Trial Review

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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT06441747




Registration number
NCT06441747
Ethics application status
Date submitted
29/05/2024
Date registered
4/06/2024
Date last updated
4/06/2024

Titles & IDs
Public title
Phase II Study of the Combination of Durvalumab (MEDI4736) (PDL1 Inhibitor) and Olaparib (PARP Inhibitor) in Advanced Cholangiocarcinoma After Initial Chemotherapy and Durvalumab (BIL-PPP)
Scientific title
Phase II Study of the Combination of Durvalumab (MEDI4736) (PDL1 Inhibitor) and Olaparib (PARP Inhibitor) in Advanced Cholangiocarcinoma After Initial Chemotherapy and Durvalumab (BIL-PPP)
Secondary ID [1] 0 0
BIL-PPP
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Cholangiocarcinoma 0 0
Condition category
Condition code
Cancer 0 0 0 0
Biliary tree (gall bladder and bile duct)
Oral and Gastrointestinal 0 0 0 0
Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Durvalumab
Treatment: Drugs - Olaparib

Experimental: Durvalumab and Olaparib - This is a trial of Durvalumab in combination with olaparib. Durvalumab will be administered at a dose of 1500mg intravenously every 4 weeks. Olaparib will be administered orally at a dose of 300mg twice daily continuously. This combination will be administered for a maximum of two years unless unacceptable toxicities or progressive disease.


Treatment: Drugs: Durvalumab
Durvalumab will be administered at a dose of 1500mg intravenously every 4 weeks.

Treatment: Drugs: Olaparib
Olaparib is administered at a dose of 300mg bd in a continuous 28-day cycle. On day 1 of each cycle, the morning dose of Olaparib should be taken no more than 1 hour prior to infusion of durvalumab. It is expected that patients will receive up to 24 months of a combination of olaparib and durvalumab, or until disease progression, unacceptable toxicities, or withdrawal of consent.
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Primary Objective
Timepoint [1] 0 0
12 months post randomisation
Primary outcome [2] 0 0
Evaluate benefit
Timepoint [2] 0 0
12 months post randomisation
Secondary outcome [1] 0 0
Evaluate toxicity
Timepoint [1] 0 0
12 months post randomisation
Secondary outcome [2] 0 0
Progression free survival
Timepoint [2] 0 0
12 months post randomisation
Secondary outcome [3] 0 0
Overall survival
Timepoint [3] 0 0
12 months post randomisation

Eligibility
Key inclusion criteria
1. Age =18 years, and life expectancy>12 weeks

2. Weight: >30kg

3. Histologically proven locally advanced or metastatic/unresectable cholangiocarcinoma

4. Documentation of RECISTv1.1 measurable disease

5. Must not have had radiologic progression after 6-8 cycles of gemcitabine and cisplatin
and durvalumab

6. Adequate haematological and end-organ function as defined by the following parameters:

1. Haemoglobin = 90g/L (without a transfusion in the past two weeks)

2. Platelets =100 x 109/L (without a transfusion in the past two weeks)

3. Neutrophils = 1.0 x 109/L (without the use of G-CSF in the 4 weeks prior to first
dose)

4. ALT/AST <3x ULN irrespective of presence of liver metastases

5. Serum bilirubin = 1.5x ULN except in cases of known Gilbert's Syndrome where
total bilirubin must be <4x ULN

6. Albumin = 25 g/L

7. Serum Creatinine =1.5 x ULN or eGFR = 30mL/min/1.73m2 as calculated by Cockcroft
Gault Equation

7. Able to swallow oral medications without any difficulties or medical history
associated with malabsorption or any conditions that may impact on compliance or
absorption of the study treatment.

8. Women of Childbearing potential must be either totally abstinent or agree to use at
least one highly effective method of birth control (e.g., oral contraceptive pill,
barrier method) for the duration of the study and for at least 6 months after the
final dose of study medication. They must also have a negative serum beta-hCG in the 7
days prior to first dose of study drug.

9. Non-sterile males and their female partners must also either be totally abstinent or
agree to use at least one highly effective method of birth control (e.g., oral
contraceptive pill, barrier method) for the duration of the study and for at least 6
months after the final dose of study medication.

10. Patient is willing and able to comply with the protocol for the duration of the study,
including undergoing treatment and scheduled visits and examinations including follow
up.

11. Capable of giving signed informed consent, which includes compliance with the
requirements and restrictions listed in the informed consent form (ICF) and in this
protocol. Written informed consent and any locally required authorization obtained
from the patient/legal representative prior to performing any protocol-related
procedures, including screening evaluations.
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. Previous use of a PARP inhibitor.

2. All prior treatment-related AEs must have resolved to a CTCAE v5 Grade 1 or less prior
to commencement of study medication, with the exception of alopecia and peripheral
neuropathy which can be grade 2 or less.

i. Patients with Grade =2 neuropathy will be evaluated on a case-by-case basis after
consultation with the Study Physician.

ii. Patients with irreversible toxicity not reasonably expected to be exacerbated by
treatment with durvalumab or olaparib may be included only after consultation with the
Study Chairs.

3. Known symptomatic or progressive CNS metastases or leptomeningeal disease. Patients
with treated brain metastases are eligible for inclusion in the study if they had
received treatment >4 weeks prior to commencement of study medication, and have a
repeat MRI scan demonstrating stability in disease.

4. Patients with severe chronic or active infections requiring systemic antibiotics or
antifungals in the two weeks prior to starting trial treatment.

5. Any of the following cardiovascular risk factors:

1. Acute myocardial infarction (MI) =6 months prior to study registration

2. New York Heart Association (NYHA) Heart Failure Class III-IV within =6 months of
registration

3. History of cerebral vascular accident (CVA) within 6 months of first dose

6. Concurrent enrolment in another clinical study, unless it is an observational
(non-interventional) clinical study, or during the follow-up period of an
interventional study.

7. Radiotherapy treatment to more than 30% of the bone marrow or with a wide field of
radiation within 4 weeks of the first dose of study drug.

8. Major surgical procedure (as defined by the Investigator) within 28 days prior to the
first dose of IP. Note: Local surgery of isolated lesions for palliative intent is
acceptable.

9. History of allogeneic organ transplantation.

10. Active or prior documented autoimmune or inflammatory disorders (including
inflammatory bowel disease [e.g., colitis or Crohn's disease], diverticulitis [with
the exception of diverticulosis], systemic lupus erythematosus, Sarcoidosis syndrome,
or Wegener syndrome [granulomatosis with polyangiitis, Graves' disease, rheumatoid
arthritis, hypophysitis, uveitis, etc]). The following are exceptions to this
criterion:

1. Patients with vitiligo or alopecia.

2. Patients with hypothyroidism (e.g., following Hashimoto syndrome) stable on
hormone replacement.

3. Any chronic skin condition that does not require systemic therapy.

4. Patients without active disease in the last 5 years may be included but only
after consultation with the study physician.

5. Patients with celiac disease controlled by diet alone.

11. Uncontrolled intercurrent illness, including but not limited to, ongoing or active
infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable
angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic
gastrointestinal conditions associated with diarrhoea, or psychiatric illness/social
situations that would limit compliance with study requirements, substantially increase
risk of incurring AEs, or compromise the ability of the patient to give written
informed consent.

12. History of another primary malignancy except for:

1. Malignancy treated with curative intent and with no known active disease =2 years
before the first dose of IP and of low potential risk for recurrence.

2. Adequately treated non-melanoma skin cancer or lentigo maligna without evidence
of disease.

3. Adequately treated carcinoma in situ without evidence of disease.

13. Mean QT interval corrected for heart rate using Fridericia's formula (QTcF) =470 ms
calculated from 3 ECGs (within 15 minutes at 5 minutes apart).

14. History of active primary immunodeficiency.

15. Known active hepatitis infection, positive hepatitis C virus (HCV) antibody, hepatitis
B virus (HBV) surface antigen (HBsAg) or HBV core antibody (anti-HBc), at screening.
Participants with a past or resolved HBV infection (defined as the presence of anti
HBc and absence of HBsAg) are eligible. Participants positive for HCV antibody are
eligible only if polymerase chain reaction is negative for HCV RNA.

1. Participants co-infected with HBV and HCV, or co-infected with HBV and HDV,
namely: HBV positive (presence of HBsAg and/or anti HBcAb with detectable HBV
DNA); AND

2. HCV positive (presence of anti-HCV antibodies); OR

3. HDV positive (presence of anti-HDV antibodies).

16. Known to have tested positive for human immunodeficiency virus (HIV) (positive HIV 1/2
antibodies) or active tuberculosis infection (clinical evaluation that may include
clinical history, physical examination and radiographic findings, or tuberculosis
testing in line with local practice). Known HIV infection that is not well controlled.
All of the following criteria are required to define an HIV infection that is well
controlled: undetectable viral RNA load for 6 months prior, CD4+ count of >500, no
history of AIDS-defining opportunistic infection within the past 12 months, and stable
for at least 6 months on the same anti-HIV medications.

17. Current or prior use of immunosuppressive medication within 14 days before the first
dose of durvalumab. The following are exceptions to this criterion:

1. Intranasal, inhaled, topical steroids, or local steroid injections (e.g.,
intra-articular injection)

2. Systemic corticosteroids at physiologic doses that do not exceed 10 mg/day of
prednisolone or its equivalent.

3. Steroids as premedication for hypersensitivity reactions (e.g., CT scan
premedication)

18. Receipt of live attenuated vaccine within 30 days prior to the first dose of IP. Note:
Patients, if enrolled, should not receive live vaccine whilst receiving IP and up to
90days after the last dose of IP.19. Female patients who are pregnant or
breastfeeding, or male or female patients of reproductive potential who are not
willing to employ effective birth control from screening to 90 days after the last
dose of durvalumab monotherapy.

20. Known allergy or hypersensitivity to any of the study drugs or any of the study drug
excipients.

21. Judgment by the investigator that the patient is unsuitable to participate in the study
and the patient is unlikely to comply with study procedures, restrictions and requirements.

Study design
Purpose of the study
Treatment
Allocation to intervention
N/A
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Single group
Other design features
Phase
Phase 2
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Not yet recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
1/08/2024
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
1/08/2028
Actual
Sample size
Target
40
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC,WA
Recruitment hospital [1] 0 0
Chris O'Brien Lifehouse - Camperdown
Recruitment hospital [2] 0 0
Monash Medical Centre - Clayton
Recruitment hospital [3] 0 0
Westmead Hospital - Westmead
Recruitment hospital [4] 0 0
Wollongong Hospital - Wollongong
Recruitment hospital [5] 0 0
Royal Brisbane Women's Hospital - Brisbane
Recruitment hospital [6] 0 0
Princess Alexandra Hospital - Woolloongabba
Recruitment hospital [7] 0 0
Flinders Medical Centre - Bedford Park
Recruitment hospital [8] 0 0
Austin Health - Melbourne
Recruitment hospital [9] 0 0
Western Health - Saint Albans
Recruitment hospital [10] 0 0
St John of God Hospital, Subiaco - Perth
Recruitment postcode(s) [1] 0 0
2050 - Camperdown
Recruitment postcode(s) [2] 0 0
3168 - Clayton
Recruitment postcode(s) [3] 0 0
2145 - Westmead
Recruitment postcode(s) [4] 0 0
2500 - Wollongong
Recruitment postcode(s) [5] 0 0
4006 - Brisbane
Recruitment postcode(s) [6] 0 0
4102 - Woolloongabba
Recruitment postcode(s) [7] 0 0
- Bedford Park
Recruitment postcode(s) [8] 0 0
3084 - Melbourne
Recruitment postcode(s) [9] 0 0
3021 - Saint Albans
Recruitment postcode(s) [10] 0 0
- Perth

Funding & Sponsors
Primary sponsor type
Other
Name
Australasian Gastro-Intestinal Trials Group
Address
Country
Other collaborator category [1] 0 0
Other
Name [1] 0 0
Wayne Elphinstone Research Fund
Address [1] 0 0
Country [1] 0 0
Other collaborator category [2] 0 0
Commercial sector/Industry
Name [2] 0 0
AstraZeneca
Address [2] 0 0
Country [2] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
The aim of this study is to investigate whether the combination of durvalumab and olaparib in
the maintenance setting after initial chemotherapy and durvalumab will benefit patients with
locally advanced or metastatic cholangiocarcinoma.
Trial website
https://clinicaltrials.gov/ct2/show/NCT06441747
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Sukanya Sathyamurthie
Address 0 0
Country 0 0
Phone 0 0
+61 2 7208 2719
Fax 0 0
Email 0 0
sukanya@gicancer.org.au
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT06441747