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Phase 2 N=40 Randomized Treatment

Talazoparib and Temozolomide in Treating Younger Patients With Refractory or Recurrent Malignancies

Adult Solid Neoplasm · Childhood Solid Neoplasm · Recurrent Childhood Central Nervous System Neoplasm · Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor · Recurrent Malignant Solid Neoplasm

Enrolled (actual)
40
Serious AEs
85.0%
Results posted
Mar 2021
Primary outcome: Primary: The Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy — 0; 0; 1; 2 Participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Laboratory Biomarker Analysis (Other); Pharmacological Study (Other); Talazoparib (Drug); Temozolomide (Drug)
Age
Pediatric, Adult · 0+ yrs
Sex
All
Sponsor
National Cancer Institute (NCI)
Primary completion
Dec 2018

Outcome Measures

OutcomeResultp-value
PRIMARY
The Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy
0; 0; 1; 2; 2; 2
PRIMARY
All Cycle 1 Toxicities >=Grade 3
0; 0; 2; 7; 5; 3
PRIMARY
T Max of Talazoparib
2
PRIMARY
C Max of Talazoparib
4670
PRIMARY
AUC of Talazoparib
17.55
PRIMARY
Accumulation Half-life of Talazoparib in Combination With Temozolomide.
46.8
PRIMARY
T Max of Talazoparib in Combination With Temozolomide
1.04
PRIMARY
C Max of Talazoparib in Combination With Temozolomide
16450
PRIMARY
AUC of Talazoparib in Combination With Temozolomide
173.08
PRIMARY
Clearance of Talazoparib in Combination With Temozolomide
3.08
PRIMARY
Accumulation Ratio of Talazoparib in Combination With Temozolomide
3.34
PRIMARY
Half-life of Temozolomide in Combination With Talazoparib
1.74
PRIMARY
T Max of Temozolomide in Combination With Talazoparib
1.03
PRIMARY
C Max of Temozolomide in Combination With Talazoparib
1234.1
PRIMARY
AUC of Temozolomide in Combination With Talazoparib
4352.16
PRIMARY
Clearance of Temozolomide in Combination With Talazoparib
6.49
PRIMARY
Number of Ewing/Peripheral PNET Participants in Phase 2 With Complete Response (CR) or Partial Response (PR)
SECONDARY
Number of Solid Tumor Patients With Complete Response (CR) or Partial Response (PR)
1

Summary

This phase I/II trial studies the side effects and best dose of talazoparib and temozolomide and to see how well they work in treating younger patients with tumors that have not responded to previous treatment (refractory) or have come back (recurrent). Talazoparib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving talazoparib together with temozolomide may work better in treating younger patients with refractory or recurrent malignancies.

Eligibility Criteria

Inclusion Criteria

  • Age:
  • Phase 1 (Part A)
  • Patients must be > than 12 months and = than 12 months and = = 0.42 m^2 at the time of study enrollment
  • Diagnosis:
  • Phase 1 (Part A)
  • Solid tumors (Part A1): patients with relapsed or refractory solid tumors including central nervous system (CNS) tumors without bone marrow involvement are eligible; patients must have had histologic verification of malignancy at original diagnosis or relapse except in patients with intrinsic brain stem tumors, optic pathway gliomas, or patients with pineal tumors and elevations of cerebrospinal fluid (CSF) or serum tumor markers including alpha-fetoprotein or beta-human chorionic gonadotropin (HCG)
  • Ewing sarcoma or peripheral primitive neuroectodermal tumor (PNET) (Part A2): patients with relapsed or refractory Ewing sarcoma or peripheral PNET without bone marrow involvement will be eligible for Part A2 if there are no available slots on Part A1; these patients will be enrolled at one dose level below the dose level at which patients on Part A1 are actively enrolling, or at the starting dose level (dose level 1) if dose escalation has not yet occurred; patients must have had histologic verification of malignancy at original diagnosis or relapse
  • Phase 2 (Part B)
  • Ewing sarcoma or peripheral PNET: patients with relapsed or refractory Ewing sarcoma or peripheral PNET are eligible; patients must have had histologic verification of malignancy at original diagnosis or relapse
  • Phase 2 (Part C)
  • Disease status:
  • Phase 1 (Part A):
  • Patients must have either measurable or evaluable disease
  • Phase 2 (Part B):
  • Ewing sarcoma or peripheral PNET: patients must have measurable disease
  • Therapeutic options: patient's current disease state must be one for which there is no known curative therapy or therapy proven to prolong survival with an acceptable quality of life
  • Karnofsky >= 50% for patients > 16 years of age and Lansky >= 50 for patients = = 50% radiation of the pelvis are not eligible
  • Stem cell infusion without TBI: no evidence of active graft vs. host disease and at least 84 days must have elapsed after transplant or stem cell infusion
  • PARP inhibitor exposure:
  • Part A: Patients who have received prior therapy with a PARP inhibitor, with the exception of BMN 673, are eligible; however, patients who have progressed on a PARP inhibitor and temozolomide regimen are not eligible
  • Part B: Patients who have previously been exposed to a PARP inhibitor are not eligible
  • For patients with solid tumors without known bone marrow involvement: peripheral absolute neutrophil count (ANC) >= 1000/mm^3
  • For patients with solid tumors without known bone marrow involvement: platelet count >= 100,000/mm^3 (transfusion independent, defined as not receiving platelet transfusions for at least 7 days prior to enrollment)
  • For patients with solid tumors without known bone marrow involvement: hemoglobin >= 8.0 g/dL (may receive red blood cell [RBC] transfusions)
  • All patients enrolled on Part A of the study must be evaluable for hematologic toxicity
  • Patients on Part B of the study with known bone marrow metastatic disease will be eligible for the study provided they meet the blood counts (may receive transfusions provided they are not known to be refractory to red cell or platelet transfusions); these patients will not be evaluable for hematologic toxicity
  • Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 ml/min/1.73 m^2 or a maximum serum creatinine (mg/dL) based on age/gender as follows:
  • 1 to = 16 years: 1.7 for males, 1.4 for females
  • Patients on Part A and Part B: bilirubin (sum of conjugated + unconjugated) = = 2 g/dL
  • All patients and/or their parents or legally authorized representatives must sign a written informed consent; assent, when appropriate, will be obtained according to institutional guidelines
  • For patients enrolling on Part B: tissue blocks or slides must be sent; if tissue blocks or slides
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02116777). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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