Description:
This phase I trial investigates the side effects and best dose of talazoparib when given
together with trifluridine/tipiracil for the treatment of patients with colorectal or
gastroesophageal cancer that has spread to nearby tissue or lymph nodes (locally advanced) or
other places in the body (metastatic). Drugs used in the chemotherapy, such as
trifluridine/tipiracil, work in different ways to stop the growth of tumor cells, either by
killing the cells, by stopping them from dividing, or by stopping them from spreading.
Talazoparib may stop the growth of tumor cells by blocking some of the enzymes needed for
cell growth. Giving talazoparib with trifluridine/ tipiracil may inhibit certain enzymes in
the cells that are responsible for tumor cell growth.
Title
- Brief Title: Trifluridine/Tipiracil and Talazoparib for the Treatment of Patients With Locally Advanced or Metastatic Colorectal or Gastroesophageal Cancer
- Official Title: A Phase I Study of Trifluridine/ Tipiracil Plus the Poly (ADP) Ribose Polymerase Inhibitor Talazoparib in Advanced Cancers
Clinical Trial IDs
- ORG STUDY ID:
I 650120
- NCT ID:
NCT04511039
Conditions
- Advanced Malignant Solid Neoplasm
- Clinical Stage III Gastroesophageal Junction Adenocarcinoma
- Clinical Stage IV Gastroesophageal Junction Adenocarcinoma
- Clinical Stage IVA Gastroesophageal Junction Adenocarcinoma
- Clinical Stage IVB Gastroesophageal Junction Adenocarcinoma A
- Locally Advanced Colorectal Carcinoma
- Locally Advanced Gastroesophageal Junction Adenocarcinoma
- Metastatic Colorectal Adenocarcinoma
- Metastatic Gastroesophageal Junction Adenocarcinoma
- Pathologic Stage III Gastroesophageal Junction Adenocarcinoma
- Pathologic Stage IIIA Gastroesophageal Junction Adenocarcinoma
- Pathologic Stage IIIB Gastroesophageal Junction Adenocarcinoma
- Pathologic Stage IV Gastroesophageal Junction Adenocarcinoma
- Pathologic Stage IVA Gastroesophageal Junction Adenocarcinoma
- Pathologic Stage IVB Gastroesophageal Junction Adenocarcinoma
- Postneoadjuvant Therapy Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IIIA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IIIB Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8
- Stage III Colorectal Cancer AJCC v8
- Stage IIIA Colorectal Cancer AJCC v8
- Stage IIIB Colorectal Cancer AJCC v8
- Stage IIIC Colorectal Cancer AJCC v8
- Stage IV Colorectal Cancer AJCC v8
- Stage IVA Colorectal Cancer AJCC v8
- Stage IVB Colorectal Cancer AJCC v8
- Stage IVC Colorectal Cancer AJCC v8
Interventions
Drug | Synonyms | Arms |
---|
Trifluridine and Tipiracil Hydrochloride | 733030-01-8, Lonsurf, TAS 102,, Thymidine, Tipiracil Hydrochlorid Mixture with Trifluridine, Trifluridine/Tipiracil, Trifluridine/Tipiracil Hydrochloride Combination Agent TAS-102 | Treatment Arm |
Talazoparib Tosylate | Talzenna | Treatment Arm |
Purpose
This phase I trial investigates the side effects and best dose of talazoparib when given
together with trifluridine/tipiracil for the treatment of patients with colorectal or
gastroesophageal cancer that has spread to nearby tissue or lymph nodes (locally advanced) or
other places in the body (metastatic). Drugs used in the chemotherapy, such as
trifluridine/tipiracil, work in different ways to stop the growth of tumor cells, either by
killing the cells, by stopping them from dividing, or by stopping them from spreading.
Talazoparib may stop the growth of tumor cells by blocking some of the enzymes needed for
cell growth. Giving talazoparib with trifluridine/ tipiracil may inhibit certain enzymes in
the cells that are responsible for tumor cell growth.
Detailed Description
PRIMARY OBJECTIVE:
I. To determine the safety, maximum tolerated dose (MTD), and recommended phase 2 dose (RP2D)
of trifluridine and tipiracil hydrochloride (trifluridine/tipiracil [FTD/TPI]) in combination
with talazoparib tosylate (talazoparib) in patients with advanced colorectal (CRC) or
gastroesophageal (EGC) adenocarcinoma.
Trial Arms
Name | Type | Description | Interventions |
---|
Treatment Arm | Experimental | Patients receive trifluridine/tipiracil PO BID and talazoparib tosylate PO QD on days 1-5. Cycles repeat every 14 days in the absence of disease progression or unacceptable toxicity. | - Trifluridine and Tipiracil Hydrochloride
- Talazoparib Tosylate
|
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed CRC or EGC adenocarcinoma that is locally
advanced or metastatic
- Has received at least one prior line of therapy with progression or intolerance
- Have measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
criteria present
- Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
- Life expectancy >= 3 months by investigator assessment
- Hemoglobin >= 9 g/dL
- Absolute neutrophil count >= 1500/mm^3
- Platelet count >= 100,000/mm^3 without transfusion or growth factor support
- Creatinine < 1.5 upper limit of normal (ULN) or creatinine clearance > 60 mL/min
- Total bilirubin < 1.5 x ULN
- Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 2.5 x ULN or < x 5
ULN in the presence of liver metastasis
- Albumin > 3 g/dL
- Ability to swallow oral medications
- Participants of child-bearing potential must agree to use adequate contraceptive
methods (e.g., hormonal or barrier method of birth control; abstinence) prior to study
entry. Should a woman become pregnant or suspect she is pregnant while she or her
partner is participating in this study, she should inform her treating physician
immediately
- Participant must understand the investigational nature of this study and sign an
Independent Ethics Committee/Institutional Review Board approved written informed
consent form prior to receiving any study related procedure
Exclusion Criteria:
- Systemic antineoplastic therapy within 2 weeks prior to initiation of FTD/TPI run-in
phase (within the past 6 weeks if this treatment is mitomycin C or nitrosourea)
- Radiotherapy within the past 2 weeks excluding palliative radiotherapy to painful bone
lesions
- Prior treatment with PARP inhibitor or FTD/TPI
- Any condition that in the investigator's opinion can limit absorption of FTD/TPI or
talazoparib from the gastrointestinal (GI) tract
- Gastrointestinal obstruction (without diversion) or perforation within 4 weeks from
initiation of FTD/TPI run-in
- Refractory ascites (requiring weekly or more frequent paracentesis or permanent
indwelling peritoneal catheter)
- Untreated central nervous system (CNS) disease. Patients with leptomeningeal disease
are ineligible but patients with treated, stable CNS metastasis for at least 4 weeks
are allowed to participate
- Significant cardiac disease defined as congestive heart failure stage III or IV (New
York Heart Association [NYHA]), acute coronary event, cerebrovascular event,
peripheral arterial embolic event, venous thromboembolic event (pulmonary embolism or
lower extremity deep vein thrombosis), or ventricular arrhythmia within the past 3
months
- Other malignancy requiring active therapy
- Presence of toxicities from prior therapy of grade 2 or higher
- Active infection requiring antibiotic therapy
- Known human immunodeficiency virus (HIV) or hepatitis B infection or untreated
hepatitis C infection. Patients with treated hepatitis C infection and undetectable
viral load are allowed to participate
- Any history of myelodysplastic syndrome, acute leukemia, or bone marrow transplant
- Pregnant or nursing female participants
- Unwilling or unable to follow protocol requirements
- Any condition which in the investigator's opinion deems the participant an unsuitable
candidate to receive study drug
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Incidence of Adverse Events |
Time Frame: | after each cycle of treatment ( 1 cycle = 14 days) |
Safety Issue: | |
Description: | All adverse events will be evaluated using Common Terminology Criteria for All Adverse Events (CTCAE) version (v.) 5. |
Secondary Outcome Measures
Measure: | Plasma Concentration (Cmax) |
Time Frame: | Day -13 post dose |
Safety Issue: | |
Description: | The pharmacokinetic parameters between Trifluridine/Tipiracil and Talazoparib will be evaluated on Day -14: pre-dose, 0.5, 1, 2, 4, 6, 8 hours (hr) post-dose; day-13: 24 hr post-initial dose and day -13 pre-dose |
Measure: | Plasma Concentration (Cmax) |
Time Frame: | day -14 pre dose |
Safety Issue: | |
Description: | The pharmacokinetic parameters between Trifluridine/Tipiracil and Talazoparib will be evaluated on Day -14: pre-dose, 0.5, 1, 2, 4, 6, 8 hours (hr) post-dose; day-13: 24 hr post-initial dose and day -13 pre-dose |
Measure: | Plasma Concentration (Cmax) |
Time Frame: | day -14 post dose |
Safety Issue: | |
Description: | The pharmacokinetic parameters between Trifluridine/Tipiracil and Talazoparib will be evaluated on Day -14: pre-dose, 0.5, 1, 2, 4, 6, 8 hours (hr) post-dose; day-13: 24 hr post-initial dose and day -13 pre-dose |
Measure: | Plasma Concentration (Cmax) |
Time Frame: | day -13 pre dose |
Safety Issue: | |
Description: | The pharmacokinetic parameters between Trifluridine/Tipiracil and Talazoparib will be evaluated on Day -14: pre-dose, 0.5, 1, 2, 4, 6, 8 hours (hr) post-dose; day-13: 24 hr post-initial dose and day -13 pre-dose |
Measure: | Overall Response Rate (ORR) |
Time Frame: | Up to 3 years |
Safety Issue: | |
Description: | Will be summarized using frequencies and relative frequencies. |
Measure: | CEA response rate (colorectal cancer patients) |
Time Frame: | Up to 3 years |
Safety Issue: | |
Description: | ill be summarized using frequencies and relative frequencies. . |
Measure: | Progression Free Survival (PFS) |
Time Frame: | From treatment until disease progression UP to 3 years |
Safety Issue: | |
Description: | Will be summarized using standard Kaplan-Meier methods |
Measure: | Overall Survival (OS) |
Time Frame: | From treatment until death or up to 3 years |
Safety Issue: | |
Description: | Will be summarized using standard Kaplan-Meier methods |
Measure: | Progressive Disease Assessment (PD) |
Time Frame: | Up to 3 years |
Safety Issue: | |
Description: | |
Measure: | Number of subjects with DNA damage response |
Time Frame: | Up to 28 days prior to first drug dose, on treatment and between cylce 1-day 8 and cycle 1 day 12 |
Safety Issue: | |
Description: | Tumor biopsies will be summarized by dose level and time-point using means and standard deviations. |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Roswell Park Cancer Institute |
Last Updated
June 2, 2021