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Study of the Effect of Intravenous AVE0005 (VEGF Trap) in Advanced Ovarian Cancer Patients With Recurrent Symptomatic Malignant Ascites

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT00327444
Recruitment Status : Completed
First Posted : May 18, 2006
Results First Posted : January 1, 2013
Last Update Posted : January 1, 2013
Sponsor:
Collaborator:
Regeneron Pharmaceuticals
Information provided by (Responsible Party):
Sanofi

Study Type Interventional
Study Design Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Double (Participant, Investigator);   Primary Purpose: Treatment
Conditions Ovarian Neoplasms
Ascites
Interventions Drug: aflibercept (ziv-aflibercept, AVE0005, VEGF trap, ZALTRAP®)
Drug: Placebo
Enrollment 58
Recruitment Details Fifty-eight (58) participants from a total of 23 sites in 7 countries were enrolled in the study.
Pre-assignment Details 55 were randomized (started population). 3 participants were not randomized but they were treated, and permanently withdrawn from the study due to disease progression (1 participant), fatal disease progression (1 participant) and a treatment emergent adverse event (1 participant).
Arm/Group Title Placebo Aflibercept
Hide Arm/Group Description Participants with advanced ovarian cancer administered placebo intravenously, once every two weeks in the DB period and 4.0 mg/kg aflibercept intravenously, once every two weeks in the OL period. Participants with advanced ovarian cancer administered 4.0 mg/kg aflibercept intravenously, once every two weeks in the DB period and the OL period.
Period Title: Double Blind Treatment (DB) Period
Started 26 29
SAFETY 25 [1] 30 [2]
Completed 0 0
Not Completed 26 29
Reason Not Completed
Disease progression             10             13
Adverse Event             5             5
Subject request             0             1
Withdrew DB and continued to OL             11             10
[1]
Excludes one participant from the Placebo arm who received aflibercept in error in the DB period.
[2]
Includes 1 from Placebo who received aflibercept in DB period
Period Title: Open Label Treatment (OL) Period
Started 11 10
ONGOING TREATMENT 1 0
Completed 0 [1] 0 [1]
Not Completed 11 10
Reason Not Completed
Disease progression             8             7
Adverse Event             2             2
Worsening dyspnea             0             1
Ongoing Treatment             1             0
[1]
All participants were treated till they met treatment discontinuation criteria
Arm/Group Title Placebo Aflibercept Total
Hide Arm/Group Description Participants with advanced ovarian cancer administered placebo intravenously, once every two weeks in the DB period and 4.0 mg/kg aflibercept intravenously, once every two weeks in the OL period. Participants with advanced ovarian cancer administered 4.0 mg/kg aflibercept intravenously, once every two weeks in the DB period and the OL period. Total of all reporting groups
Overall Number of Baseline Participants 26 29 55
Hide Baseline Analysis Population Description
[Not Specified]
Age, Customized   [1] 
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 26 participants 29 participants 55 participants
< 35 years 0 1 1
>=35 to <45 years 5 1 6
>=45 to <55 years 10 7 17
>=55 to <65 years 4 11 15
>=65 to <75 years 6 7 13
>=75 years 1 2 3
[1]
Measure Description: Baseline characteristics are reported for the randomized population
Sex: Female, Male  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 26 participants 29 participants 55 participants
Female
26
 100.0%
29
 100.0%
55
 100.0%
Male
0
   0.0%
0
   0.0%
0
   0.0%
Race/Ethnicity, Customized  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 26 participants 29 participants 55 participants
Caucasian 19 22 41
Black 1 0 1
Asian, Oriental 6 7 13
1.Primary Outcome
Title Time to Repeat Paracentesis (TRP)
Hide Description

TRP was defined as the number of days between the date of randomization and the date of the first post-randomization paracentesis.

For participants who did not undergo a postrandomization paracentesis on study, TRP was calculated from randomization to the end of the double-blind treatment period.

Time Frame From Day 1 up to 6 months from randomization
Hide Outcome Measure Data
Hide Analysis Population Description
The intent-to-treat (ITT) population - all participants who were randomized in the study.
Arm/Group Title Placebo Aflibercept
Hide Arm/Group Description:
Participants with advanced ovarian cancer administered placebo intravenously, once every two weeks in the DB period and 4.0 mg/kg aflibercept intravenously, once every two weeks in the OL period.
Participants with advanced ovarian cancer administered 4.0 mg/kg aflibercept intravenously, once every two weeks in the DB period and the OL period.
Overall Number of Participants Analyzed 26 29
Least Squares Mean (Standard Error)
Unit of Measure: days
23.3  (7.70) 55.1  (7.25)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Aflibercept
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0019
Comments Estimated using Wilcoxon rank-sum test with stratification of baseline paracentesis (=<2 weeks versus >2 weeks) at randomization.
Method ANOVA
Comments Estimated from ANOVA model with stratification of baseline paracentesis (=<2 weeks versus >2 weeks).
Method of Estimation Estimation Parameter Least squares (LS) Mean difference
Estimated Value 31.8
Confidence Interval (2-Sided) 95%
10.56 to 53.05
Parameter Dispersion
Type: Standard Error of the mean
Value: 10.59
Estimation Comments The LS mean difference is estimated for aflibercept versus placebo (aflibercept-placebo).
2.Secondary Outcome
Title Area Under the Curve (AUC) for Participant Assessed Ascites Impact Measure (AIM)
Hide Description

AIM 4 symptoms (abdominal discomfort, abdominal bloating, abdominal pain, and ability to move normally) are scored from 0 to 5, where higher scores represent worst outcomes. An AIM total score ranges from 0-20.

A plot for (The AIM questionnaire total score - Baseline score) versus time were generated. AIM AUC represents the overall improvement (scored positive) if the area is below the baseline value or worsening (scored negative) if the area is above the baseline. AIM AUC for a participant is the sum of individual areas representing improvement (+) or worsening (-).

Time Frame From Day 1 up to 60 days from randomization to the first postrandomization paracentesis
Hide Outcome Measure Data
Hide Analysis Population Description
The intent-to-treat (ITT) population - all participants who were randomized in the study, and had evaluable AIM scores.
Arm/Group Title Placebo Aflibercept
Hide Arm/Group Description:
Participants with advanced ovarian cancer administered placebo intravenously, once every two weeks in the DB period and 4.0 mg/kg aflibercept intravenously, once every two weeks in the OL period.
Participants with advanced ovarian cancer administered 4.0 mg/kg aflibercept intravenously, once every two weeks in the DB period and the OL period.
Overall Number of Participants Analyzed 15 16
Least Squares Mean (Standard Error)
Unit of Measure: (units on a 4-symptom scale)*day
29.8  (148.07) 405.3  (143.21)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Aflibercept
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0160
Comments Estimated using Wilcoxon rank-sum test with stratification of baseline paracentesis (=<2 weeks versus >2 weeks) at randomization.
Method ANOVA
Comments Estimated from ANOVA model with stratification of baseline paracentesis (=<2 weeks versus >2 weeks).
Method of Estimation Estimation Parameter Least squares (LS) Mean difference
Estimated Value 375.5
Confidence Interval (2-Sided) 95%
-46.48 to 797.42
Parameter Dispersion
Type: Standard Error of the mean
Value: 205.99
Estimation Comments The LS mean difference was estimated for aflibercept versus placebo (aflibercept-placebo).
3.Secondary Outcome
Title 60-Day Frequency of Paracentesis (FOP)
Hide Description 60-Day FOP was defined as the total number of paracenteses performed within the first 60 days after randomization during the double blind treatment period.
Time Frame From Day 1 up to 60 days from randomization
Hide Outcome Measure Data
Hide Analysis Population Description
The intent-to-treat (ITT) population - all participants who were randomized in the study.
Arm/Group Title Placebo Aflibercept
Hide Arm/Group Description:
Participants with advanced ovarian cancer administered placebo intravenously, once every two weeks in the DB period and 4.0 mg/kg aflibercept intravenously, once every two weeks in the OL period.
Participants with advanced ovarian cancer administered 4.0 mg/kg aflibercept intravenously, once every two weeks in the DB period and the OL period.
Overall Number of Participants Analyzed 26 29
Least Squares Mean (Standard Error)
Unit of Measure: paracentesis
5.1  (0.69) 2.7  (0.65)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Aflibercept
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0035
Comments Estimated using Wilcoxon rank-sum test with stratification of baseline paracentesis (=<2 weeks versus >2 weeks) at randomization.
Method ANOVA
Comments Estimated from ANOVA model with stratification of baseline paracentesis (=<2 weeks versus >2 weeks).
Method of Estimation Estimation Parameter Least squares (LS) Mean difference
Estimated Value -2.4
Confidence Interval (2-Sided) 95%
-4.33 to -0.54
Parameter Dispersion
Type: Standard Error of the mean
Value: 0.94
Estimation Comments The LS mean difference is estimated for aflibercept versus placebo (aflibercept-placebo).
4.Secondary Outcome
Title Plasma Levels of Free and VEGF-bound Aflibercept
Hide Description

Free aflibercept and VEGF-bound aflibercept plasma concentrations were measured by separate enzyme-linked immunosorbent assay (ELISA). The limit of quantitation of free aflibercept was 15.6 ng/mL, and of VEGF-bound aflibercept was 43.9 ng/mL.

Peak free aflibercept was estimated at the end of Cycle 1 (C1) administration. The median free and VEGF-bound trough concentrations were determined for each participant beyond Cycle 3 (C3), then mean values were estimated from these median values.

Time Frame Following every biweekly treatment administration up to 60 days after treatment discontinuation
Hide Outcome Measure Data
Hide Analysis Population Description
The analysis was performed using the safety population with evaluable blood samples. 42 participants were evaluated.
Arm/Group Title Double Blind (DB) Period Open-Label (OL) Period
Hide Arm/Group Description:
Participants with advanced ovarian cancer administered placebo or 4.0 mg/kg aflibercept intravenously, once every two weeks in the DB period.
Participants with advanced ovarian cancer administered 4.0 mg/kg aflibercept intravenously, once every two weeks in the OL period.
Overall Number of Participants Analyzed 30 21
Mean (Standard Deviation)
Unit of Measure: μg/mL
Peak Free Aflibercept (C1) (N=20, N=15) 69.8  (29.7) 62.1  (29.5)
Trough Free Aflibercept (Beyond C3) (N=15, N=19) 5.33  (3.67) 5.10  (5.29)
Trough Bound Aflibercept (Beyond C3) (N=16, N=17) 3.02  (1.29) 3.49  (1.48)
Time Frame From treatment initiation to October 30, 2009
Adverse Event Reporting Description Adverse events were collected and reported per arm only as there was no washout period between the double-blind and open label treatment periods.
 
Arm/Group Title Placebo Aflibercept
Hide Arm/Group Description Participants with advanced ovarian cancer administered placebo intravenously, once every two weeks in the DB period and 4.0 mg/kg aflibercept intravenously, once every two weeks in the OL period. Participants with advanced ovarian cancer administered 4.0 mg/kg aflibercept intravenously, once every two weeks in the DB period and the OL period.
All-Cause Mortality
Placebo Aflibercept
Affected / at Risk (%) Affected / at Risk (%)
Total   --/--   --/-- 
Hide Serious Adverse Events
Placebo Aflibercept
Affected / at Risk (%) Affected / at Risk (%)
Total   18/25 (72.00%)   27/30 (90.00%) 
Blood and lymphatic system disorders     
Anaemia  1/25 (4.00%)  0/30 (0.00%) 
Febrile neutropenia  1/25 (4.00%)  0/30 (0.00%) 
Pancytopenia  1/25 (4.00%)  0/30 (0.00%) 
Cardiac disorders     
Cardiopulmonary failure  0/25 (0.00%)  1/30 (3.33%) 
Pericardial effusion  1/25 (4.00%)  0/30 (0.00%) 
Gastrointestinal disorders     
Abdominal pain  0/25 (0.00%)  3/30 (10.00%) 
Ascites  2/25 (8.00%)  1/30 (3.33%) 
Colonic fistula  1/25 (4.00%)  0/30 (0.00%) 
Diarrhoea  0/25 (0.00%)  2/30 (6.67%) 
Gastric ulcer haemorrhage  1/25 (4.00%)  0/30 (0.00%) 
Intestinal obstruction  2/25 (8.00%)  0/30 (0.00%) 
Intestinal perforation  0/25 (0.00%)  1/30 (3.33%) 
Large intestinal obstruction  0/25 (0.00%)  1/30 (3.33%) 
Large intestine perforation  0/25 (0.00%)  1/30 (3.33%) 
Nausea  0/25 (0.00%)  2/30 (6.67%) 
Obstruction gastric  0/25 (0.00%)  1/30 (3.33%) 
Small intestinal obstruction  1/25 (4.00%)  3/30 (10.00%) 
Small intestinal perforation  0/25 (0.00%)  1/30 (3.33%) 
Vomiting  3/25 (12.00%)  6/30 (20.00%) 
General disorders     
Asthenia  0/25 (0.00%)  1/30 (3.33%) 
Death  0/25 (0.00%)  1/30 (3.33%) 
Disease progression  8/25 (32.00%)  10/30 (33.33%) 
Fatigue  2/25 (8.00%)  0/30 (0.00%) 
Multi-organ failure  1/25 (4.00%)  0/30 (0.00%) 
Oedema peripheral  1/25 (4.00%)  0/30 (0.00%) 
Pain  0/25 (0.00%)  1/30 (3.33%) 
Pyrexia  1/25 (4.00%)  0/30 (0.00%) 
Hepatobiliary disorders     
Bile duct obstruction  0/25 (0.00%)  1/30 (3.33%) 
Infections and infestations     
Abscess  1/25 (4.00%)  0/30 (0.00%) 
Fungal skin infection  0/25 (0.00%)  1/30 (3.33%) 
Pneumonia  0/25 (0.00%)  1/30 (3.33%) 
Sepsis  1/25 (4.00%)  1/30 (3.33%) 
Upper respiratory tract infection  0/25 (0.00%)  1/30 (3.33%) 
Injury, poisoning and procedural complications     
Hip fracture  1/25 (4.00%)  0/30 (0.00%) 
Investigations     
Blood electrolytes abnormal  0/25 (0.00%)  1/30 (3.33%) 
Metabolism and nutrition disorders     
Anorexia  1/25 (4.00%)  0/30 (0.00%) 
Dehydration  4/25 (16.00%)  4/30 (13.33%) 
Failure to thrive  0/25 (0.00%)  1/30 (3.33%) 
Hypoglycaemia  1/25 (4.00%)  0/30 (0.00%) 
Nervous system disorders     
Headache  0/25 (0.00%)  1/30 (3.33%) 
Psychiatric disorders     
Confusional state  0/25 (0.00%)  1/30 (3.33%) 
Renal and urinary disorders     
Renal failure acute  1/25 (4.00%)  0/30 (0.00%) 
Respiratory, thoracic and mediastinal disorders     
Aspiration  1/25 (4.00%)  0/30 (0.00%) 
Dyspnoea  1/25 (4.00%)  6/30 (20.00%) 
Pleural effusion  0/25 (0.00%)  1/30 (3.33%) 
Pleuritic pain  0/25 (0.00%)  1/30 (3.33%) 
Pneumonia aspiration  0/25 (0.00%)  1/30 (3.33%) 
Pulmonary embolism  0/25 (0.00%)  1/30 (3.33%) 
Respiratory distress  2/25 (8.00%)  1/30 (3.33%) 
Vascular disorders     
Hypertension  0/25 (0.00%)  1/30 (3.33%) 
Hypotension  0/25 (0.00%)  1/30 (3.33%) 
1
Term from vocabulary, MedDRA 12.0
Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 5%
Placebo Aflibercept
Affected / at Risk (%) Affected / at Risk (%)
Total   22/25 (88.00%)   28/30 (93.33%) 
Blood and lymphatic system disorders     
Anaemia  4/25 (16.00%)  3/30 (10.00%) 
Cardiac disorders     
Tachycardia  1/25 (4.00%)  2/30 (6.67%) 
Gastrointestinal disorders     
Abdominal distension  2/25 (8.00%)  5/30 (16.67%) 
Abdominal pain  5/25 (20.00%)  5/30 (16.67%) 
Abdominal pain upper  1/25 (4.00%)  6/30 (20.00%) 
Constipation  3/25 (12.00%)  5/30 (16.67%) 
Diarrhoea  5/25 (20.00%)  12/30 (40.00%) 
Dyspepsia  2/25 (8.00%)  5/30 (16.67%) 
Nausea  9/25 (36.00%)  11/30 (36.67%) 
Oral pain  0/25 (0.00%)  2/30 (6.67%) 
Stomatitis  2/25 (8.00%)  1/30 (3.33%) 
Vomiting  13/25 (52.00%)  19/30 (63.33%) 
General disorders     
Asthenia  3/25 (12.00%)  7/30 (23.33%) 
Chest pain  0/25 (0.00%)  2/30 (6.67%) 
Fatigue  14/25 (56.00%)  10/30 (33.33%) 
Gait disturbance  1/25 (4.00%)  2/30 (6.67%) 
Mucosal inflammation  0/25 (0.00%)  2/30 (6.67%) 
Oedema peripheral  10/25 (40.00%)  11/30 (36.67%) 
Pyrexia  2/25 (8.00%)  3/30 (10.00%) 
Infections and infestations     
Nasopharyngitis  0/25 (0.00%)  2/30 (6.67%) 
Pneumonia  0/25 (0.00%)  3/30 (10.00%) 
Upper respiratory tract infection  0/25 (0.00%)  2/30 (6.67%) 
Urinary tract infection  4/25 (16.00%)  1/30 (3.33%) 
Investigations     
Weight decreased  0/25 (0.00%)  5/30 (16.67%) 
Metabolism and nutrition disorders     
Anorexia  9/25 (36.00%)  8/30 (26.67%) 
Dehydration  2/25 (8.00%)  4/30 (13.33%) 
Hypoalbuminaemia  1/25 (4.00%)  2/30 (6.67%) 
Hypocalcaemia  0/25 (0.00%)  3/30 (10.00%) 
Hypomagnesaemia  0/25 (0.00%)  2/30 (6.67%) 
Hyponatraemia  2/25 (8.00%)  2/30 (6.67%) 
Musculoskeletal and connective tissue disorders     
Arthralgia  3/25 (12.00%)  0/30 (0.00%) 
Back pain  4/25 (16.00%)  7/30 (23.33%) 
Muscle spasms  2/25 (8.00%)  3/30 (10.00%) 
Muscular weakness  2/25 (8.00%)  3/30 (10.00%) 
Myalgia  3/25 (12.00%)  2/30 (6.67%) 
Pain in extremity  2/25 (8.00%)  2/30 (6.67%) 
Nervous system disorders     
Dizziness  1/25 (4.00%)  2/30 (6.67%) 
Dysgeusia  1/25 (4.00%)  2/30 (6.67%) 
Headache  1/25 (4.00%)  7/30 (23.33%) 
Psychiatric disorders     
Confusional state  0/25 (0.00%)  2/30 (6.67%) 
Insomnia  0/25 (0.00%)  2/30 (6.67%) 
Renal and urinary disorders     
Dysuria  2/25 (8.00%)  1/30 (3.33%) 
Pollakiuria  0/25 (0.00%)  3/30 (10.00%) 
Proteinuria  1/25 (4.00%)  4/30 (13.33%) 
Respiratory, thoracic and mediastinal disorders     
Cough  3/25 (12.00%)  8/30 (26.67%) 
Dysphonia  1/25 (4.00%)  7/30 (23.33%) 
Dyspnoea  9/25 (36.00%)  6/30 (20.00%) 
Dyspnoea exertional  0/25 (0.00%)  3/30 (10.00%) 
Epistaxis  0/25 (0.00%)  2/30 (6.67%) 
Oropharyngeal pain  0/25 (0.00%)  3/30 (10.00%) 
Skin and subcutaneous tissue disorders     
Palmar-plantar erythrodysaesthesia syndrome  0/25 (0.00%)  2/30 (6.67%) 
Petechiae  0/25 (0.00%)  2/30 (6.67%) 
Pruritus  0/25 (0.00%)  3/30 (10.00%) 
Rash  2/25 (8.00%)  4/30 (13.33%) 
Vascular disorders     
Hypertension  3/25 (12.00%)  4/30 (13.33%) 
Hypotension  2/25 (8.00%)  2/30 (6.67%) 
1
Term from vocabulary, MedDRA 12.0
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
The investigator shall have the right to independently publish study results from his site after a multicenter publication, or 12 months after the completion of the study by all sites. He must provide the sponsor a copy of any such publication derived from the study for review and comment at least 45 days (20 days) in advance of any submission, and delay publication till the approval of the publication is given in writing by the Sponsor (not to exceed ninety days).
Results Point of Contact
Layout table for Results Point of Contact information
Name/Title: Trial Transparency Team
Organization: Sanofi
EMail: Contact-Us@sanofi.com
Layout table for additonal information
Responsible Party: Sanofi
ClinicalTrials.gov Identifier: NCT00327444    
Other Study ID Numbers: EFC6125
EudraCT : 2005-005026-31
AVE0005A /3001
First Submitted: May 16, 2006
First Posted: May 18, 2006
Results First Submitted: August 17, 2012
Results First Posted: January 1, 2013
Last Update Posted: January 1, 2013