Phase I Study of the Oral PI3kinase Inhibitor BKM120 or BYL719 and the Oral PARP Inhibitor Olaparib in Patients With Recurrent Triple Negative Breast Cancer or High Grade Serous Ovarian Cancer

NCT01623349CompletedPHASE1INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

Dana-Farber Cancer Institute

Enrollment

118

Start Date

2012-09-01

Completion Date

2019-05-01

Study Type

INTERVENTIONAL

Official Title

Phase I Study of the Oral PI3kinase Inhibitor BKM120 or BYL719 and the Oral PARP Inhibitor Olaparib in Patients With Recurrent Triple Negative Breast Cancer or High Grade Serous Ovarian Cancer

Interventions

BKM120 and OlaparibBYL719 and Olaparib

Conditions

Ovarian CancerBreast Cancer

Eligibility

Age Range

18 Years+

Sex

ALL

Inclusion Criteria:

* Histologically or cytologically confirmed recurrent high grade serous ovarian cancer or triple negative breast cancer
* Subjects with recurrent, metastatic triple negative breast cancer must have had at least 1 chemotherapy regimen for metastatic breast cancer or have developed metastatic breast cancer within 1 year of completion of adjuvant chemotherapy
* Prior therapy for high grade serous ovarian cancer subjects must have included a first-line platinum-based regimen
* At least 4 weeks since prior radiation therapy, 3 weeks since prior chemotherapy and 6 weeks if the last regimen included BCNU or mitomycin C
* At least 4 weeks since any small-molecular kinase inhibitors or any other type of investigational agent
* Life expectancy of at least 4 months
* Able to swallow and tolerate oral medications

Exclusion Criteria:

* Evidence of bowel obstruction, abdominal fistula, gastrointestinal perforation or intra-abdominal abscess within 6 months of study entry
* Current dependency on IV hydration or total parental nutrition
* Diabetes mellitus unless well controlled
* Pregnant or breast feeding
* History of grade 3 or 4 toxicities with previous PI3kinase inhibitor or PARP inhibitor
* Current or active dermatologic diagnoses that would preclude interpretation of skin toxicities of BKM120
* Receiving any medications or substances that are strong inhibitors or inducers of CYP3A4
* History of cardiac dysfunction or disease
* Persistent toxicities (greater than or equal to CTCAE grade 2) caused by previous cancer therapy
* Major surgery within 14 days of starting study treatment
* Evidence of coagulopathy or bleeding diathesis
* History of major depressive episode, bipolar disorder, obsessive/compulsive disorder, schizophrenia, history of suicide attempt or ideation or homicide/homicidal ideation
* CTCAE grade 3 or greater anxiety
* Uncontrolled, intercurrent illness
* Known HIV positive and on combination antiretroviral therapy
* Receiving chronic treatment with steroids or another immunosuppressive agent

Outcome Measures

Primary Outcomes

Determine MTD and RP2D of the Combination of BKM120 and Olaparib, and the Combination of BYL719 and Olaparib

To determine the maximally tolerated dose (MTD) and recommended phase 2 dose (RP2D) of the combination of BKM120 and olaparib, and the combination of BYL719 and olaparib in patients with recurrent TNBC and HGSC.

Time frame: 2 years

Secondary Outcomes

Determine the overall Safety and Observed Toxicities of combining BKM120 and Olaparib, and combining BYL719 and Olaparib

To determine the safety and observed toxicities of the combination of BKM120 and olaparib, and the combination of BYL719 and olaparib in this population

Time frame: 2 years

Determine Pharmacokinetics of BKM120 and Olaparib, and BYL719 and Olaparib

To measure the drug levels of both BKM120 and olaparib, and both BYL719 and olaparib at different time points after they are started to see if either drug affects the metabolism and levels of the other. PK samples will be drawn in duplicate (one set to be sent to Astrazeneca and the second set to Novartis). BKM120 (or BYL719) and olaparib levels will be performed at the following timepoints: 1. prior to taking both BKM120 (or BYL719) and olaparib cycle 1, day 1. 2. Cycle 1, day 8: prior to dosing, 1, 2, 4, and 8 hours post am dosing. 3. Cycle 1, day 15: prior to dosing, 1, 2, 4, and 8 hours post am dosing.

Time frame: 2 years

Determine preliminary activities of these combinations at the MTD and RP2 dose

To determine a preliminary anti-cancer activities of these combinations at the MTD and RP2D dose. Anti-cancer activities of these combinations will be measured by response rate by RECIST 1.1 in patients who have measurable cancer

Time frame: 2 years

Exploratory Translational Endpoints

(A) To determine the downstream signaling effects of the PI3-kinase pathway whenboth PI3-kinase and PARP are inhibited. (B) To determine BRCA1 immnostaining, BRCA1 promoter hypermethylation and somatic mutations in BRCA1 and BRCA2 in archived formalin fixed paraffin embedded (FFPE) tissue and any new available tissues (pre- or post-treatment biopsies and biopsies or other tumor colelction for clinical care at the time of or following tumor progression)

Time frame: 2 years

Locations

Massachusetts General Hospital, Boston, United States

Beth Israel Deaconess Medical Center, Boston, United States

Dana-Farber Cancer Institute, Boston, United States

Memorial Sloan-Kettering Cancer Center, New York, United States

MD Anderson Cancer Center, Houston, United States

Linked Papers

2020-03-12

An immune-centric exploration of BRCA1 and BRCA2 germline mutation related breast and ovarian cancers

Abstract Background BRCA1/2 germline mutation related cancers are candidates for new immune therapeutic interventions. This study was a hypothesis generating exploration of genomic data collected at diagnosis for 19 patients. The prominent tumor mutation burden (TMB) in hereditary breast and ovarian cancers in this cohort was not correlated with high global immune activity in their microenvironments. More information is needed about the relationship between genomic instability, phenotypes and immune microenvironments of these hereditary tumors in order to find appropriate markers of immune activity and the most effective anticancer immune strategies. Methods Mining and statistical analyses of the original DNA and RNA sequencing data and The Cancer Genome Atlas data were performed. To interpret the data, we have used published literature and web available resources such as Gene Ontology, The Cancer immunome Atlas and the Cancer Research Institute iAtlas. Results We found that BRCA1/2 germline related breast and ovarian cancers do not represent a unique phenotypic identity, but they express a range of phenotypes similar to sporadic cancers. All breast and ovarian BRCA1/2 related tumors are characterized by high homologous recombination deficiency (HRD) and low aneuploidy. Interestingly, all sporadic high grade serous ovarian cancers (HGSOC) and most of the subtypes of triple negative breast cancers (TNBC) also express a high degree of HRD. Conclusions TMB is not associated with the magnitude of the immune response in hereditary BRCA1/2 related breast and ovarian cancers or in sporadic TNBC and sporadic HGSOC. Hereditary tumors express phenotypes as heterogenous as sporadic tumors with various degree of “BRCAness” and various characteristics of the immune microenvironments. The subtyping criteria developed for sporadic tumors can be applied for the classification of hereditary tumors and possibly also characterization of their immune microenvironment. A high HRD score may be a good candidate biomarker for response to platinum, and potentially PARP-inhibition. Trial registration Phase I Study of the Oral PI3kinase Inhibitor BKM120 or BYL719 and the Oral PARP Inhibitor Olaparib in Patients With Recurrent TNBC or HGSOC ( NCT01623349 ), first posted on June 20, 2012. The design and the outcome of the clinical trial is not in the scope of this study.

Linked Investigators

Phase I Study of the Oral PI3kinase Inhibitor BKM120 or BYL719 and the Oral PARP Inhibitor Olaparib in Patients With Recurrent Triple Negative Breast Cancer or High Grade Serous Ovarian Cancer