Camrelizumab Plus Apatinib in Patients With High-risk Gestational Trophoblastic Neoplasia

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Brief Title

Camrelizumab Plus Apatinib in Patients With High-risk Gestational Trophoblastic Neoplasia

Official Title

Camrelizumab Plus Apatinib in Patients With High-risk Gestational Trophoblastic Neoplasia: a Cohort, Open-label, Phase 2 Trial

Brief Summary

      The purpose of this study is to evaluate the efficacy and safety of camrelizumab and apatinib
      as combination therapy in patients with ultra high-risk (Cohort A) and high-risk
      chemo-refractory or relapsed (Cohort B) gestational trophoblastic neoplasia (GTN). Eligible
      patients will receive camrelizumab plus apatinib plus chemotherapy. Treatment will be
      continued until disease progression, unacceptable toxicity, or withdrawal of consent.
    

Detailed Description

      The purpose of this study is to evaluate the efficacy and safety of camrelizumab and apatinib
      as combination therapy in patients with ultra high-risk (Cohort A) and high-risk
      chemo-refractory or relapsed (Cohort B) gestational trophoblastic neoplasia (GTN).

      Cohort A: Eligible patients will receive camrelizumab (200mg q2w iv) plus apatinib (250 mg qd
      po) plus chemotherapy. After normalization of serum β-human chorionic gonadotropin (β-hCG)
      levels, patients will receive 4 cycles of consolidation chemotherapy combined with
      camrelizumab plus apatinib and then 6 months of camrelizumab plus apatinib as maintenance
      treatment. Treatment will be continued until completion of treatment, disease progression,
      unacceptable toxicity, or withdrawal of consent.The primary endpoint is complete remission
      rate (the proportion of patients achieving complete remission). Secondary endpoints include
      objective response rate (the proportion of patients achieving complete remission and partial
      remission), progression-free survival (time from the treatment initiation to disease
      progression or death, whichever comes first), overall survival (time from the treatment
      initiation to the date of death or last follow-up), duration of response (time from the first
      evidence of response to disease progression or death, whichever comes first) and safety.

      Cohort B: Eligible patients will receive camrelizumab (200mg q3w iv) plus apatinib (250 mg qd
      po) plus chemotherapy. Treatment will be continued until disease progression, unacceptable
      toxicity, or withdrawal of consent. Patients will receive 6 cycles of consolidation therapy
      if achieving a complete response. The primary endpoint is objective response rate. Secondary
      endpoints include progression-free survival, duration of response, overall survival and
      safety.
    

Study Phase

Phase 2

Study Type

Interventional


Primary Outcome

Cohort A: Complete remission rate

Secondary Outcome

 Cohort A: Objective response rate

Condition

Gestational Trophoblastic Neoplasia

Intervention

Camrelizumab plus apatinib CohortA

Study Arms / Comparison Groups

 Cohort A
Description:  Population: ultra high-risk gestational trophoblastic neoplasia

Publications

* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information


Recruitment Status

Drug

Estimated Enrollment

73

Start Date

January 27, 2022

Completion Date

June 1, 2024

Primary Completion Date

December 1, 2023

Eligibility Criteria

        Inclusion Criteria:

          1. Woman aged 18-60 years;

          2. Previously untreated patients with ultra high-risk GTN(Cohort A) or high-risk
             chemo-refractory or relapsed GTN (Cohort B);

          3. No previous chemotherapy or radiotherapy for ultra high-risk GTN(Cohort A)and have
             previously received two or more lines of combination chemotherapies for high-risk
             chemo-refractory or relapsed GTN (Cohort B);

          4. Patients with ultra high-risk GTN (FIGO stages I-III: score ≥13 and stage IV)
             according to the International Federation of Gynecology and Obstetrics (FIGO) 2000
             staging and risk factor scoring system(Cohort A)and patients with a prognostic score
             ≥7 (Cohort B);

          5. Patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1;

          6. Patients with abnormal serum hCG level (≥5 IU/L);

          7. Expected survival ≥ 4 months;

          8. The function of vital organs meets the following requirements:

             hemoglobin ≥90 g/L, absolute neutrophil count ≥1·5×109/L, platelets ≥100×109/L;
             creatinine ≤1·5 × upper limit of normal (ULN), urea nitrogen ≤2·5×ULN; total bilirubin
             ≤ULN, alanine aminotransferase and aspartate aminotransferase ≤2·5×ULN, albumin ≥25
             g/L; thyroid stimulating hormone ≤ULN (if thyroid stimulating hormone is abnormal,
             normal T3 and T4 can also be acceptable).

          9. Female patients of childbearing age must exclude pregnancy and are willing to use a
             medically approved high-efficiency contraceptive (e.g., intrauterine device,
             contraceptive or condom) during the study period and within 6 months of the last study
             drug administration.

         10. The patient should be aware of the purpose of the study and the operations required by
             the study and volunteer to participate in the study before sign the informed consent
             form.

        Exclusion Criteria:

          1. Previous treatment with immunotherapy drugs (including antibodies targeting PD-1,
             PD-L1, cytotoxic T-lymphocyte-associated protein 4, T-cell receptor, chimeric antigen
             receptor T-cell therapy, and other immunotherapy), anti-angiogenic small-molecule
             tyrosine kinase inhibitors (such as pazopanib, sorafenib, or regorafenib), or
             anti-angiogenic monoclonal antibodies (such as bevacizumab); live vaccines injected
             within 4 weeks before the first dose of study drug; other clinical trials of
             antitumour drugs within 4 weeks before the first dose of study drug;

          2. Other malignancies in the past 3 years;

          3. Immunosuppressive drugs used within 14 days prior to the first dose of camrelizumab;
             any active autoimmune disease or a history of autoimmune disease;

          4. Uncontrollable hypertension (systolic blood pressure ≥140 mmHg or diastolic blood
             pressure ≥90 mmHg, despite with the optimal drug therapy);

          5. Grade II or higher myocardial ischemia, myocardial infarction or poorly controlled
             arrhythmia (females with QTc interval ≥470 ms); grade III to IV cardiac insufficiency
             according to New York Heart Association (NYHA) criteria, or cardiac color Doppler
             ultrasound evidence of left ventricular ejection fraction <50%; myocardial infarction,
             NYHA grade II or above heart failure, uncontrolled angina, uncontrolled severe
             ventricular arrhythmia, clinically significant pericardial disease, or
             electrocardiogram suggesting acute ischemia or abnormal active conduction system
             occurring within 6 months before enrolment;

          6. Abnormal coagulation (international normalised ratio >1·5×ULN or prothrombin time
             >ULN+4 seconds or activated partial thromboplastin time >1·5×ULN), with bleeding
             tendency or undergoing thrombolysis or anticoagulant therapy;

          7. Severe infections within 4 weeks prior to the first dose of study drug (e.g., need of
             intravenous infusion of antibiotics, antifungal or antiviral drugs), or unexplained
             fever (>38·5°C) during screening or the first dose of study drug;

          8. With a history of psychotropic drug abuse and are unable to withdraw the psychotropic
             drug, or have mental disorders;

          9. Major surgery performed within 4 weeks before the first dose of study drug, or open
             wounds or fractures;

         10. Obvious factors affecting oral drug absorption, such as inability to swallow, chronic
             diarrhea and intestinal obstruction, or sinus or perforation of empty organs within 6
             months;

         11. Routine urine test indicating urinary protein ++ or more, or confirmed urinary protein
             ≥1·0 g within 24 hours;

         12. Human immunodeficiency virus infection or known acquired immunodeficiency syndrome,
             active hepatitis B (HBV DNA >500 IU/mL), hepatitis C (hepatitis C antibody positive,
             and HCV-RNA higher than the lower limit of the analysis method) or co-infection with
             hepatitis B and hepatitis C;

         13. Other reasons as judged by the investigator.
      

Gender

Female

Ages

18 Years - 60 Years

Accepts Healthy Volunteers

No

Contacts

, 010-69156068, [email protected]

Location Countries

China

Location Countries

China

Administrative Informations


NCT ID

NCT05139095

Organization ID

MA-GTN-II-001


Responsible Party

Sponsor

Study Sponsor

Peking Union Medical College Hospital

Collaborators

 Jiangsu HengRui Medicine Co., Ltd.

Study Sponsor

, , 


Verification Date

November 2021