- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT01281150
Veliparib in Combination With Carboplatin and Paclitaxel in Treating Patients With Locally Advanced or Metastatic Solid Tumors
A Phase 1 Study of ABT-888 (Veliparib) in Combination With Weekly Carboplatin and Paclitaxel in Advanced Solid Tumors
Tutkimuksen yleiskatsaus
Tila
Ehdot
Yksityiskohtainen kuvaus
PRIMARY OBJECTIVE:
I. To determine the maximum-tolerated dose (MTD) of the combination of weekly carboplatin, paclitaxel, and veliparib.
SECONDARY OBJECTIVES:
I. To assess the safety, tolerability, and MTD of the combination of weekly carboplatin, paclitaxel, and veliparib.
II. To assess the safety and toxicity of this combination as determined by the Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v. 4.0) and to determine the dose-limiting toxicity (DLT).
III. To determine the pharmacokinetic and pharmacodynamic effects of this combination, including determinations of poly (adenosine diphosphate [ADP]-ribose) polymerase (PAR) in tumor specimens when available, assessment of deoxyribonucleic acid (DNA) damage as measured by gamma H2A histone family, member X (g-H2AX) in skin biopsies and tumor specimens will be obtained.
IV. To assess characteristics of primary tumor specimens that may contribute to efficacy of this combination including breast cancer, early onset (BRCA) by immunohistochemistry, gene analysis of PARP 1, PARP 2, BRCA, and triple negative and homologous recombination repair (HRR) deficiency gene expression signatures.
V. To document any anti-tumor response.
OUTLINE: This is a dose-escalation study of veliparib.
DOSE-ESCALATION: Patients receive veliparib orally (PO) twice daily (BID) on days 1-5, 8-12, and 15-19 and paclitaxel IV over 1 hour and carboplatin IV over 30 minutes in course 1 and 3 hours in subsequent courses on days 3, 10, and 17. After 4 courses, patients receive paclitaxel and carboplatin on days 3 and 10 only. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. (Completed as of 12/2012)
EXPANSION COHORT: Patients receive veliparib PO BID on days 1-21 and paclitaxel IV over 1 hour and carboplatin IV over 3 hours on days 3 and 10. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
After completion of study therapy, patients are followed up for 4 weeks.
Opintotyyppi
Ilmoittautuminen (Todellinen)
Vaihe
- Vaihe 1
Yhteystiedot ja paikat
Opiskelupaikat
-
-
Pennsylvania
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Hershey, Pennsylvania, Yhdysvallat, 17033-0850
- Penn State Milton S Hershey Medical Center
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Pittsburgh, Pennsylvania, Yhdysvallat, 15213
- UPMC-Magee Womens Hospital
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Pittsburgh, Pennsylvania, Yhdysvallat, 15232
- University of Pittsburgh Cancer Institute (UPCI)
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
Histologically or cytologically confirmed solid tumor that has evidence of metastatic spread (stage IV) or is locally advanced and unresectable
- Patients with breast cancer may have estrogen receptor positive or negative (ER+ or ER-) disease
- Patients with breast cancer may not be human epidermal growth receptor -2 (HER2)-positive ( 3+), or fluorescent in situ hybridization (FISH) ratio > 2.2
Patients in the biopsy expansion cohort must have "triple negative" breast cancer defined as:
- Estrogen receptor staining < 10%; progesterone receptor staining <10%; Her 2 < 2.2 by FISH, or immunohistochemistry (IHC) 0-2+
Patients may have been previously treated
- In the dose escalation cohort, there is no limit to prior therapies
- In the expansion cohort, patients may have only had 1-3 prior regimens for metastatic disease
Patients may have received prior carboplatin, paclitaxel, or poly (ADP-ribose) polymerase (PARP) inhibitor therapy as part of their previous treatment regimens
- However, patients may NOT have received prior therapy with paclitaxel, carboplatin, and PARP inhibitor in combination
- Patients must not have received chemotherapy within 4 weeks of starting study (or 6 weeks if prior treatment was with carmustine [BCNU] or mitomycin C)
- Patients must not have received radiation within 2 weeks of starting study
- Eastern Cooperative Oncology Group (ECOG) performance status (PS)< 2 (Karnofsky > 60%)
- Life expectancy > 2 months
- Absolute neutrophil count (ANC) >= 1,500/mcL
- Platelet count >= 100,000/mcL
- Total bilirubin =< 1.5 times upper limit of normal (ULN)
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 times ULN
- Creatinine normal within normal institutional limits OR creatinine clearance >= 60 mL/min/1.73m^2 for patients with creatinine levels above institutional normal
- Must able to swallow pills
Pregnant women are excluded from this study
- Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
- Ability to understand and the willingness to sign a written informed consent document
Patients enrolled in the expanded cohort with mandatory biopsies must:
- Have accessible tumors
- Not be on therapeutic anticoagulation
- Have signed informed consent form
Exclusion Criteria:
- Patients who have had chemotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) or radiotherapy within 2 weeks (4 weeks for central nervous system [CNS] metastases) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
- Patients may not be receiving any other investigational agents
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to veliparib or other agents used in study
- Concurrent treatment with bisphosphonates, or other bone anti-resorptive agent such as denosumab is allowed; concurrent treatment with hormonal therapy (tamoxifen, ovarian suppression with gonadotropin-releasing hormone [GNRH] agonists, aromatase inhibitors) or trastuzumab therapy is NOT allowed in breast cancer patients; prostate cancer patients may continue GNRH agents
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated with veliparib
- Active seizure or history of seizure disorder
- Patients with CNS metastases must be stable after therapy for CNS metastases (such as surgery, radiotherapy or stereotactic radiosurgery) for > 3 months and must be off steroid treatment prior to study enrollment
- Patients who undergo biopsy as part of the study in the expanded dose cohort should not be on anti-coagulants or have a pre-existing coagulopathy
- Peripheral neuropathy of severity greater than grade 1
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Ei käytössä
- Inventiomalli: Yksittäinen ryhmätehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
|
Kokeellinen: Treatment (veliparib, paclitaxel, carboplatin)
DOSE-ESCALATION: Patients receive veliparib PO twice daily BID on days 1-5, 8-12, and 15-19 and paclitaxel IV over 1 hour and carboplatin IV over 30 minutes in course 1 and 3 hours in subsequent courses on days 3, 10, and 17. After 4 courses, patients receive paclitaxel and carboplatin on days 3 and 10 only. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. (Completed as of 12/2012) EXPANSION COHORT: Patients receive veliparib PO BID on days 1-21 and paclitaxel IV over 1 hour and carboplatin IV over 3 hours on days 3 and 10. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. |
Korrelatiiviset tutkimukset
Koska IV
Muut nimet:
Korrelatiiviset tutkimukset
Koska IV
Muut nimet:
Annettu PO
Muut nimet:
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
|---|---|
|
MTD defined as the dose level one level below the lowest dose where greater than or equal to 2 patients experience a DLT assessed by National Cancer Institute (NCI) CTCAE v. 4.0
Aikaikkuna: 21 days
|
21 days
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Change in BRCA protein levels by immunohistochemistry
Aikaikkuna: Baseline to day 4 of course 2
|
Calculated and compared using the Wilcoxon rank sum test.
|
Baseline to day 4 of course 2
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Change in PAR and g-H2AX in tumor tissue
Aikaikkuna: Baseline to day 4 of course 2
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Assessed with Wilcoxon signed rank tests.
|
Baseline to day 4 of course 2
|
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Grade >= 3 non-hematological or any grade 5 DLTs as graded by the NCI CTCAE v. 4.0
Aikaikkuna: 21 days
|
Statistics on the number of cycles received by patients and any dose reductions will be tabulated.
|
21 days
|
|
Incidence of adverse events as graded by the NCI CTCAE v. 4.0
Aikaikkuna: Up to 4 weeks post-treatment
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The maximum grade of toxicity for each category of interest will be recorded for each patient and the summary results will be tabulated by category and grade.
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Up to 4 weeks post-treatment
|
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Plasma concentration of carboplatin, paclitaxel, and veliparib using liquid chromatography-mass spectrometry (LC-MS) assay and spectrometry assay
Aikaikkuna: Baseline, at 30 minutes and at 1, 2, 4, and 8 hours on day 3 of course 1
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Baseline, at 30 minutes and at 1, 2, 4, and 8 hours on day 3 of course 1
|
|
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Response complete response [Cr], partial response [PR], and stable disease [SD]) using the Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1)
Aikaikkuna: Up to 4 weeks post-treatment
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CR, PR, and incidence of SD will be tabulated by disease diagnosis and by dose level.
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Up to 4 weeks post-treatment
|
Yhteistyökumppanit ja tutkijat
Sponsori
Tutkijat
- Päätutkija: Shannon Puhalla, University of Pittsburgh Cancer Institute (UPCI)
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Arvio)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
- Ihosairaudet
- Neoplasmat histologisen tyypin mukaan
- Neoplasmat
- Neoplasmat sivustoittain
- Kasvaimet, rauhas- ja epiteelikasvaimet
- Rintojen sairaudet
- Rintojen kasvaimet
- Karsinooma
- Rintojen kasvaimet, mies
- Farmakologisen vaikutuksen molekyylimekanismit
- Entsyymin estäjät
- Antineoplastiset aineet
- Tubuliinimodulaattorit
- Antimitoottiset aineet
- Mitoosin modulaattorit
- Antineoplastiset aineet, fytogeeniset
- Poly(ADP-riboosi)polymeraasi-inhibiittorit
- Karboplatiini
- Paklitakseli
- Albumiiniin sitoutunut paklitakseli
- Veliparib
Muut tutkimustunnusnumerot
- NCI-2011-02490 (Rekisterin tunniste: CTRP (Clinical Trial Reporting Program))
- U01CA099168 (Yhdysvaltain NIH-apuraha/sopimus)
- P30CA047904 (Yhdysvaltain NIH-apuraha/sopimus)
- CDR0000693333
- 09-084 (Muu tunniste: University of Pittsburgh Cancer Institute (UPCI))
- 8620 (Muu tunniste: CTEP)
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