Phase II Clinical Trial Of 6-Mercaptopurine (6MP) and Low-Dose Methotrexate In Patients With Known BRCA Defective Tumours
1. Patients with proven BRCA1 or BRCA2 mutations and after appropriate exposure to
standard treatment, as defined by:
- Patients with initially histologically or cytologically proven locally advanced
or metastatic breast cancer who may have received up to 3 previous lines of
chemotherapy in the locally advanced or metastatic breast cancer setting.
- Patients must have previously had a taxane and an anthracycline in either the
adjuvant or metastatic setting, provided that these were not contraindicated.
- Patients with hormone responsive disease should have had at least 1 line of
hormone therapy for metastatic disease.
- Prior treatment with a PARP inhibitor is permissible. OR Ovarian Cancer
- Patients with initially histologically or cytologically proven ovarian cancer.
- Patients must have disease that is platinum resistant or in whom further
platinum based therapy is inappropriate.
- Prior treatment with a PARP inhibitor is permissible.
2. Patients must have measurable disease on computerized tomography (CT) or MRI scan as
defined by RECIST criteria.
3. Age ≥18 years.
4. ECOG performance score of 0-2.
5. Life expectancy >12 weeks.
6. Written informed consent.
7. Patient willing and able to comply with all protocol requirements.
8. No prior anti-cancer treatment in previous 4 weeks, other than palliative RT.
9. Haematological and biochemical indices within the ranges shown below.
- Lab Test Value required
- Haemoglobin (Hb) > 10g/dL
- White Blood Count (WBC) > 3x109/L
- Platelet count > 100,000/μL
- Absolute Neutrophil count > 1.5x109/L;
- Serum bilirubin ≤ 2 x Upper limit normal (ULN)
- AST (SGOT) or ALT ≤ 5 x ULN (liver mets)
- or ≤ 3 x ULN (no liver mets)
- Alk Phos ≤ 5 x ULN
- Serum creatinine ≤ 1.5 x ULN
10. Ascites and pleural effusions must be drained prior to therapy.
1. Patients with any of the following contra-indications to thiopurines (6MP or 6TG) or
- family history of severe liver failure;
- diffuse infiltrative pulmonary or pericardial disease;
- known hypersensitivity to either trial agent.
2. Patients found to have a Low/Low genotype on TPMT testing will be excluded.
3. Pregnant or breast-feeding women or women of childbearing potential unless highly
effective methods of contraception are used (see section 7.2.3).
4. Other active malignancy, with the exception of adequately treated in situ carcinoma
of the cervix uteri and basal or squamous cell carcinoma of the skin.
5. Patients known or tested to be serologically positive for Hepatitis B, Hepatitis C or
6. Patients with active CNS lesions are excluded (i.e., those with radiographically
unstable, symptomatic lesions). However, patients treated with stereotactic therapy
or surgery and/or whole brain radiotherapy are eligible if the patient remains
without evidence of disease progression in brain ≥ 3 months prior to registration
date . They must also be off corticosteroid therapy for ≥ 3 weeks prior to
7. Patients who have received anticancer agent(s) or an investigational agent within 28
days prior to study drug administration.
8. Subjects who have not recovered to within one grade level (not to exceed grade 2) of
their baseline following a significant adverse event or toxicity attributed to
previous anticancer treatment are excluded.