The most effective strategy for managing distantly metastatic invasive carcinomas of the cervix is not defined. Based on the success of niraparib in breast and ovarian cancer trials and the concern for toxicities and comorbidities limiting the compliance of concurrent cisplatin for cervical cancer, this study is a phase I/II study of women diagnosed with distantly metastatic (Stage IV) disease to determine the maximum tolerated dose and to evaluate the safety, tolerability and preliminary efficacy of niraparib, an orally available small molecule PARP inhibitor when administered concurrently with definitive regional radiotherapy for treatment of cervical cancer. Women enrolled in this study will receive 3-6 cycles of induction-style carboplatin and paclitaxel followed by definitive doses of pelvic radiotherapy along with the oral niraparib given at the same time.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
4
(see treatment regimen and method of treatment assignment)
Baylor College of Medicine
Houston, Texas, United States
Baylor St. Luke's Medical Center McNair
Houston, Texas, United States
Harris Health System - Smith Clinic
Houston, Texas, United States
Number of Participants With Dose-limiting Toxicities Niraparib
Maximum tolerated dose (MTD) of niraparib when administered concurrently with whole pelvic radiotherapy. The initial treatment dose is 100 mg, and for every 3 patients the dose is escalated and de-escalated, and additional patients are treated by the study design. Participants continue to be enrolled and assigned to treatment doses according to these rules until 17 efficacy evaluable participants are enrolled to any single dose level.
Time frame: 7 weeks during concurrent radiation therapy and niraparib administration
Local Progression-free Survival
Local progression-free survival for patients who have received 1 or more doses of niraparib with pelvic radiation as part of their treatment for metastatic cervical cancer.
Time frame: Up to 12 months from the time of treatment initiation to progression
Acute Toxicity Profile of Niraparib
acute toxicity profile of niraparib administered concurrently with whole pelvic radiotherapy according to the CTCAE version 4 as well as the grade of each toxicity. only serious adverse events will be reported here.
Time frame: 12 months after end of treatment, up to 1 year
Quality of Life Measured Using FACT-Cx Questionnaire
Functional Assessment of Cancer Therapy-Cervix (FACT Cx). It measures health related quality of life for people with cervical cancer in 4 domains: physical well being, social/family well being, emotional well being, and functional well being. All questions are a 0-4 scale. The total score is then calculated as the sum of the un-weighted subscale scores (0-27). For all FACIT scales and symptom indices, the higher the score the better the QOL
Time frame: 12 months after end of treatment
Tumor Response
Number of tumor responses outside the radiation field using RECIST 1.1 for women receiving niraparib concurrently with whole pelvic radiotherapy. Response and progression will be evaluated in this study using the new international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) Committee (Version 1.1). Changes in only the largest unidimensional measurement (diameter) of index tumor lesions are used to assess response by RECIST criteria
Time frame: at 28 days after completing radiation therapy (XRT completion) and at every 3 months up to 12 months
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