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An Open-Label, Multicenter, Phase 1/2 Study of Poly(ADP-Ribose) Polymerase (PARP) Inhibitor E7449 as Single Agent in Subjects With Advanced Solid Tumors or With B-cell Malignancies and in Combination With Temozolomide (TMZ) or With Carboplatin and Paclitaxel in Subjects With Advanced Solid Tumors


Phase 1/Phase 2
18 Years
N/A
Open (Enrolling)
Both
Malignant Solid Tumour, Ovarian Cancer, Triple Negative Breast Cancer, Advanced Melanoma, B-cell Malignancy, Low-grade

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Trial Information

An Open-Label, Multicenter, Phase 1/2 Study of Poly(ADP-Ribose) Polymerase (PARP) Inhibitor E7449 as Single Agent in Subjects With Advanced Solid Tumors or With B-cell Malignancies and in Combination With Temozolomide (TMZ) or With Carboplatin and Paclitaxel in Subjects With Advanced Solid Tumors


Inclusion Criteria:



All subjects:

1. Subjects with measurable or non-measurable disease following the Response Evaluation
Criteria in Solid Tumors (RECIST 1.1, Appendix 1) for Phase 1 part of the study.
(Only subjects with measurable disease are allowed to enter at the MTD during the
expanded cohort of Phase 1)

2. Histologically and/or cytologically confirmed advanced or metastatic solid tumor or
Bcell malignancies which have progressed after treatment with approved therapies or
for which there are no standard therapies available (Phase 1).

3. Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 (Appendix 2).

4. Life expectancy ≥3 months after starting E7449.

5. Subjects with known brain metastases will be eligible under the following conditions
(see Exclusion Criterion #2):

- has undergone complete surgical excision and are more than 1 month post surgery
with no radiographic evidence of brain disease recurrence Or

- has undergone stereotactic radio surgery (gamma knife procedure) and are more
than 1 month post procedure and with no radiographic evidence of brain disease
progression And

- is asymptomatic And

- discontinued corticosteroid treatment at least 30 days prior to C1D1.

6. Adequate renal function defined as Serum Creatinine <1.5xULN, or use SI units or
calculated creatinine clearance ≥ 50 mL/min per the Cockroft-Gault formula (Appendix
3).

7. Adequate bone marrow function:

- Absolute neutrophil count (ANC) ≥1500/mm3 (≥ 1.5 x 103/mL);

- Platelets ≥ 100,000/mm3 (≥100 x 109/L);

- Hemoglobin ≥10.0 g/dL.

8. Adequate liver function:

- Bilirubin ≤ 1.5 x the upper limit of normal (ULN) except for unconjugated
hyperbilirubinemia of Gilbert's syndrome;

- Alkaline phosphatase (in the absence of bone disease), alanine aminotransferase
(ALT), and aspartate aminotransferase (AST) ≤ 3 x ULN (≤ 5 x ULN if subject has
liver metastasis).

9. Left ventricular ejection fraction (LVEF) > 50% on echocardiography or multiple-gated
acquisition (MUGA) scanning

10. Males or females age ≥18 years at the time of informed consent.

11. Females must not be lactating or pregnant at Screening or Baseline (as documented by
a negative beta-human chorionic gonadotropin [ß-hCG] test with a minimum sensitivity
of 25 IU/L or equivalent units of ß-hCG). A separate baseline assessment is required
if a negative screening pregnancy test was obtained more than 72 hours before the
first dose of study drug. All females will be considered to be of childbearing
potential unless they are postmenopausal (at least 12 months consecutive amenorrheic,
in the appropriate age group, and without other known or suspected cause) or have
been sterilized surgically (i.e., bilateral tubal ligation, total hysterectomy, or
bilateral oophorectomy, all with surgery at least 1 month before dosing). Females of
childbearing potential must not have had unprotected sexual intercourse within 30
days prior to study entry and must agree to use a highly effective method of
contraception (e.g., total abstinence, an intrauterine device, a double-barrier
method [such as condom plus diaphragm with spermicide], a contraceptive implant, an
oral contraceptive, or have a vasectomized partner with confirmed azoospermia)
throughout the entire study period and for 30 days after study drug discontinuation.
If currently abstinent, the subject must agree to use a double-barrier method as
described above if she becomes sexually active during the study period or for 30 days
after study drug discontinuation. Females who are using hormonal contraceptives must
have been on a stable dose of the same hormonal contraceptive product for at least 4
weeks prior to dosing and must continue to use the same contraceptive during the
study and for 30 days after study drug discontinuation.

12. Male subjects must have had a successful vasectomy (confirmed azoospermia) or they
and their female partner must meet the criteria above (i.e., not of childbearing
potential or practicing highly effective contraception throughout the study period
and for 30 days after study drug discontinuation).

13. Voluntary agreement to provide written informed consent and the willingness and
ability to comply with all aspects of the protocol.

For the Phase 2 Cohort 1 (Platinum-sensitive recurrent high-grade serous ovarian
cancer) only:

14. Histologically confirmed platinum-sensitive recurrent high grade serous ovarian
cancer locally advanced or metastatic with disease progression after standard
treatments. (Exclude platinum refractory/resistant defined as progression on platinum
or relapse within six months of prior platinum.

15. At least one lesion of ≥ 1.0 cm in the longest diameter for a non-lymph node or ≥ 1.5
cm in the short-axis diameter for a lymph node which is serially measurable according
to RECIST 1.1 using computerized tomography/magnetic resonance imaging (CT/MRI) or
photography. If there is only one target lesion, it should have a longest diameter of
≥ 1.5 cm (for a non-lymph node) or ≥ 1.5 cm in the short-axis diameter (for a lymph
node).

For the Phase 2 Cohort 2 (B-cell malignancies) Only:

16. Subjects with one of the following relapsed and/or refractory B-cell malignancies
with disease progression following up to three prior systemic treatment regimens:

- Mantle cell, Marginal zone, Follicular, Diffuse large B-cell, B-cell chronic
lymphocytic leukemia (B-CLL).

- ATM-deficient.

For the Phase 2 Cohort 3 (Melanoma) only:

17. Histopathologically confirmed advanced melanoma (except melanoma of intraocular
origin) with disease progression following up to two systemic treatment regimens

18. At least one lesion of ≥ 1.0 cm in the longest diameter for a non-lymph node or ≥ 1.5
cm in the short-axis diameter for a lymph node which is serially measurable according
to RECIST 1.1 using computerized tomography/magnetic resonance imaging (CT/MRI) or
photography. If there is only one target lesion, it should have a longest diameter of
≥ 1.5 cm (for a non-lymph node) or ≥ 1.5 cm in the short-axis diameter (for a lymph
node).

19. No previous treatment with dacarbazine (DTIC) or TMZ containing regimens

For the Phase 2 Cohort 4 (mTNBC) only:

20. Histologically confirmed metastatic triple-negative breast cancer. Estrogen receptor
(ER)-negative, Progesterone Receptor (PR)-negative, Human Epidermal Growth Factor 2
(HER2)-negative (mTNBC) with disease progression after one standard treatment.

21. At least one lesion of ≥ 1.0 cm in the longest diameter for a non-lymph node or ≥ 1.5
cm in the short-axis diameter for a lymph node which is serially measurable according
to RECIST 1.1 using computerized tomography/magnetic resonance imaging (CT/MRI) or
photography. If there is only one target lesion, it should have a longest diameter of
≥ 1.5 cm (for a non-lymph node) or ≥ 1.5 cm in the short-axis diameter (for a lymph
node).

22. No previous treatment with carboplatin and/or paclitaxel

Exclusion Criteria:

All subjects

1. Prior exposure to E7449.

2. Leptomeningeal metastases or brain metastases (except as for Inclusion Criterion #5).

3. Prior treatment with a PARP inhibitor (Phase 2 only).

4. Subjects taking medications which are either strong CYP inhibitors or inducers.

5. Subjects with active malignancies other than advanced ovarian cancer (Cohort 1 only),
ATM-deficient B-cell malignancies (Cohort 2 only), advanced melanoma (Cohort 3 only),
and mTNBC (Cohort 4 only), will be excluded from Phase 2.

6. Subjects who have received any anticancer treatment within 4 weeks or any
investigational agent within 30 days prior to the first dose of study drug or who
have not recovered from any acute toxicity greater than Grade 0 or 1 related to
previous anticancer treatment.

7. Major surgery within 4 weeks prior to the first dose of study drug.

8. Inability to take oral medication, or malabsorption syndrome or any other
uncontrolled gastrointestinal condition (e.g., nausea, diarrhea, or vomiting) that
might impair the bioavailability of E7449.

9. Significant cardiovascular impairment: history of congestive heart failure greater
than New York Heart Association (NYHA) Class II, uncontrolled arterial hypertension,
unstable angina, myocardial infarction or stroke within 6 months of the first dose of
study drug; or cardiac arrhythmia requiring medical treatment.

10. Prolongation of QTc interval to > 480 msec when electrolytes balance is normal.

11. Active infection requiring systemic therapy.

12. Known hypersensitivity to any component of E7449

13. Achlorhydria or use of antacids, proton-pump inhibitors, or other drugs known to
raise gastric pH within 2 weeks prior to study drug administration.

14. Other relevant disease or adverse clinical conditions such as:

History of significant neurological (no neuropathy > Grade 2) or psychiatric
disorders.

- Significant non-neoplastic liver disease (e.g., cirrhosis, active chronic
hepatitis).

- Significant non-neoplastic renal disease.

- Immunocompromised patients, including patients known to be infected with human
immunodeficiency virus (HIV).

- Uncontrolled endocrine diseases (e.g., diabetes mellitus, hypothyroidism or
hyperthyroidism, adrenal disorder) i.e., requiring relevant changes in
medication within the last month or hospital admission within the last three
months.

- Tumor bleeding

15. Any other major illness that, in the investigator's judgment, will substantially
increase the risk associated with the subject's participation in this study

16. Females who are pregnant or breastfeeding.

For Phase 1 Arm 2 and Phase 2 Arm 2 (E7449 in combination with TMZ) only:

17. Known intolerance or known hypersensitivity to any of the study drugs or any of the
Excipients (E7449 and/or TMZ) For Phase 1 Arm 3 and Phase 2 Arm 3 (E7449 in
combination with carboplatin and paclitaxel) only:

18. Known intolerance or known hypersensitivity reactions to E7449, carboplatin or other
platinum containing compounds, paclitaxel, macrogolglycerol ricinoleate (poloxyl
castor oil) or any of the excipients

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Phase 1 To determine the maximum tolerated dose of E7449 as a single agent

Outcome Time Frame:

Baseline to 24 months.

Safety Issue:

No

Authority:

United Kingdom: Medicines and Healthcare Products Regulatory Agency

Study ID:

E7449-E044-101

NCT ID:

NCT01618136

Start Date:

December 2011

Completion Date:

Related Keywords:

  • Malignant Solid Tumour
  • Ovarian Cancer
  • Triple Negative Breast Cancer
  • Advanced Melanoma
  • B-cell Malignancy, Low-grade
  • PARP inhibitors
  • Malignant Solid Tumour
  • ovarian cancer
  • triple negative breast cancer
  • advanced melanoma
  • Breast Neoplasms
  • Neoplasms
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Melanoma
  • Ovarian Neoplasms

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