In this proposed study the investigators will combine gemcitabine and cisplatin with talazoparib to determine the recommended Phase 2 dose (RP2D) of this combination regimen. After determination of the RP2D patients with lung cancer whose tumors carry molecular alterations in DNA repair pathway genes will be enrolled to an expansion cohort to determine anti-tumor efficacy. Tissue samples of patients with confirmed partial response, complete response, and non-responders will be obtained for whole exome, and transcriptome sequencing to characterize the genetic alterations associated with response to therapy.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Safety and toxicities as measured by NCI Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0
Time frame: 30 days after completion of treatment (estimated average to be 7 months)
Maximum tolerated dose (MTD)
The maximum tolerated dose (MTD) is defined as the dose level immediately below the dose level at which 30% of patients in a cohort are expected to experience a dose-limiting toxicity (DLT) during the second cycle based on the CRM algorithm. Dose escalations will proceed until the MTD is determined.
Time frame: Completion of dose escalation portion of study (approximately 12 months)
Objective response rate (ORR) in preselected patients with BRCAness tumoral genotype
ORR - proportion of patients who achieved a complete response or a partial response
Time frame: Up to completion of treatment (estimated average of 6 months)
Disease control rate (DCR)
* DCR - percentage of participants who have achieved complete response, partial response, and stable disease * Complete response: disappearance of all lesions and normalization of tumor marker level * Partial response: at least a 30% decrease in the sum of the diameters of target lesions and no new lesions * Stable disease: neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease
Time frame: Until death (estimated average to be 12 months)
Progression-free survival (PFS)
PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first. -Progressive disease - At least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study, appearance of one more new lesions PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first.
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Time frame: Until death (estimated average to be 12 months)
Objective response rate (ORR)
ORR - proportion of patients who achieved a complete response or a partial response
Time frame: Up to completion of treatment (estimated average of 6 months)
Overall survival (OS)
OS: duration of time from start of treatment to time of death from any cause
Time frame: Until death (estimated average to be 12 months)