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The purpose of this study is to assess pharmacokinetic concentrations of multiple probes alone followed by assessment of the same drug pharmacokinetic concentrations when the patient has steady-state exposure to rucaparib followed by cycle-by-cycle treatment with rucaparib continuing until disease progression or other reason for discontinuation.
This is a Phase 1, open-label, sequential, drug-drug-interaction (DDI) study in patients with advanced solid tumors. The study will consist of 2 parts: a DDI part (Part I) and a rucaparib treatment part (Part II).
In Part I, the PK of cytochrome P450 (CYP) cocktail probes: caffeine, S-warfarin, omeprazole, and midazolam and a P-glycoprotein probe (digoxin) will be assessed with and without rucaparib treatment. Patients will receive single doses of CYP drug cocktail (caffeine, warfarin, omeprazole, and midazolam) on Day 1 and Day 12, and single doses of digoxin on Day 2 and Day 13. Continuous treatment with 600 mg rucaparib twice daily (BID) will start on Day 5 and will last until at least Day 16 of Part I.
In Part II, the treatment with rucaparib in 28-day cycles will continue until progression of disease, unacceptable toxicity, or other reason for discontinuation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| single arm probe drugs and rucaparib | Other | Caffeine Warfarin Vitamin K Omeprazole Midazolam Digoxin rucaparib |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Caffeine | Drug | 200 mg (4 x 50mg) Tablet |
| |
| Measure | Description | Time Frame |
|---|---|---|
| PK parameters for caffeine, S-warfarin, omeprazole, midazolam, and digoxin with and without rucaparib treatment to be calculated from the plasma concentration-time data | Maximum plasma concentration [Cmax] | Days 1-5 and Days 12-16 |
| PK parameters for caffeine, S-warfarin, omeprazole, midazolam, and digoxin with and without rucaparib treatment to be calculated from the plasma concentration-time data | Area under the concentration-time curve (AUC) up to time t, where t is the last time point with concentrations above the lower limit of quantitation [AUC0-last ] | Days 1-5 and Days 12-16 |
| Measure | Description | Time Frame |
|---|---|---|
| PK parameters for caffeine, S-warfarin, omeprazole, midazolam, and digoxin with and without rucaparib treatment to be calculated from the plasma concentration-time data | Area Under the Curve, from time zero up to infinity with extrapolation of the terminal phase [AUC0-inf] | Days 1-5 and Days 12-16 |
| Tolerability and safety of rucaparib with and without co-administration of the probe drugs assessed by incidence of Adverse Events (AEs), clinical laboratory abnormalities, and dose modifications" |
| Measure | Description | Time Frame |
|---|---|---|
| Response will be determined using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 and tumor markers per applicable criteria for a given tumor type | 28 day cycles with response evaluation every 8 weeks(±7 days) until week 24 thereafter every 12 weeks (±14 days) | From cycle 1 Day 1until radiologically confirmed disease progression, death, or initiation of subsequent treatment whichever comes first up to 52 weeks |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| BioVirtus Research Site | Kajetany | Mokra 7 | 05-830 | Poland | ||
| Med Polonia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30427584 | Derived | Xiao JJ, Nowak D, Ramlau R, Tomaszewska-Kiecana M, Wysocki PJ, Isaacson J, Beltman J, Nash E, Kaczanowski R, Arold G, Watkins S. Evaluation of Drug-Drug Interactions of Rucaparib and CYP1A2, CYP2C9, CYP2C19, CYP3A, and P-gp Substrates in Patients With an Advanced Solid Tumor. Clin Transl Sci. 2019 Jan;12(1):58-65. doi: 10.1111/cts.12600. Epub 2018 Dec 20. |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D002110 | Caffeine |
| D014859 | Warfarin |
| D009853 | Omeprazole |
| C035737 | major urinary proteins |
| D008874 | Midazolam |
| D004077 | Digoxin |
| D014812 | Vitamin K |
| C531549 | rucaparib |
| ID | Term |
|---|---|
| D014970 | Xanthines |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D011688 | Purinones |
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Open Label
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| Warfarin |
| Drug |
10 mg (2 x 5mg) Tablet |
|
|
| Omeprazole | Drug | 40 mg Tablet |
|
|
| Midazolam | Drug | 5 mg/mL |
|
|
| digoxin | Drug | .25 mg Tablet |
|
|
| Vitamin K | Drug | 10 mg Tablet |
|
|
| Rucaparib | Drug | 200 & 300 mg tablet |
|
|
Incidence of Adverse Events (AEs), clinical laboratory abnormalities, and dose modifications |
| Days 1-16 |
| PK parameters will be calculated for rucaparib at steady-state | Trough plasma concentration [Ctrough] | Day 7-12 |
| PK parameters will be calculated for rucaparib at steady-state | Maximum plasma concentration during a dosing interval at steady-state [Cmax,ss] | Day 7-12 |
| PK parameters will be calculated for rucaparib at steady-state | Time to attain maximum plasma concentration at steady-state [tmax,ss] | Day 7-12 |
| PK parameters will be calculated for rucaparib at steady-state | Area Under the Curve over a dosing interval τ at steady-state [AUCτ,ss] | Day 7-12 |
| PK parameters for caffeine, S-warfarin, omeprazole, midazolam, and digoxin with and without rucaparib treatment to be calculated from the plasma concentration-time data | Terminal half-life [t1/2] | Days 1-5 and Days 12-16 |
| PK parameters for caffeine, S-warfarin, omeprazole, midazolam, and digoxin with and without rucaparib treatment to be calculated from the plasma concentration-time data | Time to attain maximum plasma concentration [tmax] | Days 1-5 and Days 12-16 |
| PK parameters for caffeine, S-warfarin, omeprazole, midazolam, and digoxin with and without rucaparib treatment to be calculated from the plasma concentration-time data | Apparent clearance [CL/F] | Days 1-5 and Days 12-16 |
| PK parameters for caffeine, S-warfarin, omeprazole, midazolam, and digoxin with and without rucaparib treatment to be calculated from the plasma concentration-time data | Apparent volume of distribution during terminal phase [Vz/F] | Days 1-5 and Days 12-16 |
| Poznan |
| 60-693 |
| Poland |
| Zachodniopomorskie Centrum Onkologii Centrum Innowacji | Szczecin | 71-730 | Poland |
| D011687 |
| Purines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D015110 | 4-Hydroxycoumarins |
| D003374 | Coumarins |
| D001578 | Benzopyrans |
| D011714 | Pyrans |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D053799 | 2-Pyridinylmethylsulfinylbenzimidazoles |
| D013454 | Sulfoxides |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
| D011725 | Pyridines |
| D001562 | Benzimidazoles |
| D001569 | Benzodiazepines |
| D001552 | Benzazepines |
| D004071 | Digitalis Glycosides |
| D002298 | Cardenolides |
| D002301 | Cardiac Glycosides |
| D002297 | Cardanolides |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
| D009285 | Naphthoquinones |
| D009281 | Naphthalenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D010836 | Phytol |
| D004224 | Diterpenes |
| D013729 | Terpenes |