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Palbociclib With Cisplatin or Carboplatin in Advanced Solid Tumors

Primary Purpose

Solid Neoplasm, Stage III Pancreatic Cancer, Stage IIIA Breast Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Carboplatin
Cisplatin
Palbociclib
Sponsored by
Emory University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Solid Neoplasm

Eligibility Criteria

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

Inclusion Criteria:

  • Patients must have histologically or cytologically confirmed solid organ malignancy
  • Patients enrolled in the expansion cohort must have histologically or cytologically confirmed squamous non-small cell lung cancer (NSCLC), breast or pancreaticobiliary tract cancer
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
  • Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as ≥ 20 mm (≥ 2 cm) with conventional techniques or as ≥ 10 mm (≥ 1 cm) with spiral computed tomography (CT) scan, magnetic resonance imaging (MRI), or calipers by clinical exam
  • Leukocytes ≥ 3,000/mL
  • Absolute neutrophil count ≥ 1,500/mL
  • Platelets ≥ 100,000/mL
  • Hemoglobin ≥ 10 g/dL
  • Total bilirubin ≤ 1.5 × institutional upper limit of normal (except for patients with Gilbert disease)
  • Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/ alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 2.5 × institutional upper limit of normal (up to 5 X upper limit of normal [ULN] for patients with liver metastasis)
  • Creatinine within normal institutional limits OR creatinine clearance ≥ 60 mL/min/1.73 m² for patients with creatinine levels above institutional normal
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately; men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and for 6 months after completion of study drug administration
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

  • Patients who have had cytotoxic anticancer chemotherapy or immune checkpoint inhibitor within 4 weeks (6 weeks for nitrosoureas or mitomycin C) or palliative radiation within 2 weeks (stereotactic radiation therapy [SRS] for brain metastasis within 48 hours) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
  • Patients receiving cytotoxic agent as immunomodulatory therapy for a non neoplastic indication (e.g. methotrexate for rheumatoid arthritis) and who are unable to discontinue such agents within 2 weeks prior to starting treatment
  • Oral targeted therapy within five days or five half-lives, whichever is longer, prior to initiating protocol therapy treatment
  • Patients who are receiving any other investigational agents
  • Use of strong cytochrome P450, family 3, subfamily A (CYP3A) inhibitors and inducers
  • Patients with symptomatic uncontrolled brain metastases are excluded; (patients with stable treated or asymptomatic untreated brain metastasis not requiring glucocorticoids are allowed)
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to palbociclib, carboplatin or cisplatin
  • Concurrent administration of strong inducers and inhibitors of CYP3A enzyme or CYP3A substrates with narrow therapeutic window
  • Uncontrolled intercurrent illness including, but not limited to:

    • Ongoing or active infection requiring intravenous antibiotics at the time of treatment initiation
    • Symptomatic congestive heart failure (requiring hospital stay within the last 6 months)
    • Myocardial infarction within the last 6 months
    • Unstable angina pectoris, cardiac arrhythmia
    • Psychiatric illness
  • Social situations or circumstances that would limit compliance with study requirements
  • Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated with palbociclib
  • Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy are ineligible

Sites / Locations

  • Emory University/Winship Cancer Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Arm A (palbociclib, cisplatin)

Arm B (palbociclib, carboplatin)

Arm Description

Patients receive cisplatin IV over 30-60 minutes on day 1 and palbociclib PO QD on days 2-22. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Patients receive carboplatin IV over 30-60 minutes on day 1 and palbociclib PO QD on days 2-22. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Incidence of adverse events according to National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0
Incidence of dose limiting toxicities defined as grade 3 or higher toxicity
Recommended phase 2 dose (RP2D) as the highest doses of palbociclib and cisplatin or palbociclib and carboplatin

Secondary Outcome Measures

Overall response rate (complete response + partial response) assessed by Response Evaluation Criteria in Solid Tumors 1.1 criteria
Will be summarized and presented along with 95% exact confidence intervals.
Pharmacokinetic (PK) characteristics of carboplatin including maximum concentration (Cmax)
Within-subject and between-cohort comparisons of Cmax will be performed using Wilcoxon (non-parametric) test.
Pharmacokinetic (PK) characteristics of cisplatin including maximum concentration (Cmax)
Within-subject and between-cohort comparisons of Cmax will be performed using Wilcoxon (non-parametric) test.

Full Information

First Posted
August 30, 2016
Last Updated
October 6, 2023
Sponsor
Emory University
Collaborators
Pfizer, National Institutes of Health (NIH), National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT02897375
Brief Title
Palbociclib With Cisplatin or Carboplatin in Advanced Solid Tumors
Official Title
A Phase 1 Study of Palbociclib in Combination With Cisplatin or Carboplatin in Advanced Solid Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Completed
Study Start Date
October 24, 2016 (Actual)
Primary Completion Date
October 15, 2021 (Actual)
Study Completion Date
October 15, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Emory University
Collaborators
Pfizer, National Institutes of Health (NIH), National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase I trial studies the side effects and best dose of palbociclib with cisplatin or carboplatin in treating patients with solid tumors that have spread to other places and usually cannot be cured or controlled with treatment. Palbociclib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cisplatin and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving palbociclib with cisplatin or carboplatin may help stop tumor growth in patients with advanced solid tumors.
Detailed Description
PRIMARY OBJECTIVES: I. Assess the safety and tolerability of palbociclib when administered along with cisplatin or carboplatin. II. Establish the recommended phase 2 dose (RP2D) of the tested combinations. SECONDARY OBJECTIVES: I. Characterize the pharmacokinetic (PK) profiles of cisplatin, carboplatin. II. Obtain preliminary evidence of anti-tumor efficacy of the tested combination regimens. III. Conduct PK/pharmacodynamics (PD) correlative analyses using palbociclib trough concentration and cyclin-dependent kinase 4 (CDK4) inhibition read-outs in tumor and surrogate samples collected on course 1 day 22 (C1D22). IV. Assess potential association between tissue-based biomarkers and efficacy. OUTLINE: This is a dose-escalation study. Patients are assigned to 1 of 2 arms. ARM A: Patients receive cisplatin intravenously (IV) over 30-60 minutes on day 1 and palbociclib orally (PO) once daily (QD) on days 2-22. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. ARM B: Patients receive carboplatin IV over 30-60 minutes on day 1 and palbociclib PO QD on days 2-22. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed for up to 4 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Solid Neoplasm, Stage III Pancreatic Cancer, Stage IIIA Breast Cancer, Stage IIIA Non-Small Cell Lung Cancer, Stage IIIB Breast Cancer, Stage IIIB Non-Small Cell Lung Cancer, Stage IIIC Breast Cancer, Stage IV Breast Cancer, Stage IV Non-Small Cell Lung Cancer, Stage IVA Pancreatic Cancer, Stage IVB Pancreatic Cancer, Sarcoma, Colorectal Cancer, Head and Neck Cancer, Cancer of Unknown Primary, Bladder Cancer, Ovarian Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Arm A (palbociclib, cisplatin)
Arm Type
Experimental
Arm Description
Patients receive cisplatin IV over 30-60 minutes on day 1 and palbociclib PO QD on days 2-22. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Arm Title
Arm B (palbociclib, carboplatin)
Arm Type
Experimental
Arm Description
Patients receive carboplatin IV over 30-60 minutes on day 1 and palbociclib PO QD on days 2-22. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Other Intervention Name(s)
Paraplatin
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Other Intervention Name(s)
CDDP, Cis-diamminedichloridoplatinum, Cisplatinum, Cismaplat, Neoplatin
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
Palbociclib
Other Intervention Name(s)
Ibrance, PD-0332991
Intervention Description
Given PO
Primary Outcome Measure Information:
Title
Incidence of adverse events according to National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0
Time Frame
Study completion, an average of 2 years
Title
Incidence of dose limiting toxicities defined as grade 3 or higher toxicity
Time Frame
Up to 4 weeks
Title
Recommended phase 2 dose (RP2D) as the highest doses of palbociclib and cisplatin or palbociclib and carboplatin
Time Frame
Study completion, an average of 2 years
Secondary Outcome Measure Information:
Title
Overall response rate (complete response + partial response) assessed by Response Evaluation Criteria in Solid Tumors 1.1 criteria
Description
Will be summarized and presented along with 95% exact confidence intervals.
Time Frame
Up to 3 years
Title
Pharmacokinetic (PK) characteristics of carboplatin including maximum concentration (Cmax)
Description
Within-subject and between-cohort comparisons of Cmax will be performed using Wilcoxon (non-parametric) test.
Time Frame
Up to 4 weeks
Title
Pharmacokinetic (PK) characteristics of cisplatin including maximum concentration (Cmax)
Description
Within-subject and between-cohort comparisons of Cmax will be performed using Wilcoxon (non-parametric) test.
Time Frame
Up to 4 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have histologically or cytologically confirmed solid organ malignancy Patients enrolled in the expansion cohort must have histologically or cytologically confirmed squamous non-small cell lung cancer (NSCLC), breast or pancreaticobiliary tract cancer Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as ≥ 20 mm (≥ 2 cm) with conventional techniques or as ≥ 10 mm (≥ 1 cm) with spiral computed tomography (CT) scan, magnetic resonance imaging (MRI), or calipers by clinical exam Leukocytes ≥ 3,000/mL Absolute neutrophil count ≥ 1,500/mL Platelets ≥ 100,000/mL Hemoglobin ≥ 10 g/dL Total bilirubin ≤ 1.5 × institutional upper limit of normal (except for patients with Gilbert disease) Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/ alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 2.5 × institutional upper limit of normal (up to 5 X upper limit of normal [ULN] for patients with liver metastasis) Creatinine within normal institutional limits OR creatinine clearance ≥ 60 mL/min/1.73 m² for patients with creatinine levels above institutional normal Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately; men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and for 6 months after completion of study drug administration Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: Patients who have had cytotoxic anticancer chemotherapy or immune checkpoint inhibitor within 4 weeks (6 weeks for nitrosoureas or mitomycin C) or palliative radiation within 2 weeks (stereotactic radiation therapy [SRS] for brain metastasis within 48 hours) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier Patients receiving cytotoxic agent as immunomodulatory therapy for a non neoplastic indication (e.g. methotrexate for rheumatoid arthritis) and who are unable to discontinue such agents within 2 weeks prior to starting treatment Oral targeted therapy within five days or five half-lives, whichever is longer, prior to initiating protocol therapy treatment Patients who are receiving any other investigational agents Use of strong cytochrome P450, family 3, subfamily A (CYP3A) inhibitors and inducers Patients with symptomatic uncontrolled brain metastases are excluded; (patients with stable treated or asymptomatic untreated brain metastasis not requiring glucocorticoids are allowed) History of allergic reactions attributed to compounds of similar chemical or biologic composition to palbociclib, carboplatin or cisplatin Concurrent administration of strong inducers and inhibitors of CYP3A enzyme or CYP3A substrates with narrow therapeutic window Uncontrolled intercurrent illness including, but not limited to: Ongoing or active infection requiring intravenous antibiotics at the time of treatment initiation Symptomatic congestive heart failure (requiring hospital stay within the last 6 months) Myocardial infarction within the last 6 months Unstable angina pectoris, cardiac arrhythmia Psychiatric illness Social situations or circumstances that would limit compliance with study requirements Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated with palbociclib Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy are ineligible
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Olatunji B Alese, MD
Organizational Affiliation
Emory University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Emory University/Winship Cancer Institute
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Palbociclib With Cisplatin or Carboplatin in Advanced Solid Tumors

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