A Phase I Study of ABT-888, an Oral Inhibitor of Poly(ADP-Ribose) Polymerase and Temozolomide in Children With Recurrent/Refractory CNS Tumors
Background
- A subset of patients with pediatric CNS tumors continue to have a poor prognosis
despite advances in surgery and radiation. Novel strategies are required for improving
outcome for these patients.
- Temozolomide, an oral alkylating agent, has shown modest activity in recurrent
pediatric CNS tumors, including high-grade gliomas, medulloblastoma/PNET, and low-grade
gliomas.
- Temozolomide induces single-stranded DNA breaks, the majority of which are repaired by
the base excision repair (BER) pathway. Poly(ADP-ribose) polymerase, or PARP, is a
critical nuclear enzyme that binds to DNA breaks, recruits and activates key proteins
in the BER and other DNA repair pathways, halts DNA replication, and facilitates repair
of damaged DNA.
- ABT-888 is a potent and orally bioavailable PARP inhibitor that has been shown to
enhance cytotoxicity of temozolomide and other chemotherapy agents in several
pre-clinical models of human tumors.
Objectives
- To estimate the maximum tolerated dose (MTD) of ABT-888 in combination with
temozolomide in children with recurrent or refractory CNS tumors.
- To study the plasma pharmacokinetics (PK) of ABT-888 and PARP inhibition in peripheral
blood mononuclear cells (PBMC) in order to recommend a Phase 2 dose of ABT-888 in
combination with temozolomide in children with recurrent or refractory CNS tumors.
- To describe the toxicities of the combination of ABT-888 and temozolomide in children
with recurrent or refractory CNS tumors.
Eligibility
- Patient must be less than or equal to 21 years of age at registration.
- Patients with a diagnosis of a primary CNS malignancy (including low-grade glioma) that
is recurrent or refractory to standard therapy and for which there is no known curative
therapy Progression and recurrence will be documented by review of MRI scans. If time
permits we will have the diagnosis confirmed by the NCI Laboratory of Pathology.
Patients with intrinsic brain stem tumors must have radiographic evidence of
progression.
- Karnofsky Performance Scale (KPS for greater than 16 yrs of age) or Lansky Performance
Score (LPS for less than or equal to 16 years of age) greater than or equal to 50
assessed within two weeks of study enrollment.
- Patients must have recovered from the toxic effects of all prior therapy.
- Patients who are receiving dexamethasone must be on a stable or decreasing dose for at
least 1 week prior to registration.
Design
-ABT-888 will be given twice daily on day 1-5, and temozolomide will be given once daily on
day 1-5, every 28 days. The morning dose of ABT-888 will be given 60-90 minutes prior to
temozolomide.
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
To estimate the maximum tolerated dose (MTD) of ABT-888 in combination with Temozolomide in children with recurrent or refractory CNS tumors
Katherine E Warren, M.D.
Principal Investigator
National Cancer Institute (NCI)
United States: Federal Government
090243
NCT00994071
September 2009
March 2013
Name | Location |
---|---|
National Institutes of Health Clinical Center, 9000 Rockville Pike | Bethesda, Maryland 20892 |