A Phase II, Open-Label, Multicenter Study to Evaluate the Effect of Tumor-Based HER2 Activation on the Efficacy of rhuMAb 2C4 (Pertuzumab) in Subjects With Advanced, Refractory or Recurrent Ovarian Cancer
Inclusion Criteria:
- Signed informed consent
- Willingness to undergo tumor biopsy and disease that is amenable to biopsy (Cohort 1
only)
- Age >=18 years old
- Advanced, histologically documented carcinoma of the ovary
- Measurable disease with at least one lesion that can be accurately measured per
RECIST in at least one dimension (longest dimension recorded). Each lesion must be
>=20 mm when measured by conventional techniques, including palpation, plain X-ray,
CT, and MRI, or >=10 mm when measured by spiral CT.
- Or, clinically or radiologically detectable disease (e.g., ascites, peritoneal
deposits, mesenteric thickening or lesions that do not fulfill RECIST for measurable
disease). In addition, the subject must have two consecutive pre-treatment CA 125
levels that are both greater than 2× the institutional upper limit of normal (ULN)
and >=40 IU/mL, taken at least 1 week and not more than 3 months apart. The second
of the two measurements of CA 125 level should not be drawn within 28 days following
the screening biopsy. The later value must be within 2 weeks of starting rhuMAb 2C4
treatment.
- One or more prior platinum-based chemotherapeutic regimens for the management of
primary disease containing carboplatin, cisplatin, or another organoplatinum compound
- Life expectancy >=12 weeks
- ECOG performance status 0 or 1
- Use of an effective means of contraception (for women of childbearing potential)
- Granulocyte count >=1500/uL, platelet count of >=75,000/uL, and hemoglobin >=9 g/dL
(hemoglobin may be supported by transfusion or erythropoietin or other approved
hematopoietic growth factors; darbopoeitin [Aranesp] is permitted)
- Serum bilirubin <=1.5× the ULN and alkaline phosphatase, AST, and ALT <=2.5× ULN
(ALT, AST, and alkaline phosphatase <=5× ULN for subjects with liver metastases)
- Serum creatinine <=1.5× ULN
- International normalized ratio (INR) <1.5 and activated partial thromboplastin time
(aPTT) <1.5 ULN (except for subjects receiving warfarin)
Exclusion Criteria:
- Prior treatment with experimental anti-cancer agents within 4 weeks prior to Day 1
(the day on which the first rhuMAb 2C4 infusion is administered)
- Prior treatment with HER pathway inhibitors (e.g., Herceptin [Trastuzumab], Iressa
[gefitinib], Tarceva [erlotinib hydrochloride], C225, CI1033, and TAK165)
- History or clinical evidence of central nervous system or brain metastases
- Ejection fraction, determined by ECHO, <50%
- Uncontrolled hypercalcemia (>11.5 mg/dL)
- Prior exposure to doxorubicin or liposomal doxorubicin >360 mg/m2 , mitoxantrone >120
mg/m2 , or idarubicin >90 mg/m2
- History of other malignancies within 5 years of Day 1 except for adequately treated
carcinoma in situ of the cervix, ductal carcinoma in situ of the breast, or basal or
squamous cell skin cancer
- History of serious systemic disease, including active infection, uncontrolled
hypertension (diastolic blood pressure >100 mmHg on two consecutive occasions),
unstable angina, congestive heart failure, or myocardial infarction within 6 months
prior to Day 1, or unstable symptomatic arrhythmia requiring medication (subjects
with chronic atrial arrhythmia, i.e., atrial fibrillation, paroxysmal
supraventricular tachycardia, or controlled hypertension are eligible)
- Ongoing liver disease, including viral or other hepatitis, current alcohol abuse, or
cirrhosis
- Known human immunodeficiency virus infection
- Pregnancy or lactation
- Major surgery or significant traumatic injury within 3 weeks prior to Day 1 with the
exception of tumor biopsy for the purposes of the study
- Inability to comply with study and follow-up procedures
- Any other diseases, metabolic dysfunction, physical examination finding, or clinical
laboratory finding giving reasonable suspicion of a disease or condition that
contraindicates the use of an investigational drug or that may affect the
interpretation of the results or render the subject at high risk from treatment
complications