PARP Inhibition for Triple Negative Breast Cancer (ER-/PR-/HER2-)With BRCA1/2 Mutations
Primary Purpose
Breast Cancer
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Cisplatin
Rucaparib
Cisplatin
Sponsored by
About this trial
This is an interventional treatment trial for Breast Cancer focused on measuring PARP inhibition + breast cancer, breast cancer, PARP inhibitor, Triple negative
Eligibility Criteria
Inclusion Criteria:
- Must have histologically or cytologically confirmed triple negative (ER-/PR-/HER2-) invasive breast cancer, stage I-III at diagnosis (AJCC 6th edition) based on initial evaluation by clinical examination and/or breast imaging. NOTE: Patients with ER+ and/or PR+ may enroll ONLY if they are known carriers of a deleterious mutation in BRCA1 or BRCA2. Patients with HER2+ tumors may not enroll regardless of BRCA status.
- Must have completed preoperative (neoadjuvant) chemotherapy. NOTE: Acceptable preoperative regimens include an anthracycline or a taxane, or both. Patients may NOT have received cisplatin as part of their neoadjuvant therapy regimen. Patients who received preoperative therapy as part of a clinical trial may enroll. No adjuvant chemotherapy after surgery other than that specified in this protocol is allowed. Adjuvant bisphosphonate use is allowed.
- Must have completed definitive resection of primary tumor. The last surgery for breast cancer must have been completed at least 14 days prior to registration for protocol therapy.
Must have significant residual invasive disease at the time of definitive surgery following preoperative chemotherapy. Significant residual disease is defined at least one of the following:
- Miller-Payne response in the breast of 0-25.
- Residual Cancer Burden (RBC) classification II or III6
- Residual carcinoma in one or more regional lymph nodes that would meet AJCC 6th edition criteria for N1 - N3 disease.
- Alternatively, if Miller-Payne or RCB grading is not available, the patient will be eligible if the pathology report indicates that the area of residual invasive disease in the breast measures at least 2 cm following preoperative therapy. The presence of DCIS without invasion does not qualify as residual disease in the breast.
- Whole breast radiotherapy is required for patients who underwent breast conserving therapy, including lumpectomy or partial mastectomy. Patients receiving adjuvant radiation therapy must have completed radiotherapy at least 14 days prior to registration for protocol therapy.
- Written informed consent and HIPAA authorization for release of personal health information.
- Age > 18 years at the time of consent.
- Must consent to allow submission of archived tumor tissue sample from definitive surgery.
- Must consent to collection of blood samples for PK analysis.
- Women of childbearing potential and males must be willing to use an effective method of contraception from the time consent is signed until 4 weeks after treatment discontinuation.
- Women of childbearing potential must have a negative pregnancy test within 14 days prior to registration for protocol therapy.
- Women must not be breastfeeding.
Exclusion Criteria:
- No stage IV (metastatic) disease, however no specific staging studies are required in the absence of symptoms or physical exam findings that would suggest distant disease.
- No treatment with any investigational agent within 30 days prior to registration for protocol therapy.
- No history of chronic hepatitis B or C
- No clinically significant infections as judged by the treating investigator.
Sites / Locations
- St. Jude Heritage Healthcare
- University of California Los Angeles
- Central Coast Medical Oncology Corporation
- University of Colorado Cancer Center
- Memorial Cancer Institute Breast Cancer Center
- University of Miami, Sylvester Comprehensive Cancer Center
- Fort Wayne Oncology & Hematology, Inc
- Indiana University Melvin and Bren Simon Cancer Center
- Community Regional Cancer Center
- Horizon Oncology Research, Inc./IU Health Arnett
- Monroe Medical Associates
- Northern Indiana Cancer Research Consortium
- Metro Health Cancer Care
- Siteman Cancer Center
- Comprehensive Cancer Centers of Nevada
- The Center for Cancer & Hematologic Disease
- Virtua Health Cancer Program
- South Jersey Health Care
- Presbyterian Medical Group
- University of New Mexico Cancer Center: Albuquerque
- HOPE a Women's Cancer Center
- Seidman Cancer Center
- Oregon Health Sciences University
- Pinnacle Health Fox Chase Regional Cancer Center
- Bux-Mont Oncology Hematology Associates (FCCC) at Grand View Hospital
- The West Clinic
- Virginia Oncology Associates
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Arm A: Cisplatin Monotherapy
Arm B: Combination Therapy
Arm Description
Cisplatin 75 mg/m2 IV infusion over 60 minutes, D1 every 21 days for 4 cycles
Rucaparib 24mg C1,30mg C2-4, D1,2,3 every 21 days for 4 cycles Cisplatin 75 mg/m2 IV infusion over 60 minutes, D1 every 21 days for 4 cycles
Outcomes
Primary Outcome Measures
Two-year Disease Free Survival
To evaluate 2-year disease-free survival (DFS), in patients with confirmed TNBC or ER/PR + HER2-, known BRCA1/2 mutations treated with single agent cisplatin and patients treated with cisplatin in combination with Rucaparib following preoperative chemotherapy
Secondary Outcome Measures
Side Effects and Tolerability
To characterize the side effects and tolerability of cisplatin and cisplatin plus Rucaparib in patients with residual disease following preoperative chemotherapy.
One-year Disease Free Survival
To evaluate 1-year DFS
Overall Survival
To determine 5-year overall survival
Pharmacokinetic Data
To collect limited pharmacokinetic data, in patients receiving study drug to compliment ongoing PK analyses in other trials with Rucaparib
Specimen Collection
To collect peripheral blood lymphocytes, archived tumor specimens, and genomic DNA to explore potential correlates of PARP inhibition, recurrence and toxicity.
Full Information
NCT ID
NCT01074970
First Posted
February 23, 2010
Last Updated
February 10, 2020
Sponsor
Hoosier Cancer Research Network
Collaborators
Clovis Oncology, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT01074970
Brief Title
PARP Inhibition for Triple Negative Breast Cancer (ER-/PR-/HER2-)With BRCA1/2 Mutations
Official Title
PARP Inhibition After Preoperative Chemotherapy in Patients With Triple Negative Breast Cancer or ER/PR +, HER2 Negative With Known BRCA1/2 Mutations: Hoosier Oncology Group BRE09-146
Study Type
Interventional
2. Study Status
Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
February 2010 (undefined)
Primary Completion Date
December 15, 2018 (Actual)
Study Completion Date
December 15, 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoosier Cancer Research Network
Collaborators
Clovis Oncology, Inc.
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this trial is to evaluate 2-year disease-free survival in this patient population treated with single agent cisplatin and patients treated with cisplatin in combination with Rucaparib following preoperative chemotherapy. Side effects and tolerability of this treatment in patients with residual disease following preoperative chemotherapy will also be observed and characterized.
Detailed Description
OUTLINE: This is a multi-center study.
Safety Run-in will be for the first 12 patients on study only (6 in cohort 1 and 6 in cohort 2). Patients in the safety run will be included in the efficacy analysis on intent to treat basis:
Cisplatin 75 mg/m2 IV D1 every 3 weeks x 4 cycles; Rucaparib 16-30 mg IV D 1,2,3 every 3 weeks x 4 cycles
If cycle 1 is well tolerated, the dose of Rucaparib will be escalated from 16 mg to 24 mg for subsequent cycles in the cohort 1, and 24 mg to 30 mg in the cohort 2.
If ≤ 1 of 6 patients in cohort 1 experiences DLT, cohort 2 will commence. If 2 or more of 6 patients in cohort 1 experience DLT, the study will be suspended and an amendment to explore lower doses will be considered.
If ≤ 1 of 6 patients in cohort 2 experiences DLT, the randomized portion of the study will commence. If 2 or more of 6 patients experience DLT, the study will be suspended and an amendment to proceed with the randomized portion at the cohort 2 dose (24 mg) will be considered.
During the randomized portion of the study, patients will be randomized to either Arm A or Arm B.
Stratification factors:
Anthracycline vs. not
Residual LN involvement vs. No Residual LN involvement
Arm A (Cisplatin Monotherapy) Cisplatin 75 mg/m2 IV D1 every 3 weeks x 4 cycles
Arm B (Combination Therapy) Cisplatin 75 mg/m2 IV D1 every 3 weeks x 4 cycles; Rucaparib 16-30 mg IV D1,2,3 every 3 weeks x 4 cycles
Rucaparib maintenance 30 mg IV weekly x 24 weeks
ECOG Performance Status 0-1
Life Expectancy: Not Specified
Hematopoietic:
Hemoglobin (Hgb) > 9.0 g/dL
Platelets > 100 K/ mm3
Absolute neutrophil count (ANC) > 1.5 K/mm3
Hepatic:
Bilirubin < upper limit of normal (except in patients with documented Gilbert's disease, who must have a total bilirubin < 3.0 mg/dL)
Aspartate aminotransferase (AST, SGOT) < 2.5 x ULN
Alanine aminotransferase (ALT, SGPT) < 2.5 x ULN
Renal:
Calculated creatinine clearance of > 50 cc/min using the Cockcroft-Gault formula
Cardiovascular:
Left ventricular ejection fraction within normal limits.
Patients with an unstable angina or myocardial infarction within 12 months of study entry are excluded.
No clinically significant arrhythmia or baseline ECG abnormalities in the opinion of the treating investigator.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
PARP inhibition + breast cancer, breast cancer, PARP inhibitor, Triple negative
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
135 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Arm A: Cisplatin Monotherapy
Arm Type
Active Comparator
Arm Description
Cisplatin 75 mg/m2 IV infusion over 60 minutes, D1 every 21 days for 4 cycles
Arm Title
Arm B: Combination Therapy
Arm Type
Active Comparator
Arm Description
Rucaparib 24mg C1,30mg C2-4, D1,2,3 every 21 days for 4 cycles
Cisplatin 75 mg/m2 IV infusion over 60 minutes, D1 every 21 days for 4 cycles
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
Cisplatin 75 mg/m2 IV infusion over 60 minutes, D1 every 21 days for 4 cycles
Intervention Type
Drug
Intervention Name(s)
Rucaparib
Intervention Description
Rucaparib 24mg C1,30mg C2-4, D1,2,3 every 21 days for 4 cycles
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
Cisplatin 75 mg/m2 IV infusion over 60 minutes, D1 every 21 days for 4 cycles
Primary Outcome Measure Information:
Title
Two-year Disease Free Survival
Description
To evaluate 2-year disease-free survival (DFS), in patients with confirmed TNBC or ER/PR + HER2-, known BRCA1/2 mutations treated with single agent cisplatin and patients treated with cisplatin in combination with Rucaparib following preoperative chemotherapy
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Side Effects and Tolerability
Description
To characterize the side effects and tolerability of cisplatin and cisplatin plus Rucaparib in patients with residual disease following preoperative chemotherapy.
Time Frame
12 months
Title
One-year Disease Free Survival
Description
To evaluate 1-year DFS
Time Frame
12 months
Title
Overall Survival
Description
To determine 5-year overall survival
Time Frame
60 months
Title
Pharmacokinetic Data
Description
To collect limited pharmacokinetic data, in patients receiving study drug to compliment ongoing PK analyses in other trials with Rucaparib
Time Frame
12 months
Title
Specimen Collection
Description
To collect peripheral blood lymphocytes, archived tumor specimens, and genomic DNA to explore potential correlates of PARP inhibition, recurrence and toxicity.
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Must have histologically or cytologically confirmed triple negative (ER-/PR-/HER2-) invasive breast cancer, stage I-III at diagnosis (AJCC 6th edition) based on initial evaluation by clinical examination and/or breast imaging. NOTE: Patients with ER+ and/or PR+ may enroll ONLY if they are known carriers of a deleterious mutation in BRCA1 or BRCA2. Patients with HER2+ tumors may not enroll regardless of BRCA status.
Must have completed preoperative (neoadjuvant) chemotherapy. NOTE: Acceptable preoperative regimens include an anthracycline or a taxane, or both. Patients may NOT have received cisplatin as part of their neoadjuvant therapy regimen. Patients who received preoperative therapy as part of a clinical trial may enroll. No adjuvant chemotherapy after surgery other than that specified in this protocol is allowed. Adjuvant bisphosphonate use is allowed.
Must have completed definitive resection of primary tumor. The last surgery for breast cancer must have been completed at least 14 days prior to registration for protocol therapy.
Must have significant residual invasive disease at the time of definitive surgery following preoperative chemotherapy. Significant residual disease is defined at least one of the following:
Miller-Payne response in the breast of 0-25.
Residual Cancer Burden (RBC) classification II or III6
Residual carcinoma in one or more regional lymph nodes that would meet AJCC 6th edition criteria for N1 - N3 disease.
Alternatively, if Miller-Payne or RCB grading is not available, the patient will be eligible if the pathology report indicates that the area of residual invasive disease in the breast measures at least 2 cm following preoperative therapy. The presence of DCIS without invasion does not qualify as residual disease in the breast.
Whole breast radiotherapy is required for patients who underwent breast conserving therapy, including lumpectomy or partial mastectomy. Patients receiving adjuvant radiation therapy must have completed radiotherapy at least 14 days prior to registration for protocol therapy.
Written informed consent and HIPAA authorization for release of personal health information.
Age > 18 years at the time of consent.
Must consent to allow submission of archived tumor tissue sample from definitive surgery.
Must consent to collection of blood samples for PK analysis.
Women of childbearing potential and males must be willing to use an effective method of contraception from the time consent is signed until 4 weeks after treatment discontinuation.
Women of childbearing potential must have a negative pregnancy test within 14 days prior to registration for protocol therapy.
Women must not be breastfeeding.
Exclusion Criteria:
No stage IV (metastatic) disease, however no specific staging studies are required in the absence of symptoms or physical exam findings that would suggest distant disease.
No treatment with any investigational agent within 30 days prior to registration for protocol therapy.
No history of chronic hepatitis B or C
No clinically significant infections as judged by the treating investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kathy D. Miller, M.D.
Organizational Affiliation
Hoosier Cancer Research Network
Official's Role
Study Chair
Facility Information:
Facility Name
St. Jude Heritage Healthcare
City
Fullerton
State/Province
California
ZIP/Postal Code
92835
Country
United States
Facility Name
University of California Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Central Coast Medical Oncology Corporation
City
Santa Maria
State/Province
California
ZIP/Postal Code
93454
Country
United States
Facility Name
University of Colorado Cancer Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Memorial Cancer Institute Breast Cancer Center
City
Hollywood
State/Province
Florida
ZIP/Postal Code
33021
Country
United States
Facility Name
University of Miami, Sylvester Comprehensive Cancer Center
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Fort Wayne Oncology & Hematology, Inc
City
Fort Wayne
State/Province
Indiana
ZIP/Postal Code
46815
Country
United States
Facility Name
Indiana University Melvin and Bren Simon Cancer Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Community Regional Cancer Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46256
Country
United States
Facility Name
Horizon Oncology Research, Inc./IU Health Arnett
City
Lafayette
State/Province
Indiana
ZIP/Postal Code
47905
Country
United States
Facility Name
Monroe Medical Associates
City
Munster
State/Province
Indiana
ZIP/Postal Code
46321
Country
United States
Facility Name
Northern Indiana Cancer Research Consortium
City
South Bend
State/Province
Indiana
ZIP/Postal Code
46601
Country
United States
Facility Name
Metro Health Cancer Care
City
Wyoming
State/Province
Michigan
ZIP/Postal Code
49519
Country
United States
Facility Name
Siteman Cancer Center
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Comprehensive Cancer Centers of Nevada
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89128
Country
United States
Facility Name
The Center for Cancer & Hematologic Disease
City
Cherry Hill
State/Province
New Jersey
ZIP/Postal Code
08003
Country
United States
Facility Name
Virtua Health Cancer Program
City
Mount Holly
State/Province
New Jersey
ZIP/Postal Code
08060
Country
United States
Facility Name
South Jersey Health Care
City
Vineland
State/Province
New Jersey
ZIP/Postal Code
08360
Country
United States
Facility Name
Presbyterian Medical Group
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87110
Country
United States
Facility Name
University of New Mexico Cancer Center: Albuquerque
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87131
Country
United States
Facility Name
HOPE a Women's Cancer Center
City
Asheville
State/Province
North Carolina
ZIP/Postal Code
28806
Country
United States
Facility Name
Seidman Cancer Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Oregon Health Sciences University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Pinnacle Health Fox Chase Regional Cancer Center
City
Harrisburg
State/Province
Pennsylvania
ZIP/Postal Code
17110
Country
United States
Facility Name
Bux-Mont Oncology Hematology Associates (FCCC) at Grand View Hospital
City
Sellersville
State/Province
Pennsylvania
ZIP/Postal Code
18960
Country
United States
Facility Name
The West Clinic
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38138
Country
United States
Facility Name
Virginia Oncology Associates
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23502
Country
United States
12. IPD Sharing Statement
Citations:
Citation
S. R. Malireddy, S. M. Perkins, S. S. Badve, G. W. Sledge, K. Miller. PARP inhibition after preoperative chemotherapy in patients with triple negative breast cancer (TNBC) or known BRCA1/2 mutations: Hoosier oncology group BRE09-146. J Clin Oncol 29: 2011 (suppl; abstr TPS130)
Results Reference
background
Citation
S. Dwadasi, Y. Tong, T. Walsh, M.A. Danso, C.X. Ma, P.A Silverman, M.C. King, S.M. Perkins, S.S. Badve, K. Miller. Cisplatin with or without rucaparib after preoperative chemotherapy in patients with triple negative breast cancer: Hoosier Oncology Group BRE09-146. J Clin Oncol 32:5s, 2014 (suppl; abstr 1019^)
Results Reference
background
Citation
Miller K, Tong Y, Jones DR, Walsh T, Danso MA, Ma CX, Silverman P, King MC, Badve SS, Perkins SM. Cisplatin with or without rucaparib after preoperative chemotherapy in patients with triple negative breast cancer: Final efficacy results of Hoosier Oncology Group BRE09-146. J Clin Oncol 33:5s, 2015 (suppl; abstr 1082)
Results Reference
result
Links:
URL
http://www.hoosiercancer.org
Description
Hoosier Cancer Research Network Homepage
Learn more about this trial
PARP Inhibition for Triple Negative Breast Cancer (ER-/PR-/HER2-)With BRCA1/2 Mutations
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