Clinical Trials /

Study of Onivyde With Talazoparib or Temozolomide in Children With Recurrent Solid Tumors and Ewing Sarcoma

NCT04901702

Description:

The phase I portion of this study is designed for children or adolescents and young adults (AYA) with a diagnosis of a solid tumor that has recurred (come back after treatment) or is refractory (never completely went away). The trial will test 2 combinations of therapy and participants will be randomly assigned to either Arm A or Arm B. The purpose of the phase I study is to determine the highest tolerable doses of the combinations of treatment given in each Arm. In Arm A, children and AYAs with recurrent or refractory solid tumors will receive 2 medications called Onivyde and talazoparib. Onivyde works by damaging the DNA of the cancer cell and talazoparib works by blocking the repair of the DNA once the cancer cell is damaged. By damaging the tumor DNA and blocking the repair, the cancer cells may die. In Arm B, children and AYAs with recurrent or refractory solid tumors will receive 2 medications called Onivyde and temozolomide. Both of these medications work by damaging the DNA of the cancer call which may cause the tumor(s) to die. Once the highest doses are reached in Arm A and Arm B, then "expansion Arms" will open. An expansion arm treats more children and AYAs with recurrent or refractory solid tumors at the highest doses achieved in the phase I study. The goal of the expansion arms is to see if the tumors go away in children and AYAs with recurrent or refractory solid tumors. There will be 3 "expansion Arms". In Arm A1, children and AYAs with recurrent or refractory solid tumors (excluding Ewing sarcoma) will receive Onivyde and talazoparib. In Arm A2, children and AYAs with recurrent or refractory solid tumors, whose tumors have a problem with repairing DNA (identified by their doctor), will receive Onivyde and talazoparib. In Arm B1, children and AYAs with recurrent or refractory solid tumors (excluding Ewing sarcoma) will receive Onivyde and temozolomide. Once the highest doses of medications used in Arm A and Arm B are determined, then a phase II study will open for children or young adults with Ewing sarcoma that has recurred or is refractory following treatment received after the initial diagnosis. The trial will test the same 2 combinations of therapy in Arm A and Arm B. In the phase II, a participant with Ewing sarcoma will be randomly assigned to receive the treatment given on either Arm A or Arm B.

Related Conditions:
  • Ewing Sarcoma
  • Malignant Solid Tumor
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Study of Onivyde With Talazoparib or Temozolomide in Children With Recurrent Solid Tumors and Ewing Sarcoma
  • Official Title: A Randomized Phase I/II Study of Talazoparib or Temozolomide in Combination With Onivyde in Children With Recurrent Solid Malignancies and Ewing Sarcoma

Clinical Trial IDs

  • ORG STUDY ID: ONITT
  • NCT ID: NCT04901702

Conditions

  • Recurrent Solid Tumor
  • Recurrent Ewing Sarcoma
  • Recurrent Hepatoblastoma
  • Recurrent Malignant Germ Cell Tumor
  • Recurrent Malignant Solid Neoplasm
  • Recurrent Neuroblastoma
  • Recurrent Osteosarcoma
  • Recurrent Peripheral Primitive Neuroectodermal Tumor
  • Recurrent Rhabdoid Tumor
  • Recurrent Rhabdomyosarcoma
  • Recurrent Soft Tissue Sarcoma
  • Recurrent Wilms Tumor
  • Refractory Ewing Sarcoma
  • Refractory Hepatoblastoma
  • Refractory Malignant Germ Cell Tumor
  • Refractory Malignant Solid Neoplasm
  • Refractory Neuroblastoma
  • Refractory Osteosarcoma
  • Refractory Peripheral Primitive Neuroectodermal Tumor
  • Refractory Rhabdoid Tumor
  • Refractory Rhabdomyosarcoma
  • Refractory Soft Tissue Sarcoma

Interventions

DrugSynonymsArms
OnivydeNanoliposomal irinotecan(Arm A) ONI plus TAL
TalazoparibBMN 673, Talzenna(Arm A) ONI plus TAL
TemozolomideTemodar, Temodal(Arm B) ONI plus TMZ

Purpose

The phase I portion of this study is designed for children or adolescents and young adults (AYA) with a diagnosis of a solid tumor that has recurred (come back after treatment) or is refractory (never completely went away). The trial will test 2 combinations of therapy and participants will be randomly assigned to either Arm A or Arm B. The purpose of the phase I study is to determine the highest tolerable doses of the combinations of treatment given in each Arm. In Arm A, children and AYAs with recurrent or refractory solid tumors will receive 2 medications called Onivyde and talazoparib. Onivyde works by damaging the DNA of the cancer cell and talazoparib works by blocking the repair of the DNA once the cancer cell is damaged. By damaging the tumor DNA and blocking the repair, the cancer cells may die. In Arm B, children and AYAs with recurrent or refractory solid tumors will receive 2 medications called Onivyde and temozolomide. Both of these medications work by damaging the DNA of the cancer call which may cause the tumor(s) to die. Once the highest doses are reached in Arm A and Arm B, then "expansion Arms" will open. An expansion arm treats more children and AYAs with recurrent or refractory solid tumors at the highest doses achieved in the phase I study. The goal of the expansion arms is to see if the tumors go away in children and AYAs with recurrent or refractory solid tumors. There will be 3 "expansion Arms". In Arm A1, children and AYAs with recurrent or refractory solid tumors (excluding Ewing sarcoma) will receive Onivyde and talazoparib. In Arm A2, children and AYAs with recurrent or refractory solid tumors, whose tumors have a problem with repairing DNA (identified by their doctor), will receive Onivyde and talazoparib. In Arm B1, children and AYAs with recurrent or refractory solid tumors (excluding Ewing sarcoma) will receive Onivyde and temozolomide. Once the highest doses of medications used in Arm A and Arm B are determined, then a phase II study will open for children or young adults with Ewing sarcoma that has recurred or is refractory following treatment received after the initial diagnosis. The trial will test the same 2 combinations of therapy in Arm A and Arm B. In the phase II, a participant with Ewing sarcoma will be randomly assigned to receive the treatment given on either Arm A or Arm B.

Detailed Description

      ONITT (ONIvyde, Talazoparib, Temozolomide) is a phase I/II study which will evaluate two
      treatment regimens; nanoliposomal irinotecan (nal-IRN, Onivyde) plus talazoparib (TAL) and
      Onivyde (ONI) plus temozolomide (TMZ) for the treatment of recurrent or refractory (RR) Ewing
      sarcoma. A dose finding phase I study will be open to patients with recurrent or refractory
      solid tumors. Patients will be assigned to receive either ONI plus TAL (Arm A) or ONI plus
      TMZ (Arm B). Once the recommended phase II doses (RP2D) of Arm A and Arm B are determined,
      expansion cohorts (A1, B1) will open at the RP2Ds for enrollment of non-Ewing sarcoma solid
      tumor patients. There will be an additional Arm A expansion cohort (A2) for patients with
      homologous recombination repair defects. Concurrently, the phase II study will open to
      patients with RR Ewing sarcoma. In the phase II study, patients with RR Ewing sarcoma will be
      randomized to receive either ONI plus TAL or ONI plus TMZ. The primary endpoint will be
      progression-free survival (PFS). PFS of both treatment arms in the phase II study will be
      compared to one another by using a two-arm non-inferiority design when superiority is
      expected.

      Phase I Primary Objective To determine the recommended phase 2 doses (RP2Ds) of Onivyde
      combined with talazoparib (Arm A) and Onivyde combined with temozolomide (Arm B) administered
      to children, adolescents and young adults with refractory or recurrent solid malignancies.

      Phase I Secondary Objectives

        -  To characterize the safety profile of the drug regimens, Onivyde plus talazoparib (Arm
           A) and Onivyde plus temozolomide (Arm B).

        -  To characterize the plasma pharmacokinetics (PK) of Onivyde and talazoparib in children,
           adolescents and young adults with refractory or recurrent solid malignancies.

        -  To estimate the antitumor activity of Onivyde plus talazoparib and Onivyde plus
           temozolomide.

      Phase I Exploratory Objectives

        -  To describe the relationship between UGT1A1 genotype status with toxicity and response.

        -  To describe the molecular profile of germline and tumors, including evaluation of
           mutations in homologous recombination genes and their possible association to therapy
           response in patients with recurrent or refractory solid tumors.

        -  To measure ctDNA at different time points and evaluate its relationship with response to
           therapy.

        -  To describe the safety profile of the combination Onivyde plus talazoparib and Onivyde
           plus temozolomide at the determined RP2D in children, adolescents and young adults
           treated in the expansion cohorts.

        -  To describe the palatability and ease of administration of talazoparib liquid suspension
           in children who are unable to swallow the capsules.

      Phase II Primary Objectives

      • To compare the progression-free survival (PFS) of Onivyde plus talazoparib and Onivyde plus
      temozolomide in patients with refractory or recurrent Ewing sarcoma.

      Phase II Secondary Objectives

        -  To describe the toxicity of the treatment regimens.

        -  To describe the objective response rate (ORR), disease control rate (DCR) after cycle 4,
           duration of response (DoR), event free survival (EFS) and overall survival (OS) for
           patients receiving Onivyde plus talazoparib and Onivyde plus temozolomide.

        -  To characterize the plasma pharmacokinetics of Onivyde and talazoparib in children,
           adolescents and young adults with refractory or recurrent Ewing sarcoma.

      Phase II Exploratory Objectives

        -  To describe the relationship between UGT1A1 genotype status with toxicity and response.

        -  To describe the molecular profile of germline and tumors, including evaluation of
           mutations in homologous recombination genes and their possible association to
           chemotherapy response in patients with recurrent or refractory Ewing sarcoma.

        -  To describe ctDNA at different time points and the relationship with response to
           therapy.

        -  To describe the palatability and ease of administration of talazoparib liquid suspension
           in children who are unable to swallow the capsules.

      Phase I The phase I portion of the study will include 2 separate treatment arms, Arms A and
      B. Arm A will evaluate Onivyde plus talazoparib (ONI + TAL). Arm B will evaluate Onivyde plus
      temozolomide (ONI + TMZ). Both phase I studies will be open to patients with recurrent or
      refractory solid tumors who meet eligibility criteria. In Arm A, patients will receive
      intravenous Onivyde on Days 1 and 8. They will receive oral talazoparib twice on Day 1 and
      then daily on Days 2-6. In Arm B, patients will receive intravenous Onivyde on Days 1 and 8.
      They will receive oral temozolomide daily on Days 1-5. Pharmacokinetic testing will take
      place during Cycle 1. Therapy may continue for up to 24 months. Tumor assessments will be
      performed at baseline and repeated after cycles 2, 4, 6 and then every 4 cycles thereafter to
      assess disease status. If at any designated disease evaluation time point a patient develops
      a response that is better than the prior response (i.e. SD at Cycle 2 evaluation, then PR at
      Cycle 4 evaluation), an interim disease evaluation is recommended after 28 days to confirm
      response. Therapy will be discontinued if there is evidence of disease progression or
      drug-related dose limiting toxicities requiring removal from treatment. Safety and
      tolerability will be monitored continuously throughout study participation.

      Phase II Following the completion of the phase I dose finding studies, patients with
      recurrent or refractory Ewing sarcoma that meet eligibility criteria will be eligible for
      randomization into the phase II study. Arm A will evaluate Onivyde plus talazoparib (ONI +
      TAL). Arm B will evaluate Onivyde plus temozolomide (ONI + TMZ). In Arm A, patients will
      receive intravenous Onivyde on Days 1 and 8. They will receive oral talazoparib twice on Day
      1 and then daily on Days 2-6. In Arm B, patients will receive intravenous Onivyde on Days 1
      and 8. They will receive oral temozolomide daily on Days 1-5. Pharmacokinetic testing will
      take place during Cycle 1. Therapy may continue for up to 24 months. Tumor assessments will
      be performed at baseline and repeated after Cycles 2, 4, 6 and then every 4 cycles thereafter
      to assess disease status. If at any designated disease evaluation time point a patient
      develops a response that is better than the prior response (i.e. SD at Cycle 2 evaluation,
      then PR at Cycle 4 evaluation), an interim disease evaluation is recommended after 28 days to
      confirm response. Therapy will be discontinued if there is evidence of disease progression
      and/or any other condition(s) occur that do not allow treatment continuation or similar
      toxicities requiring removal from the trial. Safety and tolerability will be monitored
      continuously throughout study participation.

      Sample size: In the dose escalation phase I study, approximately 18 patients per arm will be
      enrolled for a total of 36 patients. The dose expansion phase I study will include 3
      treatment cohorts. Arm A will have 2 dose expansion cohorts including 1) a non-ES solid tumor
      cohort (A1) and 2) a DNA repair defects/mutations cohort (A2). Arm B will have 1 dose
      expansion cohort including non-ES solid tumors (B1). Approximately 12 patients will enroll
      per expansion treatment cohort for a total of 36 patients. In the phase II study, 44 patients
      will be enrolled on each arm for a total of 88 patients.
    

Trial Arms

NameTypeDescriptionInterventions
(Arm A) ONI plus TALActive ComparatorThe phase I/II study will evaluate a treatment regimen; nanoliposomal irinotecan (nal-IRN, Onivyde) plus talazoparib (TAL)
  • Onivyde
  • Talazoparib
(Arm B) ONI plus TMZActive ComparatorThe phase I/II study will evaluate a treatment regimen; Onivyde (ONI) plus temozolomide (TMZ)
  • Onivyde
  • Temozolomide

Eligibility Criteria

        Inclusion Criteria

        Patients must be > 12 months and < 30 years at the time of enrollment on study.

        Phase I

          -  Patients with refractory or recurrent non-central nervous system (CNS) solid tumors
             not amenable to curative treatment are eligible. Patients must have had histologic
             verification of malignancy at original diagnosis or at the time of relapse. Patients
             eligible for the expansion cohort, A2, will include non-ES patients with refractory or
             recurrent non-CNS solid tumors with a deleterious alteration in germline or somatic
             genes involved in HR repair and DSBs signaling, germline or somatic assessed by prior
             comprehensive sequencing performed in a CLIA-approved (or equivalent) facility.

        Phase II

          -  Patients with refractory or recurrent Ewing sarcoma (during or after completion of
             first-line therapy). Refractory disease is defined as progression during first line
             treatment or within 12 weeks of completion of first line treatment. Recurrent disease
             includes patients who received first line treatment and experienced disease
             progression at any time point >12 weeks from the completion of first line therapy.

          -  Patients must have a histologic diagnosis of Ewing sarcoma with EWSR1- FLI1
             translocation or other EWS rearrangement at the time of initial diagnosis. Repeat
             biopsy at the time of disease recurrence is strongly encouraged but it is not
             required/mandated for enrollment.

        Disease status

          -  Patients must have either measurable or evaluable disease (see Section 7.0 for
             definitions). Measurable disease includes soft tissue disease evaluable by
             cross-sectional imaging (RECIST). Patients with bone disease without a measurable soft
             tissue component or bone marrow disease only are eligible for the phase 1 and phase 2
             study but will not be included in the OR endpoint.

          -  Performance level: Karnofsky > 50% for patients > 16 years of age and Lansky > 50% for
             patients < 16 years of age. Patients who are unable to walk because of paralysis, but
             who are up in a wheelchair, will be considered ambulatory for the purpose of assessing
             the performance score.

        Prior therapy

        Phase I Patients who have received prior therapy with an irinotecan-based or
        temozolomide-based regimen are eligible. Patients who have received prior therapy with a
        PARP inhibitor other than talazoparib are eligible.

        Phase II

          -  Patients should have received first line therapy and developed either refractory or
             recurrent disease (first relapse).

          -  Organ function: Must have adequate organ and bone marrow function as defined by the
             following parameters:

          -  Patients with solid tumors not metastatic to bone marrow:

          -  Peripheral absolute neutrophil count (ANC) >1,000/mm3 (1x109/L)

          -  Platelet count > 75,000/mm3 (75x109/L) (no transfusion within 7 days of enrollment)

          -  Hemoglobin > 9 g/dL (with or without support)

        In the phase I study, patients with solid tumors metastatic to bone marrow or with bone
        marrow hypocellularity defined as <30% cellularity in at least one bone marrow site will be
        eligible for study, but they will not be evaluable for hematologic toxicity. These patients
        must not be refractory to red cell or platelet transfusions. At least 2 of every cohort of
        3 patients (in the phase I study) must be evaluable for hematologic toxicity. If dose
        limiting hematologic toxicity is observed at any dose level, all subsequent patients
        enrolled at that dose level must be evaluable for hematologic toxicity.

          -  Adequate renal function defined as: Creatinine clearance or radioisotope GFR >
             60ml/min/1.73m2 or a serum creatinine maximum based on age/sex: age 6months to <1
             year, creatinine 0.4; 1 to < 2 years, creatinine 0.6; 2 < 6 years, creatinine 0.8; 6 <
             10 years, creatinine 1; 10 to <13 years, creatinine 1.2; 13 to < 16 years creatinine
             1.5 (males) or 1.4 (females); > 16 years, creatinine 1.7 (males) 1.4 (females)

          -  Adequate liver function defined as: normal liver function as defined by SGPT (ALT)
             concentration <5x the institutional ULN, a total bilirubin concentration <2x the
             institutional ULN for age, and serum albumin > 2g/dL.

          -  Adequate pulmonary function defined as no evidence of dyspnea at rest and a pulse
             oximetry > 94% if there is a clinical indication for determination. Pulmonary function
             tests are not required.

          -  Patients must have fully recovered from the acute toxic effects of chemotherapy,
             immunotherapy, surgery, or radiotherapy prior to entering this study:

          -  Myelosuppressive chemotherapy: Patient has not received myelosuppressive chemotherapy
             within 3 weeks of enrollment onto this study (8 weeks if received prior myeloablative
             therapy).

          -  Hematopoietic growth factors: At least 7 days must have elapsed since the completion
             of therapy with a growth factor. At least 14 days must have elapsed after receiving
             pegfilgrastim.

          -  Biologic (anti-neoplastic agent): At least 7 days must have elapsed since completion
             of therapy with a biologic agent. For agents that have known adverse events occurring
             beyond 7 days after administration, this period prior to enrollment must be extended
             beyond the time during which adverse events are known to occur.

          -  Monoclonal antibodies: At least 3 half-lives must have elapsed since prior therapy
             that included a monoclonal antibody or 28 days have elapsed since last dose of the
             monoclonal antibody with complete resolution of symptoms related to treatment.

          -  Radiotherapy: At least 2 weeks must have elapsed since any irradiation; at least 6
             weeks must have elapsed since craniospinal RT, 131I-mIBG therapy or substantial bone
             marrow irradiation (e.g., >50% pelvis irradiation).

          -  Female participant who is post-menarchal must have a negative urine or serum pregnancy
             test and must be willing to have additional serum and urine pregnancy tests during the
             study.

          -  Female or male participant of reproductive potential must agree to use effective
             contraceptive methods at screening and throughout duration of study treatment.

        Exclusion Criteria

        Pregnant or breastfeeding

          -  Pregnant or breast-feeding women will not be entered on this study. Pregnancy tests
             must be obtained in girls who are post-menarchal. Males or females of reproductive
             potential may not participate unless they have agreed to use two methods of birth
             control: a medically accepted barrier of contraceptive method (e.g., male or female
             condom) and a second method of birth control during protocol therapy. Two highly
             effective methods of contraception are required for female patients during treatment
             and for at least 7 months after completing therapy. Male patients with female partners
             of reproductive potential and/or pregnant partners are advised to use two highly
             effective methods of contraception during treatment and for at least 4 months after
             the final dose.

          -  Male and female participants must agree not to donate sperm or eggs, respectively,
             after the first dose of study drug through 105 days and 45 days after the last dose of
             study drug. Females considered not of childbearing potential include those who are
             surgically sterile (bilateral salpingectomy, bilateral oophorectomy, or hysterectomy).
      
Maximum Eligible Age:30 Years
Minimum Eligible Age:12 Months
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Phase I:To determine the recommended phase 2 doses (RP2Ds) of Onivyde combined with talazoparib (Arm A) and Onivyde combined with temozolomide (Arm B) administered to children, adolescents and young adults with refractory or recurrent solid malignancies.
Time Frame:approximately 21 days
Safety Issue:
Description:First cycle dose limiting toxicity (DLTs) will be used to determine the RP2Ds of the two treatment arms. The DLT is defined as any of the following events that are possibly, probably or definitely attributable to protocol therapy.

Secondary Outcome Measures

Measure:Phase I:To characterize the safety profile of the treatment regimens, Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of treatment (up to 24 months after enrollment of last participant)]
Safety Issue:
Description:Safety and tolerability will consist of monitoring and recording all AEs and SAEs as characterized by type, frequency, severity, timing, seriousness and the relationship to the study therapy. These will be reported out qualitatively.
Measure:To characterize the plasma pharmacokinetics of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of Cycle 1 (each cycle is 21 days)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For talazoparib: maximum plasma concentration (Cmax) on Day 1 and Day 6; for Onivyde: maximum plasma concentration (Cmax) on Day 1 .
Measure:To characterize the plasma pharmacokinetics of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of Cycle 1 (each cycle is 21 days)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For talazoparib: Tmax on Day 1 and Day 6; for Onivyde: Tmax on Day 1 .
Measure:To characterize the plasma pharmacokinetics of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of cycle 1 (approximately 21 days after last participant enrollment)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For both talazoparib and Onivyde: clearance (CL) in Cycle 1.
Measure:To characterize the plasma pharmacokinetics of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of cycle 1 (approximately 21 days after last participant enrollment)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For talazoparib: area under the plasma concentration time curve (AUCtau (AUC24)) in Cycle 1.
Measure:To characterize the plasma pharmacokinetics of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of cycle 1 (approximately 21 days after last participant enrollment)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For talazoparib: Ctrough (predose) in Cycle 1.
Measure:To characterize the plasma pharmacokinetics of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of cycle 1 (approximately 21 days after last participant enrollment)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For Onivyde: area under the plasma concentration time curve (AUCinf) in Cycle 1.
Measure:To characterize the plasma pharmacokinetics of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of Cycle 1 (each cycle is 21 days)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For Onivyde: half-life (t½) on Day 1.
Measure:To characterize the plasma pharmacokinetics of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of Cycle 1 (each cycle is 21 days)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided For Onivyde: Vd on Day 1.
Measure:To estimate the antitumor activity of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At time of randomization until evaluation of respective endpoints, up to 4 months after enrollment of last participant
Safety Issue:
Description:Descriptive statistics of objective response rate (ORR) at cycle 4 will be provided.
Measure:To estimate the antitumor activity of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At time of randomization until evaluation of respective endpoints, up to 4 months after enrollment of last participant
Safety Issue:
Description:Descriptive statistics of disease control rate (DCR) at cycle 4 will be provided.
Measure:To estimate the antitumor activity of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At time of randomization until evaluation of respective endpoints up to 4 months after enrollment of last participant
Safety Issue:
Description:Descriptive statistics of duration of response (DoR) will be provided.
Measure:To estimate the antitumor activity of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At time of randomization until evaluation of respective endpoints, up to 2 years after enrollment of last participant
Safety Issue:
Description:Descriptive statistics event-free survival (EFS) will be provided.
Measure:To estimate the antitumor activity of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At time of randomization until evaluation of respective endpoints, up to 2 years after enrollment of last participant
Safety Issue:
Description:Descriptive statistics of overall survival (OS) will be provided.
Measure:Phase II: To describe the toxicity of the treatment regimens.
Time Frame:At the end of treatment (up to 24 months after enrollment of last participant)
Safety Issue:
Description:Safety and tolerability will consist of monitoring and recording all AEs and SAEs as characterized by type, frequency, severity, timing, seriousness and the relationship to the study therapy. These will be reported out qualitatively.
Measure:To describe the antitumor activity of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of treatment, up to 24 months after enrollment of last participant
Safety Issue:
Description:Descriptive statistics of objective response rate (ORR) at cycle 4 will be provided.
Measure:To describe the antitumor activity of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of treatment, up to 24 months after enrollment of last participant
Safety Issue:
Description:Descriptive statistics of disease control rate (DCR) at cycle 4 will be provided.
Measure:To describe the antitumor activity of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of treatment, up to 24 months after enrollment of last participant
Safety Issue:
Description:Descriptive statistics of duration of response (DoR) will be provided.
Measure:To describe the antitumor activity of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of treatment, up to 5 years after randomization of last participant
Safety Issue:
Description:Descriptive statistics of event-free survival (EFS) will be provided.
Measure:To describe the antitumor activity of Onivyde plus talazoparib (Arm A) and Onivyde plus temozolomide (Arm B)
Time Frame:At the end of treatment, up to 5 years after randomization of last participant
Safety Issue:
Description:Descriptive statistics of overall survival (OS) will be provided.
Measure:To characterize the plasma pharmacokinetics Onivyde and talazoparib in children, adolescents and young adults with refractory or recurrent Ewing sarcoma.
Time Frame:At the end of Cycle 1 (each cycle is 21 days)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For talazoparib: maximum plasma concentration (Cmax) on Day 1 and Day 6; for Onivyde: maximum plasma concentration (Cmax) on Day 1 .
Measure:To characterize the plasma pharmacokinetics Onivyde and talazoparib in children, adolescents and young adults with refractory or recurrent Ewing sarcoma.
Time Frame:At the end of Cycle 1 (each cycle is 21 days)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For talazoparib: Tmax on Day 1 and Day 6; for Onivyde: Tmax on Day 1 .
Measure:To characterize the plasma pharmacokinetics Onivyde and talazoparib in children, adolescents and young adults with refractory or recurrent Ewing sarcoma.
Time Frame:At the end of cycle 1 (approximately 21 days after last participant enrollment
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For both talazoparib and Onivyde: clearance (CL) in Cycle 1.
Measure:To characterize the plasma pharmacokinetics Onivyde and talazoparib in children, adolescents and young adults with refractory or recurrent Ewing sarcoma.
Time Frame:At the end of cycle 1 (approximately 21 days after last participant enrollment)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For talazoparib: area under the plasma concentration time curve (AUCtau (AUC24)) in Cycle 1.
Measure:To characterize the plasma pharmacokinetics Onivyde and talazoparib in children, adolescents and young adults with refractory or recurrent Ewing sarcoma.
Time Frame:At the end of cycle 1 (approximately 21 days after last participant enrollment)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For talazoparib: Ctrough (predose) in Cycle 1.
Measure:To characterize the plasma pharmacokinetics Onivyde and talazoparib in children, adolescents and young adults with refractory or recurrent Ewing sarcoma
Time Frame:At the end of cycle 1 (approximately 21 days after last participant enrollment)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For Onivyde: area under the plasma concentration time curve (AUCinf) in Cycle 1.
Measure:To characterize the plasma pharmacokinetics Onivyde and talazoparib in children, adolescents and young adults with refractory or recurrent Ewing sarcoma.
Time Frame:At the end of Cycle 1 (each cycle is 21 days)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided. For Onivyde: half-life (t½) on Day 1.
Measure:To characterize the plasma pharmacokinetics Onivyde and talazoparib in children, adolescents and young adults with refractory or recurrent Ewing sarcoma.
Time Frame:At the end of Cycle 1 (each cycle is 21 days)
Safety Issue:
Description:Descriptive statistics of plasma drug concentrations and pharmacokinetic parameters will be provided For Onivyde: Vd on Day 1.

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:St. Jude Children's Research Hospital

Trial Keywords

  • Pediatric Cancer
  • Childhood Cancer
  • Ewing Sarcoma
  • PARP inhibitor
  • Solid tumor
  • Irinotecan
  • Onivyde
  • Talazoparib

Last Updated

June 23, 2021