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AZD2281 and Carboplatin in Treating Patients With BRCA1/BRCA2-Associated, Hereditary, or Triple Negative Metastatic or Unresectable Breast Cancer or Ovarian Epithelial Cancer
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), October 2009
First Received: March 28, 2008   Last Updated: October 20, 2009   History of Changes
Sponsor: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00647062
  Purpose

RATIONALE: AZD2281 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving AZD2281 together with carboplatin may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of AZD2281 when given together with carboplatin in treating patients with BRCA1/BRCA2-associated, hereditary, or triple negative metastatic or unresectable breast cancer or ovarian epithelial cancer.


Condition Intervention Phase
brca1 Mutation Carrier
brca2 Mutation Carrier
Breast Cancer
Hereditary Breast/Ovarian Cancer (brca1, brca2)
Ovarian Cancer
Drug: carboplatin
Drug: olaparib
Genetic: polymorphism analysis
Other: enzyme-linked immunosorbent assay
Other: laboratory biomarker analysis
Other: pharmacogenomic studies
Phase I

Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled
Official Title: A Phase I Study With an Expansion Cohort of the PARP Inhibitor AZD2281 (KU-0059436) Combined With Carboplatin in Breast and Ovarian Cancer in BRCA1/2 Mutation Carriers (Familial Breast and Ovarian Cancer) and Sporadic Triple Negative Breast Cancer and Ovarian Cancer

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Safety and toxicity [ Designated as safety issue: Yes ]
  • Biochemical changes in poly (ADP-ribose) polymerase (PARP) activity and γ-H2AX levels in mononuclear cells and in tumor tissue in response to treatment [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Clinical activity [ Designated as safety issue: No ]
  • Correlation of differences in PARP and XRCC1 polymorphisms with clinical activity and toxicity [ Designated as safety issue: No ]
  • Induction of apoptosis in tumor tissue [ Designated as safety issue: No ]
  • Pharmacodynamics [ Designated as safety issue: No ]
  • Correlation of BRCA1/BRCA2 mutation with clinical response and ethnicity [ Designated as safety issue: No ]

Estimated Enrollment: 101
Study Start Date: December 2007
Estimated Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the safety and toxicity of AZD2281 and carboplatin in patients with BRCA1/BRCA2-associated or familial breast or ovarian epithelial cancer, low genetic risk sporadic ovarian serous epithelial cancer, or low genetic risk triple negative breast cancer.
  • Determine the biochemical changes in poly (ADP-ribose) polymerase (PARP) activity and γ-H2AX levels in mononuclear cells and in tumor tissue in response to treatment with this regimen in these patients.

Secondary

  • Assess the clinical activity of this regimen.
  • Evaluate and correlate differences in PARP and XRCC1 polymorphisms with clinical activity and toxicity of this regimen.
  • Evaluate the induction of apoptosis in tumor tissue.
  • Evaluate the pharmacodynamics of this regimen.

OUTLINE: This is a dose-escalation study of AZD2281. Patients are initially enrolled in cohort 1. Once the maximum tolerated dose (MTD) of AZD2281 is determined, additional patients are enrolled in cohort 2 and treated at the MTD.

  • Cohort 1 (dose-escalation cohort): Patients receive oral AZD2281 twice daily on days 1-7 and carboplatin* IV over 15-60 minutes on day 2. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

NOTE: *Patients who experience a partial response or stable disease may receive 8-10 courses of carboplatin (more than 10 courses will be at the investigator's discretion); patients with complete response (CR) may receive no more than 2 courses of carboplatin past CR.

  • Cohort 2 (expansion cohort): Patients receive AZD2281 (at the MTD determined in cohort 1) and carboplatin as in cohort 1.

Patients in both cohorts undergo blood sample collection periodically for analysis of PARP inhibition by ELISA. Blood samples from patients in cohort 2 are also analyzed for PARP/XRCC1 polymorphism, γ-H2AX determination by immunofluorescence assay, and pharmacogenomics. Patients in cohort 2 also undergo tumor tissue sample collection at baseline for analysis of apoptosis by TUNEL assay, PARP inhibition by ELISA, γ-H2AX determination by immunofluorescence assay, and tissue proteomics.

After completion of study treatment, patients are followed periodically for 4 weeks.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed breast and/or ovarian epithelial cancer, meeting one of the following criteria:

    • Documented deleterious BRCA1/BRCA2 germline mutation or BRCAPRO score ≥ 30%
    • Sporadic ovarian serous epithelial cancer with negative family history, BRCAPRO score ≤ 20%, or negative BRCA1/BRCA2 mutation
    • Triple negative (estrogen receptor negative, progesterone receptor negative, and HER2/neu negative) breast cancer with negative family history and/or BRCAPRO score ≤ 10% or negative BRCA1/2 mutation
  • Metastatic or unresectable disease for which standard curative measures do not exist or are no longer effective

    • Patients with locally advanced, unresectable breast cancer must have been previously treated with standard therapy

      • Patients with locally advanced breast cancer presenting for initial therapy are not eligible
    • No local (i.e., only in breast or chest wall) recurrence only
  • Measurable and/or evaluable disease
  • Disease can be safely biopsied, as determined by an interventional radiologist (cohort 2)

    • Agrees to undergo mandatory biopsy at baseline
  • No diagnosis of brain metastases within the past year

    • Patients with brain metastases diagnosed > 1 year ago are eligible provided the patient has undergone resection or radiotherapy for the brain metastases and has had no CNS recurrence for a full year

PATIENT CHARACTERISTICS:

  • Male or female
  • Menopausal status not specified
  • ECOG performance status (PS) 0-2 or Karnofsky PS 60-100%
  • Life expectancy > 3 months
  • Hemoglobin ≥ 10 g/dL
  • Leukocytes ≥ 3,000/mcL
  • Absolute neutrophil count ≥ 1,500/mcL
  • Platelet count ≥ 100,000/mcL
  • Total bilirubin normal (in the absence of Gilbert's syndrome)
  • AST/ALT ≤ 2.5 times upper limit of normal (ULN)
  • Creatinine clearance ≥ 60 mL/min OR serum creatinine ≤ 1.5 times ULN
  • Corrected or ionized calcium normal
  • Potassium normal
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for ≥ 3 months after completion of study treatment
  • Able to swallow pills
  • No history of grade 4 allergic reaction to platinum

    • Patients with ≤ grade 3 (without a reaction protocol) or ≤ grade 2 (in the face of pretreatment, but not graduated treatment exposure) allergic reaction to platinums are eligible
  • No functional impairment due to neuropathy
  • No clinically significant bleeding
  • No concurrent uncontrolled illness including, but not limited to, any of the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness/social situations that would preclude study compliance
  • No other invasive malignancies within the past 5 years, except non-melanomatous skin cancer, non-invasive bladder cancer, stage I endometrial cancer, or cervical cancer cured by surgical resection (cohort 2)

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from prior therapy (≤ CTC grade 1)

    • Chronic stable grade 2 peripheral neuropathy secondary to neurotoxicity from prior therapy may be allowed at the discretion of the principal investigator
  • At least 6 months since prior platinum drugs

    • Patients with platinum-resistant disease are eligible
  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C), biological therapy, hormonal therapy, or radiotherapy
  • More than 4 weeks since prior investigational agents
  • More than 4 weeks since prior major surgery
  • No prior PARP inhibitors
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No other concurrent investigational agents
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00647062

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office Recruiting
Bethesda, Maryland, United States, 20892-1182
Contact: Clinical Trials Office - Warren Grant Magnusen Clinical Center     888-NCI-1937        
Sponsors and Collaborators
Investigators
Principal Investigator: Elise C. Kohn, MD NCI - Medical Oncology Branch
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000590680, NCI-08-C-0092, NCI-P07253
Study First Received: March 28, 2008
Last Updated: October 20, 2009
ClinicalTrials.gov Identifier: NCT00647062     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
BRCA1 mutation carrier
BRCA2 mutation carrier
male breast cancer
recurrent ovarian epithelial cancer
recurrent breast cancer
stage IV breast cancer
stage IV ovarian epithelial cancer
stage IIIA breast cancer
stage IIIB breast cancer
stage IIIC breast cancer
stage III ovarian epithelial cancer
hereditary breast/ovarian cancer (BRCA1, BRCA2)
HER2-negative breast cancer
estrogen receptor-negative breast cancer
progesterone receptor-negative breast cancer
ovarian serous cystadenocarcinoma

Additional relevant MeSH terms:
Ovarian Neoplasms
Skin Diseases
Antineoplastic Agents
Gonadal Disorders
Genital Neoplasms, Female
Breast Neoplasms
Endocrine System Diseases
Urogenital Neoplasms
Carboplatin
Ovarian Diseases
Pharmacologic Actions
Adnexal Diseases
Genital Diseases, Female
Neoplasms
Neoplasms by Site
Therapeutic Uses
Breast Diseases
Endocrine Gland Neoplasms

ClinicalTrials.gov processed this record on February 08, 2010