read more about this study

Who is it for?
Ages 18 to 89 years, women only
What is being tested?
(Arginaid®) Oral Arginine, (R-Gene® 10) IV Arginine and Pembrolizumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
1 siteUnited States
Study dates
Sep 2026to Jan 2029
Phase
Phase 1
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 to 89 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Must be at least 18 years of age
  • ECOG performance status of 0 or 1 (see Appendix A).
  • Patient must be a candidate for either cohort A or cohort B treatment backbone.
  • For patients enrolling on treatment cohort A, PD-L1 positivity must be ≥1. Patient's with PD-L1 positivity ≥1% can enroll in cohort B at physician's discretion.
  • If PD-L1 positivity is unavailable or is <1%, patients can only enroll on treatment cohort B.
  • Patients must have high-grade serous or endometrioid histology
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  • Recovery to baseline or ≤ Grade 1 CTCAE v.5.0 from toxicities related to the prior therapy, unless after discussion with the medical monitor the AE(s) are deemed clinically non-significant and/or stable on supportive therapy
  • Participant must be able to understand the study procedures and agree to participate in the study by providing written informed consent
  • Patients must have adequate hematologic, liver and kidney functions prior to lead-in chemotherapy defined as:
  • Absolute neutrophil count (ANC) ≥ 1.5 x 109 /L (1,500/μL)
  • Platelet count ≥ 100 x 109 /L (100,000/μL) without platelet transfusion in the prior 10 days
  • Hemoglobin ≥ 9.0 g/dL
  • Serum creatinine ≤ 1.5 x upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 x ULN
  • Serum bilirubin ≤ 1.5 x ULN (patients with documented diagnosis of Gilbert syndrome are eligible if total bilirubin < 3.0 x ULN)
  • Serum albumin ≥ 2 g/dL.

Who cannot join

  • History of allergic reactions contributed to compounds of similar chemical or biological composition to R-Gene 10 or Arginaid.
  • Patient unwilling/unable to receive daily arginine treatment (IV or oral)
  • Patients with a history of serologically confirmed HSV-1 or HSV-2 outbreaks
  • Receiving systemic corticosteroids or have severe comorbities where treatment with corticosteroids may be required.
  • Actively treated auto-immune disease.
  • Taking medications that interfere with the urea cycle such as valproate or xanthine oxidase inhibitors.
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  • Current intercurrent illnesses including active infection, symptomatic congestive heart failure, unstable angina, or cardiac arrhythmias.
  • Patients with history of Peptic Ulcer Disease
  • Contraindications to receive standard of care treatment backbone with either paclitaxel, bevacizumab, pembrolizumab, or cyclophosphamide.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Rebecca C Arend, MD contact

(205) 934-4986

rarend@uabmc.edu

Rebecca A Arend contact

2059752257

al2eli@uab.edu

United States1 site
  • University of Alabama at Birmingham Womens & Infants Center

    Birmingham, Alabama, 35233

    Rebecca C Arend, MD, rarend@uabmc.edu

Other trials in United States

About this study

Official title: Phase I Study of Supplemental Arginine With Chemotherapy and Immunotherapy in Platinum Resistant Ovarian, Fallopian Tube, and Peritoneal Cancer

This is an open-label, Phase 1 clinical study to evaluate the safety, tolerability, PK profiles, and clinical activity of IV and PO arginine supplementation + SOC chemoimmunotherapy regimens in participants with PROC.

Read the detailed description

This is a Phase I, investigator-initiated and open-label study. Patients will be evaluated and treated at University of Alabama Birmingham Hospital. Patients will receive both oral and IV arginine with the physician choice of paclitaxel, pembrolizumab, +/- bevacizumab or pembrolizumab, bevacizumab, and oral cyclophosphamide, where doses and schedule are consistent with standard of care. Patients who are excluded from the trial due to progression will be scheduled for three- and six-months follow-up evaluations after the last dose. The goal for enrollment will be 6-24 patients with a 3-patient safety dose escalation lead-in using a 3+3 enrollment model for each regimen.

Patients meeting eligibility criteria will be approached and both verbal and written consent will be obtained prior to treatment. Patients on trial will receive the IV R-Gene 10 (30g) IV arginine, every 3 weeks (q3w) plus PO Arginaid 4.5g PO daily with one of two systemic standard of care treatment regimens: Standard of care treatment #1 is 50mg of daily oral cyclophosphamide, intravenous pembrolizumab 200 mg q3w, and bevacizumab, 15 mg/kg, q3w; standard of care treatment #2 is weekly paclitaxel 80mg/m2 and 200mg of IV pembrolizumab q3wks +/- bevacizumab, 15 mg/kg, q3w in patients with CPS >1.

(CPS) Combined Positive Score (PD-L1)

Being tested
(Arginaid®) Oral Arginine, (R-Gene® 10) IV Arginine, Pembrolizumab, Bevacizumab, Paclitaxel
Medical subject headings
Fallopian Tube Neoplasms

What participants receive

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

  • (Arginaid®) Oral ArginineDrug

    Also called Oral Arginine

    Patients will receive one of two SOC options of chemotherapy and immunotherapy with the addition of IV and PO supplemental arginine. Regimen 1 will be pembrolizumab, bevacizumab, and oral cyclophosphamide and regimen 2 will be paclitaxel and pembrolizumab +/- bevacizumab with doses and schedule consistent with standard of care.

  • (R-Gene® 10) IV ArginineDrug

    Also called IV Arginine

    Patients will receive one of two SOC options of chemotherapy and immunotherapy with the addition of IV and PO supplemental arginine. Regimen 1 will be pembrolizumab, bevacizumab, and oral cyclophosphamide and regimen 2 will be paclitaxel and pembrolizumab +/- bevacizumab with doses and schedule consistent with standard of care.

  • PembrolizumabDrug

    Also called Keytruda

    Patients will receive one of two SOC options of chemotherapy and immunotherapy with the addition of IV and PO supplemental arginine. Regimen 1 will be pembrolizumab, bevacizumab, and oral cyclophosphamide and regimen 2 will be paclitaxel and pembrolizumab +/- bevacizumab with doses and schedule consistent with standard of care.

  • BevacizumabDrug

    Also called AVASTIN®

    Patients will receive one of two SOC options of chemotherapy and immunotherapy with the addition of IV and PO supplemental arginine. Regimen 1 will be pembrolizumab, bevacizumab, and oral cyclophosphamide and regimen 2 will be paclitaxel and pembrolizumab +/- bevacizumab with doses and schedule consistent with standard of care.

  • PaclitaxelDrug

    Also called Taxol

    Patients will receive one of two SOC options of chemotherapy and immunotherapy with the addition of IV and PO supplemental arginine. Regimen 1 will be pembrolizumab, bevacizumab, and oral cyclophosphamide and regimen 2 will be paclitaxel and pembrolizumab +/- bevacizumab with doses and schedule consistent with standard of care.

  • oral phosphamideDrug

    Also called cyclophosphamide

    Patients will receive one of two SOC options of chemotherapy and immunotherapy with the addition of IV and PO supplemental arginine. Regimen 1 will be pembrolizumab, bevacizumab, and oral cyclophosphamide and regimen 2 will be paclitaxel and pembrolizumab +/- bevacizumab with doses and schedule consistent with standard of care.

Study groups in NCT07772882
Study groupRoleWhat they receive
CPS>1, physician's choice for Cohort A or Cohort BExperimentalCohort A: Cohort A1_Weekly paclitaxel + q3w pembrolizumab +/- bevacizumab + 4.5g daily oral arginine (Arginaid®) Cohort A2_Weekly paclitaxel + q3w pembrolizumab +/- bevacizumab + q3w 30g IV arginine (R-Gene® 10) Cohort A3_Weekly paclitaxel + q3w pembrolizumab +/- bevacizumab + q3w 30g IV arginine + 4.5g daily PO arginine (Arginaid®) A3 Expansion_Continue previous regimen OR Cohort B: Cohort B1_q3w IV bevacizumab, q3w IV pembrolizumab, daily oral phosphamide, 4.5g daily oral arginine (Arginaid®) Cohort B2_q3w IV bevacizumab + q3w IV pembrolizumab + daily oral phosphamide + 30mg IV arginine (R-Gene® 10) Cohort B3_q3w IV bevacizumab + q3w IV pembrolizumab + daily oral phosphamide + 30mg IV arginine (R-Gene® 10) + 4.5g PO arginine (Arginaid®) B3 Expansion_ Continue previous regimen
Receives: Drug: (Arginaid®) Oral Arginine; Drug: (R-Gene® 10) IV Arginine; Drug: Pembrolizumab; Drug: Bevacizumab; Drug: Paclitaxel; Drug: oral phosphamide
CPS<1, must be assigned to Cohort BExperimentalCohort B: Cohort B1_q3w IV bevacizumab, q3w IV pembrolizumab, daily oral phosphamide, 4.5g daily oral arginine (Arginaid®) Cohort B2_q3w IV bevacizumab + q3w IV pembrolizumab + daily oral phosphamide + 30mg IV arginine (R-Gene® 10) Cohort B3_q3w IV bevacizumab + q3w IV pembrolizumab + daily oral phosphamide + 30mg IV arginine (R-Gene® 10) + 4.5g PO arginine (Arginaid®) B3 Expansion_ Continue previous regimen
Receives: Drug: (Arginaid®) Oral Arginine; Drug: (R-Gene® 10) IV Arginine; Drug: Pembrolizumab; Drug: Bevacizumab; Drug: oral phosphamide

What is being measured

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

  1. Proportion of patients with serious adverse events

    This measures the proportion of patients experiencing serious adverse events

    Measured: Baseline through year 2

Secondary outcomes (5)
  1. Overall Response Rate

    Tumor burden will be evaluated in all participants by the investigator at screening and during/after the intervention period per RECIST 1.1 guidelines. Based on changes in tumor burden, participants will be classified as complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), or not evaluable (NE). Participants who are classified as CR or PR will be defined as responders. The overall response rate (ORR) is the proportion of responders out of the evaluable participants. ORR = (PR + CR)/(PR + CR+ SD+ PD)

    Measured: Baseline through year 2

  2. Duration of Response

    Duration of response (DOR) is a time-to-event endpoint measured only in participants who respond to treatment. DOR is the time between response to treatment and disease progression or death. Patients who are lost to follow-up before disease progression or death are censored at time of last contact.

    Measured: Baseline through year 2

  3. Disease control rate

    Tumor burden will be evaluated in all participants by the investigator at screening and during/after the intervention period per RECIST 1.1 guidelines. Based on changes in tumor burden, participants will be classified as complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), or not evaluable (NE). Participants who are classified as CR, PR or SD will be defined as having disease control. The disease control rate (DCR) is the proportion of participants with disease control out of the evaluable participants. DCR = (PR + CR + SD)/(PR + CR+ SD+ PD)

    Measured: Baseline through year 2

  4. Progression Free Survival

    Progression free survival (PFS) is a time-to-event endpoint. PFS is the time between start of treatment and the earlier of disease progression or death. Patients who are lost to follow-up before disease progression or death are censored at time of last contact.

    Measured: Baseline through year 2

  5. Overall Survival

    Overall survival (OS) is a time-to-event endpoint. OS is the time between start of treatment and death. Patients who are lost to follow-up before death are censored at time of last contact.

    Measured: Baseline through year 2

Timeline

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

  1. First posted19 Aug 2026
  2. Study startSep 2026 (estimated)
  3. Primary completionOct 2028 (estimated)
  4. Study completionJan 2029 (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
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
24 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07772882
Sponsor's protocol ID
IRB-300016887 (UAB 2667)
Other IDs
O'Neal Cancer Center
Status last verified
Oct 2026
First submitted
14 Aug 2026
Last updated
15 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing (Arginaid®) Oral Arginine, (R-Gene® 10) IV Arginine and Pembrolizumab in people with Platinum Resistant Ovarian Cancer and Fallopian Tube Cancers, run by Rebecca Arend at 1 site 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 16 inclusion and 9 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: opening soon, as of the sponsor's last update on 15 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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 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.

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?

Contact Rebecca C Arend, MD ((205) 934-4986, rarend@uabmc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of patients with serious adverse events (time frame: Baseline through year 2). 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 15 Oct 2026; AzTrials last refreshed its copy on 26 Oct 2026.

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