Description:
The purpose of this study is to test the safety of a study drug called Rucaparib, administered in combination with the type of radiation therapy that is usually given to women with your form of breast cancer.
The purpose of this study is to test the safety of a study drug called Rucaparib, administered in combination with the type of radiation therapy that is usually given to women with your form of breast cancer.
Recruiting
Phase 1
| Drug | Synonyms | Arms |
|---|---|---|
| Rucaparib | Rucaparib Administered With Radiation |
| Name | Type | Description | Interventions |
|---|---|---|---|
| Rucaparib Administered With Radiation | Experimental | Treatment will consist of rucaparib at one dose level (300 mg BID, 400 mg BID, 500 mg BID or 600 mg BID) concurrently with a 6-week course of radiotherapy and 4 additional weeks of maintenance rucaparib at the same dose level. Radiotherapy will consist of 50 Gy in 2 Gy per fraction to the breast or chest wall with or without regional nodes plus a 10 Gy boost to the lumpectomy cavity, to a total dose of 60 Gy. A 10 Gy boost to the post-mastectomy scar is allowed at the discretion of the treating physician. |
|
Inclusion Criteria:
- Female, ≥ 18 years of age.
- Non-metastatic, histologically or cytologically-confirmed TNBC (defined as ER <1%, PR
<1%, her-2-neu 0-1+ by IHC or FISH-negative or as per MD discretion), with evidence of
residual disease in the breast or lymph nodes after neoadjuvant chemotherapy, at the
time of definitive surgical treatment.
- Non-metastatic, histologically or cytologically-confirmed hormone-receptor positive,
Her2/neu negative breast cancer (defined as ER >1% or PR >1% AND Her-2/neu 0-1+ by IHC
or FISH-negative, or as per MD discretion), with evidence of residual grade 3 invasive
breast cancer AND either 1) >5 cm of residual disease in the breast OR 2) ≥ 4 axillary
LNs in the axilla after neoadjuvant chemotherapy, at the time of definitive surgical
treatment.
- Definitive surgical treatment with breast-conserving surgery or mastectomy and
axillary lymph node evaluation.
- At least 6-month life expectancy, ECOG Performance status < 2.
- Willingness to discontinue any cytotoxic chemotherapeutic agents, immunotherapy and
biologic therapy at least 2 weeks prior to the start of RT.
- Adequate organ function (assessed within 30 days prior to initiation of protocol
treatment, unless otherwise indicated) as follows:
Hematology
- Absolute Neutrophil Count (ANC) ≥1500/mm^3
- Platelet Count ≥100,000/mm^3
- Hemoglobin ≥9.0 g/dL (after transfusion if required) Renal Function
- Creatinine Serum ≤ 1.5 mg/dL or Creatinine Clearance ≥ 45 mL/min^a Hepatic Function
- Bilirubin ≤ 1.5 mg/dL
- Aspartate Aminotransferase (AST) ≤ 2.5 x ULN^b
- Alanine Aminotransferase (ALT) ≤ 2.5 x ULN ULN = upper normal limit of institution's
normal range
1. If calculated creatinine clearance is < 45mL/min, a 24-hour urine collection for
creatinine clearance may be performed
2. Subjects with documented Gilbert's disease may have bilirubin up to 2.5 mg/dL
- Negative serum pregnancy test within 14 days prior to study treatment if a
woman has child-bearing potential. Subjects of child bearing potential are
those who have not been surgically sterilized or have not been free from
menses for > 1 year.
- Ability to swallow and retain oral medications.
- Written informed consent obtained from subject and ability for subject to
comply with the requirements of the study.
- Female subjects of childbearing potential should be willing to use 2 methods
of birth control or be surgically sterile, or abstain from heterosexual
activity for the duration of study participation. Should a woman become
pregnant while participating on study, she should inform the treating
physician immediately.
Exclusion Criteria:
- Gross residual tumor or positive margins after surgery that is un-excised, as
radiation dose in the study will be limited to 60 Gy.
- Complete pathologic response to NAC.
- Receipt of PARP inhibitor prior to RT.
- Pregnant or expecting to conceive within the projected duration of the trial, starting
with screening visit through 180 days after the last dose of trial treatment.
- Prior history of radiation therapy to the ipsilateral breast and/or regional nodes is
not allowed (prior RT to other sites is permitted).
- Patients with breast augmentation implants are excluded.
- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to rucaparib.
- Concomitant anti-neoplastic treatment is not allowed during protocol treatment and
should be completed at least 2 weeks prior to commencement of protocol treatment, with
resolution of associated acute toxicities. Bisphosphonates are permitted without
restriction even during protocol treatment.
- Significant comorbidity: Patients with clinically significant and uncontrolled major
disease or disorder that could exacerbate potential toxicities, confound safety
assessments, require excluded therapy for management, or limit study compliance.
- Ongoing therapy with other investigational agents. Patients may not be receiving any
other investigational agents.
- Unresolved toxicity from other agents. Patients with unresolved CTCAE v4.03 Grade 3 or
greater toxicity from prior administration of another investigational drug and/or
anti-cancer treatment are not eligible.
| Maximum Eligible Age: | N/A |
| Minimum Eligible Age: | 18 Years |
| Eligible Gender: | Female |
| Healthy Volunteers: | No |
| Measure: | defining the maximum tolerated dose (MTD) |
| Time Frame: | 1 year |
| Safety Issue: | |
| Description: | proportion of subjects encountering toxicity at each dose level. The trial will be monitored using TITE-CRM. Assuming a model for the time to occurrence of toxic response as a function of dose, the method allows information from all enrolled patients to be used when allocating a new patient to a dose level. |
| Phase: | Phase 1 |
| Primary Purpose: | Interventional |
| Overall Status: | Recruiting |
| Lead Sponsor: | Memorial Sloan Kettering Cancer Center |
June 23, 2021