This phase II trial studies how well ponatinib hydrochloride works in treating patients with cancer that has spread to other parts of the body (metastatic), has failed previous treatment (refractory), and has one of several alterations, or mutations, in its deoxyribonucleic acid (DNA) sequence. Ponatinib hydrochloride may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. It is not yet known whether a patient's genetic alterations may affect how well ponatinib hydrochloride works.
PRIMARY OBJECTIVES: I. To evaluate the response of ponatinib (ponatinib hydrochloride) in patients with fibroblast growth factor receptor (FGFR) altered cancers. SECONDARY OBJECTIVES: I. To assess the safety and tolerability of ponatinib in advanced solid tumors with genomic FGFR alterations. II. To assess progression free survival (PFS) and overall survival (OS) with ponatinib. III. To determine candidate genomic and proteomic biomarkers of sensitivity and resistance to ponatinib using unbiased high throughput approaches (exome, transcriptome, reverse phase protein array \[RPPA\]). IV. To assess response of ponatinib in advanced cancers with subsets of genomic FGFR alterations (fusions vs. amplifications vs. mutations). OUTLINE: Patients receive ponatinib hydrochloride orally (PO) once daily (QD) on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for 52 weeks.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
22
Given PO
Correlative studies
University of Michigan
Ann Arbor, Michigan, United States
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center
Columbus, Ohio, United States
Overall Response, Defined as the Number of Patients Who Achieve Any Response According to Disease Type in the First 6 Courses of Treatment
The proportion of responses for the purposes of the decision rule will be calculated out of all eligible patients who receive any treatment. Assuming the number of responses is binomially distributed, 95% binomial confidence intervals will also be calculated for the estimate of the proportion of responses. Response for tumors was assessed using the RECIST 1.1 criteria (using computed tomography \[CT\] scans), where response was defined as a partial or complete response.
Time frame: Up to 6 months
Percentage of Participants With Adverse Events, Defined as Adverse Events That Are Classified as Either Possibly, Probably, or Definitely Related to Study Treatment Per National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0
Frequency and severity of adverse events will be collected and summarized by descriptive statistics. The maximum grade for each type of toxicity will be recorded for each patient, and frequency tables will be reviewed to determine toxicity patterns for each of the cohorts as well as across cohorts. In addition, all adverse event data that is graded as 3, 4, or 5 will be reviewed and classified as either "unrelated" or "unlikely to be related" to study treatment in the event of an actual relationship developing.
Time frame: Up to 30 days after last dose of study drug, up to a total of 6 years
Tolerability of the Regimen, Assessed by the Number of Patients Who Required Dose Modifications and/or Dose Delays
Collected and summarized by descriptive statistics.
Time frame: Up to 30 days after last dose of study drug
Overall Survival
Kaplan-Meier curves will be used to estimate the survival distribution.
Time frame: The time from treatment initiation to death, assessed up to 72 months
Progression Free Survival
Kaplan-Meier curves will be used to estimate the survival distribution.
Time frame: The time from treatment initiation to progression or death, assessed up to 2 years
Clinical Benefit Rate (CBR)
Calculated by the number of patients who have achieve a response and/or are progression-free and alive at 6 months divided by the total number of evaluable patients. Exact binomial 95% confidence intervals for CBR will be calculated.
Time frame: 6 months
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