Advanced Solid Neoplasms
Conditions
Brief summary
This study will evaluate the efficacy and safety of olaparib (MK-7339) monotherapy in participants with multiple types of advanced cancer (unresectable and/or metastatic) that: 1) have progressed or been intolerant to standard of care therapy; and 2) are positive for homologous recombination repair mutation (HRRm) or homologous recombination deficiency (HRD).
Interventions
Olaparib 300 mg administered BID as two, 150 mg oral tablets.
Sponsors
Study design
Intervention model description
Multiple biomarker-defined cohorts
Eligibility
Inclusion criteria
* For all participants: * Has measurable disease per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) or Prostate Cancer Working Group (PCWG)-modified RECIST 1.1 as assessed by the local site Investigator/radiology and confirmed by Blinded independent central review (BICR). * Is able to provide a newly obtained core or excisional biopsy of a tumor lesion or either an archival formalin-fixed paraffin embedded (FFPE) tumor tissue block or slides. * Has a life expectancy of at least 3 months. * Has an Eastern Cooperative Oncology Group (ECOG) performance status of either 0 or 1, as assessed within 7 days of treatment initiation. * Male participants must agree to use contraception during the treatment period and for at least 95 days (3 months and 5 days) after the last dose of study treatment and refrain from donating sperm during this period. * A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies: 1. Is not a woman of childbearing potential (WOCBP). 2. Is a WOCBP and using a contraceptive method that is highly effective with low user dependency, or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis), during the intervention period and for at least 180 days after the last dose of study intervention, AND agrees not to donate eggs (ova, oocytes) to others or freeze/store for her own use for the purpose of reproduction during this period. Abstains from breastfeeding during the study intervention period and for at least 30 days after the last dose of study intervention. * Has adequate organ function. * For participants who have non-breast or ovarian cancers that are breast cancer susceptibility gene 1/2 (BRCA1/2) mutated (BRCAm), or who have cancers that are homologous recombination repair mutated (HRRm) but BRCA1/2 non-mutated, or homologous recombination repair non-mutated but homologous recombination deficiency (HRD) positive as centrally-confirmed by the Lynparza HRR-HRD Assay: * Has a histologically- or cytologically-confirmed advanced (metastatic and/or unresectable) solid tumor (except ovarian cancer whose tumor has a germline or somatic BRCA mutation and breast cancer whose tumor has a germline BRCA mutation) that is not eligible for curative treatment and for which standard of care therapy has failed. Participants must have progressed on or be intolerant to standard of care therapies that are known to provide clinical benefit. There is no limit on the number of prior treatment regimens. * For participants receiving prior platinum (cisplatin, carboplatin, or oxaliplatin either as monotherapy or in combination) for advanced (metastatic and/or unresectable) solid tumor, have no evidence of disease progression during the platinum chemotherapy or ≤4 weeks of completing the platinum-containing regimen. * For participants who have somatic BRCAm breast cancer: * Has histologically- or cytologically-confirmed breast cancer with evidence of metastatic disease. * Has a known or suspected deleterious mutation in breast cancer susceptibility gene (BRCA) 1 or BRCA2 and does not harbor a germline BRCA1 or BRCA2 mutation - testing can be done centrally or locally. Blood and tissue samples must be provided by all participants. * Has received treatment with an anthracycline unless contraindicated and a taxane in either the neoadjuvant/adjuvant or metastatic setting. * Participants with estrogen and/or progesterone receptor-positive disease must have received and progressed on at least one endocrine therapy (adjuvant or metastatic), or have disease that the treating physician believes to be inappropriate for endocrine therapy.
Exclusion criteria
* Has a known additional malignancy that is progressing or has required active treatment in the last 5 years. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, ductal carcinoma in situ, or cervical carcinoma in situ that has undergone potentially curative therapy are not excluded. * Has myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) or with features suggestive of MDS/AML. * Has known central nervous system (CNS) metastases and/or carcinomatous meningitis. Note: Participants with previously treated brain metastases may participate if radiologically stable, clinically stable, and without requirement for steroid treatment for at least 14 days prior to the first dose of study treatment. * Has received colony-stimulating factors (e.g., granulocyte colony-stimulating factor \[G-CSF\], granulocyte-macrophage colony-stimulating factor \[GM-CSF\] or recombinant erythropoietin) within 28 days prior to the first dose of study treatment. * Has a known history of human immunodeficiency virus (HIV) infection. * Has known active hepatitis infection (i.e., Hepatitis B or C). * Is unable to swallow orally administered medication or has a gastrointestinal disorder affecting absorption (e.g., gastrectomy, partial bowel obstruction, malabsorption). * Has received prior therapy with olaparib or with any other polyadenosine 5' diphosphoribose (poly\[ADP ribose\]) polymerization (PARP) inhibitor. * Has a known hypersensitivity to the components or excipients in olaparib. * Has received previous allogenic bone-marrow transplant or double umbilical cord transplantation (dUCBT). * Has received a whole blood transfusion in the last 120 days prior to entry to the study. Packed red blood cells and platelet transfusions are acceptable if not performed within 28 days of the first dose of study treatment. * Has received any anti-neoplastic systemic chemotherapy or biological therapy, targeted therapy, or an anticancer hormonal therapy within 3 weeks prior to the first dose of study intervention. * Has a primary cancer of unknown origin. * Has received prior radiotherapy within 2 weeks of start of study intervention. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-CNS disease.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cohorts 1, 2, 3: Objective Response Rate (ORR) as Assessed by Blinded Independent Central Review (BICR) Per Modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) or Prostate Cancer Working Group (PCWG)-Modified RECIST 1.1 | Up to approximately 78 months | ORR was defined as the percentage of participants who have a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) as assessed by the BICR per modified RECIST 1.1. For participants with prostate cancer, response was assessed based on PCWG-modified RECIST 1.1 criteria (CR: soft tissue CR with no evidence of disease \[NED\] on bone scan; PR: soft tissue PR with non-progressive disease, non-evaluable \[NE\], or NED on bone scan, or soft tissue CR with non-progressive disease, or NE bone scan). Per protocol, RECIST 1.1 was modified to follow a maximum of 10 target lesions in total and a maximum of 5 target lesions per organ. The percentage of participants who experienced a CR or PR as assessed by BICR is presented. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cohorts 1, 2, 3: Number of Participants Who Discontinue Study Treatment Due to an AE | Up to approximately 78 months | An AE is any unfavorable and unintended sign, symptom, or disease (new or exacerbated) in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants who discontinue study treatment due to an AE will be reported. |
| Combined Cohort 1+2: OS in Participants Who Are HRD Positive (HRD+) | Up to approximately 78 months | OS was defined as the time from the date of the first dose of study treatment to the date of death due to any cause. Per protocol, the secondary OS outcome measure analysis for HRD+ participants in Cohort 1 (BRCA 1/2) and Cohort 2 \[(HRRm, BRCA Non-mutated); (HRD+, HRR Non-mutated)\] combined, will be presented. Per protocol, Cohort 1 and Cohort 2 will be combined as a pre-specified secondary efficacy analysis. |
| Combined Cohort 1+2: OS in All Combined Cohort 1+2 Participants Regardless of Biomarker Status | Up to approximately 78 months | OS was defined as the time from the date of the first dose of study treatment to the date of death due to any cause. Per protocol, the secondary OS outcome measure analysis for all participants regardless of biomarker status in Cohort 1 (BRCA 1/2) and Cohort 2 \[(HRRm, BRCA Non-mutated); (HRD+, HRR Non-mutated)\] combined, will be presented. Per protocol, Cohort 1 and Cohort 2 will be combined as a pre-specified secondary efficacy analysis. |
| Cohorts 1, 2, 3: Duration of Response (DOR) as Assessed by BICR According to Modified RECIST 1.1 or PCWG-Modified RECIST 1.1 | Up to approximately 78 months | For participants with confirmed CR (disappearance of all target lesions) or PR (≥30% decrease in sum of diameters of target lesions) as assessed by BICR per modified RECIST; or, for participants with prostate cancer, per PCWG-modified RECIST 1.1 (CR: soft tissue CR with NED on bone scan; PR: soft tissue PR with non-progressive disease, NE, or NED on bone scan, or soft tissue CR with non-progressive disease, or NE bone scan) DOR was defined as time from first documented CR or PR to progressive disease (PD) or death. Per protocol, RECIST 1.1 was modified to allow ≤10 target lesions total (up to 5 per organ). Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions and absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also PD. Per PCWG, PD was ≥2 new bone lesions (not tumor flare) persisting ≥6 weeks. DOR is presented. |
| Cohorts 1, 2, 3: Overall Survival (OS) | Up to approximately 78 months | OS was defined as the time from the date of the first dose of study treatment to the date of death due to any cause. OS will be reported for all participants. |
| Cohorts 1, 2, 3: Progression Free Survival (PFS) as Assessed by BICR Per Modified RECIST 1.1 or PCWG-Modified RECIST 1.1 | Up to approximately 78 months | PFS was defined as the time from first dose of study treatment to the first documented progressive disease (PD) as assessed by BICR per modified RECIST 1.1 or PCWG-modified RECIST 1.1 (for participants with prostate cancer), or death due to any cause, whichever occurred first. Per protocol, RECIST 1.1 was modified to allow ≤10 target lesions total (up to 5 per organ). Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions and the sum must also have demonstrated an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. Per PCWG, PD was ≥2 new bone lesions, confirmed to not represent tumor flare, and persistent for ≥6 weeks. The PFS per modified RECIST 1.1/PCWG-modified RECIST 1.1 as assessed by BICR is presented. |
| Combined Cohort 1+2: ORR as Assessed by BICR Per Modified RECIST 1.1 or PCWG-Modified RECIST 1.1 in Participants Who Are HRRm Positive | Up to approximately 78 months | ORR is defined as the percentage of participants who have a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) as assessed by the BICR per modified RECIST 1.1. For participants with prostate cancer, response will be assessed based on PCWG-modified RECIST 1.1 criteria (CR: soft tissue CR with NED on bone scan; PR: soft tissue PR with non-progressive disease, NE, or NED on bone scan, or soft tissue CR with non-progressive disease, or NE bone scan). Per protocol, RECIST 1.1 was modified to follow a maximum of 10 target lesions in total and a maximum of 5 target lesions per organ. Per protocol, the secondary ORR outcome measure analysis for HRRm positive participants in Cohort 1 (BRCA 1/2) \& Cohort 2 \[(HRRm, BRCA Non-mutated); (HRD+, HRR Non-mutated)\] combined, is presented here. Per protocol, Cohort 1 \& 2 were combined as a pre-specified secondary efficacy analysis population. |
| Combined Cohort 1+2: ORR as Assessed by BICR Per Modified RECIST 1.1 or PCWG-Modified RECIST 1.1 In Participants Who Are HRD Positive (HRD+) | Up to approximately 78 months | ORR is defined as the percentage of participants who have a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) as assessed by the BICR per modified RECIST 1.1. For participants with prostate cancer, response will be assessed based on PCWG-modified RECIST 1.1 criteria (CR: soft tissue CR with NED on bone scan; PR: soft tissue PR with non-progressive disease, NE, or NED on bone scan, or soft tissue CR with non-progressive disease, or NE bone scan). Per protocol, RECIST 1.1 was modified to follow a maximum of 10 target lesions in total and a maximum of 5 target lesions per organ. Per protocol, the secondary ORR outcome measure analysis for HRD+ participants in Cohort 1 (BRCA 1/2) and Cohort 2 \[(HRRm, BRCA Non-mutated); (HRD+, HRR Non-mutated)\] combined, is presented here. Per protocol, Cohort 1 and Cohort 2 were combined as a pre-specified secondary efficacy analysis population. |
| Combined Cohort 1+2: ORR as Assessed by BICR Per Modified RECIST 1.1 or PCWG-Modified RECIST 1.1 in All Combined Cohort 1+2 Participants Regardless of Biomarker Status | Up to approximately 78 months | ORR is defined as the percentage of participants who have a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) as assessed by the BICR per modified RECIST 1.1. For participants with prostate cancer, response will be assessed based on PCWG-modified RECIST 1.1 criteria (CR: soft tissue CR with no evidence of disease \[NED\] on bone scan; PR: soft tissue PR with non-progressive disease, non-evaluable \[NE\], or NED on bone scan, or soft tissue CR with non-progressive disease, or NE bone scan). Per protocol, RECIST 1.1 was modified to follow a maximum of 10 target lesions in total and a maximum of 5 target lesions per organ. Per protocol, the secondary ORR outcome measure analysis for all participants regardless of biomarker status in Cohort 1 (BRCA 1/2) and Cohort 2 (\[HRRm, BRCA Non-mutated\]; \[HRD+, HRR Non-mutated\]) combined, is presented here. |
| Combined Cohort 1+2: DOR as Assessed by BICR Per Modified RECIST 1.1 or PCWG-Modified RECIST 1.1 in Participants Who Are HRRm Positive | Up to approximately 78 months | For participants with CR (disappearance of all target lesions) or PR (≥30% decrease in sum of diameters of target lesions) as assessed by BICR per modified RECIST; or, for participants with prostate cancer, per PCWG-modified RECIST 1.1 (CR: soft tissue CR with NED on bone scan; PR: soft tissue PR with non-progressive disease, NE, or NED on bone scan, or soft tissue CR with non-progressive disease, or NE bone scan) DOR was defined as time from first documented CR/PR to PD or death. Per protocol, RECIST 1.1 was modified to allow ≤10 target lesions (up to 5 per organ). Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions \& absolute increase of ≥5 mm or appearance of ≥1 new lesion. Per PCWG, PD was ≥2 new bone lesions (not tumor flare) persisting ≥6 weeks. DOR for HRRm positive participants with CR/PR in Cohort 1 \& 2 combined is presented. |
| Combined Cohort 1+2: DOR as Assessed by BICR Per Modified RECIST 1.1 or PCWG-Modified RECIST 1.1 In Participants Who Are HRD Positive (HRD+) | Up to approximately 78 months | For participants with CR (disappearance of all target lesions) or PR (≥30% decrease in sum of diameters of target lesions) as assessed by BICR per modified RECIST; or, for participants with prostate cancer, per PCWG-modified RECIST 1.1 (CR: soft tissue CR with NED on bone scan; PR: soft tissue PR with non-progressive disease, NE, or NED on bone scan, or soft tissue CR with non-progressive disease, or NE bone scan) DOR was defined as time from first documented CR/PR to PD or death. Per protocol, RECIST 1.1 was modified to allow ≤10 target lesions (up to 5 per organ). Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions \& absolute increase of ≥5 mm or appearance of ≥1 new lesion. Per PCWG, PD was ≥2 new bone lesions (not tumor flare) persisting ≥6 weeks. DOR for HRD+ participants with CR/PR in Cohort 1 \& 2 combined is presented. |
| Combined Cohort 1+2: DOR as Assessed by BICR Per Modified RECIST 1.1 or PCWG-modified RECIST 1.1 in All Combined Cohort 1+2 Participants Regardless of Biomarker Status | Up to approximately 78 months | For participants with CR (disappearance of all target lesions) or PR (≥30% decrease in sum of diameters of target lesions) as assessed by BICR per modified RECIST; or, for participants with prostate cancer, per PCWG-modified RECIST 1.1 (CR: soft tissue CR with NED on bone scan; PR: soft tissue PR with non-progressive disease, NE, or NED on bone scan, or soft tissue CR with non-progressive disease, or NE bone scan) DOR was defined as time from first documented CR/PR to PD or death. Per protocol, RECIST 1.1 was modified to allow ≤10 target lesions (up to 5 per organ). Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions \& absolute increase of ≥5 mm or appearance of ≥1 new lesion. Per PCWG, PD was ≥2 new bone lesions (not tumor flare) persisting ≥6 weeks. DOR for all participants in Cohort 1 \& 2 combined with CR/PR is presented. |
| Combined Cohort 1+2: OS in Participants Who Are HRRm Positive | Up to approximately 78 months | OS was defined as the time from the date of the first dose of study treatment to the date of death due to any cause. Per protocol, the secondary OS outcome measure analysis for HRRm positive participants in Cohort 1 (BRCA 1/2) and Cohort 2 \[(HRRm, BRCA Non-mutated); (HRD+, HRR Non-mutated)\] combined, will be presented. Per protocol, Cohort 1 and Cohort 2 will be combined as a pre-specified secondary efficacy analysis. |
| Combined Cohort 1+2: PFS as Assessed by BICR Per Modified RECIST 1.1 or PCWG-Modified RECIST 1.1 in Participants Who Are HRRm Positive | Up to approximately 78 months | PFS was defined as the time from first dose of study treatment to the first documented progressive disease (PD) as assessed by BICR per modified RECIST 1.1 or PCWG-modified RECIST 1.1 (for participants with prostate cancer), or death due to any cause, whichever occurred first. Per protocol, RECIST 1.1 was modified to allow ≤10 target lesions total (up to 5 per organ). Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions and the sum must also have demonstrated an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. Per PCWG, PD was ≥2 new bone lesions, confirmed to not represent tumor flare, and persistent for ≥6 weeks. Per protocol, the PFS analysis for HRRm positive participants in Cohort 1 and Cohort 2 combined is presented here. |
| Combined Cohort 1+2: PFS as Assessed by BICR Per Modified RECIST 1.1 or PCWG-Modified RECIST 1.1 in Participants Who Are HRD Positive (HRD+) | Up to approximately 78 months | PFS was defined as the time from first dose of study treatment to the first documented progressive disease (PD) as assessed by BICR per modified RECIST 1.1 or PCWG-modified RECIST 1.1 (for participants with prostate cancer), or death due to any cause, whichever occurred first. Per protocol, RECIST 1.1 was modified to allow ≤10 target lesions total (up to 5 per organ). Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions and the sum must also have demonstrated an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. Per PCWG, PD was ≥2 new bone lesions, confirmed to not represent tumor flare, and persistent for ≥6 weeks. Per protocol, the PFS analysis for HRD+ participants in Cohort 1 and Cohort 2 combined is presented here. |
| Combined Cohort 1+2: PFS as Assessed by BICR Per Modified RECIST 1.1 or PCWG-Modified RECIST 1.1 in All Combined Cohort 1+2 Participants Regardless of Biomarker Status | Up to approximately 78 months | PFS was defined as the time from first dose of study treatment to the first documented PD as assessed by BICR per modified RECIST 1.1 or PCWG-modified RECIST 1.1 (for participants with prostate cancer), or death due to any cause, whichever occurred first. Per protocol, RECIST 1.1 was modified to allow ≤10 target lesions total (up to 5 per organ). Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions and the sum must also have demonstrated an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. Per PCWG, PD was ≥2 new bone lesions, confirmed to not represent tumor flare, and persistent for ≥6 weeks. Per protocol, the PFS analysis for all participants regardless of biomarker status in Cohort 1 \& 2 is presented here. |
| Participants With BRCA1/2 Non-Mutated Ovarian Cancer: Time to Earliest Progression by Cancer Antigen-125 (CA-125) | Up to approximately 78 months | Time to earliest progression by CA-125 was defined as the time from first dose to progression based on CA-125. For participants with BRCA1/2 non-mutated ovarian cancer only, progression by CA-125 was defined as either CA-125 ≥2× upper limit normal (ULN) on 2 occasions 1 week apart or, for participants with elevated CA-125 (≥ULN) at baseline, ≥2× the nadir value on 2 occasions 1 week apart. Time to earliest progression based on CA-125 is presented. |
| Participants With Prostate Cancer: Prostate-Specific Antigen (PSA) Response Rate | Up to approximately 78 months | PSA response was defined as a reduction in PSA level ≥50% from baseline measured twice at least 3 weeks apart. For participants with prostate cancer with baseline PSA measurements available, the PSA response rate as assessed is presented. |
| Cohorts 1, 2, 3: Number of Participants Experiencing an Adverse Event (AE) | Up to approximately 78 months | An AE is any unfavorable and unintended sign, symptom, or disease (new or exacerbated) in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants who experience an AE will be reported. |
| Cohort 3: PFS2 as Assessed by the Investigator in Participants With sBRCAm Breast Cancer | Up to approximately 78 months | PFS2 was defined as the time from the first dose of study medication to subsequent disease progression on next-line treatment or death due to any cause, whichever occurred first, as assessed by the investigator. PFS2 for participants with sBRCAm breast cancer in Cohort 3 will be reported. |
Countries
Argentina, Australia, Canada, Colombia, Denmark, France, Guatemala, Ireland, Israel, Italy, Japan, Mexico, Peru, Romania, Russia, South Korea, Spain, Switzerland, Turkey (Türkiye), United Kingdom, United States
Contacts
Merck Sharp & Dohme LLC
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 59.4 years STANDARD_DEVIATION 11.9 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 16 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 60 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 16 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 10 Participants |
| Race (NIH/OMB) Asian | 18 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 3 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 6 Participants |
| Race (NIH/OMB) White | 229 Participants |
| Sex: Female, Male Female | 188 Participants |
| Sex: Female, Male Male | 54 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 79 / 88 | 86 / 93 | 133 / 141 | 4 / 7 |
| other Total, other adverse events | 76 / 86 | 80 / 92 | 123 / 141 | 7 / 7 |
| serious Total, serious adverse events | 25 / 86 | 26 / 92 | 44 / 141 | 1 / 7 |