Palbociclib In Progressive Brain Metastases

Study Purpose

This research study is studying palbociclib as a possible treatment for recurrent brain metastases. - Pfizer, a pharmaceutical company, is supporting this research study by providing the study drug as well as funding for research activities

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Participants must have histologically or cytologically confirmed disease from any solid tumor.
  • - Participants must have measurable disease in the CNS, defined as at least one lesion that can be accurately measured in at least one dimension as ≥10 mm .
  • - Participants must have progressive CNS lesions, as defined by one of the following: - Patients may have multiple progressive CNS lesions, some of which have been treated by SRS or surgery.
Patients are eligible if they have one or more un-treated (by surgery or SRS) progressive lesions that is measurable.
  • - Patients have measurable residual or progressive lesions after surgery.
  • - Patients who have had prior WBRT and/or SRS are eligible but there needs to be unequivocal evidence of progression of at least one lesion treated by radiation (e.g. tissue diagnosis).
Biopsy can be considered for definitive diagnosis.
  • - Patients who have previously been treated with systemic therapy for CNS metastases are eligible.
  • - Age ≥ 18 years.
The toxicity of palbociclib in children is unknown.
  • - ECOG performance status ≤2 (Karnofsky ≥60%, see Appendix A) - Participants must have normal organ and marrow function as defined below: - leukocytes ≥3,000/mcL.
  • - absolute neutrophil count ≥1,500/mcL.
  • - platelets ≥100,000/mcL.
  • - hemoglobin >9g/dL.
  • - total bilirubin ≤ 1.5 x institutional upper limit of normal.
--- OR.
  • - > 1.5 x institutional upper limit of normal allowed if direct bilirubin is within normal range.
  • - AST(SGOT)/ALT(SGPT) ≤2.5 × institutional upper limit of normal.
  • - creatinine within normal institutional limits.
--- OR.
  • - creatinine clearance ≥60 mL/min/1.73 m2 for participants with creatinine levels above institutional normal.
  • - baseline QTc <480ms.
  • - The effects of palbociclib on the developing human fetus are unknown.
For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 6 months after completion of palbociclib administration.
  • - Ability to understand and the willingness to sign a written informed consent document.
  • - Tissue from a prior craniotomy or biopsy for genetic sequencing (at least one FFPE block or 15 unstained slides).
Patients previously assessed for genetic sequencing who meet requirements of section 9.2.1 do not need to have additional tissue available for prospective genetic sequencing.
  • - Presence of alteration in CDK pathway (amplifications in CDK4, CDK6, CCND1, CCND2, CCND3 or CCNE1 or loss of CDKN2A) - Patients with progressive extracranial disease will not be excluded.
  • - Stable corticosteroids for at least 7 days.

Exclusion Criteria:

  • - Prior treatment with CDK4/6 inhibitor.
  • - Participants who have had chemotherapy, immunotherapy or radiotherapy within 2 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 2 weeks earlier.
  • - Participants who are receiving any other investigational agents.
  • - Participants who are receiving other concurrent chemotherapies or immunotherapies for their cancer (except for patients who will receive letrozole, anastrozole, exemestane, tamoxifen, fulvestrant, trastuzumab, bisphosphonates, or ovarian suppression therapy) - Leptomeningeal involvement of cancer.
  • - History of allergic reactions attributed to compounds of similar chemical or biologic composition to palbociclib (including abemaciclib) - Participants receiving any medications or substances that are moderate or strong inhibitors or inducers of CYP3A isoenzymes are ineligible.
Lists including medications and substances known or with the potential to interact with the CYP3A isoenzymes are provided in Appendix C, and can also be found within section 5.4. Because the lists of these agents are constantly changing, it is important to regularly consult a frequently-updated list such as http://medicine.iupui.edu/clinpharm/ddis/table.aspx; medical reference texts such as the Physicians' Desk Reference may also provide this information. As part of the enrollment/informed consent procedures, the patient 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 the effect of palbociclib on a developing fetus is unknown.
Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with palbociclib, breastfeeding should be discontinued if the mother is treated with palbociclib.
  • - HIV-positive participants on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with palbociclib.
In addition, these participants are at increased risk of lethal infections when treated with marrow-suppressive therapy. Appropriate studies will be undertaken in participants receiving combination antiretroviral therapy when indicated.
  • - Current use of drugs that are known to prolong the QT interval (See Appendix C) - Unable to undergo MRI scans.
  • - QTc>480 msec (based on the mean value of the triplicate ECGs), family or personal history of long or short QTc prolongation, or Torsade de Pointes (TdP).
  • - Uncontrolled electrolyte disorders that can compound the effects of QTc-prolonging drug (eg.
hypocalcemia, hypokalemia, hypomagnesemia

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT02896335
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 2
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Massachusetts General Hospital
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Priscilla Brastianos, MD
Principal Investigator Affiliation Massachusetts General Hospital
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other, Industry
Overall Status Recruiting
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Metastatic Malignant Neoplasm to Brain
Additional Details

  • - This research study is a Phase II clinical trial.
Phase II clinical trials test the safety and effectiveness of an investigational intervention to learn whether the intervention works in treating a specific disease. "Investigational" means that the intervention is being studied.
  • - This is a study designed to evaluate the efficacy and safety of palbociclib in recurrent brain metastases.
Palbociclib is being studied for use in the treatment of a broad range of cancers. This type of drug inhibits cell growth in the cells called cyclin-dependent kinases which promote tumor cell proliferation.
  • - The FDA (the U.
S. Food and Drug Administration) has not approved palbociclib for participants specific disease but it has been approved for other uses

Arms & Interventions

Arms

Experimental: Palbociclib

Description Patients who fulfill eligibility criteria will be entered into the trial to receive Palbociclib After the screening procedures confirm participation in the research study: Palbociclib- Fixed Dose, daily for 21 days per cycle. The participant will be requested to maintain a medication diary of each dose of medication. The medication diary will be returned to clinic staff at the end of each cycle.

Interventions

Drug: - Palbociclib

125 mg by mouth daily

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Massachusetts General Hospital, Boston, Massachusetts

Status

Recruiting

Address

Massachusetts General Hospital

Boston, Massachusetts, 02115

Site Contact

Priscilla Brastianos, MD

[email protected]

617-724-8770

Dana Farber Cancer Institute, Boston, Massachusetts

Status

Not yet recruiting

Address

Dana Farber Cancer Institute

Boston, Massachusetts, 02215

Site Contact

Eudocia K. Lee, MD

[email protected]

617-632-2166

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