A Phase 2 Study of Senaparib in Combination With Temozolomide in ARID1A Mutation Associated Ovarian Cancer

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Trial Details

Sponsor: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins (other)

Phase: 2

Start date: Feb. 6, 2025

Planned enrollment: 18

Trial ID: NCT06617923
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More trial details at ClinicalTrials.gov More info

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chevron Show for: Senaparib (IMP4297, Paishuning)

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Goal: Evaluate the antitumor activity of senaparib plus temozolomide in ARID1A-mutated clear cell or endometrioid ovarian cancers, using objective response rate by RECIST v1.1 as the primary endpoint, and characterize safety and tolerability.

Patients: Adult females (≥18 years) with recurrent or persistent clear cell or endometrioid ovarian, fallopian tube, or primary peritoneal carcinoma, with ≥50% clear cell or endometrioid histology, measurable disease by RECIST v1.1, and a pathogenic/likely pathogenic ARID1A alteration confirmed by qualified NGS. Patients must have received ≥2 prior cytotoxic regimens or have platinum-resistant/refractory disease, with no more than 3 prior cytotoxic lines; prior hormonal, targeted, immunotherapy, or antiangiogenic agents are allowed. Key exclusions include prior PARP inhibitor or temozolomide, active significant comorbidities, unresolved ≥grade 2 toxicities, myeloid malignancy history or MDS/MPN-associated abnormalities, untreated brain metastases, bowel obstruction, pregnancy/lactation, and HIV infection.

Design: Single-arm, two-stage, non-randomized, multicenter phase 2 study. Up to 18 participants will be treated and followed for response and safety. Imaging every 8 weeks for the first 3 cycles, then every 12 weeks until progression is confirmed; treatment continues until progression, unacceptable toxicity, or withdrawal.

Treatments: Senaparib 80 mg orally daily on days 1–28 plus temozolomide 20 mg orally daily on days 1–21 of a 28-day cycle. Senaparib is an oral PARP1/2 inhibitor that impairs base-excision repair, exploiting synthetic lethality in tumors with homologous recombination repair defects and potentially in ARID1A-deficient tumors. It has shown significant progression-free survival benefit as first-line maintenance in advanced ovarian cancer in a randomized phase 3 study and demonstrated manageable hematologic toxicity. In combination with low-dose temozolomide, a recommended phase 2 dose similar to this regimen has been defined in relapsed small cell lung cancer with modest response rates and expected myelosuppression. Temozolomide is an oral alkylating agent with established DNA-damaging activity; at low doses it may synergize with PARP inhibition.

Outcomes: Primary: Objective response rate (CR+PR) by RECIST v1.1 with binomial estimates and 95% CIs. Secondary: Incidence, nature, and severity of adverse events and serious adverse events by CTCAE v5.0, including frequency of grade 3–4 treatment-related events.

Burden on patient: Moderate. The regimen is entirely oral, minimizing infusion visits, but requires adherence to daily dosing and monitoring for myelosuppression. Imaging is relatively frequent early (every 8 weeks for three cycles) then every 12 weeks, similar to standard practice in recurrent disease. Routine clinic visits and labs for counts and chemistry are expected each cycle given PARP inhibitor and temozolomide hematologic risks; no protocol-mandated biopsies or intensive pharmacokinetic sampling are described. Travel burden centers on periodic clinic and imaging appointments; toxicity management may necessitate additional visits for transfusions or dose modifications if cytopenias occur.

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Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Baltimore, Maryland, 21231-2410, United States

[email protected] / 410-955-8804

Status: Recruiting

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