Phase I/Ib study of olaparib and carboplatin in BRCA1 or BRCA2 mutation-associated breast or ovarian cancer with biomarker analyses

Jung Min Lee, John L. Hays, Christina M. Annunziata, Anne M. Noonan, Lori Minasian, Jo Anne Zujewski, Minshu Yu, Nicolas Gordon, Jiuping Ji, Tristan M. Sissung, William D. Figg, Nilofer Azad, Bradford J. Wood, James Doroshow, Elise C. Kohn

Research output: Contribution to journalArticle

Abstract

Background Olaparib has single-agent activity against breast/ovarian cancer (BrCa/OvCa) in germline BRCA1 or BRCA2 mutation carriers (gBRCAm). We hypothesized addition of olaparib to carboplatin can be administered safely and yield preliminary clinical activity. Methods Eligible patients had measurable or evaluable disease, gBRCAm, and good end-organ function. A 3 + 3 dose escalation tested daily oral capsule olaparib (100 or 200mg every 12 hours; dose level1 or 2) with carboplatin area under the curve (AUC) on day 8 (AUC3 day 8), then every 21 days. For dose levels 3 to 6, patients were given olaparib days 1 to 7 at 200 and 400 mg every 12 hours, with carboplatin AUC3 to 5 on day 1 or 2 every 21 days; a maximum of eight combination cycles were permitted, after which daily maintenance of olaparib 400mg every12 hours continued until progression. Dose-limiting toxicity was defined in the first two cycles. Peripheral blood mononuclear cells were collected for polymorphism analysis and polyADP-ribose incorporation. Paired tumor biopsies (before/after cycle 1) were obtained for biomarker proteomics and apoptosis endpoints. Results Forty-five women (37 OvCa/8 BrCa) were treated. Dose-limiting toxicity was not reached on the intermittent schedule. Expansion proceeded with olaparib 400mg every 12 hours on days 1 to 7/carboplatin AUC5. Grade 3/4 adverse events included neutropenia (42.2%), thrombocytopenia (20.0%), and anemia (15.6%). Responses included 1 complete response (1 BrCa; 23 months) and 21 partial responses (50.0%; 15 OvCa; 6 BrCa; median = 16 [4 to >45] in OvCa and 10 [6 to >40] months in BrCa). Proteomic analysis suggests high pretreatment pS209-eIF4E and FOXO3a correlated with duration of response (two-sided P 2 = 0.94). Conclusions Olaparib capsules 400mg every 12 hours on days 1 to 7/carboplatin AUC5 is safe and has activity in gBRCAm BrCa/OvCa patients. Exploratory translational studies indicate pretreatment tissue FOXO3a expression may be predictive for response to therapy, requiring prospective validation.

Original languageEnglish (US)
JournalJournal of the National Cancer Institute
Volume106
Issue number6
DOIs
StatePublished - Jun 11 2014
Externally publishedYes

Fingerprint

Carboplatin
Tumor Biomarkers
Ovarian Neoplasms
Breast Neoplasms
Mutation
Proteomics
Capsules
Ribose
olaparib
Neutropenia
Thrombocytopenia
Area Under Curve
Anemia
Blood Cells
Appointments and Schedules
Biomarkers
Maintenance
Apoptosis
Biopsy
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Phase I/Ib study of olaparib and carboplatin in BRCA1 or BRCA2 mutation-associated breast or ovarian cancer with biomarker analyses. / Lee, Jung Min; Hays, John L.; Annunziata, Christina M.; Noonan, Anne M.; Minasian, Lori; Zujewski, Jo Anne; Yu, Minshu; Gordon, Nicolas; Ji, Jiuping; Sissung, Tristan M.; Figg, William D.; Azad, Nilofer; Wood, Bradford J.; Doroshow, James; Kohn, Elise C.

In: Journal of the National Cancer Institute, Vol. 106, No. 6, 11.06.2014.

Research output: Contribution to journalArticle

Lee, JM, Hays, JL, Annunziata, CM, Noonan, AM, Minasian, L, Zujewski, JA, Yu, M, Gordon, N, Ji, J, Sissung, TM, Figg, WD, Azad, N, Wood, BJ, Doroshow, J & Kohn, EC 2014, 'Phase I/Ib study of olaparib and carboplatin in BRCA1 or BRCA2 mutation-associated breast or ovarian cancer with biomarker analyses', Journal of the National Cancer Institute, vol. 106, no. 6. https://doi.org/10.1093/jnci/dju089
Lee, Jung Min ; Hays, John L. ; Annunziata, Christina M. ; Noonan, Anne M. ; Minasian, Lori ; Zujewski, Jo Anne ; Yu, Minshu ; Gordon, Nicolas ; Ji, Jiuping ; Sissung, Tristan M. ; Figg, William D. ; Azad, Nilofer ; Wood, Bradford J. ; Doroshow, James ; Kohn, Elise C. / Phase I/Ib study of olaparib and carboplatin in BRCA1 or BRCA2 mutation-associated breast or ovarian cancer with biomarker analyses. In: Journal of the National Cancer Institute. 2014 ; Vol. 106, No. 6.
@article{5a8d9d79f5e248d5b0e229785bde5b48,
title = "Phase I/Ib study of olaparib and carboplatin in BRCA1 or BRCA2 mutation-associated breast or ovarian cancer with biomarker analyses",
abstract = "Background Olaparib has single-agent activity against breast/ovarian cancer (BrCa/OvCa) in germline BRCA1 or BRCA2 mutation carriers (gBRCAm). We hypothesized addition of olaparib to carboplatin can be administered safely and yield preliminary clinical activity. Methods Eligible patients had measurable or evaluable disease, gBRCAm, and good end-organ function. A 3 + 3 dose escalation tested daily oral capsule olaparib (100 or 200mg every 12 hours; dose level1 or 2) with carboplatin area under the curve (AUC) on day 8 (AUC3 day 8), then every 21 days. For dose levels 3 to 6, patients were given olaparib days 1 to 7 at 200 and 400 mg every 12 hours, with carboplatin AUC3 to 5 on day 1 or 2 every 21 days; a maximum of eight combination cycles were permitted, after which daily maintenance of olaparib 400mg every12 hours continued until progression. Dose-limiting toxicity was defined in the first two cycles. Peripheral blood mononuclear cells were collected for polymorphism analysis and polyADP-ribose incorporation. Paired tumor biopsies (before/after cycle 1) were obtained for biomarker proteomics and apoptosis endpoints. Results Forty-five women (37 OvCa/8 BrCa) were treated. Dose-limiting toxicity was not reached on the intermittent schedule. Expansion proceeded with olaparib 400mg every 12 hours on days 1 to 7/carboplatin AUC5. Grade 3/4 adverse events included neutropenia (42.2{\%}), thrombocytopenia (20.0{\%}), and anemia (15.6{\%}). Responses included 1 complete response (1 BrCa; 23 months) and 21 partial responses (50.0{\%}; 15 OvCa; 6 BrCa; median = 16 [4 to >45] in OvCa and 10 [6 to >40] months in BrCa). Proteomic analysis suggests high pretreatment pS209-eIF4E and FOXO3a correlated with duration of response (two-sided P 2 = 0.94). Conclusions Olaparib capsules 400mg every 12 hours on days 1 to 7/carboplatin AUC5 is safe and has activity in gBRCAm BrCa/OvCa patients. Exploratory translational studies indicate pretreatment tissue FOXO3a expression may be predictive for response to therapy, requiring prospective validation.",
author = "Lee, {Jung Min} and Hays, {John L.} and Annunziata, {Christina M.} and Noonan, {Anne M.} and Lori Minasian and Zujewski, {Jo Anne} and Minshu Yu and Nicolas Gordon and Jiuping Ji and Sissung, {Tristan M.} and Figg, {William D.} and Nilofer Azad and Wood, {Bradford J.} and James Doroshow and Kohn, {Elise C.}",
year = "2014",
month = "6",
day = "11",
doi = "10.1093/jnci/dju089",
language = "English (US)",
volume = "106",
journal = "Journal of the National Cancer Institute",
issn = "0027-8874",
publisher = "Oxford University Press",
number = "6",

}

TY - JOUR

T1 - Phase I/Ib study of olaparib and carboplatin in BRCA1 or BRCA2 mutation-associated breast or ovarian cancer with biomarker analyses

AU - Lee, Jung Min

AU - Hays, John L.

AU - Annunziata, Christina M.

AU - Noonan, Anne M.

AU - Minasian, Lori

AU - Zujewski, Jo Anne

AU - Yu, Minshu

AU - Gordon, Nicolas

AU - Ji, Jiuping

AU - Sissung, Tristan M.

AU - Figg, William D.

AU - Azad, Nilofer

AU - Wood, Bradford J.

AU - Doroshow, James

AU - Kohn, Elise C.

PY - 2014/6/11

Y1 - 2014/6/11

N2 - Background Olaparib has single-agent activity against breast/ovarian cancer (BrCa/OvCa) in germline BRCA1 or BRCA2 mutation carriers (gBRCAm). We hypothesized addition of olaparib to carboplatin can be administered safely and yield preliminary clinical activity. Methods Eligible patients had measurable or evaluable disease, gBRCAm, and good end-organ function. A 3 + 3 dose escalation tested daily oral capsule olaparib (100 or 200mg every 12 hours; dose level1 or 2) with carboplatin area under the curve (AUC) on day 8 (AUC3 day 8), then every 21 days. For dose levels 3 to 6, patients were given olaparib days 1 to 7 at 200 and 400 mg every 12 hours, with carboplatin AUC3 to 5 on day 1 or 2 every 21 days; a maximum of eight combination cycles were permitted, after which daily maintenance of olaparib 400mg every12 hours continued until progression. Dose-limiting toxicity was defined in the first two cycles. Peripheral blood mononuclear cells were collected for polymorphism analysis and polyADP-ribose incorporation. Paired tumor biopsies (before/after cycle 1) were obtained for biomarker proteomics and apoptosis endpoints. Results Forty-five women (37 OvCa/8 BrCa) were treated. Dose-limiting toxicity was not reached on the intermittent schedule. Expansion proceeded with olaparib 400mg every 12 hours on days 1 to 7/carboplatin AUC5. Grade 3/4 adverse events included neutropenia (42.2%), thrombocytopenia (20.0%), and anemia (15.6%). Responses included 1 complete response (1 BrCa; 23 months) and 21 partial responses (50.0%; 15 OvCa; 6 BrCa; median = 16 [4 to >45] in OvCa and 10 [6 to >40] months in BrCa). Proteomic analysis suggests high pretreatment pS209-eIF4E and FOXO3a correlated with duration of response (two-sided P 2 = 0.94). Conclusions Olaparib capsules 400mg every 12 hours on days 1 to 7/carboplatin AUC5 is safe and has activity in gBRCAm BrCa/OvCa patients. Exploratory translational studies indicate pretreatment tissue FOXO3a expression may be predictive for response to therapy, requiring prospective validation.

AB - Background Olaparib has single-agent activity against breast/ovarian cancer (BrCa/OvCa) in germline BRCA1 or BRCA2 mutation carriers (gBRCAm). We hypothesized addition of olaparib to carboplatin can be administered safely and yield preliminary clinical activity. Methods Eligible patients had measurable or evaluable disease, gBRCAm, and good end-organ function. A 3 + 3 dose escalation tested daily oral capsule olaparib (100 or 200mg every 12 hours; dose level1 or 2) with carboplatin area under the curve (AUC) on day 8 (AUC3 day 8), then every 21 days. For dose levels 3 to 6, patients were given olaparib days 1 to 7 at 200 and 400 mg every 12 hours, with carboplatin AUC3 to 5 on day 1 or 2 every 21 days; a maximum of eight combination cycles were permitted, after which daily maintenance of olaparib 400mg every12 hours continued until progression. Dose-limiting toxicity was defined in the first two cycles. Peripheral blood mononuclear cells were collected for polymorphism analysis and polyADP-ribose incorporation. Paired tumor biopsies (before/after cycle 1) were obtained for biomarker proteomics and apoptosis endpoints. Results Forty-five women (37 OvCa/8 BrCa) were treated. Dose-limiting toxicity was not reached on the intermittent schedule. Expansion proceeded with olaparib 400mg every 12 hours on days 1 to 7/carboplatin AUC5. Grade 3/4 adverse events included neutropenia (42.2%), thrombocytopenia (20.0%), and anemia (15.6%). Responses included 1 complete response (1 BrCa; 23 months) and 21 partial responses (50.0%; 15 OvCa; 6 BrCa; median = 16 [4 to >45] in OvCa and 10 [6 to >40] months in BrCa). Proteomic analysis suggests high pretreatment pS209-eIF4E and FOXO3a correlated with duration of response (two-sided P 2 = 0.94). Conclusions Olaparib capsules 400mg every 12 hours on days 1 to 7/carboplatin AUC5 is safe and has activity in gBRCAm BrCa/OvCa patients. Exploratory translational studies indicate pretreatment tissue FOXO3a expression may be predictive for response to therapy, requiring prospective validation.

UR - http://www.scopus.com/inward/record.url?scp=84905187284&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905187284&partnerID=8YFLogxK

U2 - 10.1093/jnci/dju089

DO - 10.1093/jnci/dju089

M3 - Article

C2 - 24842883

AN - SCOPUS:84905187284

VL - 106

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 6

ER -