This is a phase I study to determine the safety and feasibility of the combination of enzalutamide and niraparib in subjects with metastatic castration-resistant prostate cancer (CRPC).
OUTLINE: This is a multi-center trial. INVESTIGATIONAL TREATMENT: Each eligible subject will begin treatment with a 28-day enzalutamide 160 mg/day lead-in cycle. If a subject is able to tolerate the lead-in enzalutamide cycle without Grade 2 or Grade 2-4 drug-related toxicity, dose reduction, or missed doses due to toxicity, cycle 1 of combined enzalutamide and niraparib will commence. Enzalutamide will continue at 160 mg daily. Niraparib will be dosed daily starting at 100mg (dose level 1). Six subjects will be enrolled per dose level. If less than 33% of the subjects experience a dose-limiting toxicity (DLT) at the beginning of cycle 2, then the daily dose of niraparib will escalate to 200mg (dose level 2). If dose level 2 is similarly tolerated, then the daily dose of niraparib escalate to 300mg (dose level 3). The following required laboratory values must be obtained within 14 days prior to registration for protocol therapy: Hematopoietic: * White blood cell count (WBC) ≥ 1500/mm3 * Hemoglobin (Hgb) ≥ 9 g/dL * Platelets ≥ 150,000/µL * Absolute neutrophil count (ANC) ≥ 1500/mm3 Renal: * Calculated creatinine clearance of ≥ 40 cc/min using the Cockcroft-Gault formula Hepatic: * Bilirubin ≤ 1.5 × upper limit of normal (ULN) * Aspartate aminotransferase (AST, SGOT) ≤ 2.5 × ULN
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
2
Following completion of 28-day lead-in cycle, enzalutamide 160 mg PO daily will continue to be administered in 28-day cycles until documented progression, unmanageable toxicity, or decision to discontinue for any reason.
Niraparib will be administered daily in three dose-escalation cohorts of 6 subjects per dose levels of 100mg PO, 200mg PO or 300mg PO in 28-day cycles until documented progression, unmanageable toxicity, or decision to discontinue for any reason.
Tufts Medical Center
Boston, Massachusetts, United States
Maximum Tolerated Dose (MTD) for Subjects Receiving Enzalutamide With Niraparib Without Experiencing Dose-limiting Toxicity(s) (DLT)
MTD of niraparib in combination with enzalutamide and MTD for phase II testing.
Time frame: From the start of combination treatment D29 until 30 days after last dose of study treatment per CTCAE v4, assessed up to 52 weeks
Progression-free Survival (PFS) With Enzalutamide and Niraparib Combination Therapy.
PFS per RECIST v1.1 for subjects on this combination therapy.
Time frame: From the date of enrollment until the criteria for disease progression is met as defined by RECIST 1.1 or death from any cause, whichever occurs first, assessed up to 52 weeks
Objective Response (OR) Rates for All Subjects With Confirmed Partial Response (PR) or Complete Response (CR) Outcomes, Per RECIST v1.1
OR outcomes for subjects on this combination therapy, per RECIST v1.1
Time frame: From the date of enrollment until the date of documented disease progression or the date of death from any cause, whichever occurs first, assessed up to 52 weeks
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