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DUETTE: a phase II randomized, multicenter study to investigate the efficacy and tolerability of a second maintenance treatment in patients with platinum-sensitive relapsed epithelial ovarian cancer, who have previously received poly(ADP-ribose) polymerase (PARP) inhibitor maintenance treatment
  1. Michelle McMullen1,
  2. Katherine Karakasis1,
  3. Bienvenu Loembe2,
  4. Emma Dean2,
  5. Graem Parr2 and
  6. Amit M Oza1
  1. 1Division of Medical Oncology & Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
  2. 2AstraZeneca R&D, Cambridge, Cambridgeshire, UK
  1. Correspondence to Dr Amit M Oza, Princess Margaret Cancer Centre, Toronto, M5G 2M9, Canada; amit.oza{at}


Background With the success of poly(ADP-ribose) polymerase (PARP) inhibitor therapy in the first-line and second-line treatment settings, a new patient population is emerging with platinum-sensitive relapsed ovarian cancer, who have previously received a PARP inhibitor in the maintenance setting and for whom no second maintenance standard of care exists. DUETTE (NCT04239014) will evaluate the combination of ceralasertib (a potent, selective inhibitor of the serine/threonine kinase ataxia telangiectasia and Rad3-related protein (ATR) + olaparib, or olaparib monotherapy, compared with placebo, in this patient population of unmet need.

Primary Objective The primary objective is to assess the efficacy of ceralasertib + olaparib combination, and olaparib monotherapy, compared with placebo, as second maintenance therapy in platinum-sensitive relapsed ovarian cancer.

Study Hypothesis This study will test the hypothesis that ceralasertib + olaparib, or olaparib monotherapy, is tolerable, and effective at prolonging progression-free survival compared with placebo.

Trial Design This is a phase II, multicenter study where patients will be randomized in a 1:1:1 ratio to receive either (Arm 1) ceralasertib + olaparib, (Arm 2) olaparib monotherapy, or (Arm 3) placebo. The olaparib and placebo arms will be double-blinded, whereas the ceralasertib + olaparib arm will be open label. Patients will be stratified according to BRCA status, and response to platinum-based chemotherapy.

Major Inclusion/Exclusion Criteria Eligible patients will have histologically diagnosed high-grade epithelial ovarian cancer, with platinum-sensitive relapse on, or after, completion of at least 6 months of any prior PARP inhibitor maintenance therapy (a minimum of 12 months is required if the patient received PARP inhibitor maintenance following first-line chemotherapy). If the prior PARP inhibitor used was olaparib then patients must have received treatment without significant toxicity or the need for a permanent dose reduction. Disease relapse in the second-line or third-line setting is allowed. Patients who have received secondary debulking surgery are potentially eligible if they meet all other inclusion criteria.

Primary Endpoints The primary endpoint is progression-free survival determined by blinded independent central review according to RECIST 1.1, with sensitivity analysis of progression-free survival using investigator assessments according to RECIST 1.1.

Sample Size 192 patients.

Estimated Dates for Completing Accrual and Presenting Results December 2022.

Trial Registration NCT04239014.

  • ovarian cancer
  • medical oncology

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  • Contributors All authors of this manuscript have directly participated in conceptualization, drafting, and revisions for important intellectual content. All authors have read and approved the final submitted version. The contents of this manuscript have not been copyrighted or published previously and are not now under consideration for publication elsewhere.

  • Funding This study is sponsored by AstraZeneca.

  • Competing interests AMO is on the steering committee of GSK, AstraZeneca (AZ), Clovis, Tesaro, and Merck (uncompensated), and is PI on clinical trials for AZ, GSK, and Clovis. BL, EP, and GD are employees of AZ.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article

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