Phase I trial of the triplet veliparib + VX-970 + cisplatin in patients with advanced solid tumors.

Authors

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Geraldine Helen O'Sullivan Coyne

Early Clinical Trials Development Program, DCTD, National Cancer Institute at the National Institutes of Health, Bethesda, MD

Geraldine Helen O'Sullivan Coyne , Shivaani Kummar , Robert S. Meehan , Lamin Juwara , Richard Piekarz , Elad Sharon , Howard Streicher , Barbara A. Conley , Naoko Takebe , Lyndsay Harris , Austin Doyle , Mary Flanagan Quinn , Larry Rubinstein , Deborah Wilsker , Robert J. Kinders , Ralph E. Parchment , Elliot B Levy , James H. Doroshow , Alice P. Chen

Organizations

Early Clinical Trials Development Program, DCTD, National Cancer Institute at the National Institutes of Health, Bethesda, MD, Department of Medicine–Oncology, Palo Alto, CA, National Cancer Institute, Bethesda, MD, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, MD, National Cancer Institute, Rockville, MD, National Cancer Institute, National Institutes of Health, Rockville, MD, Department of Medicine, Hematology and Oncology, Case Comprehensive Cancer Center, Cleveland, OH, Natoinal Naval Medical Center, Rockville, MD, Biometric Research Branch, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, National Cancer Institute, Frederick, MD, Clinical Biomarkers Program, Laboratory of Human Toxicology and Pharmacology, Applied/Developmental Directorate, Leidos Biomedical Research, Inc., Frederick, MD, Center for Interventional Oncology, National Institutes of Health, Bethesda, MD, Center for Cancer Research, Division of Cancer Treatment and Diagnosis, Bethesda, MD

Research Funding

NIH

Background: The DNA damage response (DDR) pathway is a key element of cellular integrity. Platinum compounds form covalent bonds with purine bases causing DNA cross-links that stall replication forks halting transcription. Poly (ADP-ribose)polymerase-1 (PARP-1) plays a pivotal role in DDR and base-excision repair. Ataxia-telangiectasia-related (ATR) protein kinase is also central to DDR and homologous recombination, activating a series of phosphorylation cascades culminating in cell cycle arrest to allow time for DNA repair. Veliparib (ABT-888) is a PARP 1/2 inhibitor (PARPi) with clinical evidence of antitumor activity in combination with cisplatin in BRCA mutation carriers (Rodler et al, Cancer Res. 2011). VX-970 is a potent ATR inhibitor, with antitumor activity across a range of cell lines in combination with DNA damaging agents, including cisplatin (Huntoon et al, Cancer Res. 2013). In this trial, we will evaluate whether the combination of veliparib + VX-970 impairs DNA repair, inducing a “BRCA null”-like phenotype leading to potentiation of the antitumor activity of cisplatin. Methods: Open label phase I trial of the veliparib+VX-970+cisplatin combination, following a 3+3 design, with dose limiting toxicities defined during cycle 1. Estimated enrollment: 24 patients (pts); Dana Farber and MD Anderson planned as additional sites. Drug administration over a 21-day cycle: VX- intravenously (IV) on Days 2 and 9; Veliparib orally twice daily (q12 hours ± 1 hour) Days 1-3 and 8-10; cisplatin 40 mg/m2 IV Day 1 (with Day 8 added from DL3 onwards). Pts must be ≥ 18 years of age; have histologically confirmed solid tumors that have progressed on standard of care therapy known to prolong survival or without known standard, ECOG PS ≤2, and life expectancy ≥3 months. Pts with treated brain metastasis with stable disease ≥4 weeks without requiring steroids or anti-seizure medication are eligible. Exclusion criteria include a prolonged QTc interval, and sensory/motor neuropathy ≥grade 2 by CTCAE v.4. At this time, cohort 3 has enrolled 1 of 3 planned pts. Assessment of DDR and apoptosis biomarkers at the maximally tolerated dose using a validated and quantitative immunofluorescence assay is planned. Clinical trial information: NCT02723864

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics—Clinical Pharmacology and Experimental Therapeutics

Track

Developmental Therapeutics and Translational Research

Sub Track

Other Novel Agents

Clinical Trial Registration Number

NCT02723864

Citation

J Clin Oncol 35, 2017 (suppl; abstr TPS2609)

DOI

10.1200/JCO.2017.35.15_suppl.TPS2609

Abstract #

TPS2609

Poster Bd #

94b

Abstract Disclosures

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