Rucaparib Phosphate in Treating Patients with Advanced Pancreatic Cancer and a Known Deleterious BRCA1/2 or PALB2 Mutation
This phase II trial studies how well rucaparib phosphate works in treating patients with pancreatic cancer that has spread to other parts of the body and a known deleterious BRCA1/2 or PALB2 mutation. Rucaparib phosphate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
Inclusion Criteria
- Histologically or cytologically confirmed diagnosis of pancreatic adenocarcinoma with locally advanced or metastatic disease
- Eastern Cooperative Oncology (ECOG) performance status of 0 to 1
- Patients may have previously failed non-platinum containing therapy or may never have previously progressed on treatment
- Patients must be on treatment with platinum-based (cisplatin, oxaliplatin or carboplatin) treatment for locally advanced or metastatic pancreatic cancer and have received a minimum of 16 weeks of therapy without evidence of disease progression based on the investigator’s opinion * Discontinuation of the platinum component of the regimen for chemotherapy-related toxicity is permissible provided the patient has previously received at least 16 weeks of platinum-based therapy without evidence of disease progression =< 8 weeks after treatment with the platinum agent
- Documented deleterious BRCA1/2 or PALB2 mutation (germline or somatic) as assessed by Clinical Laboratory Improvement Amendments (CLIA) certified laboratory; variants that are considered to be non-detrimental (“variants of uncertain significance”, “variants of unknown significance”, “variant, favor polymorphism” or “benign polymorphism” etc) are not sufficient for study entry
- Measurable disease is not required for enrollment
- Absolute neutrophil count (ANC) >= 1.5 x 10^9/L
- Platelets > 100 x 10^9/L
- Hemoglobin >= 9 g/dL
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3 x upper limit of normal (ULN)
- Total bilirubin =< 1.5 x ULN; if liver metastases or metabolic disorder such as Gilbert’s syndrome, then =< 2.5 x ULN
- Serum creatinine =< 1.5 x ULN or estimated glomerular filtration rate (GFR) >= 45 mL/min using Cockcroft Gault formula
Exclusion Criteria
- Prior treatment with a PARP inhibitor
- Patients who have demonstrated resistance to platinum agents (e.g. oxaliplatin, cisplatin) are not eligible to participate in this study
- Clinical evidence of uncontrolled malabsorption and/or any other gastrointestinal disorder or defect that would, in the opinion of the investigator, interfere with the absorption of rucaparib
- Acute infection requiring intravenous antibiotics, antiviral or antifungal agents during the 14 days prior to first dose of rucaparib
- Symptomatic or untreated central nervous system (CNS) metastases
- Expected life expectancy of < 12 weeks as determined by the investigator
- For fertile patient (female able to become pregnant or male able to father a child), refusal to use effective contraception during the period of the trial and for 6 months after the last dose of rucaparib
- Received any systemic treatment for pancreatic cancer =< 14 days prior to first dose of rucaparib
- Non-study related minor surgical procedure =< 5 days, or major surgical procedure =< 21 days, prior to the first dose of rucaparib; in all cases, patients must be sufficiently recovered and stable before treatment administration
- Active drug or alcohol use or dependence that would interfere with study compliance
- Presence of any other condition that may increase the risk associated with study participation or may interfere with the interpretation of study results, and, in the opinion of the investigator, would make the patient inappropriate for entry into the study
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT03140670.
PRIMARY OBJECTIVES:
I. To assess the efficacy of rucaparib phosphate (rucaparib) in patients with pancreatic adenocarcinoma associated with a deleterious BRCA1/2 or PALB2 mutation by assessment of progression-free survival rate at 6 months (PFS6).
SECONDARY OBJECTIVES:
I. To evaluate efficacy by assessment of objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) version (v).1.1 in those with measurable disease.
II. To assess duration of response (DOR).
III. To evaluate overall survival (OS).
IV. To evaluate the safety and tolerability of rucaparib.
TERTIARY OBJECTIVES:
I. To evaluate mechanisms of resistance to PARP inhibition by gene sequence and structural rearrangements of paired tumor samples and in circulating tumor deoxyribonucleic acid (DNA).
II. To evaluate changes circulating tumor DNA (ctDNA) and in circulating tumor cells (CTCs) as a molecular marker of response.
OUTLINE:
Patients receive rucaparib phosphate orally (PO) twice per day (BID) on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 28 days and then every 8 weeks.
Trial PhasePhase II
Trial Typetreatment
Lead OrganizationUniversity of Pennsylvania/Abramson Cancer Center
Principal InvestigatorKim Anna Reiss Binder
- Primary IDUPCC 05217
- Secondary IDsNCI-2017-00846
- ClinicalTrials.gov IDNCT03140670