PARLuNET: PARP Inhibitor With 177Lu-DOTA-Octreotate PRRT in Patients With Neuroendocrine Tumours
Study Details
Study Description
Brief Summary
This phase 1 dose-escalation study is designed to evaluate the safety and tolerability of talazoparib in combination with 177Lu-DOTA-Octreotate peptide receptor radionuclide therapy (PRRT) in patients with metastatic pancreatic or midgut neuroendocrine tumour (NET).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
| Phase 1 |
Detailed Description
This phase 1, single arm, single centre study is designed to evaluate the safety and tolerability of talazoparib in combination with 177Lu-DOTA-Octreotate in patients with metastatic NET.
Patients will receive 1 cycle of 177Lu-DOTA-Octreotate alone followed by 3 cycles of 177Lu-DOTA-Octreotate combined with 5 days of talazoparib.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: 177Lu-DOTA-Octreotate + talazoparib Patients will receive 4 cycles of 177Lu-DOTA-Octreotate every 8 weeks, the last 3 cycles combined with talazoparib on days 2-6 of each cycle. |
Drug: Talazoparib
During dose escalation, doses of talazoparib that can be administered are 0.1mg, 0.25mg, 0.5mg or 1mg oral daily. Talazoparib will be given on days 2-6 of each cycle of 177Lu-DOTA-Octreotate for cycles 2-4, every 8 weeks
Other Names:
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Outcome Measures
Primary Outcome Measures
- Maximum tolerated dose Talazoparib with 177Lu-DOTA-Octreotate [Through study completion, up to 18 months following first administration of PRRT.]
Maximum tolerated dose of Talazoparib when given in combination with 177Lu-DOTA-Octreotate
- Dose limiting toxicity talazoparib [Each cohort of 3 patients be assessed for DLTs in the first 6 weeks (cycle 2) of treatment and a dose for the next cohort will be determined (each cycle is 8 weeks)]
The toxicity (haematologic or non-haematologic) that prevents further administration of the trial talazoparib treatment at that dose level.
Secondary Outcome Measures
- Adverse Events and Serious Adverse Events measured using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.0 [Through Study completion, up to 18 months after the last patient commences treatment.]
Safety of the combination will be measured by AEs and SAEs
- Radiographic progression free survival [Through study completion, up to 18 months following first administration of PRRT.]
The time from treatment initiation to the first date of progression on imaging or death due to any cause. Imaging progression will be assessed by RECIST 1.1. Patients who commence new systemic therapy before evidence of disease progression on conventional imaging will be considered to have progressed.
- Overall Survival [Through study completion, up to 18 months following first administration of PRRT.]
The time from treatment initiation to the date of death due to any cause. For patients alive, the time will be censored at the last time the patients was known to be alive.
- Treatment discontinuation due to toxicity [Through study completion, up to 18 months following first administration of PRRT.]
The number of patients who discontinue treatment at any time due to treatment related toxicity will be reported and will be also categorised by dose level.
- Rate of Treatment discontinuation due to toxicity [Through study completion, up to 18 months following first administration of PRRT.]
The percentage of patients who discontinue treatment due to treatment related toxicity will be reported and will be also categorised by dose level
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patient must be > or equal to18 years of age and must have provided written informed consent.
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Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2
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Histologically confirmed Grade 2 NET, Ki-67 of 3-20%, from pancreatic or midgut origin.
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Must have progressed on at least one line of prior therapy, which can include somatostatin analogues
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Progressive disease on imaging (CT/MRI or GaTate PET/CT), or evidence of uncontrolled hormone-secretory symptoms despite conventional treatment
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Tumor SSR uptake on GaTate PET/CT higher than liver activity, ≥ modified Krenning 3 score
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No discordant FDG-avid disease on 18F-FDG PET/CT
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No evidence of significant uncorrected carcinoid heart disease
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Patients must be willing and able to comply with the protocol for the duration of the study including undergoing treatment, scheduled assessments
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Patients must have adequate bone marrow, hepatic and renal function defined as:
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Haemoglobin ≥100 g/L
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Absolute neutrophil count ≥1.5x109/L
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Platelets ≥150 x109/L
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Total bilirubin ≤1.5 x upper limit of normal (ULN)
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Aspartate transaminase (AST) (SGOT) and alanine transaminase (ALT) (SGPT)
≤2.5 x ULN if there is no evidence of liver metastasis or ≤5 x ULN in the presence of liver metastases.
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Albumin ≥ 30 g/L
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Adequate renal function: eGFR ≥ 60 ml/min
Exclusion Criteria:
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Surgery or radiotherapy within <3 weeks of registration. Patients must have recovered from any effects of any major surgery.
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Any prior exposure to peptide receptor radionuclide therapy (177Lu, 111In or 90Y labelled), PARPi, immunotherapy
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Uncontrolled intercurrent illness that is likely to impede participation and /or compliance
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Other malignancies unless curatively treated with no evidence of disease within previous 3-years other than adequately treated non-melanoma skin cancer or melanoma in situ.
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Previous or current history of myelodysplastic syndrome/acute myeloid leukemia
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Patients unable to swallow orally administered medications or with gastrointestinal disorders likely to interfere with the absorption of the study medication.
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Use of strong P-gp inhibitors (eg, dronedarone, quinidine, ranolazine, verapamil, ketoconazole, itraconazole), P-gp inducers (eg, rifampin, tipranavir/ritonavir), or BCRP inhibitors (eg, elacridar [GF120918]) should be avoided.
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Participation in another clinical study with an investigational product or another systemic therapy administered in the last 3 weeks (except short acting SSA).
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Peter MacCallum Cancer Centre | Melbourne | Victoria | Australia | 3000 |
Sponsors and Collaborators
- Peter MacCallum Cancer Centre, Australia
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- PMC67199