Last updated on August 2016

Study Of Nintedanib Compared To Chemotherapy in Patients With Recurrent Clear Cell Carcinoma Of The Ovary Or Endometrium


Brief description of study

The trial will recruit up to 120 patients; 90 with ovarian clear cell carcinoma and up to 30 with endometrial clear cell carcinoma. Patients will be randomised between chemotherapy and Nintedanib 200mg twice daily oral administration (PO) continuously. The primary diagnosis must be histologically confirmed and central pathological review of the presenting tumour or biopsy of relapsed disease must find at least 50% clear cell carcinoma with no serous differentiation

Detailed Study Description

Clear cell carcinoma (CCC) is an uncommon histotype of ovarian and a rare histotype of endometrial cancer. The prognosis for recurrent disease is poor with response rates to standard chemotherapy of <10% so there is an urgent need for novel therapies. Ovarian CCC (OCCC) is biologically different from other ovarian cancer histotypes but shares features with renal CCC, including upregulation of angiogenesis pathways. Hence inhibition of angiogenesis, which has been a successful strategy in renal CCC, may also be of benefit in OCCC and endometrial CCC (ECCC). Nintedanib is a well-tolerated, potent, orally-available, kinase inhibitor targeting Vascular Endothelial Growth Factor (VEGFR) 1-3, Platelet Derived Growth Factor Receptor (PDGFR)α/β, and Firbroblas Gworth Factor Receptors (FGFR) 1-3. It is licensed in Europe in combination with docetaxel after first line chemotherapy for Non-Small Cell Lung Cancer (NSCLC). Importantly it also has significant activity as a single agent in renal CCC with an Overall Response Rate (ORR) of 20.3%, disease control rate of 76.% and 43% 9 month progression free survival. Response rates (RR) of ovarian CCC to standard chemotherapy with or without platinum are poor whatever line of treatment. A number of different agents are used in recurrent CCC and, although isolated instances of response to a variety of agents have been reported, no regimen seems to offer a particular advantage. As a result the investigators do not expect to see significant differences in response rates within the chemotherapy arms of the study. Hence it is feasible to allow physicians a choice of chemotherapy from a pre-specified selection and to include patients with multiple previous relapses. Since overall and progression free survival may be shorter with successive lines of treatment, the number of previous lines of treatment will be a stratification factor. These measures should maximise recruitment of this rare tumour sub-type across different countries.

Clinical Study Identifier: NCT02866370

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Ros Glasspool

Beatson West of Scotland Cancer Centre
Glasgow, United Kingdom
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Michelle Ferguson

Ninewells Hospital
Dundee, United Kingdom
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Rosemary Lord

Clatterbridge Cancer Centre
Liverpool, United Kingdom
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Sarah McKenna

Belfast City Hospital (Northern Ireland Cancer Centre)
Belfast, United Kingdom
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Axel Walther

Bristol Heamatology and Cancer Centre
Bristol, United Kingdom
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Rachel Jones

Velindre Hospital
Cardiff, United Kingdom
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Justin Waters

Kent & Canterbury Hospital
Kent, United Kingdom
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Justin Waters

Queen Elizabeth Queen Mother Hospital
Kent, United Kingdom
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Justin Waters

William Harvey Hospital
Kent, United Kingdom
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Geoff Hall

St James Hospital
Leeds, United Kingdom
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Ana Montes

Guy's Hosital
London, United Kingdom
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Susannah Bannerjee

Royal Marsden Hospital
London, United Kingdom
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Melanie Powell

St Bartholomew's Hospital
London, United Kingdom
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Jonathan Ledermann

University College London Hospital
London, United Kingdom
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Andrew Clamp

The Christie Hospital
Manchester, United Kingdom
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Omar Khan

Great Western Hospital
Swindon, United Kingdom
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Clare Barlow

Musgrove Park Hospital
Taunton, United Kingdom
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