Randomized Phase 2 Study of MLN8237, an Aurora A Kinase Inhibitor, Plus Weekly Paclitaxel or Weekly Paclitaxel Alone in Patients With Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer, Preceded by a Phase 1 Portion in Patients With Ovarian or Breast Cancer
Inclusion Criteria:
Each patient must meet all of the following inclusion criteria to be enrolled in the
study:
- Female patients 18 years or older
- Previously treated, metastatic or locally recurrent malignancy with 1 of the
following diagnoses, which has been confirmed histologically or cytologically:
adenocarcinoma of the breast (Phase 1 only), recurrent epithelial ovarian, fallopian
tube, or primary peritoneal carcinoma (Phase 1 and 2)
- In the Phase 1 portion of the study, patients with breast cancer must have received
treatment with at least 1 but no more than 4 prior chemotherapy regimens not
including regimens received in the neoadjuvant and/or adjuvant setting
- Patients with breast cancer must have measurable disease per Response Evaluation
Criteria in Solid Tumors (RECIST) 1.1
- No antineoplastic therapy or radiotherapy within 3 weeks before enrollment (2 weeks
for regimens with recovery expected within 7 to 14 days) and recovered from
toxicities of prior therapy (except alopecia); the patient must have recovered from
all treatment-related toxicities and must have evidence of PD or persistent disease
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
- Adequate bone marrow, liver and renal function
- Postmenopausal at least 1 year, OR Surgically sterile, OR If childbearing potential,
agree to 2 effective methods of nonhormonal contraception, or agree to completely
abstain from heterosexual intercourse
- Able to provide written informed consent
- Willing to comply with scheduled visits, treatment plan, laboratory tests and other
trial procedures
- Suitable venous access
Specific Inclusion Criteria for Patients with Recurrent Ovarian, Fallopian Tube or
Peritoneal Cancer:
- Prior treatments must have included a platinum and a taxane; the most recent
treatment need not be a platinum-containing or taxane-containing regimen
- Disease must have recurred ≤ 12 months after discontinuation of platinum therapy
- Patients who previously received weekly taxane are potentially eligible, provided
that they did not progress during therapy or within 3 months of completing therapy
- Patients with platinum-refractory disease, as defined by progression during primary
or subsequent platinum-based therapy or persistent radiographic disease after primary
or subsequent platinum-based therapy, will be included
- Patients must have measurable disease in target lesions or assessable disease
(defined by CA-125 per protocol), and disease progression per Response Evaluation
Criteria in Solid Tumors (RECIST) version 1.1 or modified Gynecologic Cancer
Intergroup (GCIG) CA-125 criteria
Exclusion Criteria:
Patients meeting any of the following exclusion criteria are not to be enrolled in the
study:
- Prior treatment with an Aurora A-targeted agent (including MLN8237)
- Treatment with clinically significant enzyme inducers within 14 days prior to the
first dose of MLN8237 and during the study
- Treatment with more than 4 cytotoxic chemotherapy regimens in the metastatic setting;
prior therapy cannot include more than 2 prior taxane-containing regimens
- Known hypersensitivity to Cremophor® EL, paclitaxel or its components
- Prior history of ≥ Grade 2 neurotoxicity or any toxicity requiring discontinuation
from taxane chemotherapy that is not resolved to ≤ Grade 1
- Comorbid or unresolved toxicity that would preclude administration of weekly
paclitaxel
- Primary central nervous system malignancy or carcinomatous meningitis
- Symptomatic brain metastasis
- Inability to swallow oral medications or maintain a fast
- History of hemorrhagic or thrombotic cerebrovascular event in past 12 months
- Surgery within 3 weeks before study enrollment and not fully recovered
- Diagnosis or treatment of another malignancy within 2 years preceding first dose of
MLN8237 and have any evidence of residual disease except nonmelanoma skin cancer or
in situ malignancy completely resected
- Pregnant or lactating
- Serious illness that could interfere with protocol completion
- Investigational treatment 21 days prior to first dose of MLN8237
- Prior allogeneic bone marrow or organ transplantation
- Infection requiring systemic antibiotic therapy within 14 days prior to first dose of
MLN8237
- Known history of human immunodeficiency virus (HIV) infection, hepatitis B, or
hepatitis C
- Radiotherapy to > 25% bone marrow or whole pelvic radiotherapy
- Requirement for constant administration of proton pump inhibitor, H2 antagonist, or
pancreatic enzymes. Intermittent uses of antacids of H2 antagonists are allowed