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Background: This study evaluated safety, pharmacokinetics, and clinical activity of intravenous and oral rucaparib, a poly (ADP-ribose) polymerase inhibitor, combined with chemotherapy in patients with advanced solid tumours. Methods: Initially, patients received escalating doses of intravenous rucaparib combined with carboplatin, carboplatin/paclitaxel, cisplatin/pemetrexed, or epirubicin/cyclophosphamide. Subsequently, the study was amended to focus on oral rucaparib (once daily, days 1–14) combined with carboplatin (day 1) in 21-day cycles. Doselimiting toxicities (DLTs) were assessed in cycle 1 and safety in all cycles. Results: Eighty-five patients were enrolled (22 breast, 15 ovarian/peritoneal, 48 other primary cancers), with a median of three prior therapies (range, 1–7). Neutropenia (27.1%) and thrombocytopenia (18.8%) were the most common grade ≥3 toxicities across combinations and were DLTs with the oral rucaparib/carboplatin combination. Maximum tolerated dose for the combination was 240 mg per day oral rucaparib and carboplatin area under the curve 5 mg mL–1 min–1. Oral rucaparib demonstrated dose-proportional kinetics, a long half-life (≈17 hours) and good bioavailability (36%). Pharmacokinetics were unchanged by carboplatin coadministration. The rucaparib/carboplatin combination had radiologic antitumour activity, primarily in BRCA1- or BRCA2-mutated breast and ovarian/peritoneal cancers. Conclusions: Oral rucaparib can be safely combined with a clinically relevant dose of carboplatin in patients with advanced solid tumours. (Trial registration ID: NCT01009190)

Type

Journal article

Journal

British Journal of Cancer

Publisher

Cancer Research UK

Publication Date

25/01/2017

Keywords

rucaparib, carboplatin, PARP inhibitor, pharmacokinetics, pharmacodynamics, breast cancer, colorectal cancer, ovarian cancer, lung cancer;, pancreatic cancer, BRCA1, BRCA2