Phase 2
Completed N=41
Effects of Single Agent Niraparib and Niraparib Plus Programmed Cell Death-1 (PD-1) Inhibitors in Non-Small Cell Lung Cancer Participants
Neoplasms
Source: ClinicalTrials.gov NCT03308942 ↗
Enrolled (actual)
41
Serious AEs
62.3%
Results posted
Jul 2021
Primary outcomePrimary: Stage 1: Cohort 1: Objective Response Rate (ORR) — 56.3 Percentage of participants
Summary
This is a multicenter, open-label, phase 2 study to evaluate the efficacy and safety of niraparib alone and in combination with PD-1 inhibitors in participants with locally advanced and metastatic non-small cell lung cancer (NSCLC). The study will consist of 2 stages. In stage 1, participants from Cohorts 1 and 2 will receive niraparib plus PD-1 inhibitor; pembrolizumab and participants from Cohort 3 will receive niraparib alone. In Stage 2, participants from Cohorts 1A and 2A will receive niraparib plus the PD-1 inhibitor, TSR-042 (Dostarlimab).
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Stage 1: Cohort 1: Objective Response Rate (ORR) |
56.3 | — |
| PRIMARY Stage 1: Cohort 2: Objective Response Rate |
20.0 | — |
| PRIMARY Stage 1: Cohort 3: Objective Response Rate |
— | — |
| PRIMARY Stage 2: Cohort 1A and Cohort 2A: Objective Response Rate |
9.1 | — |
| SECONDARY Stage 1: Cohort 1: Number of Participants With Non-serious Adverse Events (Non-SAEs) and Serious Adverse Events (SAEs) |
11; 17 | — |
| SECONDARY Stage 1: Cohort 2: Number of Participants With Non-SAEs and SAEs |
14; 20 | — |
| SECONDARY Stage 1: Cohort 3: Number of Participants With Non-SAEs and SAEs |
1; 3 | — |
| SECONDARY Stage 2: Cohorts 1A and 2A: Number of Participants With Non-SAEs and SAEs |
7; 12 | — |
| SECONDARY Stage 1: Cohort 1: Number of Participants Discontinuing the Study Due to AEs |
10 | — |
| SECONDARY Stage 1: Cohort 2: Number of Participants Discontinuing the Study Due to AEs |
9 | — |
| SECONDARY Stage 1: Cohort 3: Number of Participants Discontinuing the Study Due to AEs |
1 | — |
| SECONDARY Stage 2: Cohorts 1A and 2A: Number of Participants Discontinuing the Study Due to AEs |
2 | — |
| SECONDARY Stage 1: Cohort 1: Duration of Response |
22.8 | — |
| SECONDARY Stage 1: Cohort 2: Duration of Response |
9.4 | — |
| SECONDARY Stage 1 : Cohort 3: Duration of Response |
— | — |
| SECONDARY Stage 2: Cohorts 1A and 2A: Duration of Response |
21.5 | — |
| SECONDARY Stage 1 : Cohort 1: Disease Control Rate |
87.5 | — |
| SECONDARY Stage 1 : Cohort 2: Disease Control Rate |
70.0 | — |
| SECONDARY Stage 1 : Cohort 3: Disease Control Rate |
50.0 | — |
| SECONDARY Stage 2: Cohorts 1A and 2A: Disease Control Rate |
54.5 | — |
| SECONDARY Stage 1 : Cohort 1: Progression-free Survival |
8.4 | — |
| SECONDARY Stage 1 : Cohort 2: Progression-free Survival |
4.2 | — |
| SECONDARY Stage 1 : Cohort 3: Progression-free Survival |
4.0 | — |
| SECONDARY Stage 2: Cohorts 1A and 2A: Progression-free Survival |
4.4 | — |
| SECONDARY Stage 1: Cohort 1: Plasma Concentration of Niraparib Following Combination Therapy of Niraparib and Pembrolizumab |
28.4; 201; 500; 733; 335; 353 | — |
| SECONDARY Stage 1: Cohort 2: Plasma Concentration of Niraparib Following Combination Therapy of Niraparib and Pembrolizumab |
NA; 24.5; 189; 264; 345; 238 | — |
| SECONDARY Stage 1: Cohort 3: Plasma Concentration of Niraparib Following Niraparib Monotherapy |
NA; 279; 469; 717; 615; 871 | — |
| SECONDARY Stage 2: Cohorts 1A and 2A: Plasma Concentration of Niraparib Following Combination Therapy of Niraparib and TSR-042 (Dostarlimab) |
NA; 328; 669; 967; 486; 795 | — |
Eligibility Criteria
General Inclusion Criteria:
- Male or female participants at least 18 years of age.
- Histological or cytological proven advanced (unresectable) or metastatic NSCLC as defined as stage IIIB (positive supraclavicular lymph nodes) not amenable to definitive chemoradiotherapy or stage IV NSCLC.
- Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
- Adequate organ function, defined as:
- Absolute neutrophil count (ANC) >= 1500 per microliter (/µL).
- Platelets >= 100,000/µL.
- Hemoglobin >= 9 grams per deciliter (g/dL) or >= 5.6 millimoles per liter (mmol/L).
- Serum creatinine = 50 milliliters per minute (mL/min) (as calculated using the Cockcroft Gault equation or measured using 24-hour urine creatinine clearance) for participants with creatinine levels > 1.5 times institutional ULN.
- Total bilirubin =45 years of age and has not had menses for > 1 year. ii) Amenorrheic for = 50%) per local assessment; with no known Epidermal Growth Factor Receptor (EGFR)-sensitizing mutation and/or ROS -1 or anaplastic lymphoma kinase (ALK) translocation, and no prior systemic chemotherapy or PD-1/PD-L1 inhibitor treatment for metastatic NSCLC.
- Cohorts 2 and 2A (combination of niraparib and PD-1 inhibitor): participants must have tumors with PD-L1 expression (TPS between 1% and 49%) per local assessment, with no known EGFR-sensitizing mutation and/or ROS-1 or ALK translocation, and no prior systemic chemotherapy or PD-1/PD-L1 inhibitor treatment for metastatic NSCLC.
- Cohort 3 (single agent niraparib): participants must have metastatic squamous non-small cell lung cancer (sqNSCLC) and have progressed after both prior platinum-based chemotherapy and prior PD-1 or PD-L1 inhibitor treatment.
Exclusion Criteria for Cohorts 1, 1A , 2 and 2A:
- Participant has received systemic therapy for the treatment of advanced stage NSCLC. Completion of treatment with chemotherapy and/or radiation as part of neoadjuvant/adjuvant therapy is allowed as long as therapy was completed at least 6 months prior to the diagnosis of metastatic disease.
- Prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent.
- Known hypersensitivity to the components of niraparib, pembrolizumab, TSR-042 (Dostarlimab), or their excipients.
- Known EGFR (exon 19 and 21) mutations, ALK translocations, and/or ROS-1 translocations.
- Participant has a history or current condition (such as transfusion-dependent anemia or thrombocytopenia), therapy, or laboratory abnormality that might confound the study results, or interfere with the participant's participation for the full duration of the study treatment.
- Known diagnosis of immunodeficiency or receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment.
- Participant is immunocompromised, in the opinion of the Investigator.
- Current participation in a treatment study or past participation in a study of an investigational agent within 4 weeks before the first dose of study treatment.
- Symptomatic uncontrolled brain or leptomeningeal metastases. (To be considered "controlled," central nervous system [CNS] disease must have undergone treatment [example, radiation or chemotherapy] at least 1 month prior to study entry. The participant must not have any new or progressive signs or symptoms related to the CNS disease and must be taking <= 10 mg of prednisone or equivalent per day or no steroids.) Participants who have untreated brain metastases and who are not symptomatic may enroll if the Investigator feels that treatment of these metastases is not indicated. A scan to confirm the absence of brain metastases is not required. Participants with spinal cord compression may be considered if they have received definitive treatment for this and evidence of clinically SD for 28 days.
- Active autoimmune disease that required systemic tre
Data sourced from ClinicalTrials.gov (NCT03308942). 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. Informational only — not medical advice.