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Trial of M4344 and Niraparib in Patients With Poly (ADP-ribose) Polymerase (PARP) Resistant Recurrent Ovarian Cancer (PARP)

Primary Purpose

Ovarian Cancer Recurrent

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
M4344+Niraparib
M4344+Niraparib
Sponsored by
University of Alabama at Birmingham
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ovarian Cancer Recurrent focused on measuring Ovarian Cancer, PARP Resistant, ATR inhibitor, M4344, Niraparib

Eligibility Criteria

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

Inclusion Criteria:

  • Patients must have been diagnosed with advanced epithelial serous ovarian cancer, primary peritoneal cancer or fallopian tube cancer
  • Patients must have PARP resistant ovarian cancer, defined as progression while being treated with a PARP inhibitor.
  • Patients must have at least one lesion that meets the definition of measurable disease by RECIST v1.1.
  • Patients must have received at least one but no more than five prior systemic treatment regimens
  • Female patients ≥ 18 years of age
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or

Exclusion Criteria:

  • Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment.
  • Patients cannot have had primary platinum refractory cancer, i.e. documented cancer progression while receiving platinum or within one month of receipt of a platinum based regimen.
  • Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent.
  • Has a known additional malignancy that is progressing or requires active treatment. In addition, patients cannot have been diagnosed with another malignancy within 3 years of starting treatment. Exceptions include fully resected basal cell carcinoma of the skin or squamous cell carcinoma of the skin, in situ cervical cancer, fully resected ductal carcinoma in situ, and stage IA, noninvasive grade I endometrioid endometrial cancer, that has undergone curative therapy.
  • Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment. This exception does not include clinically active and significant carcinomatous meningitis that is excluded regardless of clinical stability.
  • Has an active infection requiring systemic therapy
  • Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the participant's participation for the full duration of the trial, or is not in the best interest of the participant to participate, in the opinion of the treating investigator.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    M4344+Niraparib

    Arm Description

    all PARP resistant, recurrent ovarian cancer

    Outcomes

    Primary Outcome Measures

    Percentage of patients with treatment emergent adverse events as defined by CTCAE v.4.03
    Number and percentage of patients with treatment emergent adverse events and toxicity based upon CTCAE v.4.03 scoring.
    Maximum tolerated dose (MTD) of M4344 and Niraparib as defined by CTCAE 4.03
    To determine the MTD of M4344 and Niraparib during the dose escalation as defined by CTCAE v.4.03

    Secondary Outcome Measures

    Overall Response Rate (ORR) as defined by RECIST v.1.1
    To determine response rate among ovarian cancer patients that have become resistant to PARPi who are treated with ATRi + Niraparib as defined by RECIST v.1.1.
    Percentage progression free survival (PFS) as defined by RECIST v.1.1
    To determine percentage of patients who remain progression free at 6 months (%PFS) among ovarian cancer patients that have become resistant to PARPi who are treated with ATRi + Niraparib as defined by RECIST v.1.1.

    Full Information

    First Posted
    October 23, 2019
    Last Updated
    June 6, 2023
    Sponsor
    University of Alabama at Birmingham
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04149145
    Brief Title
    Trial of M4344 and Niraparib in Patients With Poly (ADP-ribose) Polymerase (PARP) Resistant Recurrent Ovarian Cancer
    Acronym
    PARP
    Official Title
    Trial of M4344 and Niraparib in Patients With PARP Resistant Recurrent Ovarian Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2023
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    never opened
    Study Start Date
    May 2023 (Anticipated)
    Primary Completion Date
    May 2024 (Anticipated)
    Study Completion Date
    May 2027 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    University of Alabama at Birmingham

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this study is to find out if a new drug, M4344, is safe and has beneficial effects when given in combination with the PARP inhibitor, Niraparib, in women with recurrent ovarian cancer that has progressed while on a PARP inhibitor.
    Detailed Description
    The primary, secondary, and exploratory objective are to assess the safety of the combination of M4344 and Niraparib in a phase 1 trial of patients with PARP resistant recurrent ovarian cancer; to determine the response rate and percentage of participants who remain progression free survival (PFS) at 6 months (%PFS) among ovarian cancer participants that have become resistant to poly (adenosine diphosphate [ADP]) ribose polymerase inhibitors (PARPi) who are treated with ataxia telangiectasia and Rad3-related protein inhibitors (ATRi) + Niraparib in the dose expansion cohort; and to identify potential biological predictors of response and progression of disease with the combination of M4344 and Niraparib.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Ovarian Cancer Recurrent
    Keywords
    Ovarian Cancer, PARP Resistant, ATR inhibitor, M4344, Niraparib

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    M4344+Niraparib
    Arm Type
    Experimental
    Arm Description
    all PARP resistant, recurrent ovarian cancer
    Intervention Type
    Drug
    Intervention Name(s)
    M4344+Niraparib
    Other Intervention Name(s)
    PARPi+ATRi
    Intervention Description
    The first phase will be a 3+3 design of fixed dose Niraparib by mouth (PO) every day (QD) and M4344 will be escalated from 100-200 mg PO QD (28-day cycle). There will be a 4-week lead in with niraparib only.
    Intervention Type
    Drug
    Intervention Name(s)
    M4344+Niraparib
    Other Intervention Name(s)
    PARPi+ATRi
    Intervention Description
    In the second phase eligible patients will receive combination Niraparib + the determined dose of M4344 from the first phase.
    Primary Outcome Measure Information:
    Title
    Percentage of patients with treatment emergent adverse events as defined by CTCAE v.4.03
    Description
    Number and percentage of patients with treatment emergent adverse events and toxicity based upon CTCAE v.4.03 scoring.
    Time Frame
    Baseline through 1 year
    Title
    Maximum tolerated dose (MTD) of M4344 and Niraparib as defined by CTCAE 4.03
    Description
    To determine the MTD of M4344 and Niraparib during the dose escalation as defined by CTCAE v.4.03
    Time Frame
    Baseline through 1 year
    Secondary Outcome Measure Information:
    Title
    Overall Response Rate (ORR) as defined by RECIST v.1.1
    Description
    To determine response rate among ovarian cancer patients that have become resistant to PARPi who are treated with ATRi + Niraparib as defined by RECIST v.1.1.
    Time Frame
    Baseline through 6 months
    Title
    Percentage progression free survival (PFS) as defined by RECIST v.1.1
    Description
    To determine percentage of patients who remain progression free at 6 months (%PFS) among ovarian cancer patients that have become resistant to PARPi who are treated with ATRi + Niraparib as defined by RECIST v.1.1.
    Time Frame
    Baseline through 6 months

    10. Eligibility

    Sex
    Female
    Gender Based
    Yes
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients must have been diagnosed with advanced epithelial serous ovarian cancer, primary peritoneal cancer or fallopian tube cancer Patients must have PARP resistant ovarian cancer, defined as progression while being treated with a PARP inhibitor. Patients must have at least one lesion that meets the definition of measurable disease by RECIST v1.1. Patients must have received at least one but no more than five prior systemic treatment regimens Female patients ≥ 18 years of age Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or Exclusion Criteria: Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment. Patients cannot have had primary platinum refractory cancer, i.e. documented cancer progression while receiving platinum or within one month of receipt of a platinum based regimen. Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent. Has a known additional malignancy that is progressing or requires active treatment. In addition, patients cannot have been diagnosed with another malignancy within 3 years of starting treatment. Exceptions include fully resected basal cell carcinoma of the skin or squamous cell carcinoma of the skin, in situ cervical cancer, fully resected ductal carcinoma in situ, and stage IA, noninvasive grade I endometrioid endometrial cancer, that has undergone curative therapy. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment. This exception does not include clinically active and significant carcinomatous meningitis that is excluded regardless of clinical stability. Has an active infection requiring systemic therapy Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the participant's participation for the full duration of the trial, or is not in the best interest of the participant to participate, in the opinion of the treating investigator.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Rebecca C Arend, MD, MSPH
    Organizational Affiliation
    University of Alabama at Birmingham
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    IPD Sharing Plan Description
    To-Be-Determined
    Citations:
    PubMed Identifier
    34045232
    Citation
    Jo U, Senatorov IS, Zimmermann A, Saha LK, Murai Y, Kim SH, Rajapakse VN, Elloumi F, Takahashi N, Schultz CW, Thomas A, Zenke FT, Pommier Y. Novel and Highly Potent ATR Inhibitor M4344 Kills Cancer Cells With Replication Stress, and Enhances the Chemotherapeutic Activity of Widely Used DNA Damaging Agents. Mol Cancer Ther. 2021 Aug;20(8):1431-1441. doi: 10.1158/1535-7163.MCT-20-1026. Epub 2021 May 27.
    Results Reference
    derived

    Learn more about this trial

    Trial of M4344 and Niraparib in Patients With Poly (ADP-ribose) Polymerase (PARP) Resistant Recurrent Ovarian Cancer

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