June 15, 2015
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June 17, 2015
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November 4, 2022
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January 15, 2016
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October 26, 2022 (Final data collection date for primary outcome measure)
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- Recommended phase 2 dose (R2PD) [ Time Frame: Up to 28 days ]
Defined as level at which no more than 1 of 6 patients experience a dose limiting toxicity (maximum tolerated dose or [MTD]); or doses of the combination below MTD, if in the opinion of the investigators, lower doses are better tolerated and safer.
- Toxicity profile of onalespib in combination with paclitaxel [ Time Frame: Up to 2 years ]
Will be based on the Common Terminology Criteria for Adverse Events (CTCAE) version (v.)5.0.
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- R2PD or maximum tolerated dose of HSP90 inhibitor AT13387 in combination with paclitaxel defined as the dose level at which no more than 1 of 3-6 patients experiences a dose limiting toxicity [ Time Frame: 28 days ]
- Toxicity profile of HSP90 inhibitor AT13387 in combination with paclitaxel, based on the CTCAE v.4.03 [ Time Frame: Up to 8 weeks post-treatment ]
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- Pharmacokinetic (PK) parameters of onalespib [ Time Frame: Pre-dose, immediately prior to end of infusion, 0.5, 1, 2, 4, 6, 8, and 24 hours after end of infusion on day -7 of course 1 and day 8 (and prior to starting paclitaxel, and immediately prior to end of infusion of paclitaxel on day 8) ]
A descriptive analysis will be performed to define systemic exposure, drug clearance, and other pharmacokinetic parameters. The PK parameters will be summarized with simple summary statistics, including means, medians, ranges, and standard deviations (if numbers and distribution permit).
- Pharmacokinetic (PK) parameters of paclitaxel [ Time Frame: Pre-dose, immediately prior to end of infusion, 0.5, 1, 2, 4, 6, 8, and 24 hours after end of infusion on days 1 and 8 of course 1 (and immediately prior to end of infusion of onalespib, prior to starting paclitaxel on day 8) ]
A descriptive analysis will be performed to define systemic exposure, drug clearance, and other pharmacokinetic parameters. The PK parameters will be summarized with simple summary statistics, including means, medians, ranges, and standard deviations (if numbers and distribution permit).
- Overall response rate (partial response [PR]+ complete response [CR]) [ Time Frame: Up to 6 months ]
Will be assessed based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Overall response will be assessed in all patients in an exploratory manner, using summary statistics, by dose level. Will also calculate corresponding 95% binomial confidence intervals for these response rates.
- Response duration [ Time Frame: From the time measurement criteria are met for complete response (CR) or partial response (PR) (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented, assessed up to 2 years ]
Will be based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.
- Progression-free survival [ Time Frame: From study enrollment to first documented disease progression according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 or death from any cause (whichever occurs first), assessed up to 2 years ]
Progression free survival will be summarized using Kaplan and Meier methods, where patients who are event-free at the time of their last evaluation will be censored at that time point.
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- Molecular subtype of triple negative breast cancer (basal-like 1, basal-like 2, immunomodulatory, mesenchymal, mesenchymal stem cell-like and androgen luminal type) [ Time Frame: Baseline ]
The association between response and molecular subtype of triple negative breast cancer (basal-like 1, basal-like 2, immunomodulatory, mesenchymal, mesenchymal stem cell-like and androgen luminal type) will be explored. Overall response rate will be summarized for each molecular subtype of breast cancer. Will also calculate corresponding 95% binomial confidence intervals for these response rates. Association between molecular subtype of breast cancer and overall response rate will be explored.
- Overall response rate (partial response [PR]+ complete response [CR]) based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 [ Time Frame: Up to 6 months ]
Overall response will be assessed in all patients in an exploratory manner, using summary statistics, by dose level. Response will be defined using the best response achieved in the first 6 months and will include CR or PR. The overall response rate will be calculated as the proportion of patients who achieve a CR or PR divided by the total number of patients who have received at least one dose of therapy per protocol. Will also calculate corresponding 95% binomial confidence intervals for these response rates.
- Pharmacokinetic (PK) parameters of HSP90 inhibitor AT13387 [ Time Frame: Pre-dose, immediately prior to end of infusion, 0.5, 1, 2, 4, 6, 8, and 24 hours after end of infusion on day -7 of course 1 and day 8 (and prior to starting paclitaxel, and immediately prior to end of infusion of paclitaxel on day 8) ]
A descriptive analysis will be performed to define systemic exposure, drug clearance, and other pharmacokinetic parameters. The PK parameters will be summarized with simple summary statistics, including means, medians, ranges, and standard deviations (if numbers and distribution permit).
- PK parameters of paclitaxel [ Time Frame: Pre-dose, immediately prior to end of infusion, 0.5, 1, 2, 4, 6, 8, and 24 hours after end of infusion on days 1 and 8 of course 1 (and immediately prior to end of infusion of HSP90 inhibitor AT13887, prior to starting paclitaxel on day 8) ]
A descriptive analysis will be performed to define systemic exposure, drug clearance, and other pharmacokinetic parameters. The PK parameters will be summarized with simple summary statistics, including means, medians, ranges, and standard deviations (if numbers and distribution permit).
- Progression-free survival [ Time Frame: From study enrollment to first documented disease progression according to RECIST 1.1 or death from any cause (whichever occurs first), assessed up to 8 weeks post-treatment ]
Progression free survival will be summarized using Kaplan and Meier methods, where patients who are event-free at the time of their last evaluation will be censored at that time point.
- Response duration, based on RECIST 1.1 criteria [ Time Frame: From the time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented, assessed up to 8 weeks post-treatment ]
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Not Provided
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Not Provided
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Onalespib and Paclitaxel in Treating Patients With Advanced Triple Negative Breast Cancer
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Phase 1b Study of HSP90 Inhibitor, AT13387 (Onalespib) in Combination With Paclitaxel in Patients With Advanced, Triple Negative Breast Cancer
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This phase Ib trial studies the side effects and best dose onalespib when given together with paclitaxel in treating patients with triple negative breast cancer that has spread to other places in the body and usually cannot be cured or controlled with treatment (advanced). Onalespib works by blocking proper processing of proteins that are important for cancer growth. This results in inability of these proteins to work properly. Paclitaxel kills breast cancer cells by interfering with their ability to divide. Giving onalespib together with paclitaxel may be better than giving either one alone in treating patients with breast cancer.
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PRIMARY OBJECTIVES:
I. To determine the recommended phase 2 dose (RP2D) of onalespib (AT13387) in combination with paclitaxel in patients with advanced triple negative breast cancer (TNBC).
II. To determine the toxicity profile (based on Common Terminology Criteria for Adverse Events [CTCAE] version [v.]5.0) of the combination of AT13387 in combination with paclitaxel in patients with advanced TNBC.
SECONDARY OBJECTIVES:
I. To determine the effect of AT13387 on pharmacokinetics of paclitaxel in the study patient population.
II. To determine the effect of paclitaxel on pharmacokinetics of AT13387 in the study patient population.
III. To observe anti-tumor activity determining the overall response rate (partial response + complete response), response duration and progression-free survival.
OUTLINE: This is a dose-escalation study of onalespib.
SAFETY RUN-IN: Patients receive onalespib intravenously (IV) over 1 hour on day -7.
TREATMENT: Patients receive paclitaxel IV over 60 minutes on day 1, 8, and 15. Patients also receive onalespib IV over 1 hour beginning on days 8 and 15 of cycle 1 and on days 1, 8, and 15 of subsequent cycles. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 3 months.
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Interventional
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Phase 1
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Allocation: N/A Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment
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- Advanced Breast Carcinoma
- Metastatic Breast Carcinoma
- Stage III Breast Cancer AJCC v7
- Stage IIIA Breast Cancer AJCC v7
- Stage IIIB Breast Cancer AJCC v7
- Stage IIIC Breast Cancer AJCC v7
- Stage IV Breast Cancer AJCC v6 and v7
- Triple-Negative Breast Carcinoma
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- Other: Laboratory Biomarker Analysis
Correlative studies
- Drug: Onalespib
Given IV
Other Names:
- AT 13387
- AT-13387
- AT13387
- Drug: Paclitaxel
Given IV
Other Names:
- Anzatax
- Asotax
- Bristaxol
- Praxel
- Taxol
- Taxol Konzentrat
- Other: Pharmacological Study
Correlative studies
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Experimental: Treatment (onalespib, paclitaxel)
SAFETY RUN-IN: Patients receive onalespib IV over approximately 1 hour on day -7.
TREATMENT: Patients receive paclitaxel IV over 60 minutes on day 1, 8, and 15. Patients also receive onalespib IV over 1 hour beginning on days 8 and 15 of cycle 1 and on days 1, 8, and 15 of subsequent cycles. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Interventions:
- Other: Laboratory Biomarker Analysis
- Drug: Onalespib
- Drug: Paclitaxel
- Other: Pharmacological Study
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Not Provided
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Terminated
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31
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24
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October 26, 2022
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October 26, 2022 (Final data collection date for primary outcome measure)
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Inclusion Criteria:
Exclusion Criteria:
- Patients who have had chemotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study
- Patients who are receiving any other investigational agents within 4 weeks or 5 half-lives (whichever is shorter) prior to the first dose of the study regimen
- Prior radiation therapy within 2 weeks prior to the first dose of the study regimen
- Patients in whom prior treatment related toxicities have not recovered to grade 1 or less (except for alopecia)
- Recent initiation of bone modifying therapy with a bisphosphonate or denosumab unless it has been started more than 4 weeks prior to the first dose of the study regimen; patients who are already enrolled in this study can initiate bone modifying therapy after the first set of re-staging scans (>= 8 weeks from cycle 1, day 1)
- Prior therapy with AT13387 or another HSP90 inhibitor
- Patients with known brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events; however, patients with previously treated and stable brain metastases are eligible as long as they are no longer requiring steroids, completed radiation therapy more than 2 weeks prior to the first dose of study regimen and have no seizures or worsening neurologic symptoms
- History of grade 3-4 immediate hypersensitivity reaction to paclitaxel
- History of clinically significant allergic reactions attributed to compounds of similar chemical or biologic composition to AT13387 or paclitaxel
- Based on investigator's brochure, AT13387 has no significant effects on inhibition or activation of cytochrome P450 (CYP), including 1A2, 3A4, 2D6, 2C9, and 2C19 at the half maximal inhibitory concentration (IC50) > 10 uM. Preclinical studies indicated that AT13387 is only a modest inhibitor of P-glycoprotein (P-gp). Paclitaxel is a substrate of CYP2C8 and CYP3A4. The use of CYP2C8 and CYP3A4 inhibitors/inducers while not prohibited in this study, is discouraged whenever feasible; concurrent use of strong CYP2C8 and CYP3A4 inhibitors/inducers should be documented and the principal investigator (PI) of the study shall be notified prior to dosing; as part of the enrollment/informed consent procedures, the patients will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- Pregnant women are excluded from this study because paclitaxel is a class D agent with the potential for teratogenic or abortifacient effects; because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with AT13387 and paclitaxel, breastfeeding should be discontinued if the mother is treated with AT13387 and paclitaxel
- Patients who are human immunodeficiency virus (HIV) positive on highly active anti-retroviral therapy (HAART) will be excluded from the study because of the potential for pharmacokinetic interactions with AT13387; in addition, these patients are at increased risk of lethal infections when treated with marrow-suppressive therapy; appropriate studies will be undertaken in patients receiving combination antiretroviral therapy when indicated
- Inability to understand and sign informed consent
- Any other medical or psychiatric condition that in the opinion of the investigator would make the study therapy unsafe for the patient
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Sexes Eligible for Study: |
All |
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18 Years and older (Adult, Older Adult)
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No
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Contact information is only displayed when the study is recruiting subjects
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United States
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NCT02474173
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NCI-2015-00866 NCI-2015-00866 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ) OSU 15149 9876 ( Other Identifier: Ohio State University Comprehensive Cancer Center LAO ) 9876 ( Other Identifier: CTEP ) UM1CA186712 ( U.S. NIH Grant/Contract )
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Yes
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Not Provided
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Not Provided
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National Cancer Institute (NCI)
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Same as current
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National Cancer Institute (NCI)
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Same as current
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Not Provided
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Principal Investigator: |
Robert Wesolowski |
Ohio State University Comprehensive Cancer Center LAO |
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National Cancer Institute (NCI)
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November 2022
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