Neoplasms

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All Conditions

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Gland and Hormone Related Diseases

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Breast Neoplasms

Ovarian Neoplasms

Thyroid Neoplasms

Thyroid Diseases

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Genital Neoplasms, Male

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Urogenital Neoplasms

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Genital Diseases

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Female Urogenital Diseases

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Female Urogenital Diseases and Pregnancy Complications

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Male Urogenital Diseases

Endocrine Gland Neoplasms

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All Drugs and Chemicals

Olaparib

Poly(ADP-ribose) Polymerase Inhibitors

Enzyme Inhibitors

Dose Escalation Phase: Participants take both Selumetinib and Olaparib by mouth 2 times each day, about 12 hours apart at the Starting Dose Level. Treatment cycle is 28 days.

When maximum tolerated dose reached, Dose Expansion Phase begins.

Dose Expansion Phase: Selumetinib + Olaparib taken at the maximum tolerated dose from Dose Escalation Phase.

Dose Escalation Phase Starting Dose: 50 mg by mouth twice a day on Days 1-28.

Dose Expansion Phase Starting Dose: Maximum tolerated dose from Dose Escalation Phase.

Selumetinib

Dose Escalation Phase Starting Dose: 150 mg by mouth twice a day on Days 1-28.

Dose Expansion Phase Starting Dose: Maximum tolerated dose from Dose Escalation Phase.

Shannon Westin, MD

This study has 2 phases: Phase 1 (dose escalation) and Phase 2 (dose expansion).

The goal of Phase 1 of this clinical research study is to find the highest tolerable dose combination of selumetinib and olaparib that can be given to patients who have solid tumors that are advanced or recurrent (has returned after treatment).

The goal of Phase 2 is to learn if the highest tolerable dose combination found in Phase 1 can help to control advanced or recurrent solid tumors.

The safety of the study drug combination will also be studied in both parts.

This is an investigational study. Selumetinib is not FDA approved or commercially available. It is currently being used for research purposes only. Olaparib is FDA approved and commercially available for the treatment of ovarian cancer that has a certain type of genetic mutation (change). It is considered investigational to use selumetinib in combination with olaparib to treat advanced or recurrent cancer.

The study doctor can explain how the study drugs are designed to work. Up to 90 participants will be enrolled in this study. All will take part at MD Anderson.

Study Groups:

If you are found to be eligible to take part in this study, you will be assigned to a phase depending on when you join the study. Up to 30 participants will be enrolled in Phase 1, and up to 60 participants will be enrolled in Phase 2.

If you are enrolled in Phase 1, the dose of the study drugs you receive will depend on when you join this study. Up to 3 dose level combinations of selumetinib and olaparib will be tested. The first group of participants will receive the lowest dose level of each study drugs. Each new group will receive a higher dose of either selumetinib or olaparib study drugs than the group before it, if no intolerable side effects were seen. This will continue until the highest tolerable dose combination of the study drugs is found.

If you are enrolled in Phase 2, you will receive the highest study drug combination that was tolerated in Phase 1.

Study Drug Administration:

Each study cycle is 28 days.

You will take both selumetinib and olaparib by mouth 2 times each day, about 12 hours apart (1 dose in the morning, 1 dose in the evening). You should fast (have nothing to eat or drink except water) for at least 2 hours before and 1 hour after your dose. If you vomit or miss a dose, you should not retake the dose. Wait and take your next scheduled dose.

Depending on the dose level of selumetinib you are receiving, you may only take the study drug on Days 1-5 of each week. The study doctor will tell you how often you should take selumetinib.

You will be given a study drug diary to record when you take each dose. The study staff will show you how to fill it out.

You will wait to take your morning dose of study drugs at the clinic on certain days. The study staff will remind you before each of these clinic visits.

Length of Treatment:

You may continue to receive the study drugs for as long as the study doctor thinks it is in your best interest. You will no longer be able to receive the study drugs if the disease gets worse, if intolerable side effects occur, or if you are unable to follow study directions.

Your active participation on the study will be over after the 30-day follow-up visit; however, you will be contacted by phone every 3 months to check on you and the status of the disease.

Study Visits:

On Days 1 and 15 of Cycle 1:

* You will have a physical exam
* Blood (about 3 tablespoons) will be drawn for routine and PD testing.
* If you are in Phase 1, part of this sample on Day 1 will be used for pharmacokinetic (PK) testing. PK testing measures the amount of study drug in the body at different time points.
* If you are in Phase 2, part of this sample will be used for tumor marker testing.
* You will have an EKG.
* On Day 15, if you are in Phase 2, you will have a tumor biopsy for PD testing, including genetic testing.

On Day 8 of Cycle 1:

* You will have a physical exam.
* Blood (about 3 tablespoons) will be drawn for routine and PD tests. If you are in Phase 2, part of this sample will be used for tumor marker testing.
* You will have an EKG.

On Day 22 of Cycle 1:

* You will have a physical exam.
* Blood (about 3 tablespoons) will be drawn for routine and PD tests. If you are in Phase 2 and have endometrial or ovarian cancer, part of this blood will be used for tumor marker testing.

On Day 1 of Cycle 2:

* You will have a physical exam.
* You will have an eye exam.
* Blood (about 3 tablespoons) will be drawn for routine and PD tests.
* If you are in Phase 1, part of this blood will be used for PK testing.
* If you are in Phase 2, part of this blood will be used for tumor marker testing.

On Day 26 of Cycle 2, you will have an MRI or a CT scan.

On Day 1 of Cycles 3 and beyond:

* You will have a physical exam
* Blood (about 3 tablespoons) will be drawn for routine and PD tests. If you are in Phase 2, part of this blood will be used for tumor marker testing.

Starting on Day 1 of Cycle 4 and every 3 cycles after that, you will have an ECHO.

During Cycles 4 and 6 and then every 3 cycles after that (Cycles 9, 12, 15, and so on), you will have MRI or a CT scan.

At any time the study doctor thinks it is needed, you may have some or all of these tests repeated to check on your health.

End-of-Treatment Visit:

Within 7 days after your last dose of study drugs:

* You will have a physical exam.
* Blood (about 3 tablespoons) will be drawn for routine and PD tests.
* If it has been more than 28 days since the last scan, you will have an MRI or CT scan.

Follow-Up:

About 30 days after your last study drug dose:

* You will have a physical exam.
* Blood (about 2 tablespoons) will be drawn for routine tests.

You may be called by a member of the study staff every 3 months to ask how you are doing and if you have had any side effects. This call should last about 5-10 minutes.

Selumetinib and Olaparib in Solid Tumors

Evaluation of the Combination of Selumetinib and Olaparib in Endometrial, Ovarian and Other Solid Tumors With Ras Pathway Alterations, and Ovarian Tumors With PARP Resistance

MTD defined by dose limiting toxicities (DLTs) that occur during the first 4 weeks of therapy and are related to the study medications. Grading of DLTs follow the guidelines provided in the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03.

Samples for determination of drug concentration in selumetinib and olaparib analyzed using an appropriate bioanalytical method.

Two sample t-test with a 2-sided significance level of 0.05 used to compare baseline expression values with differing treatment responses.

We will tabulate tumor response and objective response rate (ORR), as well as clinical benefit rate (objective response or stable disease for 4 months) with 95% confidence intervals. We will estimate the median PFS with a 95% confidence interval. All outcomes will first be evaluated in each expansion cohort separately, and then will be evaluated in a combined analysis that includes all expansion cohort patients.

Spots Global Cancer Trial Database for ras pathway alterations