Efficacy and Safety of Olaparib (MK-7339) With or Without Bevacizumab Compared to Bevacizumab With a Fluoropyrimidine in Unresectable or Metastatic Colorectal Cancer (CRC) (MK-7339-003/LYNK-003)
NCT ID: NCT04456699
Last Updated: 2024-10-29
Study Results
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View full resultsBasic Information
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COMPLETED
PHASE3
335 participants
INTERVENTIONAL
2020-08-19
2023-11-06
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Olaparib + bevacizumab
Participants will receive olaparib (300 mg twice daily \[BID\] oral) + Bevacizumab (5 mg/kg intravenous \[IV\] once every 2 weeks \[Q2W\]) until progressive disease or end of study.
Olaparib
300 mg BID, oral until progressive disease or end of study
Bevacizumab
5 mg/kg or 7.5 mg/kg Q2W or Q3W IV infusion until progressive disease or end of study
Olaparib
Participants will receive olaparib (300 mg BID) oral, until progressive disease or end of study.
Olaparib
300 mg BID, oral until progressive disease or end of study
Bevacizumab + chemotherapy
Participants will receive investigator's choice of either bevacizumab (7.5 mg/kg IV once every three weeks (Q3W)) + capecitabine (1000 mg/m\^2 BID for 14 days, then 7 days off, Q3W) or bevacizumab (5 mg/kg IV Q2W) + 5-FU (2400 mg/m2 IV over 46 to 48 hours Q2W; bolus 5-FU (400 mg/m2) can be added prior to infusional 5-FU, per local standards and at the investigator's discretion). Leucovorin or levoleucovorin 400 mg/m\^2 (leucovorin) or 200 mg/m\^2 (levoleucovorin) Q2W IV infusion may be added per investigator's discretion. Treatment will continue until progressive disease or end of study.
5-FU
2400 mg/m\^2 over 46 to 48 hours Q2W IV infusion until disease progression or end of study; bolus 5-FU (400mg/m2) can be added prior to infusional 5-FU, per local standards and at the investigator's discretion
Bevacizumab
5 mg/kg or 7.5 mg/kg Q2W or Q3W IV infusion until progressive disease or end of study
Capecitabine
1000 mg/m\^2 oral capsule BID for 14 days, then 7 days off, Q3W) until progressive disease or end of study
Leucovorin/ levoleucovorin
400 mg/m\^2 (leucovorin) or 200 mg/m\^2 (levoleucovorin) may be added to Bevacizumab + 5-FU per investigator's discretion Q2W IV infusion until progressive disease or end of study
Interventions
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Olaparib
300 mg BID, oral until progressive disease or end of study
5-FU
2400 mg/m\^2 over 46 to 48 hours Q2W IV infusion until disease progression or end of study; bolus 5-FU (400mg/m2) can be added prior to infusional 5-FU, per local standards and at the investigator's discretion
Bevacizumab
5 mg/kg or 7.5 mg/kg Q2W or Q3W IV infusion until progressive disease or end of study
Capecitabine
1000 mg/m\^2 oral capsule BID for 14 days, then 7 days off, Q3W) until progressive disease or end of study
Leucovorin/ levoleucovorin
400 mg/m\^2 (leucovorin) or 200 mg/m\^2 (levoleucovorin) may be added to Bevacizumab + 5-FU per investigator's discretion Q2W IV infusion until progressive disease or end of study
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
2. Has not progressed (ie, achieved a stable disease \[SD\], partial response \[PR\], or complete response \[CR\]) after a first-line induction course of at least 6 cycles of folinic acid/fluorouracil/oxaliplatin (FOLFOX) + bevacizumab or 4 cycles of capecitabine and oxaliplatin (CAPOX) + bevacizumab as first-line therapy.
* Participants must not have received an investigational agent during their induction course.
* Determination of best overall response (SD/PR/CR) will be made by the investigator.
* Non-Progressive Disease (PD) will be verified by BICR prior to randomization based on the images submitted to imaging contract research organization (iCRO) as described in inclusion criterion 4.
* "First-line therapy" is defined as the first systemic chemotherapy regimen given for the diagnosis of unresectable or metastatic colorectal cancer (CRC). Participants may have received prior adjuvant/neoadjuvant chemotherapy for CRC, as long as it was completed at least 6 months prior to initiation of first-line CAPOX + bevacizumab or FOLFOX + bevacizumab induction treatment.
3. Has experienced unacceptable toxicity to oxaliplatin that, in the opinion of the treating physician, requires/required the discontinuation of oxaliplatin. Note: As an example, unacceptable toxicity may include (but is not limited to) severe or prolonged neurotoxicity.
• Participants must be randomized within a minimum of 2 weeks and a maximum of 6 weeks after their last dose of CAPOX + bevacizumab or FOLFOX + bevacizumab (last dose is the day of the last infusion that contained oxaliplatin).
4. Has provided to the iCRO 1 set of baseline radiographic images taken before or during the CAPOX + bevacizumab or FOLFOX + bevacizumab induction period and at least 42 days prior to the imaging performed during Screening. Tumor imaging at Screening must be performed within 28 days prior to the date of randomization.
5. Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 within 10 days prior to randomization.
Exclusion Criteria
2. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable (ie, without evidence of progression for at least 28 days by repeat imaging (note that the repeat imaging should be performed during study screening), clinically stable and without requirement of steroid intervention for at least 14 days prior to first dose of study intervention.
3. Has an active infection requiring systemic therapy.
4. Has a known history of human immunodeficiency virus (HIV) infection. No HIV testing is required unless mandated by local health authority.
5. Has a known history of or is positive for hepatitis B surface antigen (HBsAg reactive) or hepatitis C ribonucleic acid (HCV RNA \[qualitative\]) is detected). Note: No testing for hepatitis B and hepatitis C is required unless mandated by local health authority.
6. Has a known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study.
7. Has myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) or with features suggestive of MDS/AML.
8. Has hemoptysis or hematemesis within 28 days prior to randomization.
9. Has evidence of bleeding diathesis or significant coagulopathy (in the absence of anticoagulation).
10. Has clinically significant bleeding within 28 days prior to randomization.
11. Is considered a poor medical risk due to a serious, uncontrolled medical disorder, nonmalignant systemic disease or active, uncontrolled infection. Examples include, but are not limited to, uncontrolled ventricular arrhythmia, recent (within 3 months) myocardial infarction, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome, extensive interstitial bilateral lung disease on high-resolution computed tomography (HRCT) scan or any psychiatric disorder that prohibits obtaining informed consent.
12. Has 1 or more conditions that, in the opinion of the treating physician, make the participant ineligible for treatment with bevacizumab. These conditions may include:
* Uncontrolled hypertension (systolic blood pressure \[SBP\] \>150 mm Hg or diastolic blood pressure \[DBP\] \>100 mm Hg) or a history of hypertensive crisis or hypertensive encephalopathy
* Arterial thromboembolic events (eg, myocardial infarction, cerebral infarction)
* History of nephrotic syndrome or moderate proteinuria
* History of gastrointestinal perforation
* History of non-gastrointestinal fistula formation
* History of possible reversible encephalopathy syndrome (RPLS)
13. Has received prior systemic anticancer therapy (other than CAPOX + bevacizumab or FOLFOX + bevacizumab induction) including investigational agents within 28 days prior to randomization. Note: Participants must have recovered from all AEs due to previous therapies to ≤Grade 1 or baseline. Participants with persistent alopecia or Grade ≤3 neuropathy are eligible.
14. Has received prior therapy with olaparib or with any other polyadenosine 5'-diphosphoribose polymerase (PARP) inhibitor.
15. Is currently receiving either strong (eg, itraconazole, telithromycin, clarithromycin, protease inhibitors boosted with ritonavir or cobicistat, indinavir, saquinavir, nelfinavir, boceprevir, telaprevir) or moderate (eg, ciprofloxacin, erythromycin, diltiazem, fluconazole, verapamil) inhibitors of cytochrome P450 3A4 (CYP3A4) that cannot be discontinued for the duration of the study. The required washout period prior to randomization is 2 weeks.
16. Is currently receiving either strong (phenobarbital, enzalutamide, phenytoin, rifampicin, rifabutin, rifapentine, carbamazepine, nevirapine and St John's Wort) or moderate (eg. bosentan, efavirenz, modafinil) inducers of CYP3A4 that cannot be discontinued for the duration of the study. The required washout period prior to randomization is 5 weeks for phenobarbital and 3 weeks for other agents.
17. Has undergone major surgery within 2 weeks of randomization or has not recovered adequately from toxicities and/or complications from any major surgery prior to randomization.
18 Years
ALL
No
Sponsors
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AstraZeneca
INDUSTRY
Merck Sharp & Dohme LLC
INDUSTRY
Responsible Party
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Principal Investigators
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Medical Director
Role: STUDY_DIRECTOR
Merck Sharp & Dohme LLC
Locations
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Providence Saint Joseph Medical Center, Disney Family Cancer ( Site 1392)
Burbank, California, United States
St Joseph Heritage Healthcare-Oncology ( Site 1383)
Fullerton, California, United States
UC Health Memorial Hospital ( Site 1401)
Colorado Springs, Colorado, United States
Poudre Valley Health System ( Site 1402)
Fort Collins, Colorado, United States
University Cancer & Blood Center, LLC ( Site 1381)
Athens, Georgia, United States
University of Chicago ( Site 1357)
Chicago, Illinois, United States
Illinois Cancer Care, PC ( Site 1352)
Peoria, Illinois, United States
James Graham Brown Cancer Center ( Site 1393)
Louisville, Kentucky, United States
University Medical Center New Orleans ( Site 1365)
New Orleans, Louisiana, United States
New England Cancer Specialists ( Site 1422)
Scarborough, Maine, United States
Cancer & Hematology Centers of Western Michigan ( Site 1358)
Grand Rapids, Michigan, United States
Hattiesburg Clinic Hematology/Oncology ( Site 1418)
Hattiesburg, Mississippi, United States
Washington University in St. Louis ( Site 1384)
St Louis, Missouri, United States
St. Vincent Frontier Cancer Center-Research ( Site 1414)
Billings, Montana, United States
CHI Health St. Francis ( Site 1406)
Grand Island, Nebraska, United States
Cancer Partners of Nebraska ( Site 1353)
Lincoln, Nebraska, United States
Providence Portland Medical Center ( Site 1400)
Portland, Oregon, United States
Oregon Health & Science University ( Site 1411)
Portland, Oregon, United States
Allegheny Singer Research Institute ( Site 1364)
Pittsburgh, Pennsylvania, United States
West Cancer Center - East Campus ( Site 1396)
Germantown, Tennessee, United States
Vanderbilt University Medical Center ( Site 1362)
Nashville, Tennessee, United States
Baylor Scott & White Medical Center - Temple ( Site 1397)
Temple, Texas, United States
Blue Ridge Cancer Care ( Site 1374)
Roanoke, Virginia, United States
St George Hospital ( Site 0052)
Kogarah, New South Wales, Australia
Liverpool Hospital ( Site 0055)
Liverpool, New South Wales, Australia
Royal Brisbane and Women s Hospital ( Site 0054)
Herston, Queensland, Australia
Queen Elizabeth Hospital ( Site 0053)
Woodville South, South Australia, Australia
Monash Health ( Site 0050)
Clayton, Victoria, Australia
Peninsula Health Frankston Hospital ( Site 0056)
Frankston, Victoria, Australia
Imelda vzw ( Site 0110)
Bonheiden, Antwerpen, Belgium
AZ Klina ( Site 0106)
Brasschaat, Antwerpen, Belgium
UZ Antwerpen ( Site 0108)
Edegem, Antwerpen, Belgium
UCL Saint Luc ( Site 0100)
Brussels, Bruxelles-Capitale, Region de, Belgium
OLV Ziekenhuis ( Site 0109)
Aalst, Oost-Vlaanderen, Belgium
UZ Gent ( Site 0101)
Ghent, Oost-Vlaanderen, Belgium
UZ Gasthuisberg ( Site 0102)
Leuven, Vlaams-Brabant, Belgium
AZ Groeninge ( Site 0105)
Kortrijk, West-Vlaanderen, Belgium
Dr. Everett Chalmers Regional Hospital ( Site 0204)
Fredericton, New Brunswick, Canada
Moncton Hospital - Horizon Health Network ( Site 0201)
Moncton, New Brunswick, Canada
Princess Margaret Cancer Centre ( Site 0209)
Toronto, Ontario, Canada
Hopital Cite de la Sante de Laval ( Site 0203)
Laval, Quebec, Canada
McGill University Health Centre ( Site 0207)
Montreal, Quebec, Canada
CIUSSS de l Estrie - CHUS - Centre Hosp. Univ. Sherbrooke ( Site 0202)
Sherbrooke, Quebec, Canada
Sociedad Oncovida S.A. ( Site 0250)
Santiago, Region M. de Santiago, Chile
Clínica San Carlos de Apoquindo Red Salud UC Christus ( Site 0252)
Santiago, Region M. de Santiago, Chile
Centro Investigación del Cáncer James Lind ( Site 0251)
Temuco, Región de la Araucanía, Chile
Administradora Country SA - Clinica del Country ( Site 0350)
Bogotá, Bogota D.C., Colombia
Instituto Nacional de Cancerologia E.S.E ( Site 0362)
Bogotá, Bogota D.C., Colombia
Sociedad de Oncología Y Hematología del Cesar S.A.S. ( Site 0353)
Valledupar, Cesar Department, Colombia
Oncomedica S.A. ( Site 0352)
Montería, Departamento de Córdoba, Colombia
Oncologos del Occidente ( Site 0364)
Pereira, Risaralda Department, Colombia
Fundacion Cardiovascular de Colombia ( Site 0360)
Bucaramanga, Santander Department, Colombia
Hemato Oncologos S.A. ( Site 0355)
Cali, Valle del Cauca Department, Colombia
Centre Leon Berard ( Site 0459)
Lyon, Auvergne-Rhône-Alpes, France
C.H.U. de Strasbourg Hopital de Hautepierre ( Site 0464)
Strasbourg, Bas-Rhin, France
Institut de Cancerologie de l Ouest Centre Rene Gauducheau ( Site 0455)
Saint-Herblain, Brittany Region, France
CHU Jean Minjoz ( Site 0450)
Besançon, Doubs, France
CHU Bordeaux Haut-Leveque ( Site 0457)
Pessac, Gironde, France
CHU Saint Eloi ( Site 0467)
Montpellier, Herault, France
Hopital Europeen Georges Pompidou ( Site 0452)
Paris, , France
Universitaetsklinikum Ulm ( Site 0500)
Ulm, Baden-Wurttemberg, Germany
St. Josef und St. Elisabeth Hospital gGmbH-Hematology, oncology and palliative medicine ( Site 0503)
Bochum, North Rhine-Westphalia, Germany
Charité Universitaetsmedizin Berlin - Campus Mitte ( Site 0504)
Berlin, , Germany
Facharztzentrum Eppendorf ( Site 0501)
Hamburg, , Germany
Bekes Megyei Kozponti Korhaz - Pandy Kalman Tagkorhaza ( Site 1432)
Gyula, Bekes County, Hungary
Borsod-Abaúj-Zemplén Megyei Központi Kórház és Egyetemi Okta-Klinikai Onkológiai és Sugárterápiás Ce
Miskolc, Borsod-Abauj Zemplen county, Hungary
Debreceni Egyetem Klinikai Kozpont ( Site 1426)
Debrecen, Hajdú-Bihar, Hungary
Jasz Nagykun Szolnok Megyei Hetenyi Geza Korhaz Rendelointezet ( Site 1427)
Szolnok, Jász-Nagykun-Szolnok, Hungary
Zala Megyei Szent Rafael Korhaz ( Site 1429)
Zalaegerszeg, Zala County, Hungary
Orszagos Onkologiai Intezet ( Site 1431)
Budapest, , Hungary
Aichi Cancer Center Hospital ( Site 0658)
Nagoya, Aichi-ken, Japan
National Cancer Center Hospital East ( Site 0650)
Kashiwa, Chiba, Japan
National Hospital Organization Shikoku Cancer Center ( Site 0652)
Matsuyama, Ehime, Japan
St. Marianna University School of Medicine Hospital ( Site 0657)
Kawasaki, Kanagawa, Japan
Saitama Cancer Center ( Site 0653)
Kitaadachi-gun, Saitama, Japan
Shizuoka Cancer Center Hospital and Research Institute ( Site 0655)
Sunto-gun, Shizuoka, Japan
Chiba Cancer Center ( Site 0656)
Chiba, , Japan
National Hospital Organization Kyushu Cancer Center ( Site 0654)
Fukuoka, , Japan
National Cancer Center Hospital ( Site 0651)
Tokyo, , Japan
The Cancer Institute Hospital of JFCR ( Site 0659)
Tokyo, , Japan
Daugavpils Regional Hospital ( Site 1502)
Daugavpils, , Latvia
P. Stradina Clinical University Hospital ( Site 1500)
Riga, , Latvia
Riga East Clinical University Hospital ( Site 1501)
Riga, , Latvia
LSMUL Kauno Klinikos ( Site 1528)
Kaunas, , Lithuania
Nacionalinis Vezio Institutas ( Site 1527)
Vilnius, , Lithuania
Vilniaus Universiteto Ligonine Santaros Klinikos ( Site 1526)
Vilnius, , Lithuania
Arkhangelsk Clinical Oncological Dispensary ( Site 1113)
Arkhangelsk, Arkhangelskaya oblast, Russia
GBUZ Republican Clinical Oncological Dispensary-Antitumor drug therapy department ( Site 1130)
Ufa, Baskortostan, Respublika, Russia
Krasnoyarsk Regional Clinical Oncological Dispensary ( Site 1121)
Krasnoyarsk, Krasnoyarsk Krai, Russia
National Medical and Surgical Center n.a. N.I.Pirogov ( Site 1126)
Moscow, Moscow, Russia
N.N. Blokhin NMRCO ( Site 1106)
Moscow, Moscow, Russia
First Moscow State Medical University n.a. I.M.Sechenov ( Site 1127)
Moscow, Moscow, Russia
MROI n.a. P.A. Herzen - branch of FSBI NMICR of MoH of Russia ( Site 1128)
Moscow, Moscow, Russia
MEDSI Clinical Hospital on Pyatnitsky Highway-Departmentof Antitumor Drug therapy ( Site 1129)
Krasnogorsk, Moscow Oblast, Russia
City Clinical Oncology Center ( Site 1114)
Saint Petersburg, Sankt-Peterburg, Russia
Sandton Oncology Medical Group PTY LTD ( Site 0900)
Sandton, Gauteng, South Africa
The Oncology Centre ( Site 0903)
Durban, Limpopo, South Africa
Cancercare Rondebosch Oncology ( Site 0904)
Rondebosch, Western Cape, South Africa
Asan Medical Center ( Site 0952)
Songpagu, Seoul, South Korea
Kyungpook National University Chilgok Hospital ( Site 0956)
Daegu, Taegu-Kwangyokshi, South Korea
Korea University Anam Hospital ( Site 0955)
Seoul, , South Korea
Seoul National University Hospital ( Site 0950)
Seoul, , South Korea
Severance Hospital Yonsei University Health System ( Site 0951)
Seoul, , South Korea
Samsung Medical Center ( Site 0954)
Seoul, , South Korea
The Catholic University of Korea St. Mary s Hospital ( Site 0953)
Seoul, , South Korea
Hospital General Universitario de Elche ( Site 1155)
Elche, Alicante, Spain
Hospital Universitario Central de Asturias ( Site 1153)
Oviedo, Principality of Asturias, Spain
Hospital Vall D Hebron ( Site 1151)
Barcelona, , Spain
Hospital Universitario Gregorio Maranon ( Site 1152)
Madrid, , Spain
Hospital 12 de Octubre de Madrid ( Site 1150)
Madrid, , Spain
Inonu Universitesi Medical Fakultesi ( Site 1207)
Malatya, Adana, Turkey (Türkiye)
Baskent University Adana Training Hospital ( Site 1205)
Adana, , Turkey (Türkiye)
Hacettepe University Faculty of Medicine ( Site 1200)
Ankara, , Turkey (Türkiye)
Gazi Universitesi Tip Fakultesi ( Site 1215)
Ankara, , Turkey (Türkiye)
Trakya Universitesi Tip Fakultesi ( Site 1210)
Edirne, , Turkey (Türkiye)
Istanbul Universitesi Cerrahpasa Tip Fakultesi ( Site 1202)
Istanbul, , Turkey (Türkiye)
Prof. Dr. Cemil Tascioglu Sehir Hastanesi ( Site 1216)
Istanbul, , Turkey (Türkiye)
Göztepe Prof. Dr. Süleyman Yalçın Şehir Hastanesi-oncology ( Site 1214)
Istanbul, , Turkey (Türkiye)
Kartal Dr. Lutfi Kirdar Egitim ve Arast Hast ( Site 1211)
Istanbul, , Turkey (Türkiye)
Ege Universitesi Tip Fakultesi Tulay Aktas Onkoloji Hastanesi ( Site 1204)
Izmir, , Turkey (Türkiye)
Necmettin Erbakan Universitesi Meram Tip Fakultesi ( Site 1203)
Konya, , Turkey (Türkiye)
Medical center Medikal Plaza of Ecodnipro LLC ( Site 1317)
Dnipro, Dnipropetrovsk Oblast, Ukraine
Communal non profit enterprise Regional Clinical Oncology Center ( Site 1304)
Kharkiv, Kharkivs’ka Oblast’, Ukraine
Medical Center of Yuriy Spizhenko LLC.-Clinical Trial ( Site 1319)
Kapitanivka Village, Kyivska Oblast, Ukraine
Medical Center Asklepion LLC ( Site 1309)
Khodosovka, Kyivska Oblast, Ukraine
Medical Center Verum ( Site 1318)
Kyiv, Kyivska Oblast, Ukraine
Shalimov s NI of Surgery and Transplantation ( Site 1321)
Kyiv, Kyivska Oblast, Ukraine
Medical center of the Limited Liability Company Yulis ( Site 1314)
Zaporizhzhia, Zaporizhzhia Oblast, Ukraine
Dobrobut Medical Center ( Site 1320)
Kyiv, , Ukraine
Countries
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References
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Takashima A, Garcia-Alfonso P, Manneh R, Besen AA, Hong YS, Cuyle PJ, Yanez P, Burge M, Yoshino T, Kim TW, Cui K, Li C, Jain R, Adelberg D, Taieb J. Olaparib with or without bevacizumab versus bevacizumab plus a fluoropyrimidine as maintenance therapy in advanced colorectal cancer: The randomized phase 3 LYNK-003 study. Eur J Cancer. 2024 Jul;205:114036. doi: 10.1016/j.ejca.2024.114036. Epub 2024 Mar 21.
Kim TW, Taieb J, Gurary EB, Lerman N, Cui K, Yoshino T. Olaparib with or without bevacizumab or bevacizumab and 5-fluorouracil in advanced colorectal cancer: Phase III LYNK-003. Future Oncol. 2021 Dec;17(36):5013-5022. doi: 10.2217/fon-2021-0899. Epub 2021 Nov 15.
Provided Documents
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Document Type: Study Protocol and Statistical Analysis Plan
Related Links
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Merck Clinical Trials Information
Plain Language Summary
Other Identifiers
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MK-7339-003
Identifier Type: OTHER
Identifier Source: secondary_id
LYNK-003
Identifier Type: OTHER
Identifier Source: secondary_id
jRCT2031200146
Identifier Type: REGISTRY
Identifier Source: secondary_id
2019-000698-22
Identifier Type: EUDRACT_NUMBER
Identifier Source: secondary_id
7339-003
Identifier Type: -
Identifier Source: org_study_id
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