Study of Drug to Reduce Thrombocytopenia in Patients Receiving Chemo for Ovarian, Fallopian Tube or Peritoneal Cancer

This is a Phase IIb, multicenter, randomized, double-blind, placebo-controlled study comparing safety and efficacy of two dose levels of TXA127 when administered during 6 cycles of combination gemcitabine and platinum-based chemotherapy. This study intends to investigate the effectiveness of TXA127 for the mitigation of severity and/or incidence of thrombocytopenia, as well as safety when administered as a self-injected, subcutaneous solution.

Females 18 years of age or older with a confirmed diagnosis of ovarian carcinoma who are scheduled to undergo combination chemotherapy with gemcitabine and carboplatin or gemcitabine and cisplatin will be considered for this study. Subjects may be chemotherapy naïve, newly diagnosed, or post a single course of chemotherapy followed by a progression- and treatment-free interval of at least 3 months, or post 2 or more previous courses of chemotherapy after a progression- and treatment-free interval of at least 6 months.

Subjects will be randomized in a 1:1:1 ratio to one of the following three blinded treatment groups: placebo, 100 ug/kg/day TXA127 and 300 ug/kg/day TXA127.

Treatment will be concurrent with up to six consecutive 21-day cycles of one of the following gemcitabine and platin regimens:

Regimen A

• Intravenous cisplatin therapy at a dose of 30-50 mg/m2 given on Day 1 of the cycle
• Intravenous gemcitabine at a dose of 800 mg/m2 given on Day 1 after cisplatin and on Day 8 of the cycle.

Regimen B

• Intravenous gemcitabine at a dose of 1000 mg/m2 given on Days 1 and 8 of the cycle
• Intravenous carboplatin AUC 4 given after gemcitabine on Day 1 of the cycle

TXA127 will be self-administered as a subcutaneous injection by the subject once daily on Days 2-6 and 9-15 during each cycle of chemotherapy. Blood specimens will be drawn for hematologic analysis on Days 1, 8 and 15 of each treatment cycle.

Inclusion criteria

• Females at least 18 years of age with ovarian carcinoma who are one of the following:

• Newly diagnosed with ovarian cancer and chemotherapy naïve, or
• Post a single previous course of chemotherapy, with a 3-month disease-progression and treatment-free interval, with the exception of antibody therapy, prior to the study screening visit, or
• Post two or more previous courses of chemotherapy with a 6-month disease-progression and treatment-free interval, with the exception of antibody therapy, prior to the study screening visit.
• Must be scheduled for a course of combination chemotherapy consisting of gemcitabine and cisplatin or gemcitabine and carboplatin to be administered in 21-day cycles
• Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2
• Adequate bone marrow, renal, and hepatic functions as measured by standard chemistry and hematology blood tests
• Adequate blood coagulation parameters as measured by standard blood tests for coagulation

Exclusion criteria

• Any clinical or laboratory abnormality greater than Grade 2 toxicity (NCI criteria), with the exception of laboratory parameters specified in the inclusion criteria
• Significant unstable cardiovascular disease
• Uncontrolled high blood pressure
• Current use of an angiotensin converting enzyme (ACE) inhibitor or angiotensin II antagonists
• Evidence of metastatic disease to the bone
• Metastatic disease to the CNS requiring treatment or radiation therapy
• Uncontrolled infection(s)
• Radiation therapy or chemotherapy (except as specified in the inclusion criteria) within the previous 5 years
• Concurrent use of hematopoietic or erythropoietic agents