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Withdrawn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
About this trial
This is an interventional treatment trial for Squamous Cell Carcinoma of the Head and Neck
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)
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
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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