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Talazoparib and Temozolomide in Treating Younger Patients With Refractory or Recurrent Malignancies

A Phase 1/2 Study of BMN 673, an Oral Poly(ADP-Ribose) Polymerase Inhibitor, Plus Temozolomide in Children With Refractory or Recurrent Malignancies

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02116777
Enrollment
40
Registered
2014-04-17
Start date
2014-05-16
Completion date
2018-12-31
Last updated
2021-03-26

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Adult Solid Neoplasm, Childhood Solid Neoplasm, Recurrent Childhood Central Nervous System Neoplasm, Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor, Recurrent Malignant Solid Neoplasm, Refractory Central Nervous System Neoplasm

Brief summary

This phase I/II trial studies the side effects and best dose of talazoparib and temozolomide and to see how well they work in treating younger patients with tumors that have not responded to previous treatment (refractory) or have come back (recurrent). Talazoparib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving talazoparib together with temozolomide may work better in treating younger patients with refractory or recurrent malignancies.

Detailed description

PRIMARY OBJECTIVES: I. To estimate the maximum tolerated dose (MTD) and/or recommended phase 2 dose (RP2D) of temozolomide when combined with a dose of talazoparib (BMN 673) given once daily for 5 days after a one day dose of BMN 673 administered orally (either once daily or twice daily), every 28 days to children with refractory or recurrent solid tumors. (Phase I) II. To define and describe the toxicities of BMN 673 given with temozolomide administered on this schedule. (Phase I) III. To characterize the pharmacokinetics of BMN 673 and temozolomide when given in combination to children with refractory or recurrent cancer. (Phase I) IV. To define the antitumor activity of BMN 673 when given with temozolomide in recurrent/refractory Ewing sarcoma.(Phase II) SECONDARY OBJECTIVES: I. To preliminarily define the antitumor activity of BMN 673 and temozolomide in pediatric patients with recurrent or refractory solid tumors within the confines of a phase I study. II. To explore possible predictive biomarkers in archival tumor tissue from Ewing sarcoma patients in Phase II. OUTLINE: This is a phase I, dose-escalation study followed by a phase II study. Patients receive talazoparib orally (PO) once daily (QD) or twice daily (BID) on days 1-6 and temozolomide PO QD on days 2-6. Treatment repeats every 28 days for up to 24 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 30 days.

Interventions

OTHERLaboratory Biomarker Analysis

Correlative studies

OTHERPharmacological Study

Correlative studies

DRUGTalazoparib

Given PO

DRUGTemozolomide

Given PO

Sponsors

National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
13 Months to 30 Years
Healthy volunteers
No

Inclusion criteria

* Age: * Phase 1 (Part A) * Patients must be \> than 12 months and =\< 21 years of age at the time of study enrollment * Phase 2 (Part B) * Patients must be \> than 12 months and =\< 30 years of age at the time of study enrollment * Body surface area (for Parts A and B): * Patients must have a body surface area (BSA) of \>= 0.42 m\^2 at the time of study enrollment * Diagnosis: * Phase 1 (Part A) * Solid tumors (Part A1): patients with relapsed or refractory solid tumors including central nervous system (CNS) tumors without bone marrow involvement are eligible; patients must have had histologic verification of malignancy at original diagnosis or relapse except in patients with intrinsic brain stem tumors, optic pathway gliomas, or patients with pineal tumors and elevations of cerebrospinal fluid (CSF) or serum tumor markers including alpha-fetoprotein or beta-human chorionic gonadotropin (HCG) * Ewing sarcoma or peripheral primitive neuroectodermal tumor (PNET) (Part A2): patients with relapsed or refractory Ewing sarcoma or peripheral PNET without bone marrow involvement will be eligible for Part A2 if there are no available slots on Part A1; these patients will be enrolled at one dose level below the dose level at which patients on Part A1 are actively enrolling, or at the starting dose level (dose level 1) if dose escalation has not yet occurred; patients must have had histologic verification of malignancy at original diagnosis or relapse * Phase 2 (Part B) * Ewing sarcoma or peripheral PNET: patients with relapsed or refractory Ewing sarcoma or peripheral PNET are eligible; patients must have had histologic verification of malignancy at original diagnosis or relapse * Phase 2 (Part C) * Disease status: * Phase 1 (Part A): * Patients must have either measurable or evaluable disease * Phase 2 (Part B): * Ewing sarcoma or peripheral PNET: patients must have measurable disease * Therapeutic options: patient's current disease state must be one for which there is no known curative therapy or therapy proven to prolong survival with an acceptable quality of life * Karnofsky \>= 50% for patients \> 16 years of age and Lansky \>= 50 for patients =\< 16 years of age; Note: neurologic deficits in patients with CNS tumors must have been relatively stable for at least 7 days prior to study enrollment; patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score * Patients who have received prior therapy with a temozolomide-based regimen are eligible; Note: patients who have progressed on a poly adenosine diphosphate ribose polymerase (PARP) inhibitor and temozolomide regimen are not eligible for Part A of the study * Patients must have fully recovered from the acute toxic effects of all prior anti-cancer chemotherapy * Myelosuppressive chemotherapy: * Solid tumors (Part A and Part B): at least 21 days after the last dose of myelosuppressive chemotherapy (42 days if prior nitrosourea) * Hematopoietic growth factors: at least 14 days after the last dose of a long-acting growth factor (e.g. Neulasta) or 7 days for short-acting growth factor; for agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur; the duration of this interval must be discussed with the study chair * Biologic (anti-neoplastic agent): at least 7 days after the last dose of a biologic agent; for agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur; the duration of this interval must be discussed with the study chair * Immunotherapy: at least 42 days after the completion of any type of immunotherapy, e.g. tumor vaccines * Monoclonal antibodies: at least 3 half-lives of the antibody after the last dose of a monoclonal antibody * Radiation therapy (XRT): at least 14 days after local palliative XRT (small port); at least 42 days must have elapsed if other substantial bone marrow (BM) radiation; patients with prior total body irradiation (TBI), craniospinal XRT and/or \>= 50% radiation of the pelvis are not eligible * Stem cell infusion without TBI: no evidence of active graft vs. host disease and at least 84 days must have elapsed after transplant or stem cell infusion * PARP inhibitor exposure: * Part A: Patients who have received prior therapy with a PARP inhibitor, with the exception of BMN 673, are eligible; however, patients who have progressed on a PARP inhibitor and temozolomide regimen are not eligible * Part B: Patients who have previously been exposed to a PARP inhibitor are not eligible * For patients with solid tumors without known bone marrow involvement: peripheral absolute neutrophil count (ANC) \>= 1000/mm\^3 * For patients with solid tumors without known bone marrow involvement: platelet count \>= 100,000/mm\^3 (transfusion independent, defined as not receiving platelet transfusions for at least 7 days prior to enrollment) * For patients with solid tumors without known bone marrow involvement: hemoglobin \>= 8.0 g/dL (may receive red blood cell \[RBC\] transfusions) * All patients enrolled on Part A of the study must be evaluable for hematologic toxicity * Patients on Part B of the study with known bone marrow metastatic disease will be eligible for the study provided they meet the blood counts (may receive transfusions provided they are not known to be refractory to red cell or platelet transfusions); these patients will not be evaluable for hematologic toxicity * Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 ml/min/1.73 m\^2 or a maximum serum creatinine (mg/dL) based on age/gender as follows: * 1 to \< 2 years: 0.6 * 2 to \< 6 years: 0.8 * 6 to \< 10 years: 1 * 10 to \< 13 years: 1.2 * 13 to \< 16 years: 1.5 for males, 1.4 for females * \>= 16 years: 1.7 for males, 1.4 for females * Patients on Part A and Part B: bilirubin (sum of conjugated + unconjugated) =\< 1.5 x upper limit of normal (ULN) for age * Patients on Part A and Part B: serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\]) =\< 110 U/L; for the purpose of this study, the ULN for SGPT is 45 U/L * Patients on Part A and Part B: serum albumin \>= 2 g/dL * All patients and/or their parents or legally authorized representatives must sign a written informed consent; assent, when appropriate, will be obtained according to institutional guidelines * For patients enrolling on Part B: tissue blocks or slides must be sent; if tissue blocks or slides are unavailable, the Study Chair must be notified prior to enrollment

Exclusion criteria

* Pregnant or breast-feeding women will not be entered on this study; pregnancy tests must be obtained in girls who are post-menarchal; males or females of reproductive potential may not participate unless they have agreed to use an effective contraceptive method * Patients receiving corticosteroids who have not been on a stable or decreasing dose of corticosteroid for at least 7 days prior to enrollment are not eligible * Patients who are currently receiving another investigational drug are not eligible * Patients who are currently receiving other anti-cancer agents are not eligible (except leukemia patients receiving hydroxyurea, which may be continued until 24 hours prior to start of protocol therapy); patients with acute lymphoblastic leukemia may receive intrathecal therapy * Patients who are receiving cyclosporine, tacrolimus or other agents to prevent graft-versus-host disease post bone marrow transplant are not eligible for this trial * Patients must be able to swallow capsules whole * Patients who have an uncontrolled infection are not eligible * Patients who have received a prior solid organ transplantation are not eligible * Patients with prior TBI, craniospinal XRT and/or those with \>= 50% radiation of the pelvis are not eligible * Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study are not eligible * Patients with known hypersensitivity to temozolomide or dacarbazine are not eligible * Phase 1 (Part A): patients who have progressed on a PARP inhibitor and temozolomide regimen are not eligible * Phase 2 (Part B): patients who have previously been exposed to a PARP inhibitor are not eligible * Phase 1 (Part A): patients with known bone marrow involvement are not eligible

Design outcomes

Primary

MeasureTime frameDescription
Number of Ewing/Peripheral PNET Participants in Phase 2 With Complete Response (CR) or Partial Response (PR)Up to 24 monthsFrequency of Ewing sarcoma and peripheral PNET participants with Complete Response (CR) or Partial Response (PR) per the Response Evaluation Criteria In Solid Tumors (RECIST)
The Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy28 daysThe Maximum Tolerated Dose (MTD) reflects the highest dose of Talazoparib (BMN 673) when combined with a dose of temozolomide that did not cause a Grade 3 or higher toxicity in children with refractory or recurrent solid tumors.
All Cycle 1 Toxicities >=Grade 3Up to 28 daysThe number of patients with at least one toxicity (DLT or non-DLT) in cycle 1 that is at least possibly attributable to study agent
T Max of TalazoparibCycle 1 Day 1 pre-dose, and 1, 2, 4, 8 and 24 hours after the first talazoparib dose.Median with minimum and maximum for the time at which the maximum (peak) serum concentration occurs.
C Max of TalazoparibCycle 1 Day 1 pre-dose, and 1, 2, 4, 8 and 24 hours after the first talazoparib dose.Median with minimum and maximum for the time at which the maximum (peak) serum concentration occurs.
AUC of TalazoparibCycle 1 Day 1 pre-dose, and 1, 2, 4 and 8 hours after the first talazoparib doseMedian with minimum and maximum for the area under the drug concentration over time curve.
Accumulation Half-life of Talazoparib in Combination With Temozolomide.Cycle 1 Day 1 pre-dose, and 1, 2, 4 and 8 hours after the first talazoparib dose. Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib doseMedian with minimum and maximum for the time required for the serum concentration to fall to 50% of its starting dose.
T Max of Talazoparib in Combination With TemozolomideCycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib doseMedian with minimum and maximum for the time at which the maximum (peak) serum concentration occurs.
C Max of Talazoparib in Combination With TemozolomideCycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib doseMedian with minimum and maximum for the time at which the maximum (peak) serum concentration occurs.
AUC of Talazoparib in Combination With TemozolomideCycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib doseMedian with minimum and maximum area under the drug concentration over time curve
Clearance of Talazoparib in Combination With TemozolomideCycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib doseMedian with minimum and maximum for the rate of elimination of the drug.
Accumulation Ratio of Talazoparib in Combination With TemozolomideCycle 1 Day 1 pre-dose, and 1, 2, 4 and 8 hours after the first talazoparib dose. Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib doseMedian with minimum and maximum of the accumulation ratio.
Half-life of Temozolomide in Combination With TalazoparibCycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the temozolomide doseMedian with minimum and maximum for the time required for the serum concentration to fall to 50% of its starting dose.
T Max of Temozolomide in Combination With TalazoparibCycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the temozolomide doseMedian with minimum and maximum for the time at which the maximum (peak) serum concentration occurs.
C Max of Temozolomide in Combination With TalazoparibCycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the temozolomide doseMedian with minimum and maximum for the maximum (peak) serum concentration.
AUC of Temozolomide in Combination With TalazoparibCycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the temozolomide dose.Median with minimum and maximum for the area under the drug concentration over time curve.
Clearance of Temozolomide in Combination With TalazoparibCycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the temozolomide doseMedian with minimum and maximum for the rate of elimination of the drug.

Secondary

MeasureTime frameDescription
Number of Solid Tumor Patients With Complete Response (CR) or Partial Response (PR)Up to 24 monthsFrequency of solid tumor participants with Complete Response (CR) or Partial Response (PR) per the Response Evaluation Criteria In Solid Tumors (RECIST)

Countries

United States

Participant flow

Pre-assignment details

Patients receive talazoparib PO QD or BID on days 1-6 and temozolomide PO QD on days 2-6. Treatment repeats every 28 days for up to 24 courses in the absence of disease progression or unacceptable toxicity.

Participants by arm

ArmCount
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/Day
Phase 1: Part A Part A1: Patients with relapsed or refractory solid tumors and CNS tumors Part A2: Patients with relapsed or refractory Ewing sarcoma or Peripheral PNET
3
400 mcg/m²/Dose BMN 673 BID+20mg/m²/Dose TEM,Max 800 mcg/Day
Phase 1: Part A Part A1: Patients with relapsed or refractory solid tumors and CNS tumors Part A2: Patients with relapsed or refractory Ewing sarcoma or Peripheral PNET
3
600 mcg/m²/Dose BMN 673 BID+20mg/m²/Dose TEM,Max 1000 mcg/Day
Phase 1: Part A Part A1: Patients with relapsed or refractory solid tumors and CNS tumors Part A2: Patients with relapsed or refractory Ewing sarcoma or Peripheral PNET
3
600 mcg/m²/Dose BMN 673 BID+30mg/m²/Dose TEM, Max 1000 mcg/Day
Phase 1: Part A Part A1: Patients with relapsed or refractory solid tumors and CNS tumors Part A2: Patients with relapsed or refractory Ewing sarcoma or Peripheral PNET
13
600 mcg/m²/Dose BMN 673 BID+40mg/m²/Dose TEM, Max 1000 mcg/Day
Phase 1: Part A Part A1: Patients with relapsed or refractory solid tumors and CNS tumors Part A2: Patients with relapsed or refractory Ewing sarcoma or Peripheral PNET
6
600 mcg/m²/doseBMN 673 BID+55mg/m²/Dose TEM, Max 1000 mcg/Day
Phase 1: Part A Part A1: Patients with relapsed or refractory solid tumors and CNS tumors Part A2: Patients with relapsed or refractory Ewing sarcoma or Peripheral PNET
3
600 mcg/m²/Dose BMN 673 BID+30mg/m²/Dose TEM,Max 1000 mcg/Day
Phase 2: Part B Part B: Patients with relapsed or refractory Ewing sarcoma or Peripheral PNET (Phase 2)
9
Total40

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005FG006
Overall StudyAdverse Event0000220
Overall StudyDeath0001000
Overall StudyLack of Efficacy3338419
Overall StudyPhysician Decision0002000
Overall StudyProtocol Violation0001000
Overall StudyWithdrawal by Subject0001000

Baseline characteristics

Characteristic400 mcg/m²/Dose BMN 673 BID+20mg/m²/Dose TEM,Max 800 mcg/Day600 mcg/m²/Dose BMN 673 BID+20mg/m²/Dose TEM,Max 1000 mcg/Day600 mcg/m²/Dose BMN 673 BID+30mg/m²/Dose TEM, Max 1000 mcg/Day600 mcg/m²/Dose BMN 673 BID+40mg/m²/Dose TEM, Max 1000 mcg/Day600 mcg/m²/doseBMN 673 BID+55mg/m²/Dose TEM, Max 1000 mcg/Day600 mcg/m²/Dose BMN 673 BID+30mg/m²/Dose TEM,Max 1000 mcg/Day400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayTotal
Age, Categorical
<=18 years
2 Participants3 Participants12 Participants5 Participants3 Participants3 Participants2 Participants30 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
1 Participants0 Participants1 Participants1 Participants0 Participants6 Participants1 Participants10 Participants
Age, Continuous16 Years14 Years13 Years13.5 Years12 Years22 Years18 Years15.5 Years
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants1 Participants2 Participants0 Participants0 Participants1 Participants0 Participants6 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
1 Participants2 Participants11 Participants6 Participants2 Participants7 Participants3 Participants32 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants1 Participants1 Participants0 Participants2 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants1 Participants1 Participants0 Participants0 Participants0 Participants0 Participants2 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants2 Participants1 Participants0 Participants0 Participants1 Participants4 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants3 Participants0 Participants1 Participants1 Participants0 Participants5 Participants
Race (NIH/OMB)
White
3 Participants2 Participants7 Participants5 Participants2 Participants8 Participants2 Participants29 Participants
Sex: Female, Male
Female
1 Participants1 Participants3 Participants4 Participants2 Participants4 Participants1 Participants16 Participants
Sex: Female, Male
Male
2 Participants2 Participants10 Participants2 Participants1 Participants5 Participants2 Participants24 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
EG006
affected / at risk
deaths
Total, all-cause mortality
0 / 30 / 30 / 32 / 131 / 60 / 30 / 9
other
Total, other adverse events
3 / 33 / 33 / 313 / 136 / 63 / 39 / 9
serious
Total, serious adverse events
2 / 32 / 32 / 311 / 136 / 63 / 38 / 9

Outcome results

Primary

Accumulation Half-life of Talazoparib in Combination With Temozolomide.

Median with minimum and maximum for the time required for the serum concentration to fall to 50% of its starting dose.

Time frame: Cycle 1 Day 1 pre-dose, and 1, 2, 4 and 8 hours after the first talazoparib dose. Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib dose

Population: Pharmacokinetic (PK) studies were completed for all but 4 patients in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayAccumulation Half-life of Talazoparib in Combination With Temozolomide.46.8 Hours
Primary

Accumulation Ratio of Talazoparib in Combination With Temozolomide

Median with minimum and maximum of the accumulation ratio.

Time frame: Cycle 1 Day 1 pre-dose, and 1, 2, 4 and 8 hours after the first talazoparib dose. Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib dose

Population: Pharmacokinetic (PK) studies were completed for all but 4 patients in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayAccumulation Ratio of Talazoparib in Combination With Temozolomide3.34 Ratio
Primary

All Cycle 1 Toxicities >=Grade 3

The number of patients with at least one toxicity (DLT or non-DLT) in cycle 1 that is at least possibly attributable to study agent

Time frame: Up to 28 days

Population: Patients with toxicity grade 3 or above.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayAll Cycle 1 Toxicities >=Grade 30 Participants
400 mcg/m²/Dose BMN 673 BID+20mg/m²/Dose TEM,Max 800 mcg/DayAll Cycle 1 Toxicities >=Grade 30 Participants
600 mcg/m²/Dose BMN 673 BID+20mg/m²/Dose TEM,Max 1000 mcg/DayAll Cycle 1 Toxicities >=Grade 32 Participants
600 mcg/m²/Dose BMN 673 BID+30mg/m²/Dose TEM, Max 1000 mcg/DayAll Cycle 1 Toxicities >=Grade 37 Participants
600 mcg/m²/Dose BMN 673 BID+40mg/m²/Dose TEM, Max 1000 mcg/DayAll Cycle 1 Toxicities >=Grade 35 Participants
600 mcg/m²/doseBMN 673 BID+55mg/m²/Dose TEM, Max 1000 mcg/DayAll Cycle 1 Toxicities >=Grade 33 Participants
600 mcg/m²/Dose BMN 673 BID+30 mg/m²/Dose TEM,Max 1000 mcg/DayAll Cycle 1 Toxicities >=Grade 35 Participants
Primary

AUC of Talazoparib

Median with minimum and maximum for the area under the drug concentration over time curve.

Time frame: Cycle 1 Day 1 pre-dose, and 1, 2, 4 and 8 hours after the first talazoparib dose

Population: Pharmacokinetic (PK) studies were completed for all but 4 patients in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayAUC of Talazoparib17.55 h•µg/L
Primary

AUC of Talazoparib in Combination With Temozolomide

Median with minimum and maximum area under the drug concentration over time curve

Time frame: Cycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib dose

Population: Pharmacokinetic (PK) studies were completed for all but 3 patients in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayAUC of Talazoparib in Combination With Temozolomide173.08 h•µg/L
Primary

AUC of Talazoparib in Combination With Temozolomide

Median with minimum and maximum area under the drug concentration over time curve

Time frame: Cycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib dose

Population: Pharmacokinetic (PK) studies were completed for all but 3 patients in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayAUC of Talazoparib in Combination With Temozolomide82.08 h•µg/L
Primary

AUC of Temozolomide in Combination With Talazoparib

Median with minimum and maximum for the area under the drug concentration over time curve.

Time frame: Cycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the temozolomide dose.

Population: Pharmacokinetic (PK) studies were completed for all but 1 patient in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayAUC of Temozolomide in Combination With Talazoparib4352.16 h•µg/L
Primary

Clearance of Talazoparib in Combination With Temozolomide

Median with minimum and maximum for the rate of elimination of the drug.

Time frame: Cycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib dose

Population: Pharmacokinetic (PK) studies were completed for all but 3 patients in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayClearance of Talazoparib in Combination With Temozolomide3.08 L/hr/m²
Primary

Clearance of Temozolomide in Combination With Talazoparib

Median with minimum and maximum for the rate of elimination of the drug.

Time frame: Cycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the temozolomide dose

Population: Pharmacokinetic (PK) studies were completed for all but 1 patient in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayClearance of Temozolomide in Combination With Talazoparib6.49 L/hr/m²
Primary

C Max of Talazoparib

Median with minimum and maximum for the time at which the maximum (peak) serum concentration occurs.

Time frame: Cycle 1 Day 1 pre-dose, and 1, 2, 4, 8 and 24 hours after the first talazoparib dose.

Population: Pharmacokinetic (PK) studies were completed for all but 3 patients in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayC Max of Talazoparib4670 ng/mL
Primary

C Max of Talazoparib in Combination With Temozolomide

Median with minimum and maximum for the time at which the maximum (peak) serum concentration occurs.

Time frame: Cycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib dose

Population: Pharmacokinetic (PK) studies were completed for all but 3 patients in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayC Max of Talazoparib in Combination With Temozolomide16450 pg/ml
Primary

C Max of Temozolomide in Combination With Talazoparib

Median with minimum and maximum for the maximum (peak) serum concentration.

Time frame: Cycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the temozolomide dose

Population: Pharmacokinetic (PK) studies were completed for all but 1 patient in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayC Max of Temozolomide in Combination With Talazoparib1234.1 ng/mL
Primary

Half-life of Temozolomide in Combination With Talazoparib

Median with minimum and maximum for the time required for the serum concentration to fall to 50% of its starting dose.

Time frame: Cycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the temozolomide dose

Population: Pharmacokinetic (PK) studies were completed for all but 1 patient in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayHalf-life of Temozolomide in Combination With Talazoparib1.74 Hours
Primary

Number of Ewing/Peripheral PNET Participants in Phase 2 With Complete Response (CR) or Partial Response (PR)

Frequency of Ewing sarcoma and peripheral PNET participants with Complete Response (CR) or Partial Response (PR) per the Response Evaluation Criteria In Solid Tumors (RECIST)

Time frame: Up to 24 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayNumber of Ewing/Peripheral PNET Participants in Phase 2 With Complete Response (CR) or Partial Response (PR)0 Participants
Primary

The Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy

The Maximum Tolerated Dose (MTD) reflects the highest dose of Talazoparib (BMN 673) when combined with a dose of temozolomide that did not cause a Grade 3 or higher toxicity in children with refractory or recurrent solid tumors.

Time frame: 28 days

Population: Patients with toxicity grade 3 or above.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayThe Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy0 Participants
400 mcg/m²/Dose BMN 673 BID+20mg/m²/Dose TEM,Max 800 mcg/DayThe Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy0 Participants
600 mcg/m²/Dose BMN 673 BID+20mg/m²/Dose TEM,Max 1000 mcg/DayThe Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy1 Participants
600 mcg/m²/Dose BMN 673 BID+30mg/m²/Dose TEM, Max 1000 mcg/DayThe Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy2 Participants
600 mcg/m²/Dose BMN 673 BID+40mg/m²/Dose TEM, Max 1000 mcg/DayThe Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy2 Participants
600 mcg/m²/doseBMN 673 BID+55mg/m²/Dose TEM, Max 1000 mcg/DayThe Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy2 Participants
600 mcg/m²/Dose BMN 673 BID+30 mg/m²/Dose TEM,Max 1000 mcg/DayThe Number of Participants With Dose Limiting Toxicities to Determine the Maximum Tolerated Dose of Temozolomide and Talazoparib Combination Therapy0 Participants
Primary

T Max of Talazoparib

Median with minimum and maximum for the time at which the maximum (peak) serum concentration occurs.

Time frame: Cycle 1 Day 1 pre-dose, and 1, 2, 4, 8 and 24 hours after the first talazoparib dose.

Population: Pharmacokinetic (PK) studies were completed for all but 3 patients in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayT Max of Talazoparib2 Hours
Primary

T Max of Talazoparib in Combination With Temozolomide

Median with minimum and maximum for the time at which the maximum (peak) serum concentration occurs.

Time frame: Cycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the talazoparib dose

Population: Pharmacokinetic (PK) studies were completed for all but 3 patients in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayT Max of Talazoparib in Combination With Temozolomide1.04 Hours
Primary

T Max of Temozolomide in Combination With Talazoparib

Median with minimum and maximum for the time at which the maximum (peak) serum concentration occurs.

Time frame: Cycle 1 Day 5 or 6 pre-dose, and 1, 2, 4 and 8 hours after the temozolomide dose

Population: Pharmacokinetic (PK) studies were completed for all but 1 patient in Phase 1. PK analysis was performed regardless of dose level as pre-specified in the protocol. PK was not performed in Phase 2

ArmMeasureValue (MEDIAN)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayT Max of Temozolomide in Combination With Talazoparib1.03 Hours
Secondary

Number of Solid Tumor Patients With Complete Response (CR) or Partial Response (PR)

Frequency of solid tumor participants with Complete Response (CR) or Partial Response (PR) per the Response Evaluation Criteria In Solid Tumors (RECIST)

Time frame: Up to 24 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
400 mcg/m²/Dose BMN 673 QD+20mg/m²/Dose TEM,Max 800 mcg/DayNumber of Solid Tumor Patients With Complete Response (CR) or Partial Response (PR)1 Participants

Source: ClinicalTrials.gov · Data processed: Feb 26, 2026