- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03968406
Talazoparib and Radiation Therapy in Treating Patients With Locally Recurrent Gynecologic Cancers
Phase I Study of Talazoparib in Combination With Radiation Therapy for Locally Recurrent Gynecologic Cancers
Study Overview
Status
Conditions
- Recurrent Fallopian Tube Carcinoma
- Recurrent Ovarian Carcinoma
- Recurrent Primary Peritoneal Carcinoma
- Recurrent Endometrial Carcinoma
- Stage IV Uterine Corpus Cancer AJCC v8
- Stage IVA Uterine Corpus Cancer AJCC v8
- Stage IVB Uterine Corpus Cancer AJCC v8
- Recurrent Cervical Carcinoma
- Malignant Female Reproductive System Neoplasm
- Stage IV Cervical Cancer AJCC v8
- Stage IVA Cervical Cancer AJCC v8
- Stage IVB Cervical Cancer AJCC v8
- Stage IV Fallopian Tube Cancer AJCC v8
- Stage IV Ovarian Cancer AJCC v8
- Stage IV Primary Peritoneal Cancer AJCC v8
- Stage IVA Fallopian Tube Cancer AJCC v8
- Stage IVA Ovarian Cancer AJCC v8
- Stage IVA Primary Peritoneal Cancer AJCC v8
- Stage IVB Fallopian Tube Cancer AJCC v8
- Stage IVB Ovarian Cancer AJCC v8
- Stage IVB Primary Peritoneal Cancer AJCC v8
- Recurrent Vaginal Carcinoma
- Stage IV Vaginal Cancer AJCC v8
- Stage IVA Vaginal Cancer AJCC v8
- Stage IVB Vaginal Cancer AJCC v8
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVE:
I. To determine the safety, tolerability, and maximally tolerated dose (MTD) of talazoparib combining talazoparib and fractionated radiotherapy in patients with refractory or recurrent ovarian, fallopian tube, primary peritoneal, cervical, or vaginal or endometrial carcinoma.
SECONDARY OBJECTIVES:
I. To determine the safety profile of talazoparib in combination with fractionated radiotherapy for recurrent gynecologic cancers.
II. To determine a preliminary anti-cancer activity of this combination at the MTD.
EXPLORATORY OBJECTIVES:
I. To explore the potential feasibility of using biomarkers in tumor tissue, whole blood or serum as predictive markers of treatment response.
II. To explore the impact of talazoparib when combined with radiotherapy for recurrent gynecologic cancers on 1) patient reported acute gastrointestinal (GI) toxicity and 2) overall longitudinal quality of life at week 5 of therapy.
OUTLINE: This is a dose escalation study of talazoparib.
Patients receive talazoparib orally (PO) once daily (QD) beginning on days -10 to -7 and continuing for up to 8 weeks in the absence of disease progression or unacceptable toxicity. Patients also undergo radiation therapy 5 days a week (Monday-Friday) for up to 7 weeks.
After completion of study treatment, patients are followed up at 1, 3, 6, 9, and 12 months, and then every 6 months for up to 1 year.
Study Type
Enrollment (Estimated)
Phase
- Phase 1
Contacts and Locations
Study Contact
- Name: Lilie Lin
- Phone Number: 713-563-2300
- Email: lllin@mdanderson.org
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77030
- Recruiting
- M D Anderson Cancer Center
-
Contact:
- Lilie L. Lin
- Phone Number: 713-563-2300
- Email: lllin@mdanderson.org
-
Principal Investigator:
- Lilie L. Lin
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Provision of informed consent prior to any study specific procedures
- Histologically-confirmed recurrent ovarian, fallopian tube, primary peritoneal cancer, endometrial, vaginal, or cervical cancer in the abdomen and pelvis
- Subjects with stage IV disease are eligible as long as disease elsewhere (other than the site(s) to receive radiation therapy [RT]) is undetectable or stable (>= 3 months) and immediate chemotherapy is not required. Willingness to discontinue any cytotoxic chemotherapeutic agents, immunotherapy, biologic therapy, and targeted therapies at least three weeks prior to start of investigational therapy
- Hemoglobin >= 10.0 g/dL and no blood transfusions in the 28 days prior to entry/randomization (choose whichever is most applicable to the study) (within 28 days prior to administration of study treatment)
- Absolute neutrophil count (ANC) >= 1.5 x 10^9/L (within 28 days prior to administration of study treatment)
- No features suggestive of myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) on peripheral blood smear (within 28 days prior to administration of study treatment)
- White blood cells (WBC) > 3 x 10^9/L (within 28 days prior to administration of study treatment)
- Platelet count >= 100 x 10^9/L (within 28 days prior to administration of study treatment)
- Total bilirubin =< 1.5 x institutional upper limit of normal (ULN) (within 28 days prior to administration of study treatment)
- Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional upper limit of normal unless liver metastases are present in which case it must be =< 5 x ULN (within 28 days prior to administration of study treatment)
- Serum creatinine =< 1.5 x institutional upper limit of normal (ULN) (within 28 days prior to administration of study treatment)
Eastern Cooperative Oncology Group (ECOG) performance status 0-1
- Note: If cannot fulfill ECOG 0-1, must fulfill inclusion criteria below (minimum life expectancy of >= 16 weeks)
- Patients must have a life expectancy >= 16 weeks
Evidence of non-childbearing status for women of childbearing potential: negative urine or serum pregnancy test within 28 days of study treatment, confirmed prior to treatment on day 1. Postmenopausal is defined as:
- Amenorrheic for 1 year or more following cessation of exogenous hormonal treatments, luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels in the post menopausal range for women under 50, radiation-induced oophorectomy with last menses > 1 year ago, chemotherapy-induced menopause with > 1 year interval since last menses, or surgical sterilization (bilateral oophorectomy or hysterectomy)
- Patient of child-bearing potential is willing to adhere to using two forms of highly effective birth control. Condoms with spermicide and one of the following are acceptable: oral contraceptive or hormonal therapy or placement of an intrauterine device (IUD). Acceptable non-hormonal birth control methods include: total sexual abstinence, vasectomized sexual partner plus male condom, tubal occlusion plus male condom with spermicide, IUD plus male condom+spermicide. Acceptable hormonal methods include: etonogestrel implants (i.e. Implanon, Norplan), normal and low dose combined oral pills, norelgestromin/ethinyl estradiol (EE) transdermal system, intravaginal device (i.e. EE and etonogestrel) or cerazette (desogestrel). All of these would need to be combined with male condom with spermicide
- Patient is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow up
- At least one lesion, not previously irradiated, that can be accurately measured at baseline as >= 10 mm in the longest diameter (except lymph nodes which must have short axis >= 15 mm) with computed tomography (CT) or magnetic resonance imaging (MRI) and which is suitable for accurate repeated measurements
For inclusion in biomarker endpoint, patients must fulfill the following criterion:
- Provision of informed consent for tumor biopsies * If a patient declines to participate in tumor biopsies, there will be no penalty or loss of benefit to the patient. The patient will not be excluded from other aspects of the study described in this Clinical Study Protocol, so long as they consent to that part
Exclusion Criteria:
- Ascites, peritoneal carcinomatosis, hepatic metastases
- Prior radiotherapy in the region of planned radiotherapy
- Chemotherapy, radiotherapy, endocrine therapy, immunotherapy or use of other investigational agents within the 3 weeks prior to start of therapy
- Previous enrollment in the present study
- Participation in another clinical study with an investigational product during the last 4 weeks
- Patients with second primary cancer, except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, or other solid tumors curatively treated with no evidence of disease for >= 5 years (will require discussion with study physician)
- Patients receiving any systemic chemotherapy, radiotherapy
- Concomitant use of known CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, indinavir, saquinavir, telithromycin, clarithromycin and nelfinavir
- Concomitant use of known P-gp inhibitors (i.e. dronedarone, quinidine, ranolazine, verapamil, ketoconazole, itraconazole), P-glycoprotein (P-gp) inducers (i.e. rifampin, tipranavir, ritonavir), or breast cancer resistance protein (BCRP) inhibitors (i.e. elacridar [GF120918]) should be avoided. If patients are taking any P-gp inhibitors, P-gp inducers, or BRCP inhibitors, they will need to stop them prior to enrolment on the study
- Persistent toxicities (>= Common Terminology Criteria for Adverse Events [CTCAE] grade 2) with the exception of alopecia, caused by previous cancer therapy
- Resting electrocardiogram (ECG) with corrected QT (QTc) > 470 msec on 2 or more time points within a 24 hour period or family history of long QT syndrome
- Patients with myelodysplastic syndrome/acute myeloid leukemia
- Patients with symptomatic uncontrolled brain metastases. A scan to confirm the absence of brain metastases is not required. The patient can receive a stable dose of corticosteroids before and during the study as long as these were started at least 28 days prior to treatment
- Major surgery within 14 days of starting study treatment and patients must have recovered from any effects of any major surgery
- Patients considered a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease or active, uncontrolled infection. Examples include, but are not limited to, uncontrolled ventricular arrhythmia, recent (within 3 months) myocardial infarction, unstable spinal cord compression (untreated and unstable for at least 28 days prior to study entry), superior vena cava syndrome, extensive bilateral lung disease on high resolution computed tomography (CT) scan or any psychiatric disorder that prohibits obtaining informed consent
- Patients unable to swallow orally administered medication and patients with gastrointestinal disorders likely to interfere with absorption of the study medication
- Breast feeding women
- Patients with a known hypersensitivity to talazoparib or any of the excipients of the product
- Patients with uncontrolled seizures
- Patients requiring pelvic and para-aortic radiotherapy (defined as levels L1/T12)
- Patients with isolated vaginal relapse (i.e. no disease in lymph nodes or else where in pelvis/abdomen)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment (talazoparib, radiation therapy)
Patients receive talazoparib PO QD beginning on days -10 to -7 and continuing for up to 8 weeks in the absence of disease progression or unacceptable toxicity.
Patients also undergo radiation therapy 5 days a week (Monday-Friday) for up to 7 weeks.
|
Ancillary studies
Other Names:
Undergo radiation therapy
Other Names:
Given PO
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Maximum tolerated dose (MTD)
Time Frame: Up to 30 days
|
MTD is determined by dose limiting toxicity (DLT).
The MTD will be determine using the time-to-event Bayesian optimal interval (TITE-BOIN) model, and it is defined as the dose for which the isotonic estimate of the DLT rate is closest to the target DLT rate.
|
Up to 30 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of adverse events
Time Frame: Up to 2 years
|
Incidence of adverse events graded according to Common Terminology Criteria for Adverse Events (CTCAE).
|
Up to 2 years
|
Response rate
Time Frame: From the start of study treatment until documentation of local or regional recurrence, progression, time to next therapy, and death, assessed up to 2 years
|
Anti-cancer activity will be measured by response rate by the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.
Each endpoint will be analyzed using the cumulative incidence method when competing events exist or the product-limit method of Kaplan and Meier when competing events are absent.
Additionally, competing risk regression or proportional hazards modeling, whichever is appropriate, will be used to examine each endpoint while adjusting for disease.
Estimates and 95% intervals will be reported.
|
From the start of study treatment until documentation of local or regional recurrence, progression, time to next therapy, and death, assessed up to 2 years
|
Local control rate
Time Frame: From the start of study treatment until documentation of local or regional recurrence, progression, time to next therapy, and death, assessed up to 2 years
|
Will be analyzed using the cumulative incidence method when competing events exist or the product-limit method of Kaplan and Meier when competing events are absent.
Additionally, competing risk regression or proportional hazards modeling, whichever is appropriate, will be used to examine each endpoint while adjusting for disease.
Local control will be summarized as freedom from local failure calculated as 1 minus the cumulative incidence of local or regional recurrence.
Estimates and 95% intervals will be reported.
|
From the start of study treatment until documentation of local or regional recurrence, progression, time to next therapy, and death, assessed up to 2 years
|
Time to progression
Time Frame: From the start of study treatment until documentation of local or regional recurrence, progression, time to next therapy, and death, assessed up to 2 years
|
Will be analyzed using the cumulative incidence method when competing events exist or the product-limit method of Kaplan and Meier when competing events are absent.
Additionally, competing risk regression or proportional hazards modeling, whichever is appropriate, will be used to examine each endpoint while adjusting for disease.
Estimates and 95% intervals will be reported.
|
From the start of study treatment until documentation of local or regional recurrence, progression, time to next therapy, and death, assessed up to 2 years
|
Progression-free survival
Time Frame: From the start of study treatment until documentation of local or regional recurrence, progression, time to next therapy, and death, assessed up to 2 years
|
Will be analyzed using the cumulative incidence method when competing events exist or the product-limit method of Kaplan and Meier when competing events are absent.
Additionally, competing risk regression or proportional hazards modeling, whichever is appropriate, will be used to examine each endpoint while adjusting for disease.
Estimates and 95% intervals will be reported.
|
From the start of study treatment until documentation of local or regional recurrence, progression, time to next therapy, and death, assessed up to 2 years
|
Overall survival
Time Frame: From the start of study treatment until documentation of local or regional recurrence, progression, time to next therapy, and death, assessed up to 2 years
|
Will be analyzed using the cumulative incidence method when competing events exist or the product-limit method of Kaplan and Meier when competing events are absent.
Additionally, competing risk regression or proportional hazards modeling, whichever is appropriate, will be used to examine each endpoint while adjusting for disease.
Estimates and 95% intervals will be reported.
|
From the start of study treatment until documentation of local or regional recurrence, progression, time to next therapy, and death, assessed up to 2 years
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Level of PAR inhibition
Time Frame: Up to 2 years
|
Ninety-five percent confidence intervals will be generated for all summary statistics.
No formal statistical testing will be completed.
Summary statistics and box plots will be created to examine Functional Assessment of Cancer Therapy (FACT) component scores at each assessment time as well as to examine the Expanded Prostate Cancer Index Composite (EPIC) bowel questionnaire measured at week 5. Models will be created to examine impact of dosage upon quality of life (QoL) and acute gastrointestinal (GI) toxicity.
In the case of QoL, the models will examine QoL over time using linear mixed models, and we will test for an interaction effect between dose and time to examine whether any potential effects of dose upon QoL change over time.
No testing will be completed; 95% confidence intervals will be created for all model coefficients.
|
Up to 2 years
|
Gamma-H2AX and RAD51 foci formation levels
Time Frame: Up to 2 years
|
Gamma-H2AX and RAD51 foci formation levels in peripheral mononuclear cells and CTCs will be tested for association with PAR inhibition using Pearson and Spearman correlation methods.
An association between germline and tumor BRCA mutation status and PAR inhibition, H2AX.
Ninety-five percent confidence intervals will be generated for all summary statistics.
No formal statistical testing will be completed.
|
Up to 2 years
|
Functional Assessment of Cancer Therapy (FACT)
Time Frame: Up to 2 years
|
Will examine the component scores at each assessment time.
as well as to examine the Expanded Prostate Cancer Index Composite (EPIC) bowel questionnaire measured at week 5. .
No testing will be completed; 95% confidence intervals will be created for all model coefficients.
|
Up to 2 years
|
Expanded Prostate Cancer Index Composite (EPIC)
Time Frame: Up to 2 years
|
Will examine the Expanded Prostate Cancer Index Composite (EPIC) bowel questionnaire measured at week 5.
No testing will be completed; 95% confidence intervals will be created for all model coefficients.
|
Up to 2 years
|
Overall quality of life as assessed by the FACT questionnaire
Time Frame: Up to 2 years
|
Models will be created to examine impact of dosage upon quality of life (QoL).
In the case of QoL, the models will examine QoL over time using linear mixed models, and we will test for an interaction effect between dose and time to examine whether any potential effects of dose upon QoL change over time.
No testing will be completed; 95% confidence intervals will be created for all model coefficients.
|
Up to 2 years
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Lilie L Lin, M.D. Anderson Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Pathologic Processes
- Neoplasms by Histologic Type
- Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Peritoneal Diseases
- Uterine Neoplasms
- Uterine Cervical Diseases
- Uterine Diseases
- Endocrine System Diseases
- Disease Attributes
- Ovarian Diseases
- Adnexal Diseases
- Gonadal Disorders
- Digestive System Neoplasms
- Endocrine Gland Neoplasms
- Fallopian Tube Diseases
- Abdominal Neoplasms
- Vaginal Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Genital Diseases
- Genital Diseases, Female
- Uterine Cervical Neoplasms
- Carcinoma
- Recurrence
- Ovarian Neoplasms
- Fallopian Tube Neoplasms
- Peritoneal Neoplasms
- Endometrial Neoplasms
- Carcinoma, Ovarian Epithelial
- Genital Neoplasms, Female
- Vaginal Neoplasms
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Poly(ADP-ribose) Polymerase Inhibitors
- Talazoparib
Other Study ID Numbers
- 2018-0899 (Other Identifier: M D Anderson Cancer Center)
- NCI-2019-00101 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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