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A Study to Evaluate Dostarlimab Plus Carboplatin-paclitaxel Versus Placebo Plus Carboplatin-paclitaxel in Participants With Recurrent or Primary Advanced Endometrial Cancer (RUBY)

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ClinicalTrials.gov Identifier: NCT03981796
Recruitment Status : Active, not recruiting
First Posted : June 11, 2019
Last Update Posted : August 14, 2023
Sponsor:
Collaborators:
European Network of Gynaecological Oncological Trial Groups (ENGOT)
GOG Foundation
Information provided by (Responsible Party):
Tesaro, Inc.

Study Description
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Brief Summary:
This is a 2 part study. Part 1 is to evaluate the efficacy and safety of dostarlimab plus carboplatin-paclitaxel followed by dostarlimab versus placebo plus carboplatin-paclitaxel followed by placebo; and Part 2 is to evaluate the efficacy and safety of dostarlimab plus carboplatin-paclitaxel followed by dostarlimab plus niraparib versus placebo plus carboplatin-paclitaxel followed by placebo in participants with recurrent or primary advanced (Stage III or IV) endometrial cancer.

Condition or disease Intervention/treatment Phase
Neoplasms Biological: Dostarlimab Drug: Placebo matching dostarlimab Drug: Carboplatin Drug: Paclitaxel Drug: Niraparib Drug: Placebo matching Niraparib Phase 3

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 787 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description: The participant, Investigator, study staff, and the Sponsor study team and its representatives will be blinded to the assigned treatment.
Primary Purpose: Treatment
Official Title: A Phase 3, Randomized, Double-blind, Multicenter Study of Dostarlimab (TSR-042) Plus Carboplatin-paclitaxel Versus Placebo Plus Carboplatin-paclitaxel in Patients With Recurrent or Primary Advanced Endometrial Cancer (RUBY)
Actual Study Start Date : July 18, 2019
Estimated Primary Completion Date : November 26, 2026
Estimated Study Completion Date : November 26, 2026

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Active Comparator: Arm 1: Participants receiving dostarlimab + Carboplatin-paclitaxel followed by dostarlimab Biological: Dostarlimab
Participants will be administered dostarlimab
Other Name: TSR-042

Drug: Carboplatin
Participants will be administered carboplatin

Drug: Paclitaxel
Participants will be administered paclitaxel
Placebo Comparator: Arm 2: Participants receiving placebo + carboplatin-paclitaxel followed by placebo Drug: Placebo matching dostarlimab
Participants will be administered placebo matching dostarlimab

Drug: Carboplatin
Participants will be administered carboplatin

Drug: Paclitaxel
Participants will be administered paclitaxel
Active Comparator: Arm 3: Participants receiving dostarlimab + carboplatin-paclitaxel followed by dostarlimab+niraparib Biological: Dostarlimab
Participants will be administered dostarlimab
Other Name: TSR-042

Drug: Carboplatin
Participants will be administered carboplatin

Drug: Paclitaxel
Participants will be administered paclitaxel

Drug: Niraparib
Participants will be administered niraparib
Placebo Comparator: Arm 4: Participants receiving placebo + carboplatin-paclitaxel followed by placebo Drug: Placebo matching dostarlimab
Participants will be administered placebo matching dostarlimab

Drug: Carboplatin
Participants will be administered carboplatin

Drug: Paclitaxel
Participants will be administered paclitaxel

Drug: Placebo matching Niraparib
Participants will be administered placebo matching Niraparib


Outcome Measures
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Primary Outcome Measures :
  1. Parts 1 and 2: Progression-Free Survival (PFS) - investigator assessment [ Time Frame: Up to 6 years ]
  2. Part 1: Overall survival [ Time Frame: Up to 6 years ]

Secondary Outcome Measures :
  1. Part 2: Overall survival [ Time Frame: Up to 6 years ]
  2. Parts 1 and 2: Progression free survival (PFS) blinded independent central review (BICR) [ Time Frame: Up to 6 years ]
  3. Parts 1 and 2: Objective response rate (ORR) - BICR and Investigator assessment [ Time Frame: Up to 6 years ]
  4. Parts 1 and 2: Duration of response (DOR) - BICR and Investigator assessment [ Time Frame: Up to 6 years ]
  5. Parts 1 and 2: Disease control rate (DCR) - BICR and Investigator assessment [ Time Frame: Up to 6 years ]
  6. Parts 1 and 2: Patient-reported outcomes (PROs) in the European Quality of Life scale, 5-Dimensions, 5-Levels (EQ-5D-5L) [ Time Frame: Up to 6 years ]
    EQ-5D-5L is a validated questionnaire to assess the overall health-related quality of life in participants across diseases.

  7. Parts 1 and 2: PROs in the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30 [Core]) [ Time Frame: Up to 6 years ]
    EORTC QLQ-C30 is validated questionnaire to assess overall health-related quality of life in participants with cancer.

  8. Parts 1 and 2: PROs in the EORTC Quality of Life Questionnaire (Endometrial Cancer Module [QLQ-EN24]) [ Time Frame: Up to 6 years ]
    EORTC QLQ-EN24 is a validated questionnaire to assess the overall health-related quality of life in participants with all stages of endometrial cancer.

  9. Parts 1 and 2: Progression-free survival 2 (PFS2) [ Time Frame: Up to 6 years ]
  10. Parts 1 and 2: Number of participants with adverse events (AEs), Serious adverse events (SAEs) and treatment-emergent adverse events (TEAEs) [ Time Frame: Up to 6 years ]
  11. Parts 1 and 2: Number of participants with clinically significant changes in clinical laboratory parameters, physical examination, electrocardiogram (ECG) and participants reporting the intake of concomitant medication [ Time Frame: Up to 6 years ]
  12. Parts 1 and 2: Change from Baseline in vital sign: Diastolic Blood Pressure (DBP) and Systolic Blood Pressure (SBP) (Millimeters of mercury) [ Time Frame: Baseline and up to 6 Years ]
  13. Parts 1 and 2: Change from Baseline in vital sign: Heart Rate [ Time Frame: Baseline and up to 6 Years ]
  14. Parts 1 and 2: Change from Baseline in vital sign: Respiratory rate [ Time Frame: Baseline and up to 6 Years ]
  15. Parts 1 and 2: Change from Baseline in vital sign: Body temperature [ Time Frame: Baseline and up to 6 Years ]
  16. Parts 1 and 2: Number of participants with Eastern Cooperative Oncology Group (ECOG) Performance Status Scores [ Time Frame: Up to 6 years ]
    Performance status will be assessed using the ECOG scale, with status score ranging from 0 to 5.

  17. Parts 1 and 2: Minimum observed concentration (Cmin) and maximum observed concentration (Cmax) of dostarlimab (micrograms per milliliter) [ Time Frame: Predose (Day 1) and postdose (Day 1) of Cycles 1, 2, 6, 7, 10, 15, and 20 (Cycle 1, 2, 6 is 21 days and Cycle 7, 10, 15, 20 is 42 days) ]
  18. Parts 1 and 2: Cmin and Cmax at steady state of dostarlimab (micrograms per milliliter) [ Time Frame: Predose (Day 1) and postdose (Day 1) of Cycles 1, 2, 6, 7, 10, 15, and 20 (Cycle 1, 2, 6 is 21 days and Cycle 7, 10, 15, 20 is 42 days) ]
  19. Part 2: Cmin and Cmax of niraparib (nanograms per milliliter) [ Time Frame: Predose (Day 1) and 3 hours postdose (Day 1) of Cycles 7 and 8 and Predose (Day 1) of Cycles 10 and 14 (each cycle is 42 days) ]
  20. Part 2: Cmin and Cmax at steady state of niraparib (nanograms per milliliter) [ Time Frame: Predose (Day 1) and 3 hours postdose (Day 1) of Cycles 7 and 8 and Predose (Day 1) of Cycles 10 and 14 (each cycle is 42 days) ]
  21. Parts 1 and 2: Number of participants with anti-drug antibodies (ADA) against dostarlimab [ Time Frame: Predose (Day 1) ]

Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Gender Based Eligibility:   Yes
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Part 1 and Part 2:

  • Female participant is at least 18 years of age.
  • Participant has histologically or cytologically proven endometrial cancer with recurrent or advanced disease.

  • Participant must have primary Stage III or Stage IV disease or first recurrent endometrial cancer with a low potential for cure by radiation therapy or surgery alone or in combination and meet at least one of the following criteria;

    1. Participant has primary Stage IIIA to IIIC1 disease with presence of evaluable or measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) version (v).1.1 based on Investigator's assessment. Lesions that are equivocal or can be representative of post-operative change should be biopsied and confirmed for the presence of tumor;
    2. Participant has primary Stage IIIC1 disease with carcinosarcoma, clear cell, serous, or mixed histology (containing greater than or equal to [>=] 10 percent carcinosarcoma, clear cell, or serous histology) regardless of presence of evaluable or measurable disease on imaging;
    3. Participant has primary Stage IIIC2 or Stage IV disease regardless of the presence of evaluable or measurable disease;
    4. Participant has first recurrent disease and is naïve to systemic anticancer therapy;
    5. Participant has received prior neo-adjuvant/adjuvant systemic anticancer therapy and had a recurrence or progression of disease (PD) >=6 months after completing treatment (first recurrence only).
  • Participant has an ECOG performance status of 0 or 1.
  • Participant has adequate organ function.

Part 2 only:

  • Participants must have normal blood pressure (BP) or adequately treated and controlled hypertension (systolic BP lesser than or equal to [<=] 140 millimeter of mercury [mmHg] and diastolic BP <=90 mmHg).
  • Participants must be able to take medication orally, by mouth (PO).

Exclusion Criteria:

Part 1 and Part 2:

  • Participant has received neo-adjuvant/adjuvant systemic anticancer therapy for primary Stage III or IV disease and:

    1. has not had a recurrence or PD prior to first dose on the study OR
    2. has had a recurrence or PD within 6 months of completing systemic anticancer therapy treatment prior to first dose on the study.
  • Participant has had >1 recurrence of endometrial cancer.
  • Participant has received prior therapy with an anti-programmed cell death protein 1 (anti-PD-1), anti-PD-ligand 1 (anti-PD-L1), or anti-PD-ligand 2 (anti-PD-L2) agent.
  • Participant has received prior anticancer therapy (chemotherapy, targeted therapies, hormonal therapy, radiotherapy, or immunotherapy) within 21 days or <5 times the half-life of the most recent therapy prior to Study Day 1, whichever is shorter.
  • Participant has a concomitant malignancy, or participant has a prior non-endometrial invasive malignancy who has been disease-free for <3 years or who received any active treatment in the last 3 years for that malignancy. Non-melanoma skin cancer is allowed.
  • Participant has known uncontrolled central nervous system metastases, carcinomatosis meningitis, or both.
  • Participant has not recovered (that is [i.e.], to Grade <=1 or to Baseline) from cytotoxic therapy induced AEs or has received transfusion of blood products (including platelets or red blood cells) or administration of colony-stimulating factors (including granulocyte colony-stimulating factor [G-CSF], granulocyte macrophage colony-stimulating factor [GM-CSF], or recombinant erythropoietin) within 21 days prior to the first dose of study drug.
  • Participant has not recovered adequately from AEs or complications from any major surgery prior to starting therapy.
  • Participant is currently participating and receiving study treatment or has participated in a study of an investigational agent and received study treatment or used an investigational device within 4 weeks of the first dose of treatment.
  • Participant is considered a poor medical risk due to a serious, uncontrolled medical disorder, nonmalignant systemic disease, or active infection requiring systemic therapy.
  • Participant has received, or is scheduled to receive, a live vaccine within 30 days before first dose of study treatment, during study treatment, and for up to 180 days after receiving the last dose of study treatment.

Part 2 only:

  • Participant has received prior therapy with a poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitor.
  • Participant has clinically significant cardiovascular disease.
  • Participant has any known history or current diagnosis of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML).
  • Participant is at increased bleeding risk due to concurrent conditions.
  • Participant has participated in Part 1 of this study
Contacts and Locations
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Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03981796


Locations
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Sponsors and Collaborators
Tesaro, Inc.
European Network of Gynaecological Oncological Trial Groups (ENGOT)
GOG Foundation
Investigators
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Study Director: GSK Clinical Trials GlaxoSmithKline
More Information
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Publications:

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Responsible Party: Tesaro, Inc.
ClinicalTrials.gov Identifier: NCT03981796    
Other Study ID Numbers: 213361
ENGOT-EN6 ( Other Identifier: ENGOT )
GOG-3031 ( Other Identifier: GOG )
4010-03-001 ( Other Identifier: Tesaro )
First Posted: June 11, 2019    Key Record Dates
Last Update Posted: August 14, 2023
Last Verified: August 2023
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Tesaro, Inc.:
Dostarlimab
Carboplatin
Paclitaxel
 Niraparib
Recurrent or primary advanced endometrial cancer
TSR-042
Additional relevant MeSH terms:
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Endometrial Neoplasms
Uterine Neoplasms
Genital Neoplasms, Female
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Uterine Diseases
Genital Diseases, Female
Female Urogenital Diseases
Female Urogenital Diseases and Pregnancy Complications
Urogenital Diseases
Genital Diseases
 Paclitaxel
Carboplatin
Niraparib
Dostarlimab
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Poly(ADP-ribose) Polymerase Inhibitors
Enzyme Inhibitors