Veliparib and Dinaciclib in Treating Patients With Advanced Solid Tumors - Full Text View

Purpose

This phase I trial studies the side effects and the best dose of veliparib and dinaciclib in treating patients with solid tumors that have spread to other places in the body and usually cannot be cured or controlled with treatment. Veliparib and dinaciclib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Condition	Intervention	Phase
Advanced Malignant Solid Neoplasm BRCA1 Gene Mutation BRCA2 Gene Mutation	Drug: Dinaciclib Other: Laboratory Biomarker Analysis Other: Pharmacological Study Drug: Veliparib	Phase 1


Study Type:	Interventional
Study Design:	Intervention Model: Single Group Assignment Masking: No masking Primary Purpose: Treatment
Official Title:	Phase 1 Trial of ABT-888 and SCH727965 in Patients With Advanced Solid Tumors

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

Primary Outcome Measures:

Recommended phase 2 dose of veliparib/dinaciclib determined by dose-limiting toxicities graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0) [ Time Frame: Up to day 28 ]
Frequency tables of worst grade of adverse event, drug-related adverse events, and worst grade of laboratory value will be presented by dose cohort.

Secondary Outcome Measures:

Anti-tumor activity of veliparib/dinaciclib as assessed by Response Evaluation Criteria in Solid Tumors 1.1 [ Time Frame: Up to 6 years ]
Change in homologous recombination deficiency (HRD) score [ Time Frame: Baseline up to 56 days ]
The relationship between change in HRD score and clinical response will be assessed with the Wilcoxon rank-sum test to compare percent change in marker levels in patients whose best response is PR or SD, compared to those whose best response is PD.
Changes in immunohistochemical or biochemical measurements of cyclin-dependent kinase (cdk), poly (ADP-ribose) polymerase 1 activity [ Time Frame: Baseline up to day 10 ]
Levels of activity and percent changes post-treatment will be summarized using descriptive statistics.
Expression of homologous recombination repair proteins [ Time Frame: 56 days ]
Level of deoxyribonucleic acid damage in tissue samples [ Time Frame: Up to day 10 ]
Objective response rate [ Time Frame: Up to 6 years ]
Conducted using the Kaplan Meier method. Estimates will be provided with 95% confidence interval.
Pharmacokinetic parameters (Cmax, AUC, t1/2) of dinaciclib in the presence of veliparib [ Time Frame: At 0.25, 0.5, 1, 2, 2.25, 2.50, 3.0, 4.0, 6.0, 8.0, and 24.0 hours after dosing (days 1 and 8 of course 1) ]
Pharmacokinetic parameters (maximum concentration [Cmax], area under the curve [AUC], and half-life [t1/2]) of veliparib in the absence or presence of dinaciclib [ Time Frame: At 0.25, 0.5, 1, 2, 2.25, 2.50, 3.0, 4.0, 6.0, 8.0, and 24.0 hours after dosing (days 1 and 8 of course 1) ]
Progression-free survival [ Time Frame: Up to 6 years ]
Conducted using the Kaplan Meier method and overall survival estimates will be provided with 95% confidence interval.

Other Outcome Measures:

Change in BRCA1 and RAD51 expression [ Time Frame: Baseline to day 7 of course 1 ]
A tumor biopsy pair will be classified as demonstrating proof-of-mechanism if there is at least a 50% decrease in the proportion of BRCA1 and/or RAD51 foci-positive cells between the biopsy obtained after veliparib alone and the biopsy obtained after veliparib and dinaciclib. A one-sided binomial test will be used.
Change in BRCA1 and RAD51 expression [ Time Frame: Baseline and within 48 hours of combination therapy in course 1 ]
A tumor biopsy pair will be classified as demonstrating proof-of-mechanism if there is at least a 50% decrease in the proportion of BRCA1 and/or RAD51 foci-positive cells between the biopsy obtained after veliparib alone and the biopsy obtained after veliparib and dinaciclib. A one-sided binomial test will be used.
Change in parameters defining combined cdk and PARP inhibition [ Time Frame: Baseline up to 56 days ]
The relationship between change in parameters defining combined cdk and PARP inhibition and clinical response will be assessed with the Wilcoxon rank-sum test to compare percent change in marker levels in patients whose best response is PR or SD, compared to those whose best response is PD.


Estimated Enrollment:	130
Actual Study Start Date:	November 1, 2011
Estimated Primary Completion Date:	June 30, 2017 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Treatment (veliparib and dinaciclib) PART 1A: Patients receive veliparib PO BID on days 1-28 and dinaciclib IV over 2 hours on days 8 and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. PART 1B: Patients receive veliparib and dinaciclib as patients in Part 1A. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. PART 1C: Patients receive veliparib PO BID on days 1-7 of course 0. Patients then receive veliparib PO BID on days 1-21 and dinaciclib IV over 2 hours on days 1, 4, 8, and 11 or days 1 and 8. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.	Drug: Dinaciclib Given IV Other Names: CDK Inhibitor SCH 727965 MK-7965 SCH 727965 Other: Laboratory Biomarker Analysis Correlative studies Other: Pharmacological Study Correlative studies Drug: Veliparib Given PO Other Names: ABT-888 PARP-1 inhibitor ABT-888

Arms

Assigned Interventions

Experimental: Treatment (veliparib and dinaciclib)

PART 1A: Patients receive veliparib PO BID on days 1-28 and dinaciclib IV over 2 hours on days 8 and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

PART 1B: Patients receive veliparib and dinaciclib as patients in Part 1A. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

PART 1C: Patients receive veliparib PO BID on days 1-7 of course 0. Patients then receive veliparib PO BID on days 1-21 and dinaciclib IV over 2 hours on days 1, 4, 8, and 11 or days 1 and 8. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Drug: Dinaciclib

Given IV

Other Names:

CDK Inhibitor SCH 727965
MK-7965
SCH 727965

Other: Laboratory Biomarker Analysis

Correlative studies

Other: Pharmacological Study

Correlative studies

Drug: Veliparib

Given PO

Other Names:

ABT-888
PARP-1 inhibitor ABT-888

Detailed Description:

PRIMARY OBJECTIVES:

I. To evaluate the safety and tolerability of ABT-888 (veliparib) and SCH727965 (dinaciclib) in patients with advanced solid tumors.

II. To determine the recommended phase 2 dose (RP2D) for ABT-888 in combination with SCH727965, determined by evaluating the feasibility, safety, dose-limiting toxicities, and the maximally tolerated dose(s).

SECONDARY OBJECTIVES:

I. To confirm the safety of the combination of ABT-888 and SCH727965 in patients with known BRCA1 or BRCA2 germline mutation.

II. To characterize the pharmacokinetic parameters of ABT-888 both alone and in combination with SCH727965.

III. To assess the pharmacodynamic effects of ABT-888 in combination with SCH727965, both in surrogate tissues and in tumor.

IV. To assess preliminary antitumor activity of the ABT-888/SCH727965 combinations in subjects with solid tumors.

OUTLINE: This is a dose-escalation study of veliparib and dinaciclib followed by expanded doublet cohort studies of non-breast BRCA-proficient patients and BRCA-proficient triple negative breast cancer (TNBC) patients, a safety doublet cohort for BRCA-deficient patients, and cohorts of BRCA-associated TNBC (PARP inhibitor-naive and PARP inhibitor-resistant).

PART 1A: Patients receive veliparib orally (PO) twice daily (BID) on days 1-28 and dinaciclib intravenously (IV) over 2 hours on days 8 and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

PART 1B: Patients receive veliparib and dinaciclib as patients in Part 1A. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

PART 1C: Patients receive veliparib PO BID on days 1-7 of course 0. Patients then receive veliparib PO BID on days 1-21 and dinaciclib IV over 2 hours on days 1, 4, 8, and 11 or days 1 and 8. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 3 months.

Eligibility


Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Participants must have histologically confirmed diagnosis of a solid tumor for which no curative therapy exists
Participants must have measurable or evaluable disease
Eastern Cooperative Oncology Group (ECOG) performance status =< 2
Prior chemotherapy is allowed; patients must not have received chemotherapy for 3 weeks prior to the initiation of study treatment and must have full recovery from any acute effects of any prior chemotherapy; patients must not have had nitrosoureas or mitomycin C for 6 weeks prior to the initiation of study treatment
Prior exposure to approved receptor tyrosine kinase inhibitors is permitted; at least 5 half-lives must have elapsed since the completion of the kinase inhibitor and the initiation of study treatment
Prior radiation therapy is allowed; patients must not have received any radiation within 3 weeks prior to the initiation of study treatment; patients may not have areas of irradiated marrow exceeding 40% of bone marrow volume
Prior experimental (non-Food and Drug Administration [FDA] approved) therapies and immunotherapies are allowed; patients must not have received these therapies for 3 weeks prior to the initiation of study treatment and must have full recovery from any acute effects of these therapies
Prior exposure to ABT888 or other PARP inhibitors is permitted in all cohorts except the cohort evaluating BRCA-mutated PARP inhibitor naive patients, where prior PARP inhibitor treatment will not be permitted; prior exposure to cyclin-dependent kinase inhibitors other than SCH727965 is permitted
Absolute neutrophil count >= 1,500/mm^3
Hemoglobin (Hgb) > 9.0 g/dl
Platelets >= 100,000/mm^3
Total bilirubin < 1.5 mg/dl
Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 times the institutional upper limit of normal; for subjects with known liver metastases, AST and ALT =< 5 times institutional upper limit of normal
Creatinine =< 1.5 times institutional upper limit of normal or creatinine clearance >= 60 mL/min/1.73 m^2
Prothrombin time (PT)/international normalized ratio (INR) and partial thromboplastin time (PTT) =< 1.5 times institutional upper limit of normal
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 should inform her treating physician immediately; additionally, if a man suspects that he has fathered a child while taking study agents, he should also inform his treating physician immediately
Eligible patients in the dose escalation phases of the trial must agree to biopsies of normal skin, unless they undergo optional tumor biopsies; the mandatory biopsy requirement can be waived at the discretion of principal investigator in the event of any medical contraindication (e.g. lidocaine allergy); patients enrolled to the expanded cohorts must agree to tumor sampling; patients on anticoagulation must be able to hold warfarin or low molecular weight heparin for a sufficient amount of time to make skin and tumor biopsies safe to perform; PT/INR and PTT should be =< 1.5 times the institutional upper limit of normal prior to performance of skin or tumor biopsies, with values re-checked after the eligibility screen as medically indicated
Patients must be able to swallow pills
Patients enrolling in the BRCA-deficient cohorts must have a documented BRCA1 or BRCA2 germline mutation; alternatively, patients with tumors harboring somatic BRCA mutations may also enroll after discussion with the principal investigator
All patients must agree to provide an archival tissue block or paraffin sample from archival tissue block (approximately 10 sections) for use in pharmacodynamic correlative studies; however, patients are not considered ineligible if archival tumor is not available
Ability to understand and the willingness to sign a written informed consent document; subjects must be willing to adhere to dose and visit schedules

Exclusion Criteria:

Patients must not receive any other anti-cancer therapy (cytotoxic, biologic, radiation, or hormonal other than for replacement) while on this study except for medications that are prescribed for supportive care but may potentially have an anti-cancer effect (i.e. megestrol acetate, bisphosphonates); in addition, men receiving treatment for prostate cancer will be maintained at castrate levels of testosterone by continuation of luteinizing-releasing hormone agonists
Patients with known active brain metastases are excluded; patients with a history of central nervous system (CNS) metastases that have been treated must be stable with no symptoms for > 3 months after completion of that treatment and off steroid treatment, with image documentation required prior to study enrollment
Any patient requiring chronic maintenance of white blood cell counts or granulocyte counts through the use of growth factor support (e.g. Neulasta, Neupogen)
Patients who have previously received SCH727965
Patients with other medical conditions judged by the investigator to be clinically relevant in the setting of this study, which may include active infectious processes, intractable emesis, or chronic diarrheal disease
Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or psychiatric illness/social situations that would limit compliance with study requirements
Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated with ABT-888 and SCH727965; these potential risks may also apply to other agents used in this study
Patients with prior seizure history who have experienced a seizure within the three months prior to enrollment are excluded
Subjects with a known allergy to lidocaine
Subjects on a potent cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) inhibitor or CPY3A4 inducer who cannot be changed to another medication are excluded

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01434316

Locations


United States, Massachusetts
Massachusetts General Hospital Cancer Center	Recruiting
Boston, Massachusetts, United States, 02114
Contact: Geoffrey I. Shapiro 617-632-4942 geoffrey_shapiro@dfci.harvard.edu
Principal Investigator: Geoffrey I. Shapiro
Brigham and Women's Hospital	Recruiting
Boston, Massachusetts, United States, 02115
Contact: Scott J. Rodig 617-525-7825 srodig@partners.org
Principal Investigator: Scott J. Rodig
Dana-Farber Cancer Institute	Recruiting
Boston, Massachusetts, United States, 02215
Contact: Geoffrey I. Shapiro 617-632-4942 geoffrey_shapiro@dfci.harvard.edu
Principal Investigator: Geoffrey I. Shapiro
Massachusetts General Hospital	Recruiting
Charlestown, Massachusetts, United States, 02129
Contact: Jeffrey Supko 617-724-1970 jsupko@partners.org
Principal Investigator: Jeffrey Supko

Sponsors and Collaborators

National Cancer Institute (NCI)

Investigators


Principal Investigator:	Geoffrey Shapiro	Dana-Farber Cancer Institute

More Information


Responsible Party:	National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:	NCT01434316 History of Changes
Other Study ID Numbers:	NCI-2011-03458 NCI-2011-03458 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ) CDR0000710900 DFCI-11-144 11-144 8484 ( Other Identifier: Dana-Farber Cancer Institute ) 8484 ( Other Identifier: CTEP ) P30CA006516 ( U.S. NIH Grant/Contract ) R01CA090687 ( U.S. NIH Grant/Contract ) U01CA062490 ( U.S. NIH Grant/Contract ) UM1CA186709 ( U.S. NIH Grant/Contract )
Study First Received:	September 13, 2011
Last Updated:	June 30, 2017

Additional relevant MeSH terms:


Veliparib Poly(ADP-ribose) Polymerase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Antineoplastic Agents

ClinicalTrials.gov processed this record on July 07, 2017