Phase 1
N=17
Pharmacokinetic and Safety Study of Niraparib With Normal or Moderate Hepatic Impairment Patients
Ovarian Neoplasms · Neoplasms · Solid Tumor · Hepatic Impairment
Bottom Line
View on ClinicalTrials.gov: NCT03359850 ↗Enrolled (actual)
17
Serious AEs
18.8%
Results posted
Nov 2020
Primary outcome: Primary: Area Under the Plasma Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration (AUClast) of Niraparib and Its Major Metabolite (M1) During PK Phase — 18500; 26800; 19000; 12400 Hour*nanogram per milliliter (hr*ng/mL)
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 1
- Interventions
- Niraparib (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Tesaro, Inc.
- Primary completion
- Sep 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Area Under the Plasma Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration (AUClast) of Niraparib and Its Major Metabolite (M1) During PK Phase |
18500; 26800; 19000; 12400 | — |
| PRIMARY Area Under the Plasma Concentration-time Curve From Time 0 Extrapolated to Infinity (AUC 0-infinity) of Niraparib and M1 During PK Phase |
19700; 30800; 20700; 21500 | — |
| PRIMARY Observed Maximum Plasma Concentration (Cmax) of Niraparib and M1 During PK Phase |
594; 553; 398; 151 | — |
| PRIMARY Time to Maximum Concentration (Tmax) of Niraparib and M1 During PK Phase |
4.00; 4.09; 6.00; 17.73 | — |
| PRIMARY Terminal Half-life (t½) of Niraparib and M1 During PK Phase |
43.9; 54.8; 47.9; 43.7 | — |
| PRIMARY Apparent Total Body Clearance (CL/F) of Niraparib and M1 During PK Phase |
15.2; 9.74; NA; NA | — |
| SECONDARY Number of Participants With Treatment-Emergent Adverse Events (TEAE) Including Non-serious Adverse Events (Non-SAEs), Serious Adverse Events (SAEs) and Discontinuations Due to AEs During PK Phase |
5; 3; 1; 0; 1; 0 | — |
| SECONDARY Change From Baseline in Hemoglobin (Hb) During PK Phase |
-0.5; 0.6 | — |
| SECONDARY Change From Baseline in Platelets, Neutrophils, Monocytes, Lymphocytes and Leukocyte During PK Phase |
0.2; -0.1; 0.1; -0.1; -0.5; -0.7 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter of Protein and Albumin During PK Phase |
-1.0; -3.5; -0.9; -2.3 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter of Alkaline Phosphatase, Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST) and Lactate Dehydrogenase (LDH) During PK Phase |
26.3; -32.6; 34.6; -6.4; 24.3; -4.4 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter of Amylase During PK Phase |
74.4; 0.3 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter of Bilirubin and Creatinine During PK Phase |
0.6; 8.3; -1.9; -0.7 | — |
| SECONDARY Change From Baseline in Chemistry Parameters: Glucose, Calcium, Chloride, Phosphate, Potassium, Sodium, Magnesium and Blood Urea Nitrogen (BUN) During PK Phase |
-0.8; -0.5; 0.0; -0.1; 1.8; -0.3 | — |
| SECONDARY Change From Baseline in Weight During PK Phase |
-0.0; 0.8; -0.0; 0.3 | — |
| SECONDARY Change From Baseline in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) During PK Phase |
5.9; 5.7; 0.9; 0.3; 3.6; 2.7 | — |
| SECONDARY Change From Baseline in Pulse Rate During PK Phase |
8.9; 1.3; 2.8; -2.3 | — |
| SECONDARY Change From Baseline in Body Temperature During PK Phase |
-0.0; 0.1; 0.1; 0.1 | — |
| SECONDARY Number of Participants With TEAE Including Non-SAEs, SAEs and Discontinuations Due to AEs During Extension Phase |
8; 7; 3; 2; 0; 1 | — |
| SECONDARY Change From Baseline in Hb During Extension Phase |
4.3; 1.0; -0.5; -8.3; -2.6; -22.3 | — |
| SECONDARY Change From Baseline in Platelets, Neutrophils, Monocytes, Lymphocytes and Leukocytes During Extension Phase |
-0.2; -0.1; -0.1; -0.0; -0.1; -0.2 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter of Protein and Albumin During Extension Phase |
-1.0; -2.0; -2.0; -5.0; 1.0; 4.0 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter of Alkaline Phosphatase, ALT, AST and LDH During Extension Phase |
23.3; -53.5; 19.7; 57.0; 20.0; 12.0 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter of Amylase During Extension Phase |
-1.0; -2.5; -7.0; -4.0; -2.3; 3.0 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter of Bilirubin and Creatinine During Extension Phase |
0.9; -6.0; 0.6; 1.7; 0.6; 2.9 | — |
| SECONDARY Change From Baseline in Chemistry Parameters: Glucose, Calcium, Chloride, Phosphate, Potassium, Sodium, Magnesium and BUN During Extension Phase |
-0.0; 1.6; 0.7; -2.3; -0.4; -0.7 | — |
| SECONDARY Change From Baseline in Weight During Extension Phase |
-1.6; -4.6; -0.3; -4.5; -2.3; -3.3 | — |
| SECONDARY Change From Baseline in SBP and DBP During Extension Phase |
-0.2; -12.0; 8.7; -9.0; -0.3; 12.3 | — |
| SECONDARY Change From Baseline in Pulse Rate During Extension Phase |
17.2; 9.0; 23.0; 4.0; 15.3; 9.3 | — |
| SECONDARY Change From Baseline in Temperature During Extension Phase |
-0.3; 0.1; -0.1; 0.0; -0.0; -0.1 | — |
Summary
Niraparib (Zejula®)is extensively metabolized and eliminated primarily by hepatic and renal pathways. The purpose of this study is to evaluate pharmacokinetics and safety of niraparib in patients with moderate hepatic impairment, for the purpose of providing recommendations to guide the initial dose and dose titration in this patient population.
Eligibility Criteria
Inclusion Criteria
Diagnosis and Criteria for Inclusion:
All patients:
To be considered eligible to participate in this study, all of the following requirements must be met:
- Patient, male or female, is at least 18 years of age.
- Patient has a diagnosis of advanced solid malignancy that has failed standard therapy or for which standard therapy is not likely to provide meaningful benefit, or patient has refused standard therapy.
- Patient has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
- Patient is able to take oral medications.
- Female patient, if of childbearing potential, has a negative serum pregnancy test within 72 hours prior to taking study drug and agrees to abstain from activities that could result in pregnancy from enrollment through 120 days after the last dose of study treatment, or be of non-childbearing potential. Non-childbearing potential is defined as (by other than medical reasons):
- ≥45 years of age and has not had menses for > 1 year.
- Amenorrheic for 1.5 × to 3 × ULN, for at least 2 weeks prior to Day 1
- AST: Any value
- INR less than 1.8 unless the patient is receiving anticoagulant therapy and the INR is within therapeutic range of intended use of anticoagulants.
- Patient has hematologic and renal function as defined below:
- Absolute neutrophil count ≥1000/µL
- Platelets ≥75,000/µL
- Hemoglobin ≥8 g/dL
- Serum creatinine ≤1.5 × ULN or a calculated creatinine clearance ≥60 mL/min using the Cockcroft-Gault equation.
- Patient's hepatic disease is deemed stable by the Investigator
Criteria for Exclusion:
Patients will not be eligible for study entry if any of the following criteria are met:
All patients:
- Patient has undergone palliative radiotherapy within 1 week of study drug administration, encompassing >20% of the bone marrow.
- Patient is starting chemotherapy within 3 weeks of study drug administration.
- Patient has a known hypersensitivity to the components of niraparib or excipients
- Patients who received colony-stimulating factors within 2 weeks prior to the first dose of study treatment are not eligible.
- Patient has persistent chemotherapy associated Grade 2 or greater toxicity except for neuropathy, alopecia or fatigue.
- Patient has symptomatic uncontrolled brain or leptomeningeal metastases.
- Patient has undergone major surgery within 3 weeks of starting the study or patient has not recovered from any effects of any major surgery.
- Patient is considered a poor medical risk due to a serious, uncontrolled medical disorder (other than hepatic impairment) or active, uncontrolled infection.
- Patient has received a transfusion (platelets or red blood cells) within 3 weeks of receiving niraparib.
- Patient is pregnant, breastfeeding, or expecting to conceive children while receiving study treatment or for 3 months after the last dose of study treatment.
- Patient has a known history of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML).
NOTE: Exclusion Criteria 12-16 apply patients participating in the PK phase of the study.
- Patient is currently receiving, or unable to refrain from taking from 4 days prior to dosing until the time of the last PK blood draw, any of the following cytochrome (CYP) 1A2 substrates: alosetron, duloxetine, melatonin, ramelteon, tacrine, tizanidine, and theophylline.
- Patient is unable to refrain from any intake of grapefruit or grapefruit juice within 4 days of the first administration of niraparib until the final PK sample collection.
- Patient is currently receiving, or unable to refrain from taking from 4 days prior to dosing until the last PK blood draw, any of the following P-glycoprotein (P-gp) inhibitors: amiodarone, azithromycin, captopril, carvedilol, clarithromycin, conivaptan, cyclosporine, diltiazem, dronedarone, erythromycin, felodipine, itraconazole, ketoconazole, lopinavir and ritonavir, quercetin, quinidine, ranolazine, ticagrelor and verapamil.
- Patient is t
Data sourced from ClinicalTrials.gov (NCT03359850). 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.