Description:
This is a Phase I study to test the safety of a combination of ASTX727 with talazoparib in
patients with triple negative breast cancer or hormone resistant/HER2-negative metastatic
breast cancer
Title
- Brief Title: Study of ASTX727 Plus Talazoparib in Patients With Triple Negative or Hormone Resistant/HER2-negative Metastatic Breast Cancer
- Official Title: A Phase I Study of ASTX727 Plus Talazoparib in Patients With Triple Negative or Hormone Resistant/ Human Epidermal Growth Factor Receptor 2 (HER2)-Negative Metastatic Breast Cancer
Clinical Trial IDs
- ORG STUDY ID:
CTO-IUSCC-0684
- NCT ID:
NCT04134884
Conditions
- Metastatic Breast Cancer
- Triple Negative Breast Cancer
- Hormone Receptor Positive Tumor
Interventions
Drug | Synonyms | Arms |
---|
Talazoparib | | ASTX727 + Talazoparib |
ASTX727 | | ASTX727 + Talazoparib |
Purpose
This is a Phase I study to test the safety of a combination of ASTX727 with talazoparib in
patients with triple negative breast cancer or hormone resistant/HER2-negative metastatic
breast cancer
Detailed Description
The phase I portion will use a traditional 3 + 3 design and standard definitions of DLT based
on toxicity experienced during the first cycle of therapy. Patients with triple negative
breast cancer (TNBC) and hormone resistant/HER2 negative (HRBC) metastatic disease will be
enrolled and analyzed together during the dose escalation cohorts. Once the maximum tolerated
dose is determined, we will enroll a small expansion cohort to further characterize safety
and provide preliminary efficacy estimates.The expansion cohort will be limited to 14
patients; 7 with TNBC and 7 with HRBC. The dose level selected for expansion will be based on
the totality of the data available including toxicity during the DLT evaluation period,
toxicity during subsequent cycles, and correlative results.
Trial Arms
Name | Type | Description | Interventions |
---|
ASTX727 + Talazoparib | Experimental | | |
Eligibility Criteria
Inclusion Criteria:
1. ≥ 18 years old at the time of informed consent
2. Ability to provide written informed consent and HIPAA authorization
3. Locally recurrent (not amenable to local therapy with curative intent) or metastatic
breast cancer
1. Patients with triple negative breast cancer must have received at least one prior
chemotherapy regimen for metastatic disease.
2. Patients with hormone-positive, HER2-negative disease must have received
treatment with and progressed on at least one prior endocrine therapy including a
CDK4/6 inhibitor in the metastatic setting.
4. Measurable or evaluable disease based on RECIST 1.1 criteria.
5. Only subjects who have disease amenable to biopsy will be asked to consent to serial
tumor biopsies. Consent for biopsy is not required for participation.
a. NOTE: If no amendable disease is present at the time of biopsy, subjects may
continue participation in the study and further study specific biopsies will not be
required.
6. Eastern Cooperative Oncology Group Performance Status 0 or 1
7. Patients with treated, asymptomatic central nervous system (CNS) disease may
participate if the patient is > 4 weeks from completion of CNS therapy (radiation
and/or surgery), is clinically stable at the time of study entry, and is receiving a
stable or decreasing dose of corticosteroid therapy. Brain MRI or head CT is required
at screening for patients with known brain metastases.
8. Adequate organ function as indicated by:
1. Total bilirubin </= ULN (upper limit of normal) (except in patients with
documented Gilbert's disease, who must have a total bilirubin </= 3.0 mg/dL)
2. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) </= 3.0 x ULN
(</= 1.5-3.0 x baseline if baseline is abnormal)
3. Calculated creatinine clearance of >/= 60 mL/min using the Cockcroft-Gault
formula
4. Absolute neutrophil count (ANC) >/= 1.5 K/mm3
5. Platelets >/= 100 K/mm3
6. Hemoglobin (Hgb) >/= 9.0 g/dL
9. Women of childbearing potential must have a negative pregnancy test within 14 days of
protocol registration. Women are considered to have childbearing potential (regardless
of sexual orientation, having undergone a tubal ligation, or remaining celibate by
choice) unless they meet one of the following criteria:
1. Has undergone a hysterectomy or bilateral oophorectomy; or
2. Has been naturally amenorrheic for at least 24 consecutive months.
10. Women of childbearing potential and men must agree to use effective contraception
throughout the study and for 7 months after the last study treatment. Note: Acceptable
methods of birth control include abstinence, partner with previous vasectomy,
placement of an intrauterine device (IUD), condom with spermicidal
foam/gel/film/cream/suppository, diaphragm or cervical vault cap, or hormonal birth
control (pills or injections).
Exclusion Criteria:
1. Prior treatment with decitabine, guadecitabine or other known DNA Methyltransferase
inhibitors (DNMTis)
2. Prior treatment with talazoparib or other known PARPi (poly(ADP-ribose polymeras
inhibitor)
3. Known deleterious breast cancer susceptibility gene (BRCA) mutation. Patients with
BRCA variants of unknown significance (VUS) or who have not had germline genetic
testing may participate.
4. Active or symptomatic CNS disease
5. Patients with HER2+ disease
- HER2 will be considered positive if scored 3+ by immunohistochemistry (IHC) or 2+
by IHC associated with a fluorescence in situ hybridization (FISH) ratio of > 2.0
or > 6 total HER2 gene copies per cell.
6. Patients with active malignancy other than breast cancer. Patients with prior
malignancies without recurrence after standard treatment will not be excluded
7. Chemotherapy within 3 weeks of registration
8. Radiation therapy within 2 weeks of registration
9. Hormone therapy within 2 weeks of registration
10. Patients requiring ongoing therapy with strong P-gp inhibitors
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Safety of ASTX727 plus talazoparib using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v 5.0 |
Time Frame: | through study completion i.e up to 1 year |
Safety Issue: | |
Description: | rate of dose limiting toxicity will be assessed during cycle 1 (28 days) in patients enrolled during the dose escalation phase |
Secondary Outcome Measures
Measure: | Overall response rate |
Time Frame: | through study completion (i.e. up to 1 year) |
Safety Issue: | |
Description: | |
Measure: | Clinical benefit response for triple negative disease subjects |
Time Frame: | 18 weeks |
Safety Issue: | |
Description: | clinical benefit response defined as complete response, partial response, or stable disease |
Measure: | Clinical benefit response for hormone receptor positive/ HER2 negative subjects |
Time Frame: | 24 weeks |
Safety Issue: | |
Description: | clinical benefit response defined as complete response, partial response, or stable disease |
Measure: | Progression free survival in all enrolled subjects |
Time Frame: | through study completion (i.e. up to 1 year) |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Kathy Miller |
Trial Keywords
Last Updated
August 13, 2021