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ABT-888 and Topotecan Hydrochloride in Treating Patients With Advanced Solid Tumors or Relapsed or Refractory Ovarian Epithelial Cancer or Primary Peritoneal Cancer
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), November 2009
First Received: November 11, 2009   No Changes Posted
Sponsor: Mayo Clinic
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT01012817
  Purpose

RATIONALE: ABT-888 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as topotecan hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving ABT-888 together with topotecan hydrochloride may kill more tumor cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of giving ABT-888 together with topotecan hydrochloride and to see how well it works in treating patients with advanced solid tumors or relapsed or refractory ovarian epithelial cancer or primary peritoneal cancer.


Condition Intervention Phase
Ovarian Cancer
Peritoneal Cavity Cancer
Unspecified Adult Solid Tumor, Protocol Specific
Drug: ABT-888
Drug: topotecan hydrochloride
Other: laboratory biomarker analysis
Other: pharmacological study
Phase I
Phase II

Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I/II Trial of ABT-888, an Inhibitor of Poly(ADP-ribose) Polymerase (PARP), and Topotecan (TPT) in Patients With Solid Tumors (Phase I) and Relapsed or Refractory Ovarian Cancer or Primary Peritoneal Cancer (Phase II) After Prior Platinum Containing First-Line Chemotherapy

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Toxicity (Phase I) [ Designated as safety issue: Yes ]
  • Confirmed tumor response (Phase II) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Overall survival [ Designated as safety issue: No ]
  • Progression-free survival [ Designated as safety issue: No ]
  • Duration of response [ Designated as safety issue: No ]
  • Time to treatment failure [ Designated as safety issue: No ]
  • Poly (ADP-ribose) level [ Designated as safety issue: No ]
  • BRCA1 and BRCA 2 mutation status [ Designated as safety issue: No ]
  • Biomarker expression as measured by IHC staining [ Designated as safety issue: No ]
  • Gene expression in responders vs non-responders [ Designated as safety issue: No ]

Estimated Enrollment: 104
Study Start Date: October 2009
Estimated Primary Completion Date: January 2011 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • To determine the maximum tolerated dose of ABT-888 and topotecan hydrochloride in patients with advanced solid tumors. (Phase I)
  • To identify any pharmacokinetic interactions between ABT-888 and topotecan hydrochloride. (Phase I)
  • To determine whether topotecan hydrochloride stimulates ADP-ribose polymer formation in circulating peripheral blood mononuclear cells. (Phase I)
  • To determine whether ABT-888 inhibits basal or topotecan hydrochloride-stimulated ADP-ribose polymer formation. (Phase I)
  • To identify any antitumor activity of this regimen, as assessed by objective response, in patients with advanced solid tumors. (Phase I)
  • To assess the progression-free survival of patients with relapsed or refractory ovarian epithelial cancer or primary peritoneal cancer treated with this regimen. (Phase II)
  • To assess the toxicity of this regimen in patients with ovarian epithelial cancer or primary peritoneal cancer. (Phase II)
  • To determine whether topotecan hydrochloride stimulates ADP-ribose polymer formation in circulating tumor cells and whether ABT-888 modulates this. (Phase II)
  • To assess differences in the toxicity and/or efficacy of this regimen based on BRCA1/2 mutational status. (Phase II)
  • To determine whether pretreatment tumor cell levels of topoisomerase I, poly (ADP-ribose) polymerase, BRCA1, BRCA2, XRCC1, TDP1, P-glycoprotein, or BCRP predict response to this regimen. (Phase II)
  • To identify, in an exploratory manner, any transcriptional profiles that may predict response to this regimen. (Phase II)

OUTLINE: Patients receive oral ABT-888 once daily on days 1-3, 8-10, and 15-17*. Patients also receive topotecan hydrochloride IV over 30 minutes on days 2, 9, and 16. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

NOTE: *Patients do not receive ABT-888 on days 1-3 during course 2.

Patients undergo blood and urine sample collection periodically for pharmacokinetic, pharmacogenetic, and other correlative laboratory studies. Patients enrolled in phase II also undergo tumor tissue collection at baseline for biomarker laboratory studies.

After completion of study treatment, patients are followed up every 3-6 months for up to 5 years.

PROJECTED ACCRUAL: A total of 104 patients (56 for phase I and 48 for phase II) will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Diagnosis of 1 of the following:

    • Histologically confirmed malignant solid tumor (phase I)

      • Metastatic or unresectable disease
      • Disease for which standard curative measures or other therapy that may provide clinical benefit do not exist or are no longer effective
    • Histologically confirmed ovarian epithelial or primary peritoneal cancer (phase II)

      • Radiological evidence of recurrence at a previous site of disease OR biopsy-confirmed disease if the site represents a new site of disease
      • Refractory to platinum-based therapy OR relapsed < 1 year after receiving a prior platinum-based regimen
  • Measurable disease, defined as ≥ 1 lesion whose longest diameter can be accurately measured as ≥ 2.0 cm with conventional techniques or as ≥ 1.0 cm with spiral CT scan
  • No known standard therapy that is potentially curative or definitely capable of extending life expectancy exists
  • No known CNS metastases

    • Brain metastases that have been successfully treated and stable for ≥ 6 months are allowed provided there is no requirement for corticosteroids and there is no seizure activity

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Life expectancy ≥ 12 weeks
  • ANC ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 9.0 g/dL
  • Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • ALT or AST ≤ 2.5 times ULN (ALT ≤ 3 times ULN or AST ≤ 5 times ULN in the presence of hepatic metastases)
  • Creatinine ≤ 1.5 times ULN
  • INR ≤ 1.4 (unless receiving therapeutic doses of coumadin)
  • PTT ≤ 36 seconds
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Willing to return to Mayo Clinic for follow up
  • Willing to provide biologic specimens as required for translational research
  • Able to swallow and absorb medication
  • 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 or social situation that would limit compliance with study requirements
  • No NYHA class III-IV heart disease
  • No myocardial infarction within the past 6 months
  • No congestive heart failure requiring the use of ongoing maintenance therapy for life-threatening ventricular arrhythmias
  • Not immunocompromised (other than that related to the use of corticosteroids)
  • No known HIV positivity
  • No other active malignancy except for nonmelanoma skin cancer or carcinoma in situ of the cervix
  • No known seizure disorder
  • No comorbid systemic illness or other severe concurrent disease that, in the judgement of the investigator, would make the patient inappropriate for study entry or interfere significantly with the proper assessment of the safety and toxicity of study treatment

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • More than 4 weeks since prior investigational therapy or ancillary therapy considered investigational (i.e., utilized for a non-FDA-approved indication and in the context of a research investigation)
  • More than 4 weeks since prior chemotherapy (6 weeks for mitomycin C and nitrosoureas) and recovered
  • More than 4 weeks since prior immunotherapy, biologic therapy, or radiotherapy
  • No prior radiotherapy to > 25% of bone marrow
  • No more than 2 prior therapeutic regimens for ovarian epithelial cancer or primary peritoneal cancer
  • Concurrent hormonal therapy for prostate cancer allowed
  • No concurrent specific treatment for a prior malignancy (other than hormonal therapy)
  • No concurrent enrollment in any other study involving a pharmacologic agent (e.g., drugs, biologics, immunotherapy approaches, or gene therapy) whether for symptom control or therapeutic intent
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01012817

Locations
United States, Arizona
Mayo Clinic Scottsdale Recruiting
Scottsdale, Arizona, United States, 85259-5499
Contact: Clinical Trials Office - All Mayo Clinic Locations     507-538-7623        
United States, Florida
Mayo Clinic - Jacksonville Recruiting
Jacksonville, Florida, United States, 32224
Contact: Clinical Trials Office - All Mayo Clinic Locations     507-538-7623        
United States, Minnesota
Mayo Clinic Cancer Center Recruiting
Rochester, Minnesota, United States, 55905
Contact: Clinical Trials Office - All Mayo Clinic Locations     507-538-7623        
Sponsors and Collaborators
Mayo Clinic
Investigators
Principal Investigator: Michael Menefee, MD Mayo Clinic
  More Information

Additional Information:
No publications provided

Responsible Party: Mayo Clinic Cancer Center ( Michael Menefee )
Study ID Numbers: CDR0000657976, MAYO-MC0861, 8329
Study First Received: November 11, 2009
Last Updated: November 11, 2009
ClinicalTrials.gov Identifier: NCT01012817     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified adult solid tumor, protocol specific
recurrent ovarian epithelial cancer
peritoneal cavity cancer

Additional relevant MeSH terms:
Digestive System Neoplasms
Endocrine Gland Neoplasms
Genital Neoplasms, Female
Ovarian Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Ovarian Diseases
Neoplasms
Peritoneal Neoplasms
Abdominal Neoplasms
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Gonadal Disorders
Endocrine System Diseases
Enzyme Inhibitors
Pharmacologic Actions
Adnexal Diseases
Genital Diseases, Female
Digestive System Diseases
Therapeutic Uses
Peritoneal Diseases
Topotecan

ClinicalTrials.gov processed this record on November 20, 2009