๐ฌIn plain words
What the trial is, and whether it could suit you
This research study is studying This research study is studying the efficacy and safety of the following study drugs as a possible treatment for recurrent central nervous system (CNS) metastases:
* Palbociclib alone (Cohort 1)
* The combination of palbociclib and pembrolizumab (Cohort 2) Pfizer and Merck, pharmaceutical companies, are supporting this research study by providing the study drugs as well as funding for research activities.
Sign in to get the eligibility rules as simple questions to take to your doctor.
๐ Eligibility rules (as published)
Inclusion Criteria:
* Participants must have histologically or cytologically confirmed disease from any solid tumor (Cohort 1)
* Participants must have histologically or cytologically confirmed disease from breast cancer or melanoma (Cohort 2).
* Participants must have measurable disease in the CNS, defined as at least one lesion that can be accurately measured in at least one dimension as โฅ10 mm.
* Participants must have progressive CNS lesions, as defined by one of the following:
* Patients may have multiple progressive CNS lesions, some of which have been treated by SRS or surgery. Patients are eligible if they have one or more un-treated (by surgery or SRS) progressive lesions that is measurable.
* Patients have measurable residual or progressive lesions after surgery.
* Patients who have had prior WBRT and/or SRS are eligible but there needs to be unequivocal evidence of progression of at least one lesion treated by radiation (e.g. tissue diagnosis). Biopsy can be considered for definitive diagnosis.
* Patients who have previously been treated with systemic therapy for CNS metastases are eligible.
* Age \> 18 years. The toxicity of palbociclib in children is unknown.
* ECOG performance status of 0, 1 or 2 (Karnofsky โฅ 60, see Appendix A).
* Participants must have normal organ and marrow function as defined below:
* leukocytes โฅ3,000/mcL
* absolute neutrophil count โฅ1,500/mcL
* platelets โฅ100,000/mcL
* hemoglobin โฅ9g/dL
* total bilirubin \< 1.5 x institutional upper limit of normal OR \> 1.5 x institutional upper limit of normal allowed if direct bilirubin is within normal range.
* AST(SGOT)/ALT(SGPT) โค2.5 ร institutional upper limit of normal
* creatinine within normal institutional limits OR
* creatinine clearance โฅ60 mL/min/1.73 m2 for participants with creatinine levels above institutional normal (Cohort 1)
* creatinine clearance โฅ30 mL/min/1.73 m2 for participants with creatinine levels above institutional normal (Cohort 2)
* baseline QTc \<480ms
* The effects of palbociclib on the developing human fetus are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 6 months after completion of palbociclib administration.
* Ability to understand and the willingness to sign a written informed consent document.
* Tissue from a prior biopsy or resection of intracranial or extracranial site (primary or metastatic site) for clinical genetic sequencing (at least one FFPE block or 15 unstained slides). Patients previously assessed for genetic sequencing who meet requirements of section 9.2.1 do not need to have additional tissue available for prospective genetic screening.
* Presence of alteration in CDK pathway in any biopsy or resection (amplifications in CDK4, CDK6, CCND1, CCND2, CCND3 or CCNE1 or loss of CDKN2A) as described in Section 9.2 using a CLIA-certified assay (Cohort 1 only).
* Patients with progressive extracranial disease will not be excluded.
* Stable dose of corticosteroids for at least 7 days.
* Participants who are HBsAg positive are eligible if they have received HBV anti-viral therapy for at least 4 weeks, and have undetectable HBV viral load prior to enrollment
* Note: Participants should remain on anti-viral therapy throughout study intervention and follow local guidelines for HBV anti-viral therapy post completion of study intervention
* Hepatits B screening tests are not required unless:
* Known history of HBV infection
* As mandated by local health authority
* Participants with a history of HCV infection are eligible if HCV viral load is undetectable at screening.
* Note: Participants must have completed curative anti-viral therapy at least 4 weeks prior to enrollment
* Heptatits C screening tests are not required unless:
* Known history of HCV infection
* As mandated by local health authority
Exclusion Criteria
* Prior treatment with CDK4/6 inhibitor.
* Participants who have had chemotherapy, immunotherapy or radiotherapy within 2 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have โฅ grade 2 adverse events due to agents administered more than 2 weeks earlier.
* Participants who are receiving any other investigational agents.
* Participants who are receiving other concurrent chemotherapies or immunotherapies for their cancer (except for patients who will receive letrozole, anastrozole, exemestane, tamoxifen, fulvestrant, trastuzumab, bisphosphonates, or ovarian suppression therapy)
* Leptomeningeal involvement of cancer (Cohort 1). Leptomeningeal involvement is allowed for Cohort 2.
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to palbociclib (including abemaciclib).
* Participants receiving any medications or substances that are moderate or strong inhibitors or inducers of CYP3A isoenzymes are ineligible. Lists including medications and substances known or with the potential to interact with the CYP3A isoenzymes are provided in Appendix C, and can also be found within section 5.4. Because the lists of these agents are constantly changing, it is important to regularly consult a frequently-updated list such as http://medicine.iupui.edu/clinpharm/ddis/table.aspx; medical reference texts such as the Physicians' Desk Reference may also provide this information. As part of the enrollment/informed consent procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if new medicati