A Study of Niraparib in Combination With Abemaciclib for Late Line Treatment of Ovarian Cancer: a Single Center, Open Label, Single Arm, Phase Ib/II Trial NICHOL TRIAL
This is an interventional trial. The goal of this clinical trial is dose finding. There are two phases: phase Ib to determine the MTD and recommended phase II dose of niraparib in combination with abemaciclib in patients with advanced ovarian cancer. Target population will be patients (woman, age \> 18 years) with epithelial ovarian, fallopian tube or peritoneal cancer treated with at least 2 lines of therapy.
• Has read and understands the informed consent form and has given written informed consent prior to any study procedures.
• Age \> 18 years
• Life expectancy of at least 3 months
• Histologically confirmed epithelial ovarian, primary peritoneal, or fallopian tube cancer
• Confirmed recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer for which there is no known or established treatment available with curative intent.
• Able to provide archived tumor tissue;(formalin fixed-paraffin embedded (FFPE) tumor sample or a minimum of 20 unstained slides is required for study eligibility.
∙ NOTE: if archived tissue is not available, patient must be willing to undergo a tumor biopsy at screening if medically feasible.
• Patients must have completed at least 2 previous chemotherapy regimens for platinum sensitive disease (\> 6 months). Patients must have completed their last therapy regimen \> 4 weeks prior to treatment initiation and have radiological confirm of progression disease.
• Patients could have received maintenance therapy with a PARPi, but they must remain sensitive to platinum-based chemotherapy, based on the radiological or CA-125 response to their most recent course of platinum-based chemotherapy (carboplatin, cisplatin or oxaliplatin) or have demonstrated progressive disease while taking a PARP inhibitor as a previous therapy. Response to prior PARP inhibitor is not required.
• Prior PARP therapy could have been administered as either treatment for recurrent disease or as maintenance following prior treatment.
• Patients must have or agree to undergo tumor HRD testing and somatic BRCAmut status testing at screening.
• Patients must agree to undergo blood samples during screening and at the end of treatment for cytogenetic analysis.
• Phase 2 patients only: presence of measurable disease according to RECIST v1.1 criteria as assessed locally by Investigators.
• Eastern Cooperative Oncology Group (ECOG) performance status (PS) score of 0-1.
• Absolute neutrophil count (ANC) ≥ 1500/L (within 14 days of study drugs initiation).
• Hemoglobin (Hgb) \> 9 g/dL with no blood transfusion in the past 14 days (within 14 days of study drug\[s\] initiation).
• Platelets \> 100,000/L (within 14 days of study drug\[s\] initiation) with no platelets transfusion in the past 14 days.
• Alanine transaminase (ALT) and aspartate transaminase (AST) ≤ 2.5 x upper limit of normal (ULN) or ≤ 5 x ULN if known hepatic metastases (within 14 days of study drugs initiation).
• Serum bilirubin within normal limits (WNL) or ≤ 1.5 x ULN in patients with liver metastases; or total bilirubin ≤ 2.0 x ULN with direct bilirubin WNL in patients with well documented Gilbert's syndrome (within 14 days of study drugs initiation).
• Patients should have calculated or measured creatinine clearance of ≥ 50 mL/min according to Cockroft-Gault.
• Willingness and ability to comply with study and follow-up procedures.
• Women of child-bearing potential must have a negative pregnancy test (serum) within 3 days prior to starting the study drug. Both males and females must agree to adequate birth control if conception is possible during the study and for 6 months after the last dose; in this case, patients must take a monthly pregnancy test for the duration of the study. Female patients are considered to not be of child-bearing potential if they have a history of tubal ligation or hysterectomy or are post-menopausal with a minimum of 1 year without menses.
∙ The methods that can achieve a failure rate of less than 1% per year when used consistently and correctly are considered as highly effective birth control methods. Such methods include:
• combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation:
‣ oral;
⁃ intravaginal;
⁃ transdermal
• progestogen-only hormonal contraception associated with inhibition of ovulation:
‣ oral;
⁃ injectable;
⁃ implantable.
• intrauterine device (IUD);
• intrauterine hormone-releasing system (IUS);
• bilateral tubal occlusion;
• vasectomised partner;
• sexual abstinence.
∙ Additional inclusion criteria:
∙ \- Patients must agree to not donate blood during the study or for 90 days after the last dose of study treatment.