Rucaparib(CO-338;Formally Called AG-014699 or PF-0136738) in Treating Patients With Locally Advanced or Metastatic Breast Cancer or Advanced Ovarian Cancer

This is an interventional treatment trial for brca1 Mutation Carrier focused on measuring stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, stage IV breast cancer, recurrent breast cancer, stage IV ovarian epithelial cancer, recurrent ovarian germ cell tumor, stage IV ovarian germ cell tumor, ovarian stromal cancer, ovarian sarcoma, BRCA1 mutation carrier, BRCA2 mutation carrier, stage IIIA ovarian epithelial cancer, stage IIIA ovarian germ cell tumor, stage IIIB ovarian epithelial cancer, stage IIIB ovarian germ cell tumor, stage IIIC ovarian epithelial cancer, stage IIIC ovarian germ cell tumor, ovarian papillary serous carcinoma Read More

INCLUSION CRITERIA

1. All stages of the study (IV and oral):

   Patients must be proven known carriers of a mutation of BRCA1 or BRCA2 or considered to be highly likely to be carriers of a BRCA1 or 2 mutation* (score of ≥ 20 as per Manchester criteria) and have histologically documented locally advanced or metastatic breast cancer or advanced ovarian cancer.

   *Patients considered highly likely to be carriers will be tested after consenting and a BRCA1 or 2 mutation must be confirmed for the patient to be eligible to receive treatment.

   Oral stage 1 only:

   In addition to the above, patients with high grade serous ovarian cancer with unknown BRCA status may be entered into oral stage 1.

2. Patients with ovarian cancer (including epithelial, fallopian tube cancer and primary peritoneal cancer) who have had no more than 5 prior chemotherapy regimens in the last 5 years. For the BRCA carriers > 2 months must have elapsed since their last treatment with a carboplatin- or cisplatin-containing regimen or for high grade serous ovarian cancer patients ≥ 6 months.
3. Patients with breast cancer who have had no more than 5 prior chemotherapy regimens in the last 5 years.
4. Measurable disease as measured by X-ray, computerised tomography (CT), or MRI scan as defined by RECIST criteria. These measurements must be done within 4 weeks of the patient going on study. Clinical measurements must be done within one week of the patient going on study. Patients with bone disease must have other measurable disease for evaluation. Previously irradiated lesions cannot be used for measurable disease.
5. Life expectancy of at least 12 weeks
6. World Health Organisation (WHO) performance status of 0 or 1 (Appendix 1)

7. Haematological and biochemical indices within the ranges shown below. These measurements must be performed within one week before the patient goes on study.

   Lab Test Value Required Haemoglobin (Hb) ≥9.0 g/dl Neutrophils ≥1.5 x 10^9/L Platelets (Plts) ≥100 x 10^9/L Serum bilirubin ≤1.5 x upper normal limit Alanine amino-transferase (ALT) and/or ≤ 2.5 x upper limit of normal (ULN) aspartate amino-transferase (AST) unless due to tumour in which case up to 5 x ULN is permissible Glomerular Filtration Rate (GFR) calculated either by the Wright formula ≥50 ml/min or Cockcroft-Gault formula or by isotope clearance measurement

8. 18 years or over
9. Written (signed and dated) informed consent and be capable of co-operating with treatment and follow-up

EXCLUSION CRITERIA

1. Radiotherapy (except for palliative reasons), endocrine therapy, immunotherapy, chemotherapy, biological agents or investigational agents during the previous 4 weeks (6 weeks for nitrosoureas and Mitomycin-C) before treatment.
2. Ongoing toxic manifestations of previous treatments. Exceptions to this are alopecia or certain Grade 1 toxicities, which in the opinion of the Investigator and the Drug Development Office (DDO) should not exclude the patient.
3. Known brain metastases.
4. Female patients able to become pregnant (or already pregnant or lactating). However, those female patients who have a negative serum or urine pregnancy test before enrolment and agree to use two highly effective forms of contraception (oral, injected or implanted hormonal contraception and condom, have an intrauterine device and condom, diaphragm with spermicidal gel and condom, or are surgically sterilised) 4 weeks before entering the trial, during the trial and for 6 months afterwards are considered eligible.
5. Male patients with partners of child-bearing potential (unless they agree to use one form of highly effective contraception such as a barrier method of condom plus spermicide during the trial and for 6 months afterwards).
6. Major thoracic and/or abdominal surgery in the preceding 4 weeks from which the patient has not recovered.
7. At high medical risk because of non-malignant systemic disease including active uncontrolled infection.
8. Concurrent malignancies at other sites, with the exception of adequately treated cone-biopsied in situ carcinoma of the cervix uteri and basal or squamous cell carcinoma of the skin and concurrent breast and ovarian carcinoma. Cancer survivors, who have undergone potentially curative therapy for a prior malignancy, are eligible for the study.
9. Patients with active or unstable cardiac disease or history of myocardial infarction within 6 months. Patients with cardiovascular signs or symptoms should have a MUGA scan or echocardiogram, and those patients with left ventricular ejection fraction (LVEF) below the institutional limit of normal should be excluded.
10. Any other condition which in the Investigator's opinion would not make the patient a good candidate for the clinical trial.
11. Patients who have already received a PARP inhibitor.