Olaparib for Pancreatic Cancer
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Phase 2
Recruiting
Sponsor: National Cancer Institute (NCI)
Must not be taking: CYP3A inhibitors, CYP3A inducers
Disqualifiers: HIV, Hepatitis B/C, Heart failure, others
No Placebo Group
Prior Safety Data
Approved in 2 Jurisdictions
Trial Summary
What is the purpose of this trial?Background:
Pancreatic Acinar Cell Carcinoma (PACC) is a rare pancreatic tumor. People with PACC usually present with advanced disease, and their prognosis is poor. Researchers want to learn if a cancer drug called olaparib can help.
Objective:
To see if olaparib is an effective treatment for PACC.
Eligibility:
People aged 18 and older with PACC whose cancer did not respond to previous treatments or is not eligible for surgery.
Design:
Participants will be screened with the following:
Medical history
Physical exam
Blood and urine tests
Electrocardiogram (to test heart function)
Computed tomography (CT) scans
Pregnancy test (if needed)
Tumor biopsy (if a sample is not available)
Treatment will be given in 28-day cycles. Participants will take olaparib by mouth twice daily for each cycle. They will keep a medicine diary. They will receive treatment for up to 2 years. They may stop treatment early if their cancer gets worse or they have serious side effects.
Participants will have study visits at the beginning of each cycle. At visits, they will repeat some screening tests. They will be asked about any changes in medicines they are taking and how they are feeling. They will have CT scans every 8 weeks starting in cycle 2.
Participants will give blood samples for research. They may have optional tumor biopsies.
Participants will have 2 follow-up visits in the 30 days after treatment ends or before they begin a new anti-cancer treatment. Then they will be contacted every 3 months by phone for 1 year.
Participation will last for up to 3 years.
Will I have to stop taking my current medications?
The trial requires that you stop taking certain medications before starting treatment. You must stop using strong or moderate CYP3A inhibitors and inducers at least 2 to 5 weeks before starting the trial, depending on the specific medication.
What data supports the effectiveness of the drug Olaparib for pancreatic cancer?
Olaparib has shown activity in patients with pancreatic cancer who have BRCA mutations, similar to its effectiveness in treating ovarian cancer with the same genetic mutations.
12345Is Olaparib safe for humans?
Olaparib (also known as Lynparza) has been tested in various clinical trials for different cancers, including ovarian and pancreatic cancer. Common side effects include nausea, fatigue, and anemia (low red blood cell count), while more serious effects like myelodysplastic syndrome (a blood disorder) and acute myeloid leukemia (a type of blood cancer) occurred in a small percentage of patients.
14567How is the drug Olaparib unique in treating pancreatic cancer?
Olaparib is unique because it is an oral drug that targets specific genetic mutations (BRCA mutations) in pancreatic cancer, working by inhibiting PARP enzymes which help repair DNA damage in cancer cells, potentially making it more effective for certain patients compared to standard treatments.
12478Eligibility Criteria
Adults with advanced Pancreatic Acinar Cell Carcinoma (PACC) who have tried other treatments without success or can't undergo surgery. They must be at least 18, not pregnant, and agree to use contraception. Participants need measurable disease per specific criteria, adequate organ function, and no recent major surgeries or investigational therapies.Inclusion Criteria
I haven't taken strong or moderate CYP3A inhibitors in the last 2 weeks.
I have recovered from recent surgeries and it's been over 2 weeks since any minor procedure.
My kidneys are functioning well enough, based on a calculation involving my age, weight, and gender.
+21 more
Exclusion Criteria
I have no severe side effects from past cancer treatments.
I have been diagnosed with superior vena cava syndrome.
I have symptoms of heart failure.
+18 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
1 visit (in-person)
Treatment
Participants receive olaparib by mouth twice daily in 28-day cycles for up to 2 years
Up to 2 years
Study visits at the beginning of each cycle, CT scans every 8 weeks starting in cycle 2
Follow-up
Participants have 2 follow-up visits in the 30 days after treatment ends, then contacted every 3 months by phone for 1 year
1 year
2 visits (in-person), phone contact every 3 months
Participant Groups
The trial is testing the effectiveness of olaparib for PACC in adults. Olaparib will be taken orally twice daily in cycles of 21 days for up to two years unless side effects become severe or cancer worsens. The study includes regular check-ups, blood tests, CT scans every eight weeks starting from cycle two, and optional tumor biopsies.
1Treatment groups
Experimental Treatment
Group I: Arm 1Experimental Treatment1 Intervention
Olaparib, taken orally, twice daily
Olaparib is already approved in European Union, United States for the following indications:
🇪🇺 Approved in European Union as Lynparza for:
- Breast cancer
- Ovarian cancer
- Fallopian tube cancer
- Peritoneal cancer
- Pancreatic cancer
- Prostate cancer
- Endometrial cancer
🇺🇸 Approved in United States as Lynparza for:
- Ovarian, fallopian tube, and primary peritoneal cancer
- Breast cancer
- Prostate cancer
- Pancreatic cancer
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
National Institutes of Health Clinical CenterBethesda, MD
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Who Is Running the Clinical Trial?
National Cancer Institute (NCI)Lead Sponsor
References
Olaparib in combination with irinotecan, cisplatin, and mitomycin C in patients with advanced pancreatic cancer. [2022]Olaparib is an oral inhibitor of polyadenosine 5'-diphosphoribose polymerization (PARP) that has previously shown signs of activity in patients with BRCA mutations and pancreatic ductal adenocarcinoma (PDAC).
Olaparib: first global approval. [2020]Olaparib (Lynparza™) is an oral, small molecule, poly (ADP-ribose) polymerase inhibitor being developed by AstraZeneca for the treatment of solid tumours. The primary indication that olaparib is being developed for is BRCA mutation-positive ovarian cancer. A capsule formulation of the drug has received approval for use in this setting in the EU and USA, and a tablet formulation is in global phase III trials (including in the USA, EU, Australia, Brazil, Canada, China, Israel, Japan, Russia and South Korea). In addition, phase III trials in breast, gastric and pancreatic cancer are underway/planned, and phase I/II investigation is being conducted in other malignancies, including prostate cancer, non-small cell lung cancer, Ewing's sarcoma and advanced cancer. This article summarizes the milestones in the development of olaparib leading to this first approval for ovarian cancer.
Clinical Activity and Safety of Cediranib and Olaparib Combination in Patients with Metastatic Pancreatic Ductal Adenocarcinoma without BRCA Mutation. [2022]Cediranib and olaparib combination did not result in clinically meaningful activity in patients with metastatic pancreatic ductal adenocarcinoma without known BRCA mutation.
Olaparib: an oral PARP-1 and PARP-2 inhibitor with promising activity in ovarian cancer. [2016]Olaparib (Lynparza™; AZD2281) is a potent PARP-1 and PARP-2 inhibitor with biologic activity in ovarian cancer as well as other solid tumors. It has been tested in Phase I and II trials and has single-agent activity in both germline BRCA mutated and sporadic ovarian cancer. Phase III trials assessing the efficacy of olaparib in the maintenance setting following first line and platinum-sensitive recurrence are underway for patients with a germline BRCA mutation, given the inherent molecular compatibility with the drug's mechanism of action.
Olaparib monotherapy in patients with advanced relapsed ovarian cancer and a germline BRCA1/2 mutation: a multistudy analysis of response rates and safety. [2022]The PARP inhibitor olaparib (Lynparza™) demonstrates antitumor activity in women with relapsed ovarian cancer and a germline BRCA1/2 mutation (gBRCAm). Data from olaparib monotherapy trials were used to explore the treatment effect of olaparib in patients with gBRCAm ovarian cancer who had received multiple lines of prior chemotherapy.
FDA Approval Summary: Olaparib Monotherapy in Patients with Deleterious Germline BRCA-Mutated Advanced Ovarian Cancer Treated with Three or More Lines of Chemotherapy. [2022]On December 19, 2014, the FDA approved olaparib capsules (Lynparza; AstraZeneca) for the treatment of patients with deleterious or suspected deleterious germline BRCA-mutated (gBRCAm) advanced ovarian cancer who have been treated with three or more prior lines of chemotherapy. The BRACAnalysis CDx (Myriad Genetic Laboratories, Inc.) was approved concurrently. An international multicenter, single-arm trial enrolled 137 patients with measurable gBRCAm-associated ovarian cancer treated with three or more prior lines of chemotherapy. Patients received olaparib at a dose of 400 mg by mouth twice daily until disease progression or unacceptable toxicity. The objective response rate (ORR) was 34% with median response duration of 7.9 months in this cohort. The most common adverse reactions (≥20%) in patients treated with olaparib were anemia, nausea, fatigue (including asthenia), vomiting, diarrhea, dysgeusia, dyspepsia, headache, decreased appetite, nasopharyngitis/pharyngitis/upper respiratory infection, cough, arthralgia/musculoskeletal pain, myalgia, back pain, dermatitis/rash, and abdominal pain/discomfort. Myelodysplatic syndrome and/or acute myeloid leukemia occurred in 2% of the patients enrolled on this trial.
New Adjuvant Treatment for High-Risk Early Breast Cancer. [2022]Olaparib (Lynparza) is now approved for the adjuvant treatment of adult patients who have, or are suspected to have, the germline variation of BRCA-mutated human epidermal growth factor receptor 2-negative high-risk early breast cancer and who were previously treated with neoadjuvant or adjuvant chemotherapy.
Candidate biomarkers of PARP inhibitor sensitivity in ovarian cancer beyond the BRCA genes. [2020]Olaparib (Lynparza™) is a PARP inhibitor approved for advanced BRCA-mutated (BRCAm) ovarian cancer. PARP inhibitors may benefit patients whose tumours are dysfunctional in DNA repair mechanisms unrelated to BRCA1/2. We report exploratory analyses, including the long-term outcome of candidate biomarkers of sensitivity to olaparib in BRCA wild-type (BRCAwt) tumours.