AZD2281 and Irinotecan in Treating Patients With Locally Advanced or Metastatic Colorectal Cancer

This is an interventional treatment trial for Colorectal Cancer focused on measuring recurrent colon cancer, stage IV colon cancer, recurrent rectal cancer, stage IV rectal cancer, stage III rectal cancer, stage III colon cancer Read More

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed colorectal cancer

  • Locally advanced and/or metastatic disease
  • Disease considered incurable
• Suitable for treatment with single agent irinotecan hydrochloride as a palliative intervention, as determined by the investigator

• Must have clinically and/or radiologically documented disease

  • Patients whose only evidence of disease progression is tumor marker elevation are not eligible

• Must have received no more than one prior oxaliplatin- and/or irinotecan hydrochloride-based chemotherapy regimen given either with adjuvant, neoadjuvant, or palliative intent

  • One additional adjuvant fluoropyrimidine (fluorouracil or capecitabine) regimen may have been given for relapsed or metastatic disease
• No untreated brain or meningeal metastases (CT scan required if there is a clinical suspicion of CNS disease)

PATIENT CHARACTERISTICS:

• ECOG performance status 0-2
• Absolute granulocyte count ≥ 1,500/mm³
• Platelet count ≥ 100,000/mm³
• Bilirubin ≤ 1.5 times upper limit of normal (ULN)
• ALT and AST ≤ 2 times ULN (≤ 5 times ULN if liver metastasis is present)
• Serum creatinine ≤ 1.5 x ULN OR creatinine clearance ≥ 50 mL/min
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for 90 days after completion of study therapy
• Must reside within a 1½ hour drive from participating center
• No other invasive malignancies, unless curatively treated with no evidence of disease

• No GI tract disease resulting in an inability to absorb oral medication, including the following:

  • Uncontrolled inflammatory GI disease (e.g., Crohn's disease or ulcerative colitis)

  • Post-surgical malabsorption characterized by uncontrolled diarrhea that results in weight loss and vitamin deficiency or requires IV hyperalimentation

    • Pancreatic enzyme supplementation is allowed
• No untreated and/or uncontrolled hypertension, cardiovascular conditions, and/or symptomatic cardiac dysfunction
• No active or uncontrolled infections
• No serious illnesses or medical conditions that would preclude study participation
• No known hypersensitivity to the study drugs or their components, atropine, or loperamide
• Not known to be homozygous for the UGT1A1*28 allele
• No known deficiency in glucuronidation of bilirubin, such as Gilbert's syndrome

• No neuropathy ≥ grade 2

  • Patients with persistent, stable, grade 3 sensory neuropathy, who meet other eligibility criteria may be allowed at the discretion of the investigator

PRIOR CONCURRENT THERAPY:

• Recovered from all prior therapy
• No prior PARP inhibitor
• No prior radical pelvic irradiation
• No prior radiotherapy to ≥ 25% of bone marrow stores
• Prior irinotecan hydrochloride allowed provided the drug was not discontinued due to toxic effects and the patient did not have severe irinotecan hydrochloride-related toxicity (grade 4 or requiring hospitalization)
• At least 21 days since prior radiotherapy (exceptions may be made for low-dose, nonmyelosuppressive radiotherapy)
• At least 30 days since prior chemotherapy
• At least 21 days since prior hormonal, immunologic, biologic, or signal transduction inhibitor therapies
• More than 3 weeks since prior and no other concurrent investigational drugs or anticancer therapy

• At least 14 days since prior major surgery

  • Wound healing must have occurred

• At least 14 days since prior and no concurrent CYP3A4 enzyme-inducing or -inhibiting drugs, including enzyme-inducing anticonvulsants, rifampin, rifabutin, St. John's wort, atazanavir, or ketoconazole

  • Dexamethasone is allowed for antiemetic prophylaxis