NIraparib and Quality of LifE is a Longitudinal Study Evaluating in Real Life the Tolerability of Niraparib.

NCT03752216CompletedPHASE4INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

ARCAGY/ GINECO GROUP

Enrollment

141

Start Date

2019-04-03

Completion Date

2021-08-18

Study Type

INTERVENTIONAL

Official Title

Longitudinal Study Evaluating in Real Life the Tolerability of Niraparib in Maintenance After Platine-based Chemotherapy for Patients with Ovarian Cancer Late Relapse : the French GINECO - NiQoLe Study

Interventions

Niraparib

Conditions

Ovarian Cancer

Eligibility

Age Range

18 Years+

Sex

FEMALE

Inclusion Criteria:

I-1 Female patients must be ≥ 18 years of age. I-2 Signed informed consent and ability to comply with treatment and follow-up. I-3 Patients with histologically proved high grade epithelial ovarian cancer or fallopian tube or primary peritoneal adenocarcioma.

I-4 Platine sensitive and ovarian, fallopian or peritoneal cancer recurrent patients with a complete response or partial response after a line of platine based chemotherapy.

I-5 Participant must have adequate organ function, defined as follows:

* Absolute neutrophil count ≥ 1,500/μL
* Platelets ≥ 100,000/μL
* Hemoglobin ≥ 9 g/dL
* Serum creatinine ≤ 1.5 x upper limit of normal (ULN) or calculated creatinine clearance ≥ 30 mL/min using the Cockcroft-Gault equation
* Total bilirubin ≤ 1.5 x ULN (≤2.0 in patients with known Gilberts syndrome) OR direct bilirubin ≤ 1 x ULN
* Aspartate aminotransferase and alanine aminotransferase ≤ 2.5 x ULN unless liver metastases are present, in which case they must be ≤ 5 x ULN I-6 Patients with an indication of maintenance by Niraparib after platine based chemotherapy according to the labelling (see appendix 17).

I-7 As this study will include patients in France, a subject will be eligible in this study only if either affiliated to, or a beneficiary of, a social category.

I-8 Participant must have an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2.

I-9 Participant receiving corticosteroids may continue as long as their dose is stable for least 4 weeks prior to initiating protocol therapy.

I-10 Participant must agree to not donate blood during the study or for 90 days after the last dose of Niraparib.

I-11 Female participant has a negative urine or serum pregnancy test within 7 days prior to taking study treatment if of childbearing potential and agrees to abstain from activities that could result in pregnancy from screening through 1 month after the last dose of study treatment, or is of nonchildbearing potential.

I-12 Participant must agree to not breastfeed during the study or for 1 month after the last dose of Niraparib.

I-13 Participant must have normal blood pressure or adequately treated and controlled hypertension

Exclusion Criteria:

E-1 Known hypersensitivity or allergy to active principle or to any components or excipients of the Niraparib formulation.

E-2 Participant must not be simultaneously enrolled in any interventional clinical trial.

E-3 Participant must not have had major surgery ≤ 3 weeks prior to initiating protocol therapy and participant must have recovered from any surgical effects.

E-4 Participant must not have received investigational therapy ≤ 4 weeks, or within a time interval less than at least 5 half-lives of the investigational agent, whichever is shorter, prior initiating protocol therapy.

E-5 Participant last treatment with platinum-based chemotherapy was ≥12 weeks from initiation of protocol therapy E-6 Participant has had radiation therapy encompassing \>20% of the bone marrow within 2 weeks; or any radiation therapy within 1 week prior to Day 1 of protocol therapy.

E-7 Participant must not have received a transfusion (platelets or red blood cells) ≤ 4 weeks NiQoLe - Study protocol - v3.0 on 08/10/2020 Page 10 on 109 N° EudraCT: 2018-002274-44 prior to initiating protocol therapy. E-8 Participant must not have received colony stimulating factors (e.g., granulocyte colonystimulating factor, granulocyte macrophage colony stimulating factor, or recombinant erythropoietin) within 4 weeks prior initiating protocol therapy. E-9 Participant has had any known Grade 3 or 4 anemia, neutropenia or thrombocytopenia due to prior chemotherapy that persisted \> 4 weeks and was related to the most recent treatment. E-10 Participant must not have any known history of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). E-11 Participant must not have a serious, uncontrolled medical disorder, nonmalignant systemic disease, or active, uncontrolled infection. Examples include, but are not limited to, uncontrolled ventricular arrhythmia, recent (within 90 days) myocardial infarction, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome, or any psychiatric disorder that prohibits obtaining informed consent. E-12 Participant must not be deprived of liberty, under guardianship or under trusteeship.

Outcome Measures

Primary Outcomes

Toxicities inducing dose modifications of Niraparib between the start to the cycle 3 (interruption, discontinuation and dose reduction).

Evaluate treatment toxicities

Time frame: 3 months

Secondary Outcomes

Self-reported fatigue by patient by FACT-F questionnaire (Functional Assessment of Cancer Therapy General - Fatigue)

Functional Assessment of Cancer Therapy General Fatigue questionnaire (score range from 0 to 52 - Higher scores represent better quality of life)

Time frame: Up to 18 months.

Self-reported symptoms and side effects with the NCI PRO-CTCAE

Self-reported symptoms and side effects

Time frame: Up to 18 months.

Reasons of the dose modification of Niraparib

Reasons of the dose modification of Niraparib

Time frame: Up to 18 months.

General health-related quality of life by FACT-G questionnaire (Functional Assessment of Cancer Therapy General)

Functional Assessment of Cancer Therapy General questionnaire (score range from 0 \[worse outcome\] to 108 \[better outcome\])

Time frame: Up to 18 months.

Pain related to the treatment by Visual Analogic Scale (VAS)

Score range from 0 \[worse outcome\] to 10 \[better outcome\])

Time frame: Up to 18 months.

Side effects of interest (HTA, anemia, thrombocytopenia)

Side effects of interest (HTA, anemia, thrombocytopenia)

Time frame: Up to 18 months.

Duration of Niraparib treatment

From the start of Niraparib until progression or unacceptable toxicity.

Time frame: Up to 18 months.

Time to first subsequent line of anti-cancer therapy

From the stop of Niraparib to the first subsequent line of anti-cancer therapy.

Time frame: Up to 18 months.

Overall response rate

Overall response rate

Time frame: Up to 18 months.

Initial cognitive functions by FACT-cog (Functional Assessment of Cancer Therapy - Cognitive Function) questionnaire

FACT-cog questionnaire (score range from 0 to 132 - Higher scores represent better functioning)

Time frame: At the inclusion visit

Plasma level of Niraparib before Niraparib administration

residual dosage of Niraparib

Time frame: Day 8

Plasma level of Niraparib before Niraparib administration

residual dosage of Niraparib

Time frame: 3 months

Geriatric Depression Scale (score range from 0 [better outcome] to 30 [worse outcome])

Geriatric Depression Scale (score range from 0 \[better outcome\] to 30 \[worse outcome\])

Time frame: Up to 6 months.

Locations

Sainte-Catherine Institut du Cancer Avignon-Provence, Avignon, France

Centre Hospitalier de la Côte Basque, Bayonne, France

CHRU Jean Minjoz, Besançon, France

Clinique Tivoli, Bordeaux, France

Institut Bergonié, Bordeaux, France

Hôpital Fleyriat, Bourg-en-Bresse, France

Centre François Baclesse, Caen, France

Medipole de Savoie, Challes-les-Eaux, France

SASU Centre d'Oncologie et Radiothérapie 37, Chambray-lès-Tours, France

Centre Jean Perrin, Clermont-Ferrand, France

Centre Georges François Leclerc, Dijon, France

Groupe Hospitalier Mutualiste de Grenoble - Institut Daniel Hollard, Grenoble, France

Les Hôpitaux de Chartres - Hôpital Louis Pasteur, Le Coudray, France

Hôpital Privé Jean Mermoz, Lyon, France

ICM Val d'Aurelle, Montpellier, France

Médipôle de NANCY / Centre d'Oncologie de Gentilly, Nancy, France

Centre Antoine Lacassagne, Nice, France

Centre ONCOGARD - Institut de Cancérologie du Gard, Nîmes, France

Centre Hospitalier Régional d'Orléans, Orléans, France

Hôpital Cochin, Paris, France

Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris, France

Centre CARIO - HPCA, Plérin, France

Centre Hospitalier Universitaire de Poitiers, Poitiers, France

Institut du Cancer Courlancy, Reims, France

Clinique Mutualiste de l'Estuaire, Saint-Nazaire, France

CHU de Saint-Etienne - Pôle de Cancérologie, Saint-Priest-en-Jarez, France

Centre Hospitalier Saint-Malo, St-Malo, France

Hôpitaux Universitaires de Strasbourg - Institut de Cancérologie Strasbourg Europe, Strasbourg, France

Clinique Pasteur, Toulouse, France

Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France

Linked Papers

Improving real-world evaluation of patient- and physician-reported tolerability: niraparib for recurrent ovarian cancer (NiQoLe)

Abstract Background Maintenance niraparib at an individualized starting dose (ISD) is established in platinum-sensitive recurrent ovarian cancer (PSROC). However, patients’ perspectives on the burden of prolonged maintenance therapy have not been reported in prospective trials or routine practice. Methods In the real-life multicenter NiQoLe study, patients with PSROC received ISD maintenance niraparib. The primary objective was to describe physician-reported adverse events (AEs) leading to treatment modification during the first 3 months. Secondary endpoints included patient-reported outcomes (symptomatic AEs using PRO-CTCAE, self-reported fatigue, and impact on daily activities/function using FACT-F) collected remotely weekly using a specifically designed electronic device. Results Most (80%) of 139 treated patients (median age = 70 years) began niraparib at 200 mg/day. Median treatment duration was 5.7 (range = 0.2-21.4) months. During the first 3 months, 86 patients (62%) required treatment modification (median = 27 days to modification). Physician-reported grade ≥3 niraparib-related AEs occurred in 34 patients (24%); 68 patients (49%) had treatment modification for AEs, predominantly thrombocytopenia. The most frequent patient-reported AEs (PRO-CTCAE) were fatigue, insomnia, constipation, and dry mouth. Self-reported AEs were severe in 66% of patients. At baseline, 33% of patients reported severe fatigue (FACT-F), which generally persisted during niraparib. Physicians systematically underestimated major patient-reported symptoms. Conclusions In routine practice, niraparib dose modification was often required during the first 3 months despite individualized dosing. Physicians underestimated the burden of fatigue and symptomatic AEs. Digital self-reporting of AEs is feasible, provides patient-centered information complementing physician-reported AEs, and allows fuller appreciation of toxicity in real-world studies. Clinical trial information NCT03752216