This is a Phase 1b, multi-site, open-label, non-randomized clinical trial evaluating the safety, tolerability, and pharmacokinetics of escalating doses of olaparib and trabectedin in patients with unresectable advanced/metastatic sarcomas. Patients will continue to be treated on this combination regimen in the absence of disease progression, intolerable toxicity or patient's decision.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
trabectedin will be administered in a 24-h continuous i.v. infusion every 3 weeks
olaparib will be administered in a continuous daily dose every 12 hours
Fondazione del Piemonte per l'Oncologia IRCC Candiolo
Candiolo, Torino, Italy
Istituti Ortopedici Rizzoli - Unit of Chemotherapy of Muscoloskeletal Tumors
Bologna, Italy
Istituto Nazionale Tumori - Unit of Medical Oncology
Milan, Italy
maximum tolerated dose
safety will be evaluated according to Common Terminology Criteria for Adverse Events (CTCAE) v 4.03
Time frame: from start up to 6 weeks
Best Overall Response
best overall response will be defined according to the Response Evaluation Criteria in Solid Tumor version 1.1 (RECIST v 1.1)
Time frame: baseline and every 2 cycles (6 weeks +/- 1 week) up to 2 years
Clinical Benefit Rate
Clinical Benefit Rate (CBR): will be defined as the rate of CR (complete response) + PR (partial response) + stable disease lasting at least 12 weeks. CR, PR and stable disease will be defined according to RECIST v 1.1.
Time frame: baseline and every 2 cycles (6 weeks +/- 1 week) up to 2 years
Growth Modulation Index
Growth modulation index (GMI) will be calculated as: GMI=TTPn/TTPn-1. TTPn: Time To Progression on the new agent. TTP n-1: Time To Progression on the treatment the patient received just before the new agent was started.
Time frame: baseline and every 2 cycles (6 weeks +/- 1 week) up to 2 years
Overall Survival
time from the date of enrollment to date of death or to the date being censored at two years (whichever occurs first).
Time frame: baseline and up to 2 years
Duration of Tumor Response
Duration of Objective Response (complete or partial responses) will be measured from the date that a complete or partial response is first documented (whichever occurs first) to date of progression or death due to progressive disease, whichever occurs first.
Time frame: baseline and every 2 cycles (6 weeks +/- 1 week) up to 2 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Progression-Free Survival (PFS)
PFS is defined as the time from the date of enrollment to the date of first documentation of disease progression, or to the death from any cause.
Time frame: baseline and every 2 cycles (6 weeks +/- 1 week) up to 2 years
Pharmacokinetic of trabectedin (AUC)
The concentration-time data will be used for a preliminary assessment of the effect of combination therapy on the single-dose pharmacokinetics of trabectedin and olaparib. The data will be analyzed by noncompartmental methods. Pharmacokinetic parameters for trabectedin: steady state profile, end of infusion concentration, area under the concentration-time curve (AUC), and, if data permit, terminal phase half-life. For these parameters, the following descriptive statistics will be calculated: mean, standard deviation, coefficient of variation, median, and geometric mean. Any drug-drug interaction will be thoroughly searched. For both trabectedin and olaparib all pharmacokinetic evaluations will be done only for the first 2 cycles.
Time frame: baseline, days 1-2-3-4-5-8-15 of the first two cycles
Pharmacokinetic of olaparib (steady state profile and so maximum concentration, minimal concentration, and AUC will be calculated)
The concentration-time data will be used for a preliminary assessment of the effect of combination therapy on the single-dose pharmacokinetics of trabectedin and olaparib. The data will be analyzed by noncompartmental methods. The following pharmacokinetic parameter values will be obtained for olaparib: steady state profile and so maximum concentration, minimal concentration, and AUC will be calculated. For these parameters, the following descriptive statistics will be calculated: mean, standard deviation, coefficient of variation, median, and geometric mean. Any drug-drug interaction will be thoroughly searched. For both trabectedin and olaparib all pharmacokinetic evaluations will be done only for the first 2 cycles.
Time frame: baseline, day -5 cycle 1, day 1 cycle 2, of the first two cycles
safety evaluated according to Common Terminology Criteria for Adverse Events (CTCAE) v 4.03
safety will be evaluated according to Common Terminology Criteria for Adverse Events (CTCAE) v 4.03
Time frame: baseline up to 28 days after last dose of study treatment up to 2 years
Biomarkers (composite outcome)
Several gene assessments (expression, amplification/ deletion, single nucleotide polymorphisms) on DNA-damage response-related markers (including but not limited to BRCA 1-2, ERCC 1-2-5, XRCC 1-2-3, RAD51 and 53BP1, PARP 1-2, P-histone H2AX and others) will be conducted. Statistical analysis will be performed to investigate the association between trial outcomes and polymorphisms of these genes.
Time frame: baseline, day 1-2-8-15 of each cycle up to 2 years