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Pharmacodynamic Study to Assess the Anti-proliferative Activity of the PARP Inhibitor Olaparib in Patients With HPV Positive and HPV Negative HNSCC

Primary Purpose

Squamous Cell Carcinoma of the Head and Neck

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Olaparib
Sponsored by
Yale University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Squamous Cell Carcinoma of the Head and Neck

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically confirmed HNSCC with surgically resectable disease
  • No prior chemotherapy or radiation therapy as treatment for the observed HNSCC
  • Patients must provide written informed consent
  • Age >=18 years of age
  • Eastern Cooperative Oncology Group (ECOG) Performance Status score of <2
  • Normal organ and bone marrow function measured within 28 days prior to administration of study treatment as defined below:
  • Hemoglobin >= 10 g/dL and no blood transfusions in the 28 days prior to entry/randomization
  • Absolute neutrophil count >=1.5 x 10^9/L
  • No features suggesting of MDS/AML on peripheral blood smear
  • White blood cells > 3 x 10^9/L
  • Platelet count >= 100 x 10^9/L
  • Total bilirubin <= 1.5 x institutional upper limit of normal (ULN)
  • AST (SGOT)/ALT (SGPT) < 2.5 x institutional upper limit of normal unless liver metastases are present in which case it must be < 5x ULN
  • Serum creatinine <= 1.5 x institutional ULN OR creatinine clearance >= 50 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal
  • Women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of the study participation and must have negative serum or urine pregnancy test within 1 week prior to beginning treatment on this trial
  • Must be abler to understand and sign a written informed consent document

Exclusion Criteria:

  • Patients with known brain metastases. Patients may have received WBRT within 14 days or focal radiation within 1 week of cycle 1, day 1. 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
  • Women must not be pregnant or breastfeeding
  • Patients with known hypersensitivity to olaparib or any of the excipients of the product
  • Patients receiving any other investigational agents within 4 weeks of starting the study
  • Involvement in the planning and/or conduct of the study
  • Any previous treatment with a PARP inhibitor, including olaparib
  • Concomitant use of known CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, indinavir, saquinavir, telithromycin, clarithromycin, and nelfinavir
  • Persistent toxicities (>=CTCAE grade 2)
  • Resting ECG with QTC >470msec on 2 or more time points within a 24 hour period or family history of long QT syndrome
  • Blood transfusions within 1 month prior to study start
  • Patients with myelodysplastic syndrome/acute myeloid leukemia
  • 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.
  • Unable to swallow oral medication
  • Immunocompromised patients, e.g., patients who are known to be serologically positive for HIV and are receiving antiviral therapy
  • Known active hepatic disease
  • Uncontrolled seizures
  • Previous 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
  • Currently on warfarin(subcutaneous heparin is permitted)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    HPV negative tumors

    HPV positive tumors

    Arm Description

    10 patients with HPV negative tumors: Non-oropharyngeal tumors or p16 negative and HPV negative oropharyngeal tumors

    10 patients with HPV positive tumors: p16 positive and HPV positive tumors

    Outcomes

    Primary Outcome Measures

    Change in Level of IHC-Ki-67 expression
    Tissue biopsy sections will be analyzed for proliferation (IHC-Ki-67) Ki-67 is a nuclear non-histone protein that is present at low levels in quiescent cells but is increased in proliferating cells. Thus, Ki-67 reactivity, defined as percent tumor cells staining positive as measured by immunohistochemical (IHC) staining, is a specific nuclear marker for cell proliferation.

    Secondary Outcome Measures

    Change in Tissue apoptosis
    Tissue biopsy sections will be analyzed for apoptosis. For example using the IHC-cleaved caspase-3 assay.
    Change in DNA repair pathways
    Tissue biopsy sections will be analyzed to determine effect on DNA repair pathways (PARP activity). Specifically Poly(ADP-ribose) immunohistochemical staining of tissue biopsies will be performed and PAR intensity scored as 0 (no signal), 1 (weak), 2 (strong intensity in >50% of tumor cells).

    Full Information

    First Posted
    September 24, 2015
    Last Updated
    January 9, 2020
    Sponsor
    Yale University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02686008
    Brief Title
    Pharmacodynamic Study to Assess the Anti-proliferative Activity of the PARP Inhibitor Olaparib in Patients With HPV Positive and HPV Negative HNSCC
    Official Title
    A Pilot Pharmacodynamic Study to Assess the Anti-proliferative Activity a of the Poly ADP Ribose Polymerase (PARP) Inhibitor Olaparib in Patients With Human Papilloma Virus (HPV) Positive and Human Papilloma Virus (HPV) Negative Head and Neck Squamous Cell Carcinoma (HNSCC)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2020
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    The study was stopped due to lack of funding.
    Study Start Date
    January 2018 (Anticipated)
    Primary Completion Date
    January 2019 (Anticipated)
    Study Completion Date
    July 2019 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Yale University

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Product Manufactured in and Exported from the U.S.
    Yes
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This is an open label pilot study evaluating the pharmacodynamics and safety of single agent olaparib administered at 300mg bid (twice a day) for 14 days orally in patients with human papillomavirus (HPV) -positive and human papillomavirus (HPV)-negative head and neck squamous cell carcinoma (HNSCC)

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Squamous Cell Carcinoma of the Head and Neck

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    HPV negative tumors
    Arm Type
    Experimental
    Arm Description
    10 patients with HPV negative tumors: Non-oropharyngeal tumors or p16 negative and HPV negative oropharyngeal tumors
    Arm Title
    HPV positive tumors
    Arm Type
    Experimental
    Arm Description
    10 patients with HPV positive tumors: p16 positive and HPV positive tumors
    Intervention Type
    Drug
    Intervention Name(s)
    Olaparib
    Other Intervention Name(s)
    Lynparza
    Intervention Description
    Patients will receive olaparib administered at 300 mg bid x 14 days orally
    Primary Outcome Measure Information:
    Title
    Change in Level of IHC-Ki-67 expression
    Description
    Tissue biopsy sections will be analyzed for proliferation (IHC-Ki-67) Ki-67 is a nuclear non-histone protein that is present at low levels in quiescent cells but is increased in proliferating cells. Thus, Ki-67 reactivity, defined as percent tumor cells staining positive as measured by immunohistochemical (IHC) staining, is a specific nuclear marker for cell proliferation.
    Time Frame
    Baseline and 14 days
    Secondary Outcome Measure Information:
    Title
    Change in Tissue apoptosis
    Description
    Tissue biopsy sections will be analyzed for apoptosis. For example using the IHC-cleaved caspase-3 assay.
    Time Frame
    Baseline and 14 days
    Title
    Change in DNA repair pathways
    Description
    Tissue biopsy sections will be analyzed to determine effect on DNA repair pathways (PARP activity). Specifically Poly(ADP-ribose) immunohistochemical staining of tissue biopsies will be performed and PAR intensity scored as 0 (no signal), 1 (weak), 2 (strong intensity in >50% of tumor cells).
    Time Frame
    Baseline and 14 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Histologically confirmed HNSCC with surgically resectable disease No prior chemotherapy or radiation therapy as treatment for the observed HNSCC Patients must provide written informed consent Age >=18 years of age Eastern Cooperative Oncology Group (ECOG) Performance Status score of <2 Normal organ and bone marrow function measured within 28 days prior to administration of study treatment as defined below: Hemoglobin >= 10 g/dL and no blood transfusions in the 28 days prior to entry/randomization Absolute neutrophil count >=1.5 x 10^9/L No features suggesting of MDS/AML on peripheral blood smear White blood cells > 3 x 10^9/L Platelet count >= 100 x 10^9/L Total bilirubin <= 1.5 x institutional upper limit of normal (ULN) AST (SGOT)/ALT (SGPT) < 2.5 x institutional upper limit of normal unless liver metastases are present in which case it must be < 5x ULN Serum creatinine <= 1.5 x institutional ULN OR creatinine clearance >= 50 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal Women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of the study participation and must have negative serum or urine pregnancy test within 1 week prior to beginning treatment on this trial Must be abler to understand and sign a written informed consent document Exclusion Criteria: Patients with known brain metastases. Patients may have received WBRT within 14 days or focal radiation within 1 week of cycle 1, day 1. 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 Women must not be pregnant or breastfeeding Patients with known hypersensitivity to olaparib or any of the excipients of the product Patients receiving any other investigational agents within 4 weeks of starting the study Involvement in the planning and/or conduct of the study Any previous treatment with a PARP inhibitor, including olaparib Concomitant use of known CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, indinavir, saquinavir, telithromycin, clarithromycin, and nelfinavir Persistent toxicities (>=CTCAE grade 2) Resting ECG with QTC >470msec on 2 or more time points within a 24 hour period or family history of long QT syndrome Blood transfusions within 1 month prior to study start Patients with myelodysplastic syndrome/acute myeloid leukemia 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. Unable to swallow oral medication Immunocompromised patients, e.g., patients who are known to be serologically positive for HIV and are receiving antiviral therapy Known active hepatic disease Uncontrolled seizures Previous 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 Currently on warfarin(subcutaneous heparin is permitted)
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Anne Chiang, MD, PhD
    Organizational Affiliation
    Yale University
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Pharmacodynamic Study to Assess the Anti-proliferative Activity of the PARP Inhibitor Olaparib in Patients With HPV Positive and HPV Negative HNSCC

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