This research study is studying a combination of drugs as a possible treatment for breast cancer with a BRCA mutation. The interventions involved in this study are: * Sapacitabine (CYC682) * Olaparib (Lynparza™)
This is a Phase I/II clinical trial. A Phase I clinical trial tests the safety of an investigational intervention and also tries to define the appropriate dose of the investigational intervention to use for further studies. "Investigational" means that the intervention is being studied. It also means that the FDA (the U.S. Food and Drug Administration) has not approved the combination of Olaparib and Sapacitabine as a treatment for any disease. The FDA (the U.S. Food and Drug Administration) has approved Olaparib as a treatment for metastatic HER2 negative breast cancer with a BRCA mutation. Olaparib is an inhibitor of PARP (poly \[adenosine diphosphate-ribose\] polymerase), which means that it stops PARP from working. PARP is an enzyme (a type of protein) found in the cells of the body. In normal cells when DNA is damaged, PARP helps to repair the damage. The FDA has not approved Sapacitabine for use in patients including people with this type of cancer. Sapacitabine and drugs of its class have been shown to have antitumor properties in many types of cancer, e.g., leukemia, lung, breast, ovarian, pancreatic and bladder cancer. Sapacitabine may help to stop the growth of some types of cancers. In this research study, the investigators are evaluating the safety and effectiveness of Olaparib in combination with Sapacitabine in BRCA mutant breast cancer.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
10
Sapacitabine may help to stop the growth of some types of cancers
Olaparib is an inhibitor of PARP (poly \[adenosine diphosphate-ribose\] polymerase), which means that it stops PARP from working
Dana Farber Cancer Institute
Boston, Massachusetts, United States
Broad Institute of MIT
Cambridge, Massachusetts, United States
Maximum Tolerated Dose (MTD)
The dose level immediately below the maximally-administered dose (MAD; defined as the dose level where at least two participants develop dose-limiting toxicity \[DLT\]) will be defined as the MTD. In the situation where none of the dose levels have ≥ 2 DLTs, the MTD will be the highest dose administered. The MTD will be established in a minimum of 6 participants.
Time frame: Assessed from the time of the first patient registration to the time that the last patient comes off protocol therapy in the dose escalation phase, up to 41 months
Recommended Phase II dose (RPIID)
The highest dose level below the MAD at which ≤1 out of 6 patients develop DLT. The RPIID will be established in a minimum of 6 participants.
Time frame: Assessed from the time of the first patient registration to the time that the last patient comes off protocol therapy, up to 41 months
Objective Response Rate
Defined as the percentage of patients achieving a complete response (disappearance of all target and non-target lesions; no new lesions) or partial response (at least 30% decrease in the sum of the diameters of target lesions; persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits \["non-CR/non-PD" in non-target lesions\]; and no new lesions) based on RECIST 1.1
Time frame: Assessed for each patient from the time of registration until 30 days after removal from protocol therapy or until death, whichever occurs first, up to 41 months
Progression-Free Survival
Defined as the time from registration to the earlier of progression by RECIST 1.1 or death due to any cause. Participants alive without disease progression are censored at date of last disease evaluation.
Time frame: Assessed for each patient from the time of registration until 30 days after removal from protocol therapy or until death, whichever occurs first, up to 41 months
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Dose Limiting Toxicity
Evaluated among participants enrolled to the phase I trial during the first cycle of therapy. DLTs are defined as toxicities that are considered at least possibly related to the study regimen and that fit one or more of the following criteria: * Any death not clearly due to the underlying disease or extraneous causes * Any non-hematologic toxicity ≥ Grade 3 * Any occurrence of Hy's Law (see protocol Appendix B) * Febrile neutropenia ≥ Grade 3 * Grade 4 neutropenia or thrombocytopenia lasting \>7 days * Thrombocytopenia with bleeding ≥ Grade 3 * ≥ Grade 3 nausea, vomiting, diarrhea lasting \> 72 hours with adequate antiemetic or other supportive care. * ≥ Grade 3 fatigue lasting \> 7 days * ≥Grade 3 electrolyte abnormality that lasts \> 72 hours with no clinical symptoms. * ≥ Grade 3 electrolyte abnormality with clinical symptoms, regardless of duration. Toxicities are defined according to NCI CTCAE, Version 5.0
Time frame: Assessed for each patient from the start of protocol therapy to the end of the first cycle of therapy (28 days post start of therapy)