Single-Arm, Prospective, Multicenter Study Evaluating Safety, Tolerability, and Metabolism of Niraparib as Maintenance following Front-Line Treatment for Ovarian Cancer in Women of African Ancestry
About
About This Trial
This is a prospective, single-arm, multicenter, international clinical study of women of African ancestry designed to evaluate the safety and tolerability of niraparib maintenance therapy following completion of primary treatment (surgery and platinum-based chemotherapy) for high-grade serous or high-grade endometrioid epithelial ovarian, fallopian-tube, and primary peritoneal carcinoma.
Why This Study Matters
Large-scale clinical studies investigating the safety and efficacy of novel therapeutics in ovarian cancer rarely include Black women or women of African ancestry. The sampled population in the landmark PRIMA study was only 1.6% Black, and the NOVA study was only 1.3% Black. This means the current evidence base for niraparib — a PARP inhibitor now widely used in ovarian cancer maintenance — was established almost entirely in women of European ancestry.
Black women with ovarian cancer have disproportionately worse responses to platinum-based chemotherapy, have been systematically undertested for germline and somatic mutations, and yet carry higher-than-expected rates (10–25%) of germline BRCA1 and BRCA2 mutations. Genetic analysis of tumors in women from the Caribbean islands of The Bahamas and Trinidad and Tobago revealed that 10–25% have genetic markers of hereditary breast and ovarian cancer syndrome, compared to 5–10% in the general US population. There is a clear and urgent need to generate safety, efficacy, and pharmacogenomic data for this population.
Study Design
All eligible participants will receive single-agent oral niraparib once daily at a starting dose of 300 mg (modified to 200 mg daily if weight is below 77 kg or platelet count is below 150,000/μL). Treatment will continue for up to 24 months, or until disease progression, unacceptable toxicity, or withdrawal of consent. Assessment of disease progression will be determined by RECIST v1.1.
Participation consists of three periods:
- Screening Period (up to 30 days): Eligibility assessments, baseline blood work, genetic and ancestry samples.
- Treatment Period (up to 24 months / 2 years): Monthly visits for safety monitoring, blood draws, pharmacokinetic samples, and quality-of-life questionnaires.
- Follow-Up Period (up to 12 months / 1 year): Five follow-up visits to monitor long-term health after study treatment ends.
Primary Objective
To evaluate the safety and tolerability of maintenance niraparib treatment in women of African ancestry, specifically the proportion of women experiencing any Grade 3 or higher adverse event as measured by the NCI Common Terminology for Adverse Events (CTCAE) version 5.0.
Secondary & Translational Objectives
Secondary endpoints include recurrence-free survival, CA-125 levels, and health-related quality of life (HRQoL) using the FOSI-8 and FACT-GP5 instruments. Translational aims include pharmacokinetic and pharmacogenomic profiling of niraparib, assessment of germline and somatic HRD/HRP status, and measurement of circulating tumour DNA (ctDNA).
Who Can Join
Women who self-identify as Black, African, and/or Afro-Caribbean with newly diagnosed Stage III or IV high-grade serous or endometrioid ovarian carcinoma who have completed primary treatment (surgery and chemotherapy) with a complete or partial response. Recruitment is open at five international sites: Miami, FL; Fort Lauderdale, FL; Jacksonville, FL (USA); Nassau, The Bahamas (Site 105 — PeriomedCare Ltd); and Zaria, Kaduna State, Nigeria.
Sample Size & Timeline
A total of 70 participants will be enrolled globally. Accrual is expected to be completed by 2027, with preliminary results presented in 2028.
Funding & Sponsorship
This study is sponsored by the University of Miami Sylvester Comprehensive Cancer Center and funded by GlaxoSmithKline (GSK). The Bahamas site (Site 105) is managed by PeriomedCare Ltd, Nassau, Bahamas, in collaboration with the University of the West Indies — Nassau.
The Team
Trial Team
Dr. Matthew Schlumbrecht, MD, MPH
Lead Principal Investigator (University of Miami / Sylvester Comprehensive Cancer Center)
Dr. Matthew Schlumbrecht is the Corresponding Author and Lead Principal Investigator of this multicentre trial. He is a Gynecologic Oncologist at the Sylvester Comprehensive Cancer Center and Associate Professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of Miami Miller School of Medicine. His research focuses on equity in gynecologic cancer care, pharmacogenomics, and international clinical trials.
Dr. Raleigh Butler
Principal Investigator — Site 105
Dr. Raleigh Butler is the Principal Investigator for Site 105 (Nassau, Bahamas) and a Gynaecologic Oncologist affiliated with the University of the West Indies — Nassau and PeriomedCare Ltd. He leads the clinical conduct of the trial at the Bahamas site and is responsible for participant safety, eligibility assessments, and protocol compliance.
Dr. Darron Halliday
Sub-Investigator — Site 105
Dr. Darron Halliday is a Sub-Investigator and Gynaecologic Oncologist at PeriomedCare Ltd, Nassau, Bahamas. He holds Good Clinical Practice (GCP) certification and is actively involved in participant care, study visits, and adverse event management at the Bahamas site.
Dr. Saida Bowe
Sub-Investigator — Site 105
Dr. Saida Bowe is a Sub-Investigator and Gynaecologic Oncologist at PeriomedCare Ltd, Nassau, Bahamas. She holds GCP certification (valid through 2029) and contributes to participant evaluation, informed consent procedures, and clinical data collection at the Bahamas site.
Dr. Justin Pintard
Sub-Investigator — Site 105
Dr. Justin Pintard is a Sub-Investigator and Gynaecologic Oncologist at PeriomedCare Ltd, Nassau, Bahamas. He supports the principal investigator in participant assessment and the day-to-day clinical activities of the trial at Site 105.
Ms. Cicely Stuart
Study Pharmacist — Site 105
Ms. Cicely Stuart is the Study Pharmacist at Site 105, Nassau, Bahamas. She is responsible for niraparib dispensing, drug accountability, product management, and safe handling procedures in accordance with the site pharmacy SOP.
Ms. Marva Jervis
Regulatory Consultant — Site 105
Ms. Marva Jervis serves as Regulatory Consultant for Site 105 at Princess Margaret Hospital, Nassau, Bahamas. She provides regulatory support, liaison with the Public Hospital Authority Research Ethics Committee, and oversight of essential document management.
Research
Publications
Niraparib in Patients with Newly Diagnosed Advanced Ovarian Cancer (PRIMA Trial)
New England Journal of Medicine · 2019
Treatment with Niraparib Maintenance Therapy in Patients with Newly Diagnosed Advanced Ovarian Cancer (PRIME Study)
JAMA Oncology · 2023
Niraparib Maintenance Therapy in Platinum-Sensitive Recurrent Ovarian Cancer (NOVA Trial)
Journal of Clinical Oncology · 2019
Questions
Frequently Asked Questions
You may be eligible if you:
- Self-identify as Black, African, and/or Afro-Caribbean
- Are a woman aged 18 or older
- Have been diagnosed with Stage III or IV high-grade serous or high-grade endometrioid ovarian, fallopian tube, or primary peritoneal carcinoma
- Have completed primary treatment (surgery and platinum-based chemotherapy) and have a complete or partial response confirmed by CT scan
- Have an ECOG performance status of 0–2
- Do not have a known contraindication or hypersensitivity to niraparib
A full list of inclusion and exclusion criteria will be reviewed by your study doctor during the screening visit.
Niraparib is an oral tablet taken once daily. It belongs to a class of medicines called PARP inhibitors (poly ADP-ribose polymerase inhibitors). It works by blocking proteins that cancer cells need to repair their DNA. By doing so, it prevents cancer cells from repairing themselves, ultimately causing them to die.
Niraparib has been approved by the US FDA and regulatory authorities in more than 30 countries for use as maintenance treatment following platinum-based chemotherapy in ovarian cancer.
Landmark trials like PRIMA and NOVA — which led to niraparib’s approval — enrolled very few Black women (1.6% and 1.3%, respectively). Because women of African ancestry may have different genetic profiles, metabolism of niraparib, and cancer biology compared to women of European ancestry, it is unknown whether the drug behaves the same way in this population.
We also know that Black women with ovarian cancer carry higher rates of BRCA1/2 mutations than previously recognized, and that certain pharmacogenomic variants prevalent in populations of African ancestry may affect drug metabolism. This study is designed to fill these critical knowledge gaps and ensure equitable cancer care.
Total participation is approximately 3 years:
- Screening Period: Up to 30 days — eligibility tests and baseline assessments
- Treatment Period: Up to 24 months (2 years) — you take niraparib once daily and attend monthly visits
- Follow-Up Period: Up to 12 months (1 year) — 5 follow-up visits to monitor your long-term health
You may stop treatment earlier if your disease progresses, if you develop unacceptable side effects, or if you choose to withdraw your consent at any time.
Niraparib is taken as an oral tablet, once per day, preferably at night, with or without food. You should swallow the tablet whole with water — do not chew, crush, or split it.
Your starting dose will be determined by your weight and baseline platelet count:
- 300 mg/day — if your weight is ≥77 kg and your platelet count is ≥150,000/μL
- 200 mg/day — if your weight is <77 kg or your platelet count is <150,000/μL
Your study doctor may adjust your dose based on how you are tolerating treatment.
As with all medicines, niraparib can cause side effects. The most commonly reported side effects in previous trials include:
- Anaemia (low red blood cells)
- Thrombocytopenia (low platelet count)
- Neutropenia (low white blood cells)
- Nausea, constipation, vomiting
- Fatigue
- Headache and insomnia
- Elevated blood pressure
- Abdominal pain
A rare but serious risk is myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML), which occurred in approximately 1.2% of patients in prior studies. Your study doctor will monitor you closely with regular blood tests, and dose adjustments are made if needed. You should report any new or worsening symptoms to the study team promptly.
Participation in this study is voluntary. You will not be paid for taking part; however, study-related tests, procedures, and the study medication (niraparib) will be provided at no cost to you during the study. Any expenses related to travel or other costs should be discussed with the study team. You will not lose any benefits to which you are otherwise entitled if you decide not to participate or choose to withdraw.
Yes. Your privacy is protected by applicable laws and regulations. Your personal data will be coded so that your name and identifying details are not used in study reports or publications. Only authorised study personnel, regulatory authorities, and the Institutional Review Board (IRB) / Research Ethics Committee (REC) may access your identifiable information for monitoring purposes. All data is stored securely.
Study visits are primarily monthly during the treatment period. At visits you may have:
- Blood tests (safety monitoring, pharmacokinetics, CA-125)
- Physical examination and vital signs
- Electrocardiogram (ECG)
- CT/MRI/PET imaging (at specified timepoints to assess disease status)
- Quality-of-life questionnaires (FOSI-8 and FACT-GP5)
- Pill diary review
- Pregnancy test (if applicable)
Some visits may be conducted remotely (by telephone or video) where permitted by the protocol.
Yes, under specific conditions. Participants with known HIV infection may be enrolled if they meet all of the following criteria:
- CD4 cell count ≥350/μL and viral load <400 copies/mL
- No history of AIDS-defining opportunistic infections within the past 12 months
- No history of HIV-associated malignancy in the past 5 years
- Currently on stable antiretroviral therapy per current NIH guidelines, started more than 4 weeks before study enrolment
Yes. Participation is entirely voluntary. You may withdraw from the study at any time without penalty and without affecting your standard medical care. If you decide to withdraw, please inform your study doctor so that appropriate follow-up care can be arranged. Withdrawing does not affect your rights as a patient.
The Bahamas site (Site 105) is managed by PeriomedCare Ltd in Nassau, Bahamas, in collaboration with the University of the West Indies — Nassau. Laboratory services are provided by Doctor’s Hospital, Nassau. The site has received ethics approval from the Public Hospital Authority Research Ethics Committee.
To enquire about participation or to be referred, please use the Contact form on this page.