A Study to Investigate Biomarker Effects of Pre-Surgical Treatment With DNA Damage Repair (DDR) Agents in Patients With Head and Neck Squamous Cell Carcinoma (HNSCC).

NCT03022409 | Completed Phase 1 FDA Drug

• 1 other identifier: D5330C00007
• Study Type: interventional
• Target: 21
• Locations: 3 countries
• Sites: 4

Brief Summary

This biomarker study has been designed to assess the effects of different agents in both tumour tissue and peripheral samples to help inform the best combinations of DDR agents with immuno-oncology (IO) therapies. In the first instance 2 DDR agents will be assessed separately as monotherapy. Additional arms may be added later to evaluate other DDR agents and/or DDR and immunotherapy agents in combination or in sequence. The primary objective of the study is to investigate immune activation due to DDR inhibition by assessing tumour and blood samples of patients treated with study investigational agent(s).

Conditions

Head and Neck Squamous Cell Carcinoma

Keywords

Treatment naïve- or a second tumour; Head and Neck Squamous Cell Carcinoma (HNSCC); DNA Damage Repair (DDR)

Outcome Measures

Primary Outcomes (1)

• Conversion of an immunologically based 25-gene signature from a prognostically unfavourable state to a prognostically favourable state.

  To investigate prognosis-correlated immune activation due to DDR inhibition by monitoring the induction of immunologically relevant genes in tumours of patients treated with study investigational agent(s)

  From baseline through Day 31 (Follow up)

Secondary Outcomes (6)

• Transition from a low tumour infiltrating leukocyte (TIL) state (poor prognosis) to a high TIL state (favourable prognosis) shown by TIL enumeration and an increase in CD8+ T-cells

  From baseline through Day 31 (Follow up)

• Transition from a low TIL infiltrative state (poor prognosis) to a high TIL infiltrative state (favourable prognosis) shown by TIL enumeration and an increase in CD3+ T-cells

  From baseline through Day 31 (Follow up)

• Number of patients with adverse events (AE) / serious adverse events (SAE)

  From time of signature of informed consent throughout the treatment period and including the follow-up period

• Vital signs

  From screening until Day 15 (+ 2 days)

• Clinical chemistry/haematology

  From screening until Day 15 (+ 2 days)

Study Arms (2)

AZD6738

EXPERIMENTAL

AZD6738 (160 mg) tablet twice daily continuous dosing for a minimum of 9 days and a maximum of 21 days.

Drug: Ceralasertib

Olaparib

EXPERIMENTAL

Olaparib (300 mg) tablets administered orally twice daily continuously for a minimum of 9 days and a maximum of 21 days.

Drug: Olaparib

Interventions

Ceralasertib DRUG

Ceralasertib is an oral agent and will be dosed at 160 mg. Ceralasertib tablets should be taken at the same time each day, approximately 12 hours apart (maximum ± 2 hour window) with one glass of water. Ceralasertib is a potent, selective inhibitor of the serine/threonine-specific protein kinase, ataxia telangiectasia and Rad3-related protein (ATR), with good selectivity against other phosphatidylinositol 3-kinase-related kinase (PIKK) family members.

Also known as: AZD6738

AZD6738

Olaparib DRUG

Olaparib is available as a green film-coated tablet containing 100 mg or 150 mg of Olaparib. Patients will be administered Olaparib orally twice daily at 300 mg bid. The Olaprib tablets should be taken at the same time each day, approximately 12 hours apart with one glass of water. Olaparib (AZD2281, KU-0059436) is a potent Polyadenosine 5'diphosphoribose \[poly (ADP ribose)\] polymerisation (PARP) inhibitor (PARP-1, -2 and -3) that is being developed as an oral therapy, both as a monotherapy (including maintenance) and for combination with chemotherapy and other anti-cancer agents.

Also known as: AZD2281

Olaparib

Eligibility Criteria

• Age: 18 Years - 130 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Provision of informed consent
• Aged at least 18 years
• Eastern Cooperative Oncology Group (ECOG) performance status 0,1 or 2 with no deterioration over the previous 2 weeks and an estimated life expectancy of greater than 12 weeks
• Treatment naïve HNSCC either newly diagnosed, or a second tumour at more than two years after successful treatment of the primary cancer, suitable for surgical resection that is likely to be followed by radiotherapy and/or chemotherapy after surgery. Patients who are suitable for radical chemoradiation without surgery are eligible if they are willing to undergo an on-treatment biopsy (FNA samples are not acceptable, specimens must be core or surgical biopsy).
• Females must be using adequate contraceptive measures, must not be breast feeding and must have a negative pregnancy test prior to start of dosing if of child-bearing potential or must have evidence of non-child-bearing potential
• For the duration of the study and for 6 months after the last study drug administration, sexually active male patients must be willing to use barrier contraception i.e., condoms with all sexual partners
• No previous systemic cancer treatment or radiotherapy for the current malignancy
• Provision of genetics research informed consent

You may not qualify if:

• Involvement in the planning and/or conduct of the study
• Previous treatment with a DDR agent
• Participation in another clinical study with an investigational product during the last 21 days or 5 half-lives of the investigational product, whichever is longer
• Receiving, or having received during the week prior to first dose, corticosteroids at a dose \> 10 mg prednisone/day or equivalent for any reason
• Known hypersensitivity or contraindication to any of the investigational agents or their excipients
• Small molecule investigational medicinal products (IMPs) within 28 days prior to first dose; biological IMP within 42 days prior to first dose
• Receiving, or received, concomitant medications, herbal supplements and/or foods that significantly modulate Cytochrome P450 3A4 (CYP3A4) inhibitors or moderate Cytochrome P450, family 3, subfamily A (CYP3A) inhibitors, strong CYP3A inducers or moderate CYP3A inducers
• Impaired hepatic or renal function,inadequate bone marrow reserve or organ function
• Cardiac dysfunction defined as: Myocardial infarction within six months of study entry, New York Heart Association (NYHA) Class II/III/IV heart failure, unstable angina, unstable cardiac arrhythmias or reduced LVEF \< 55%
• Any of the following cardiac criteria: Mean resting corrected QTc interval using the Fridericia formula (QTcF) greater than 450 msec/male and greater than 470 msec/female or congenital long QT syndrome, clinically important abnormalities in rhythm, conduction or morphology of resting electrocardiography (ECG), factors that increase the risk of QTc prolongation or risk of arrhythmic events, patients at risk of brain perfusion problems, relative hypotension (\<100/60 mm Hg) or clinically relevant orthostatic hypotension (\>20 mm Hg), uncontrolled hypertension
• Any other malignancy (i.e., non-HNSCC) which has been active or treated within the past three years (except cervical intra-epithelial neoplasia and non-melanoma skin cancer)
• Patients unable to swallow orally administered medication and patients with gastrointestinal disorders likely to interfere with absorption of the study medication
• Patients considered a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease or active, uncontrolled infection
• Judgement by the Investigator that the patient should not participate in the study
• Patients with myelodysplastic syndrome (MDS)/acute myeloid leukaemia (AML) or with features suggestive of MDS/AML

Sponsors & Collaborators

• AstraZeneca: lead

Study Sites (4)

Research Site

Pittsburgh, Pennsylvania, 15240, United States

Location

Research Site

Toulouse, 31300, France

Location

Research Site

Changhua, 50006, Taiwan

Location

Research Site

Taipei, 100, Taiwan

Location

MeSH Terms

Conditions

Squamous Cell Carcinoma of Head and Neck

Interventions

ceralasertib; olaparib

Condition Hierarchy (Ancestors)

Carcinoma, Squamous Cell; Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Head and Neck Neoplasms; Neoplasms by Site

Study Officials

• Dr. Umamaheshwar Duvvuri

  University of Pittsburgh Medical Center (UPMC)

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 13, 2017
• First Posted: January 16, 2017
• Study Start: September 18, 2017
• Primary Completion: January 20, 2021
• Study Completion: January 20, 2021
• Last Updated: August 10, 2021

Record last verified: 2021-08

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
• Access Criteria: When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

Locations

TW (2); FR (1); US (1)