Overview

Study of ASTX727 Plus Talazoparib in Patients With Triple Negative or Hormone Resistant/HER2-negative Metastatic Breast Cancer

Status:
Recruiting
Trial end date:
2023-07-01
Target enrollment:
0
Participant gender:
All
Summary
This is a Phase I study to test the safety of a combination of ASTX727 with talazoparib in patients with triple negative breast cancer or hormone resistant/HER2-negative metastatic breast cancer
Phase:
Phase 1
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Kathy Miller
Collaborators:
Astex Pharmaceuticals, Inc.
Pfizer
Van Andel Institute Stand Up to Cancer Team
Treatments:
Hormones
Talazoparib
Criteria
Inclusion Criteria:

1. ≥ 18 years old at the time of informed consent

2. Ability to provide written informed consent and HIPAA authorization

3. Locally recurrent (not amenable to local therapy with curative intent) or metastatic
breast cancer

1. Patients with triple negative breast cancer must have received at least one prior
chemotherapy regimen for metastatic disease.

2. Patients with hormone-positive, HER2-negative disease must have received
treatment with and progressed on at least one prior endocrine therapy including a
CDK4/6 inhibitor in the metastatic setting.

4. Measurable or evaluable disease based on RECIST 1.1 criteria.

5. Only subjects who have disease amenable to biopsy will be asked to consent to serial
tumor biopsies. Consent for biopsy is not required for participation.

a. NOTE: If no amendable disease is present at the time of biopsy, subjects may
continue participation in the study and further study specific biopsies will not be
required.

6. Eastern Cooperative Oncology Group Performance Status 0 or 1

7. Patients with treated, asymptomatic central nervous system (CNS) disease may
participate if the patient is > 4 weeks from completion of CNS therapy (radiation
and/or surgery), is clinically stable at the time of study entry, and is receiving a
stable or decreasing dose of corticosteroid therapy. Brain MRI or head CT is required
at screening for patients with known brain metastases.

8. Adequate organ function as indicated by:

1. Total bilirubin documented Gilbert's disease, who must have a total bilirubin
2. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (
3. Calculated creatinine clearance of >/= 60 mL/min using the Cockcroft-Gault
formula

4. Absolute neutrophil count (ANC) >/= 1.5 K/mm3

5. Platelets >/= 100 K/mm3

6. Hemoglobin (Hgb) >/= 9.0 g/dL

9. Women of childbearing potential must have a negative pregnancy test within 14 days of
protocol registration. Women are considered to have childbearing potential (regardless
of sexual orientation, having undergone a tubal ligation, or remaining celibate by
choice) unless they meet one of the following criteria:

1. Has undergone a hysterectomy or bilateral oophorectomy; or

2. Has been naturally amenorrheic for at least 24 consecutive months.

10. Women of childbearing potential and men must agree to use effective contraception
throughout the study and for 7 months after the last study treatment. Note: Acceptable
methods of birth control include abstinence, partner with previous vasectomy,
placement of an intrauterine device (IUD), condom with spermicidal
foam/gel/film/cream/suppository, diaphragm or cervical vault cap, or hormonal birth
control (pills or injections).

Exclusion Criteria:

1. Prior treatment with decitabine, guadecitabine or other known DNA Methyltransferase
inhibitors (DNMTis)

2. Prior treatment with talazoparib or other known PARPi (poly(ADP-ribose polymeras
inhibitor)

3. Known deleterious breast cancer susceptibility gene (BRCA) mutation. Patients with
BRCA variants of unknown significance (VUS) or who have not had germline genetic
testing may participate.

4. Active or symptomatic CNS disease

5. Patients with HER2+ disease

- HER2 will be considered positive if scored 3+ by immunohistochemistry (IHC) or 2+
by IHC associated with a fluorescence in situ hybridization (FISH) ratio of > 2.0
or > 6 total HER2 gene copies per cell.

6. Patients with active malignancy other than breast cancer. Patients with prior
malignancies without recurrence after standard treatment will not be excluded

7. Chemotherapy within 3 weeks of registration

8. Radiation therapy within 2 weeks of registration

9. Hormone therapy within 2 weeks of registration

10. Patients requiring ongoing therapy with strong P-gp inhibitors