Randomized phase 2, multicenter, biomarker directed clinical trial with a safety lead-in to assess the efficacy of Stenoparib plus Temozolomide (TMZ) in relapsed Small Cell Lung Cancer patients. Participants will receive either a combination of oral Stenoparib at the highest tolerated dose with oral Temozolomide 40mg daily or standard of care Lurbinectedin for 21-day cycles. The Dose limiting toxicity period will be 1 cycle of 21 days. This study will explore if the biomarkers the investigators test predict sensitivity to the combination of Stenoparib plus TMZ and therefore leads to a better treatment response. There are two potential tests of biomarkers that can predict who would benefit from the oral combination of Stenoparib with Temozolomide (TMZ), but they have not been evaluated. This study will test for this sensitivity using a biomarker (found in the blood that may be related to how a person reacts to a drug). The study will include 9 participants for the safety evaluation of the Stenoparib+TMZ group and 5 participants for the standard of care Lurbinectedin safety group. We will first determine safety dose for the experiment arm which, will include 3 groups with 3 participants in each group. Three doses of Stenoparib will be evaluated for toxicity. The initial starting dose of Stenoparib will be 200mg po QD. Once the maximum tolerated dose has been determined, participants will be assigned to one of the two groups in the phase 2 portion. Group 1 will be patients that test negative for the biomarker and will receive treatment with Lurbinectedin as per standard of care guidelines. Group 2 will be patients that test positive for the biomarker that will be randomly assigned to either the combination of Stenoparib plus Temozolomide (TMZ) or Lurbinectedin.
Randomized phase 2, multicenter, biomarker directed clinical trial with a safety lead-in to assess the efficacy of Stenoparib plus Temozolomide (TMZ) in relapsed Small Cell Lung Cancer patients. Participants will receive either a combination of oral Stenoparib at the highest tolerated dose with oral Temozolomide 40mg daily or standard of care Lurbinectedin for 21-day cycles. The Dose limiting toxicity period will be 1 cycle of 21 days. This study will explore if the biomarkers the investigators test predict sensitivity to the combination of Stenoparib plus TMZ and therefore leads to a better treatment response. There are two potential tests of biomarkers that can predict who would benefit from the oral combination of Stenoparib with Temozolomide (TMZ), but they have not been evaluated. This study will test for this sensitivity using a biomarker (found in the blood that may be related to how a person reacts to a drug). The study will include 9 participants for the safety evaluation of the Stenoparib+TMZ group and 5 participants for the standard of care Lurbinectedin safety group. We will first determine safety dose for the experiment arm which, will include 3 groups with 3 participants in each group. Three doses of Stenoparib will be evaluated for toxicity. The initial starting dose of Stenoparib will be 200mg po QD. Once the maximum tolerated dose has been determined, participants will be assigned to one of the two groups in the phase 2 portion. Group 1 will be patients that test negative for the biomarker and will receive treatment with Lurbinectedin as per standard of care guidelines. Group 2 will be patients that test positive for the biomarker that will be randomly assigned to either the combination of Stenoparib plus Temozolomide (TMZ) or Lurbinectedin.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
166
Stenoparib at the recommended phase 2 dose +Temozolomide 40mg/day daily will be given in combination x21 days each cycle
Lurbinectedin 3.2mg/m2 one-hour intravenous (IV) infusion x 21 days each cycle
Patients will be assigned to one of three doses of Stenoparib (200mg po qd, 200mg po BID, and 200mg in am and 400mg in pm). The initial starting dose will be the 200 mg po QD orally daily for 21 days.
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, California, United States
RECRUITINGJesse Brown VA Medical Center, Chicago, IL
Chicago, Illinois, United States
NOT_YET_RECRUITINGRichard L. Roudebush VA Medical Center, Indianapolis, IN
Indianapolis, Indiana, United States
RECRUITINGRobley Rex VA Medical Center, Louisville, KY
Louisville, Kentucky, United States
NOT_YET_RECRUITINGVA Ann Arbor Healthcare System, Ann Arbor, MI
Ann Arbor, Michigan, United States
NOT_YET_RECRUITINGMinneapolis VA Health Care System, Minneapolis, MN
Minneapolis, Minnesota, United States
NOT_YET_RECRUITINGOmaha VA Nebraska-Western Iowa Health Care System, Omaha, NE
Omaha, Nebraska, United States
NOT_YET_RECRUITINGSalisbury W.G. (Bill) Hefner VA Medical Center, Salisbury, NC
Salisbury, North Carolina, United States
RECRUITINGCorporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
Philadelphia, Pennsylvania, United States
RECRUITINGVA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA
Pittsburgh, Pennsylvania, United States
RECRUITING...and 1 more locations
Progression Free Survival (PFS)
According to response evaluation criteria in solid tumors RECIST 1.1(imaging criteria or progression or patient death).
Time frame: Through study completion up to 2 years.
Recommended Phase 2 dose
Defined as the recommended dose of Stenoparib for phase 2
Time frame: Through end of cycle 1 (21 days)
Disease control rate (DCR)
Defined as Complete Response (CR) + Partial Response (PR) + Stable Disease (SD) per RECIST 1.1.
Time frame: Through study completion up to 2 years.
Overall Survival (OS)
Will be measured from Day 1 of treatment until death from any cause.
Time frame: Through study completion up to 2 years.
Overall response rate (ORR)
Defined as complete response (CR) + partial response (PR) per RECIST 1.1 criteria.
Time frame: Through study completion up to 2 years.
Treatment Toxicities
As defined by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.0.
Time frame: Through study completion up to 2 years.
Progression Free Survival (PFS)
Compare PFS between biomarker positive and biomarker negative patient receiving Lurbinectedin.
Time frame: Through study completion up to 2 years.
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