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Talazoparib in Combination With Gemcitabine and Cisplatin in Patients With Advanced Solid Tumors

Primary Purpose

Solid Tumors, Carcinoma, Non-Small Cell Lung, Non-Small Cell Lung Cancer

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Cisplatin
Gemcitabine
Talazoparib
Sponsored by
Washington University School of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Solid Tumors

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically confirmed diagnosis of advanced solid tumor for which no curative standard treatment options exist and for which gemcitabine and cisplatin is a suitable treatment regimen.
  • After the determination of the maximum tolerated dose, an expansion cohort of 20 patients with non-small cell lung cancer whose tumors demonstrate variants in DNA repair pathway genes will be enrolled.
  • Measurable disease defined as lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 10 mm with CT scan, as ≥ 20 mm by chest x-ray, or ≥ 10 mm with calipers by clinical exam.
  • Prior treatment for this disease is allowed if it has been completed at least 2 weeks prior to study enrollment and if all treatment-related toxicities are resolved. Prior exposure to a PARP inhibitor is allowed for patients in the dose-finding portion of the study.
  • At least 18 years of age.
  • ECOG performance status ≤ 1
  • Normal bone marrow and organ function as defined below:

    • Leukocytes ≥ 3,000/mcL
    • Absolute neutrophil count ≥ 1,500/mcl
    • Platelets ≥ 100,000/mcl
    • Total bilirubin ≤ 1.5 x IULN
    • AST(SGOT)/ALT(SGPT) ≤ 3.0 x IULN
    • Creatinine ≤ IULN OR creatinine clearance ≥ 60 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal
    • Tissue available for sequencing (either archival tissue or readily accessible tumor for fresh routine biopsy).
    • Able to swallow tablets.
    • Women of childbearing 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 participating in this study, she must inform her treating physician immediately.
    • Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable).

Exclusion Criteria:

  • A history of other malignancy ≤ 5 years previous with the exception of basal cell or squamous cell carcinoma of the skin which were treated with local resection only or carcinoma in situ of the cervix.
  • Received any other investigational agent within 2 weeks of starting the first dose on study.
  • Symptomatic brain metastases. Known brain metastases are allowed if asymptomatic and previously treated. Patients must be at least 4 weeks post-brain radiation therapy.
  • A history of allergic reactions attributed to compounds of similar chemical or biologic composition to cisplatin, gemcitabine, talazoparib, or other agents used in the study.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active coronary artery disease, uncontrolled seizure, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Pregnant and/or breastfeeding. Women of childbearing potential must have a negative pregnancy test within 14 days of study entry.
  • Known HIV-positivity.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Arm 1: Cisplatin, Gemcitabine, Talazoparib Solid Tumors

    Arm 2: Cisplatin, Gemcitabine, Talazoparib NSCLC

    Arm Description

    Dose levels of the drugs will be dependent on which dose level the participants is enrolled. Cisplatin will be infused as a 30 minute intravenous piggyback (IVPB) on Day 1 of each 21 day cycle. Gemcitabine will be infused as a 30 minute IVPB on Days 1 and 8 of each 21 day cycle. On day 1, gemcitabine will be given before cisplatin. Talazoparib will be started with cycle 2. It is an oral drug which will be administered on an outpatient basis daily. Cisplatin and gemcitabine will be given for a total of 6 cycles. Talazoparib may be continued as a single agent maintenance therapy.

    Dose levels of the drugs will depend on what the MTD is in the dose escalation portion of the study Cisplatin will be infused as a 30 minute intravenous piggyback (IVPB) on Day 1 of each 21 day cycle. Gemcitabine will be infused as a 30 minute IVPB on Days 1 and 8 of each 21 day cycle. On day 1, gemcitabine will be given before cisplatin. Talazoparib will be started with cycle 2. It is an oral drug which will be administered on an outpatient basis daily. Cisplatin and gemcitabine will be given for a total of 6 cycles. Talazoparib may be continued as a single agent maintenance therapy.

    Outcomes

    Primary Outcome Measures

    Safety and toxicities as measured by NCI Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0
    Maximum tolerated dose (MTD)
    The maximum tolerated dose (MTD) is defined as the dose level immediately below the dose level at which 30% of patients in a cohort are expected to experience a dose-limiting toxicity (DLT) during the second cycle based on the CRM algorithm. Dose escalations will proceed until the MTD is determined.
    Objective response rate (ORR) in preselected patients with BRCAness tumoral genotype
    ORR - proportion of patients who achieved a complete response or a partial response

    Secondary Outcome Measures

    Disease control rate (DCR)
    DCR - percentage of participants who have achieved complete response, partial response, and stable disease Complete response: disappearance of all lesions and normalization of tumor marker level Partial response: at least a 30% decrease in the sum of the diameters of target lesions and no new lesions Stable disease: neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease
    Progression-free survival (PFS)
    PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first. -Progressive disease - At least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study, appearance of one more new lesions PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first.
    Objective response rate (ORR)
    ORR - proportion of patients who achieved a complete response or a partial response
    Overall survival (OS)
    OS: duration of time from start of treatment to time of death from any cause

    Full Information

    First Posted
    August 28, 2015
    Last Updated
    February 10, 2016
    Sponsor
    Washington University School of Medicine
    Collaborators
    BioMarin Pharmaceutical
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02537561
    Brief Title
    Talazoparib in Combination With Gemcitabine and Cisplatin in Patients With Advanced Solid Tumors
    Official Title
    A Phase I Adaptive Design Trial of Talazoparib in Combination With Gemcitabine and Cisplatin in Patients With Advanced Solid Tumors
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2016
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    The pharmaceutical company did not want to follow through with support for the study.
    Study Start Date
    December 2015 (undefined)
    Primary Completion Date
    June 2018 (Anticipated)
    Study Completion Date
    December 2018 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Washington University School of Medicine
    Collaborators
    BioMarin Pharmaceutical

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    In this proposed study the investigators will combine gemcitabine and cisplatin with talazoparib to determine the recommended Phase 2 dose (RP2D) of this combination regimen. After determination of the RP2D patients with lung cancer whose tumors carry molecular alterations in DNA repair pathway genes will be enrolled to an expansion cohort to determine anti-tumor efficacy. Tissue samples of patients with confirmed partial response, complete response, and non-responders will be obtained for whole exome, and transcriptome sequencing to characterize the genetic alterations associated with response to therapy.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Solid Tumors, Carcinoma, Non-Small Cell Lung, Non-Small Cell Lung Cancer, Non-Small-Cell Lung Carcinoma, Nonsmall Cell Lung Cancer

    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
    Arm 1: Cisplatin, Gemcitabine, Talazoparib Solid Tumors
    Arm Type
    Experimental
    Arm Description
    Dose levels of the drugs will be dependent on which dose level the participants is enrolled. Cisplatin will be infused as a 30 minute intravenous piggyback (IVPB) on Day 1 of each 21 day cycle. Gemcitabine will be infused as a 30 minute IVPB on Days 1 and 8 of each 21 day cycle. On day 1, gemcitabine will be given before cisplatin. Talazoparib will be started with cycle 2. It is an oral drug which will be administered on an outpatient basis daily. Cisplatin and gemcitabine will be given for a total of 6 cycles. Talazoparib may be continued as a single agent maintenance therapy.
    Arm Title
    Arm 2: Cisplatin, Gemcitabine, Talazoparib NSCLC
    Arm Type
    Experimental
    Arm Description
    Dose levels of the drugs will depend on what the MTD is in the dose escalation portion of the study Cisplatin will be infused as a 30 minute intravenous piggyback (IVPB) on Day 1 of each 21 day cycle. Gemcitabine will be infused as a 30 minute IVPB on Days 1 and 8 of each 21 day cycle. On day 1, gemcitabine will be given before cisplatin. Talazoparib will be started with cycle 2. It is an oral drug which will be administered on an outpatient basis daily. Cisplatin and gemcitabine will be given for a total of 6 cycles. Talazoparib may be continued as a single agent maintenance therapy.
    Intervention Type
    Drug
    Intervention Name(s)
    Cisplatin
    Other Intervention Name(s)
    cis-DDP, cis-Platinum II, cis-Diamminedichloroplatinum, DDP
    Intervention Type
    Drug
    Intervention Name(s)
    Gemcitabine
    Other Intervention Name(s)
    Gemzar®
    Intervention Type
    Drug
    Intervention Name(s)
    Talazoparib
    Other Intervention Name(s)
    BMN 673
    Primary Outcome Measure Information:
    Title
    Safety and toxicities as measured by NCI Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0
    Time Frame
    30 days after completion of treatment (estimated average to be 7 months)
    Title
    Maximum tolerated dose (MTD)
    Description
    The maximum tolerated dose (MTD) is defined as the dose level immediately below the dose level at which 30% of patients in a cohort are expected to experience a dose-limiting toxicity (DLT) during the second cycle based on the CRM algorithm. Dose escalations will proceed until the MTD is determined.
    Time Frame
    Completion of dose escalation portion of study (approximately 12 months)
    Title
    Objective response rate (ORR) in preselected patients with BRCAness tumoral genotype
    Description
    ORR - proportion of patients who achieved a complete response or a partial response
    Time Frame
    Up to completion of treatment (estimated average of 6 months)
    Secondary Outcome Measure Information:
    Title
    Disease control rate (DCR)
    Description
    DCR - percentage of participants who have achieved complete response, partial response, and stable disease Complete response: disappearance of all lesions and normalization of tumor marker level Partial response: at least a 30% decrease in the sum of the diameters of target lesions and no new lesions Stable disease: neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease
    Time Frame
    Until death (estimated average to be 12 months)
    Title
    Progression-free survival (PFS)
    Description
    PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first. -Progressive disease - At least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study, appearance of one more new lesions PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first.
    Time Frame
    Until death (estimated average to be 12 months)
    Title
    Objective response rate (ORR)
    Description
    ORR - proportion of patients who achieved a complete response or a partial response
    Time Frame
    Up to completion of treatment (estimated average of 6 months)
    Title
    Overall survival (OS)
    Description
    OS: duration of time from start of treatment to time of death from any cause
    Time Frame
    Until death (estimated average to be 12 months)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Histologically confirmed diagnosis of advanced solid tumor for which no curative standard treatment options exist and for which gemcitabine and cisplatin is a suitable treatment regimen. After the determination of the maximum tolerated dose, an expansion cohort of 20 patients with non-small cell lung cancer whose tumors demonstrate variants in DNA repair pathway genes will be enrolled. Measurable disease defined as lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 10 mm with CT scan, as ≥ 20 mm by chest x-ray, or ≥ 10 mm with calipers by clinical exam. Prior treatment for this disease is allowed if it has been completed at least 2 weeks prior to study enrollment and if all treatment-related toxicities are resolved. Prior exposure to a PARP inhibitor is allowed for patients in the dose-finding portion of the study. At least 18 years of age. ECOG performance status ≤ 1 Normal bone marrow and organ function as defined below: Leukocytes ≥ 3,000/mcL Absolute neutrophil count ≥ 1,500/mcl Platelets ≥ 100,000/mcl Total bilirubin ≤ 1.5 x IULN AST(SGOT)/ALT(SGPT) ≤ 3.0 x IULN Creatinine ≤ IULN OR creatinine clearance ≥ 60 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal Tissue available for sequencing (either archival tissue or readily accessible tumor for fresh routine biopsy). Able to swallow tablets. Women of childbearing 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 participating in this study, she must inform her treating physician immediately. Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable). Exclusion Criteria: A history of other malignancy ≤ 5 years previous with the exception of basal cell or squamous cell carcinoma of the skin which were treated with local resection only or carcinoma in situ of the cervix. Received any other investigational agent within 2 weeks of starting the first dose on study. Symptomatic brain metastases. Known brain metastases are allowed if asymptomatic and previously treated. Patients must be at least 4 weeks post-brain radiation therapy. A history of allergic reactions attributed to compounds of similar chemical or biologic composition to cisplatin, gemcitabine, talazoparib, or other agents used in the study. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active coronary artery disease, uncontrolled seizure, or psychiatric illness/social situations that would limit compliance with study requirements. Pregnant and/or breastfeeding. Women of childbearing potential must have a negative pregnancy test within 14 days of study entry. Known HIV-positivity.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Saiama Waqar, M.D.
    Organizational Affiliation
    Washington University School of Medicine
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Links:
    URL
    http://www.siteman.wustl.edu
    Description
    Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

    Learn more about this trial

    Talazoparib in Combination With Gemcitabine and Cisplatin in Patients With Advanced Solid Tumors

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