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Niraparib Combined With Anlotinib in Homologous Recombination Repair (HRR) Gene-mutated Advanced Solid Tumors

Primary Purpose

HER2-negative Breast Cancer, Gastric Adenocarcinoma, Cholangiocarcinoma

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Niraparib
Anlotinib
Sponsored by
Peking University Cancer Hospital & Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HER2-negative Breast Cancer focused on measuring Niraprib, Anlotinib, Homologous Recombination Repair, breast cancer, gastric Adenocarcinoma, cholangiocarcinoma, pancreatic cancer

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subjects understand the trial process, sign informed consent, agree to participate in the study, and have the ability to follow the protocol;
  • 18 ~ 70 years old
  • HER2 negative breast cancer, cholangiocarcinoma, gastric adenocarcinoma and pancreatic cancer confirmed by histology or cytology meet any of the following conditions: first line treatment failure of HER2 negative breast cancer; first line treatment failure of cholangiocarcinoma; second line treatment failure of gastric adenocarcinoma; first line treatment failure of pancreatic cancer
  • At least one measurable target lesion that meet RECIST 1.1 criteria
  • Can provide paraffin-embedded tumor tissue samples or plasma samples for HRR gene detection
  • Carry pathogenic or suspected pathogenic germline or somatic HRR gene mutations, HRR genes include BRCA1, BRCA2, ATM, ATR, BAP1, BRIP1, CHEK2, FANCA, PALB2 and RAD51, mutations in other HRR genes should be evaluated by researchers and the pathogenicity should be supported by published literature or clinical studies.
  • ECOG physical status score is 0-1
  • Life expectancy > 6 months
  • Good organ function, including: Neutrophil count >= 1500 / μL; Platelets >= 100,000 / μL; Hemoglobin >= 10g / dL; Serum creatinine <= 1.5 times the upper limit of normal value, or creatinine clearance >= 60mL / min (calculated according to Cockcroft-Gault formula); Total bilirubin <= 1.5 times the upper limit of normal value or direct bilirubin <= 1.0 times the upper limit of normal value; AST and ALT <= 2.5 times the upper limit of normal value. When liver metastases are present, it must be <= 5 times the upper limit of normal value
  • The toxic side effects of any previous chemotherapy have recovered to <= CTCAE level 1 or baseline levels, except for sensory neuropathy or hair loss with stable symptoms <= CTCAE level 2

Exclusion Criteria:

  • People who are known to be allergic to Niraparib or Anlotinib (or active or inactive ingredients of drugs with similar chemical structure)
  • Symptomatic, uncontrolled brain or pia mater metastases
  • Underwent major surgery within 3 weeks before the study began or has not recovered after surgery
  • Received palliative radiotherapy of > 20% bone marrow 1 week before enrollment
  • Have invasive cancer other than ovarian cancer (except fully treated basal or squamous cell skin cancer) within 2 years before enrollment
  • Patients with tumor invasion of large vessels
  • Previous or currently diagnosed myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML)
  • Severe or uncontrolled diseases, including but not limited to: uncontrollable nausea and vomiting, inability to swallow or gastrointestinal diseases that may interfere with drug absorption and metabolism; active viral infections; mental illnesses that affect patients' signed informed consent History of bleeding tendency and thrombosis; history of severe cardiovascular disease
  • Laboratory abnormalities: hyponatremia; hypokalemia; uncontrollable nail function abnormalities
  • Receive platelet or red blood cell transfusions within 4 weeks
  • Patients who are pregnant or nursing, or who plan to become pregnant during study treatment
  • Have previously received any PARP inhibitor or Anlotinib treatment

Sites / Locations

  • Beijing Cancer Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment group

Arm Description

Niraparib-Anlotinib combination therapy

Outcomes

Primary Outcome Measures

Dose limiting toxicity (DLT) and maximum tolerated dose (MTD)

Secondary Outcome Measures

The frequency and severity of adverse events
The frequency and severity of adverse events and toxicity based upon NCI CTCAE version 5.0 during subjects receiving the treatment
Objective Response Rate (ORR)
The ORR is a combination of CR (the target lesion completely disappeared over 4 weeks) and PR (Target lesions were reduced by more than 30% for more than 4 weeks).
Progression-free survival (PFS)
PFS is defined as the time from enrollment to first documentation of tumor progression, or to death due to any cause in the absence of previous documentation of objective tumor progression.

Full Information

First Posted
February 18, 2021
Last Updated
February 18, 2021
Sponsor
Peking University Cancer Hospital & Institute
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1. Study Identification

Unique Protocol Identification Number
NCT04764084
Brief Title
Niraparib Combined With Anlotinib in Homologous Recombination Repair (HRR) Gene-mutated Advanced Solid Tumors
Official Title
A Single Arm, Single Center, Phase I Trial of Niraparib Plus Anlotinib in Advanced Solid Tumors With Homologous Recombination Repair (HRR) Gene Mutations
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Unknown status
Study Start Date
April 1, 2021 (Anticipated)
Primary Completion Date
November 1, 2021 (Anticipated)
Study Completion Date
February 28, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking University Cancer Hospital & Institute

4. Oversight

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

5. Study Description

Brief Summary
Homologous Recombination Repair (HRR) gene mutations can be detected in many solid tumors, patients with HRR gene mutations may benefit from PARP inhibitor. Antiangiogenic drugs can induce hypoxia and increase the sensitivity to PARP inhibitor. The combination of PARP inhibitor and antiangiogenic drug can play a synergistic anti-tumor role and achieve good efficacy in HRR gene-mutated tumors. The purpose of the study is to determine the dose limiting toxicity (DLT) and maximum tolerable dose (MTD) of Niraparib plus Anlotinib in HRR gene-mutated advanced solid tumors, and evaluate the safety and effectiveness of this combination therapy preliminarily.
Detailed Description
This is a single-arm, single-center, phase I study to investigate the DLT and MDT, safety and efficacy of Niraparib combined with Anlotinib in the treatment of advanced solid tumors with HRR gene mutations. In this study, 52 histological or cytological diagnosis, previous treatment failure patients of HER2 negative breast cancer, cholangiocarcinoma, gastric adenocarcinoma and pancreatic cancer are included and receive Niraparib combined with Anlotinib. Patients are required to carry pathogenic or suspected pathogenic gBRCA or sBRCA mutations, or HRR gene mutations defined by the inclusion criteria. The study will be divided into two phase. The first phase will include 6-12 patients on a 21-day cycle to determine the DLT and MTD. In the second phase, 40 patients will be included to treated with Niraparib plus Anlotinib until disease progression or intolerable toxicity or withdrawal of the trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HER2-negative Breast Cancer, Gastric Adenocarcinoma, Cholangiocarcinoma, Pancreatic Cancer
Keywords
Niraprib, Anlotinib, Homologous Recombination Repair, breast cancer, gastric Adenocarcinoma, cholangiocarcinoma, pancreatic cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment group
Arm Type
Experimental
Arm Description
Niraparib-Anlotinib combination therapy
Intervention Type
Drug
Intervention Name(s)
Niraparib
Other Intervention Name(s)
Zejula
Intervention Description
Niraparib 100mg or 200mg, PO, qd,d1-d21
Intervention Type
Drug
Intervention Name(s)
Anlotinib
Intervention Description
Anlotinib 12mg, PO, qd,d1-d14
Primary Outcome Measure Information:
Title
Dose limiting toxicity (DLT) and maximum tolerated dose (MTD)
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
The frequency and severity of adverse events
Description
The frequency and severity of adverse events and toxicity based upon NCI CTCAE version 5.0 during subjects receiving the treatment
Time Frame
Baseline through 1 year
Title
Objective Response Rate (ORR)
Description
The ORR is a combination of CR (the target lesion completely disappeared over 4 weeks) and PR (Target lesions were reduced by more than 30% for more than 4 weeks).
Time Frame
at 6 months
Title
Progression-free survival (PFS)
Description
PFS is defined as the time from enrollment to first documentation of tumor progression, or to death due to any cause in the absence of previous documentation of objective tumor progression.
Time Frame
at 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects understand the trial process, sign informed consent, agree to participate in the study, and have the ability to follow the protocol; 18 ~ 70 years old HER2 negative breast cancer, cholangiocarcinoma, gastric adenocarcinoma and pancreatic cancer confirmed by histology or cytology meet any of the following conditions: first line treatment failure of HER2 negative breast cancer; first line treatment failure of cholangiocarcinoma; second line treatment failure of gastric adenocarcinoma; first line treatment failure of pancreatic cancer At least one measurable target lesion that meet RECIST 1.1 criteria Can provide paraffin-embedded tumor tissue samples or plasma samples for HRR gene detection Carry pathogenic or suspected pathogenic germline or somatic HRR gene mutations, HRR genes include BRCA1, BRCA2, ATM, ATR, BAP1, BRIP1, CHEK2, FANCA, PALB2 and RAD51, mutations in other HRR genes should be evaluated by researchers and the pathogenicity should be supported by published literature or clinical studies. ECOG physical status score is 0-1 Life expectancy > 6 months Good organ function, including: Neutrophil count >= 1500 / μL; Platelets >= 100,000 / μL; Hemoglobin >= 10g / dL; Serum creatinine <= 1.5 times the upper limit of normal value, or creatinine clearance >= 60mL / min (calculated according to Cockcroft-Gault formula); Total bilirubin <= 1.5 times the upper limit of normal value or direct bilirubin <= 1.0 times the upper limit of normal value; AST and ALT <= 2.5 times the upper limit of normal value. When liver metastases are present, it must be <= 5 times the upper limit of normal value The toxic side effects of any previous chemotherapy have recovered to <= CTCAE level 1 or baseline levels, except for sensory neuropathy or hair loss with stable symptoms <= CTCAE level 2 Exclusion Criteria: People who are known to be allergic to Niraparib or Anlotinib (or active or inactive ingredients of drugs with similar chemical structure) Symptomatic, uncontrolled brain or pia mater metastases Underwent major surgery within 3 weeks before the study began or has not recovered after surgery Received palliative radiotherapy of > 20% bone marrow 1 week before enrollment Have invasive cancer other than ovarian cancer (except fully treated basal or squamous cell skin cancer) within 2 years before enrollment Patients with tumor invasion of large vessels Previous or currently diagnosed myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) Severe or uncontrolled diseases, including but not limited to: uncontrollable nausea and vomiting, inability to swallow or gastrointestinal diseases that may interfere with drug absorption and metabolism; active viral infections; mental illnesses that affect patients' signed informed consent History of bleeding tendency and thrombosis; history of severe cardiovascular disease Laboratory abnormalities: hyponatremia; hypokalemia; uncontrollable nail function abnormalities Receive platelet or red blood cell transfusions within 4 weeks Patients who are pregnant or nursing, or who plan to become pregnant during study treatment Have previously received any PARP inhibitor or Anlotinib treatment
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jiayang Zhang, M.D.
Phone
+86-010-88196380
Email
jiayangzhang2015@qq.com
First Name & Middle Initial & Last Name or Official Title & Degree
Anqiang Wang, M.D.
Phone
+86-010-88196970
Email
wanganqiang0902@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Huiping Li, M.D.
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jiafu Ji, M.D.
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Cancer Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100142
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Huiping Li, M.D.
Phone
+86-010-88196739
Email
huipingli2012@hotmail.com
First Name & Middle Initial & Last Name & Degree
Jiafu Ji, M.D.
Phone
+86-010-88122437
Email
jijiafu@hsc.pku.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Within six months after the trial complete, study protocol, informed consent form and clinical study report will be shared.
IPD Sharing Time Frame
Within six months after the trial complete
IPD Sharing Access Criteria
Publication

Learn more about this trial

Niraparib Combined With Anlotinib in Homologous Recombination Repair (HRR) Gene-mutated Advanced Solid Tumors

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