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 combining the PARP inhibitor senaparib with low‑dose temozolomide (TMZ) in ARID1A‑mutation–associated clear cell or endometrioid ovarian cancers, using objective response rate per RECIST v1.1.

Patients: Adult women (≥18 years) with recurrent or persistent clear cell or endometrioid ovarian, fallopian tube, or primary peritoneal carcinoma with ≥50% clear cell or endometrioid histology, harboring pathogenic or likely pathogenic ARID1A variants confirmed by next‑generation sequencing. All patients must have measurable disease and have received at least two prior cytotoxic regimens or have platinum‑resistant/refractory disease, with no more than three prior cytotoxic lines; prior targeted, hormonal, immunotherapy, or antiangiogenic therapy permitted. Key exclusions include prior PARP inhibitor or temozolomide, unresolved ≥grade 2 toxicities, history of myeloid malignancy or cytogenetic features of MDS/MPN, bowel obstruction, significant uncontrolled comorbidities, pregnancy/lactation, untreated brain metastases, and strong CYP3A4 inhibitors/inducers during therapy.

Design: Single‑arm, two‑stage, non‑randomized, multicenter phase 2 study enrolling up to 18 patients. Tumor assessments every 8 weeks for the first three cycles, then every 12 weeks until confirmed progression. Treatment continues until progression, unacceptable toxicity, or withdrawal.

Treatments: Senaparib 80 mg orally once daily on Days 1–28 plus temozolomide 20 mg orally once daily on Days 1–21 of each 28‑day cycle. Senaparib is an oral PARP1/2 inhibitor that impairs base‑excision repair and induces synthetic lethality in tumors with homologous recombination repair defects. It has shown significant progression‑free survival benefit as first‑line maintenance in advanced ovarian cancer in a randomized phase 3 study and demonstrated antitumor activity across solid tumors in early‑phase studies. The senaparib plus low‑dose temozolomide combination has an established RP2D from a relapsed SCLC phase Ib/II study, with modest response rates and manageable hematologic toxicity, supporting exploration in ARID1A‑mutated ovarian cancer where DNA repair vulnerabilities may be exploitable.

Outcomes: Primary: Objective response rate (CR+PR) by RECIST v1.1, estimated with binomial methods and 95% Clopper‑Pearson confidence intervals. Secondary: Safety and tolerability per CTCAE v5.0, including frequency and severity of adverse events and serious adverse events, and summary of grade 3–4 treatment‑related adverse events.

Burden on patient: Moderate. The regimen is fully oral, which reduces infusion‑center visits, but requires daily adherence and periodic monitoring for hematologic toxicity typical of PARP inhibitors and temozolomide. Imaging is performed every 8 weeks initially then every 12 weeks, comparable to common practice in recurrent ovarian cancer. No pharmacokinetic or mandatory biopsy procedures are specified, limiting additional procedures. However, frequent labs early in treatment are anticipated to monitor for anemia, neutropenia, and thrombocytopenia, and there are contraception requirements and medication restrictions related to CYP3A4 interactions, adding some logistical burden and counseling needs.

Last updated: Oct 2025

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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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