This phase I trial investigates the side effects and best dose of talazoparib when given together with trifluridine/tipiracil for the treatment of patients with colorectal or gastroesophageal cancer that has spread to nearby tissue or lymph nodes (locally advanced) or other places in the body (metastatic). Drugs used in the chemotherapy, such as trifluridine/tipiracil, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Talazoparib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving talazoparib with trifluridine/ tipiracil may inhibit certain enzymes in the cells that are responsible for tumor cell growth.
PRIMARY OBJECTIVE: I. To determine the safety, maximum tolerated dose (MTD), and recommended phase 2 dose (RP2D) of trifluridine and tipiracil hydrochloride (trifluridine/tipiracil \[FTD/TPI\]) in combination with talazoparib tosylate (talazoparib) in patients with advanced colorectal (CRC) or gastroesophageal (EGC) adenocarcinoma. SECONDARY OBJECTIVES: I. To determine the pharmacokinetics (PK) and pharmacodynamic (PD) markers of activity. II. To evaluate the preliminary antineoplastic efficacy of the combination.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
45
Given PO
Given PO
Roswell Park Cancer Institute
Buffalo, New York, United States
RECRUITINGIncidence of Adverse Events
All adverse events will be evaluated using Common Terminology Criteria for All Adverse Events (CTCAE) version (v.) 5.
Time frame: after each cycle of treatment ( 1 cycle = 14 days)
Maximum tolerated dose/ recommended phase II dose
Will utilize the keyboard design - a novel model- assisted dose-finding method to find the maximum tolerated dose
Time frame: Up to 14 days
Plasma Concentration (Cmax)
The pharmacokinetic parameters between Trifluridine/Tipiracil and Talazoparib will be evaluated on Day -14: pre-dose, 0.5, 1, 2, 4, 6, 8 hours (hr) post-dose; day-13: 24 hr post-initial dose and day -13 pre-dose
Time frame: Day -13 post dose
Plasma Concentration (Cmax)
The pharmacokinetic parameters between Trifluridine/Tipiracil and Talazoparib will be evaluated on Day -14: pre-dose, 0.5, 1, 2, 4, 6, 8 hours (hr) post-dose; day-13: 24 hr post-initial dose and day -13 pre-dose
Time frame: day -14 pre dose
Plasma Concentration (Cmax)
The pharmacokinetic parameters between Trifluridine/Tipiracil and Talazoparib will be evaluated on Day -14: pre-dose, 0.5, 1, 2, 4, 6, 8 hours (hr) post-dose; day-13: 24 hr post-initial dose and day -13 pre-dose
Time frame: day -14 post dose
Plasma Concentration (Cmax)
The pharmacokinetic parameters between Trifluridine/Tipiracil and Talazoparib will be evaluated on Day -14: pre-dose, 0.5, 1, 2, 4, 6, 8 hours (hr) post-dose; day-13: 24 hr post-initial dose and day -13 pre-dose
Time frame: day -13 pre dose
Overall Response Rate (ORR)
Will be summarized using frequencies and relative frequencies.
Time frame: Up to 3 years
CEA response rate (colorectal cancer patients)
ill be summarized using frequencies and relative frequencies. .
Time frame: Up to 3 years
Progression Free Survival (PFS)
Will be summarized using standard Kaplan-Meier methods
Time frame: From treatment until disease progression UP to 3 years
Overall Survival (OS)
Will be summarized using standard Kaplan-Meier methods
Time frame: From treatment until death or up to 3 years
Progressive Disease Assessment (PD)
Time frame: Up to 3 years
Number of subjects with DNA damage response
Tumor biopsies will be summarized by dose level and time-point using means and standard deviations.
Time frame: Up to 28 days prior to first drug dose, on treatment and between cylce 1-day 8 and cycle 1 day 12
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