A phase I study of continuous veliparib in combination with IV carboplatin/paclitaxel or IV/IP paclitaxel/cisplatin and bevacizumab in newly diagnosed patients with previously untreated epithelial ovarian, fallopian tube, or primary peritoneal cancer: An NRG Oncology/Gynecologic Oncology Group study.

Authors

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Katherine M. Bell-McGuinn

Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY

Katherine M. Bell-McGuinn , William E Brady , Russell J. Schilder , Paula M Fracasso , Kathleen N. Moore , Joan L. Walker , Linda R. Duska , Cara Amanda Mathews , Alice Chen , Stacie Peacock Shepherd , Vincent L. Giranda , Carol Aghajanian

Organizations

Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, Roswell Park Cancer Institute, Buffalo, NY, Thomas Jefferson University, Philadelphia, PA, University of Virginia School of Medicine, Charlottesville, VA, University of Oklahoma Health Sciences Center, Oklahoma City, OK, Stephenson Cancer Center, OUHSC, Oklahoma City, OK, University of Virginia Health System, Charlottesville, VA, Women and Infants Hosp of Rhode Island, Providence, RI, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, MD, Abbott, Abbott Park, IL, AbbVie, North Chicago, IL

Research Funding

NIH

Background: Veliparib, a poly-(ADP-ribose)-polymerase inhibitor, increases anti-tumor activity when combined with platinum chemotherapy and has monotherapeutic activity in BRCA1 or BRCA2 deficient tumors. This study was done to determine the recommended phase II dose (RP2D) of continuous veliparib in combination with initial treatment for epithelial ovarian, fallopian tube, or primary peritoneal cancer. Methods: Eligible patients had newly diagnosed, untreated, stage II-IV epithelial ovarian, fallopian tube, or primary peritoneal carcinoma or carcinosarcoma. Three regimens (six 21 day cycles) were evaluated: 1, IV q3week carboplatin (AUC 6) and paclitaxel (175mg/m2); 2, IV q3week carboplatin (AUC 6) and weekly paclitaxel (80mg/m2); and 3, IV paclitaxel (135mg/m2, day 1), IP cisplatin (75mg/m2, day 1 or 2) and IP paclitaxel (60mg/m2, day 8). Bevacizumab 15mg/kg started in cycle 2 and continued as monotherapy for cycles 7-22. Veliparib continuous oral BID dosing in cycles 1-6 started at 30mg. A 3+3 dose escalation design evaluated dose-limiting toxicities (DLTs) in cycles 1 and 2. Once <2/6 patients experienced a DLT, that dose level was expanded to evaluate feasibility over 4 cycles. Results: We enrolled 189 patients; 32 were not evaluable. DLTs at ≥RP2D levels were as seen in the table. Conclusions: The RP2D for all regimens is veliparib 150mg BID. Clinical trial information: NCT00989651

Veliparib dose
(mg BID)
No. Evaluable
Patients
No. Patients
with DLTs
DLT (grade)[no. patients]
Regimen 1
150172febrile neutropenia (3)
hyponatremia (3)
200166febrile neutropenia (3)[2]
thrombocytopenia (4)[2]
>3 week delay for thrombocytopenia
syncope (3)
250177febrile neutropenia (3)[3]
thrombocytopenia (4)[4]
30062febrile neutropenia (3)
thrombocytopenia (4)
Regimen 2
150171headache (3)
20030significant early cycle delays
Regimen 3
150319febrile neutropenia (3)
sepsis (4)
pulmonary embolism (3,4)[2]
myocardial infarction (4)
cerebrovascular event (4)
mucositis & extremity pain (3)
syncope (3)
abdominal pain (3)
20062headache (3)
sepsis (5)

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Abstract Details

Meeting

2015 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Ovarian Cancer

Clinical Trial Registration Number

NCT00989651

Citation

J Clin Oncol 33, 2015 (suppl; abstr 5507)

DOI

10.1200/jco.2015.33.15_suppl.5507

Abstract #

5507

Abstract Disclosures