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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2012-01473 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| OSU-09100 | |||
| OSU# 09100 | |||
| 2009C0069 | |||
| 09100 | |||
| NCI 8472 | |||
| CDR0000656393 | |||
| OSU 09100 | Other Identifier | Ohio State University Comprehensive Cancer Center | |
| 8472 | Other Identifier | CTEP | |
| N01CM00070 | U.S. NIH Grant/Contract | View source | |
| N01CM62207 | U.S. NIH Grant/Contract | View source | |
| P30CA016058 | U.S. NIH Grant/Contract | View source |
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This phase I trial studies the side effects and best dose of veliparib when given with or without mitomycin C in treating patients with solid tumors that have spread to other places in the body, cannot be removed by surgery or have come back. Veliparib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as mitomycin C, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving veliparib together with mitomycin C may kill more tumor cells.
PRIMARY OBJECTIVES:
I. To screen cancer patients across different histological sites to identify those with functional defects in the Fanconi anemia (FA) pathway in their tumors.
II. To establish the safety and practicality of treating patients with FA deficient tumors with the poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitor ABT-888 (veliparib) as protracted monotherapy.
III. To establish the safety and practicality of treating patients with FA deficient tumors with the combination of mitomycin C (MMC) and ABT-888.
IV. To select a dose of ABT-888 protracted monotherapy and a dose-schedule of the combination of mitomycin C and ABT-888 in patients with FA deficient tumors for phase 2 trials.
SECONDARY OBJECTIVES:
I. To evaluate for germ-line FA repair deficiency and BRCA mutations in peripheral blood mononuclear (PBMC) in patients receiving ABT-888 treatment.
II. To evaluate in PBMC samples for foci produced by the histone variant gamma-H2A histone family, member X (H2AX) in patients receiving mitomycin C with or without ABT-888 in order to assess any possible effect of ABT-888 in the cellular sensing and processing of mitomycin C-induced deoxyribonucleic acid (DNA) double strand breaks.
III. Quantify the number of patients with antitumor responses.
OUTLINE: This is a dose-escalation study of veliparib. Patients are assigned to 1 of 2 treatment arms.
ARM I: Patients receive veliparib orally (PO) twice daily (BID) in the absence of disease progression or unacceptable toxicity.
ARM II: Patients receive veliparib PO BID on days 1-7, 1-14, or 1-21. Patients also receive mitomycin C intravenously (IV) over 10-20 minutes on day 1. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 12 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm I (veliparib) | Experimental | Patients receive veliparib PO BID in the absence of disease progression or unacceptable toxicity. |
|
| Arm II (veliparib and mitomycin C) | Experimental | Patients receive veliparib PO BID on days 1-7, 1-14, or 1-21. Patients also receive mitomycin C IV over 10-20 minutes on day 1. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laboratory Biomarker Analysis | Other | Correlative studies |
|
| Measure | Description | Time Frame |
|---|---|---|
| Ability to safely deliver the combination of mitomycin C and veliparib | Up to 12 weeks post-treatment | |
| Ability to safely deliver veliparib in a continuous dose as monotherapy | Up to 12 weeks post-treatment | |
| Feasibility of screening for FA deficiency across different tumor types, defined as adequate number of patients deficient on this pathway | Up to 12 weeks post-treatment | |
| Selection of a dose schedule of the combination of mitomycin C and veliparib for phase II trials | Up to 12 weeks post-treatment | |
| Selection of a dose schedule of veliparib monotherapy for phase II trials | Up to 12 weeks post-treatment |
| Measure | Description | Time Frame |
|---|---|---|
| BRCA mutations | Descriptive statistics will be provided: proportions for categorical variables; mean and standard deviation for the continuous variables. | Baseline |
| FancD2 foci formation in peripheral blood mononuclear cells |
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Inclusion Criteria:
Patients must have a histologically confirmed solid malignancy that is metastatic, or unresectable, or recurrent, for which no curative or standard of care exist, or this standard of care is no longer effective
Tumors have been shown to be deficient for the FA pathway, based on Fanconi anemia triple stain immunofluorescence (FATSI) screening
Patients will be consented to have their existing, or about to be obtained, paraffin embedded tumor tissue screened for FA deficiency; screening will be performed on an ongoing basis on the breast, thoracic, gastrointestinal (GI), Georgetown University (GU), and gynecologic (GYN) Ohio State University (OSU) clinics, anteceding and concurrently with the clinical trial; it will continue until the numbers of patients required for the clinical trial are identified and enrolled; based on the estimation from our preliminary data of 15 to 30% of patients, depending on the primary organ site, having tumors deficient for the FA pathway we will need to screen around 300 patients' samples to identify 40-50 patients; none of the eligibility criteria defined above or below will need to be met for the screening portion, since FA deficient patients identified by screening may meet eligibility criteria for the clinical trial at a later time; (e.g., patient is undergoing standard of care treatment at the time of the screening); separate written consents for screening and for the clinical trial will be obtained from patients
Up to two chemotherapy regimens for metastatic disease are allowed; in addition, prior adjuvant/neo-adjuvant chemotherapy, hormonal therapy, molecular targeted therapy or estrogen receptor B (Erb) inhibitor treatments (e.g., erlotinib, Herceptin, sorafenib, sunitinib) will be allowed and will not count towards eligibility; at least 4 weeks must elapse since prior chemotherapy or radiation therapy (two weeks for erlotinib, hormonal therapy, or limited field palliative radiation to bone, brain, or radiosurgery), 6 weeks if the last regimen included nitrosoureas or mitomycin C; previous use of mitomycin C would be restricted to topical applications (bladder cancer) or chemoembolization (e.g., liver tumors)
Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 60%)
Life expectancy of greater than 3 months
Leukocytes >= 3,000/mcL
Absolute neutrophil count (ANC) >= 1,500/mcL
Hemoglobin >= 9 g/dL
Platelets >= 100,000/mcL
Total bilirubin within normal institutional limit
Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional upper limit of normal
Creatinine within normal institutional limits OR creatinine clearance >= 60 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal
Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
Ability to understand and the willingness to sign a written informed consent document
Patients should be able to swallow capsules
EXPANSION COHORT:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sameh Mikhail | Ohio State University Comprehensive Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Georgetown Cancer Treatment Center | Georgetown | Kentucky | 40324 | United States | ||
| Ohio State University Comprehensive Cancer Center |
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| ID | Term |
|---|---|
| D016685 | Mitomycin |
| C473651 | Mitozytrex |
| C521013 | veliparib |
| ID | Term |
|---|---|
| D008937 | Mitomycins |
| D045563 | Indolequinones |
| D011809 | Quinones |
| D009930 | Organic Chemicals |
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| Mitomycin | Drug | Given IV |
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| Veliparib | Drug | Given PO |
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Descriptive statistics will be provided: proportions for categorical variables; mean and standard deviation for the continuous variables.
| Up to week 5 |
| Foci produced by the histone variant gamma-H2AX | Descriptive statistics will be provided: proportions for categorical variables; mean and standard deviation for the continuous variables. | Up to week 5 |
| Tumor shrinkage as assessed by radiological means | Up to 12 weeks post-treatment |
| Columbus |
| Ohio |
| 43210 |
| United States |
| D001389 |
| Azirines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D007211 | Indoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |