AZD1775 Plus Carboplatin-Paclitaxel in Squamous Cell Lung Cancer
Condition: Lung Cancer
MeSH terms: Lung Neoplasms
Intervention: Carboplatin; Paclitaxel; AZD1775
Intervention description: Participants will be treated with carboplatin (area under the curve 5 (AUC5) will be used to determine the dosage) twice daily, days 1 and 2 and once a day on day 3 (5 doses) during each 21 day cycle of treatment.; Participants will be treated with paclitaxel 175 mg/m^2 twice daily, days 1 and 2 and once a day on day 3 (5 doses) during each 21 day cycle of treatment.; Participants will receive AZD1775 225 mg twice daily, days 1 and 2 and once a day on day 3 (5 doses) during each 21 day cycle of treatment.
Intervention MeSH terms: Paclitaxel; Carboplatin; Adavosertib
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 42.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: Squamous cell lung cancer

Summary:

      The purpose of this study is to find out what effects (good and bad) AZD1775 used in
      combination with carboplatin and paclitaxel will have on participants and their cancer.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Provision of informed consent prior to any study specific procedures

          -  Histologic or cytological diagnosis of Squamous Cell Lung Cancer (SQCLC) with
             advanced/metastatic stage, with no known curative treatment options. Prior
             platinum-containing adjuvant, neoadjuvant, or definitive chemoradiation therapy given
             for locally advanced disease is considered first line therapy only if recurrent (local
             or metastatic) disease developed within 6 months of completing therapy. Potential
             participants with recurrent disease > 6 months will be eligible.

          -  Female or male aged >/= 18 years

          -  Eastern Cooperative Oncology Group (ECOG) performance status of 0/1

          -  Prior chemotherapy in the adjuvant setting is allowed

          -  Prior radiotherapy is allowed

          -  Any prior palliative radiation must have been completed at least 7 days prior to the
             start of the studies drugs and participants must have been recovered from any acute
             adverse effects prior to the start of the study treatment

          -  Prior Immunotherapy with PD1i, PDL1i, anti-CTLA -4 or vaccines is allowed

          -  Must have normal organ and marrow function

          -  Have archival tissue available or undergo a fresh biopsy where clinically feasible
             after discussion with the sponsor

          -  Women of childbearing potential and men must agree to use adequate contraception prior
             to study entry and for the duration of study participation and women who are breast
             feeding are excluded from the study. Both women and men should be fully informed of
             the lack of reproductive toxicity testing, and women must have a negative pregnancy
             test prior to enrollment.

        Exclusion Criteria:

          -  Progressive, symptomatic untreated brain metastases

          -  Pregnancy or breast feeding

          -  A serious uncontrolled medical disorder or active infection that in the investigator's
             opinion would impair the participant's ability to receive study treatment

          -  Prior use of platinum or paclitaxel for stage IV Non-small Cell Lung Cancer (NSCLC) or
             concurrent use of other anticancer approved or investigational agents

          -  Use of anti-cancer treatment drug ?21 days or 5 half-lives (whichever is shorter)
             prior to the first dose of AZD1775. For drugs for which 5 half-lives is <21 days, a
             minimum of 10 days between termination of the prior treatment and administration of
             AZD1775 treatment is required.

          -  Major surgical procedures ?28 days of beginning study treatment, or minor surgical
             procedures ?7 days. No waiting period required following port-a-cath or other central
             venous access placement.

          -  Grade >1 toxicity from prior therapy EXCEPT: Alopecia, anorexia, and/or
             endocrinopathies on replacement therapy.

          -  Unable to swallow oral medications. Note: Patient may not have a percutaneous
             endoscopic gastrostomy (PEG) tube or be receiving total parenteral nutrition (TPN).

          -  Known Hepatitis B or C or HIV infection

          -  Second primary malignancy, other than in situ malignancies or adequately treated basal
             cell carcinoma of the skin or other malignancy treated at least 2 years previously
             with no evidence of recurrence

          -  Any of the following cardiac diseases currently or within the last 6 months: unstable
             angina pectoris, acute myocardial infarction, congestive heart failure > Class 2 (as
             defined by New York Heart Association (NYHA)), conduction abnormality not controlled
             with pacemaker or medication, significant ventricular or supraventricular arrhythmias
             (patients with chronic rate-controlled atrial fibrillation in the absence of other
             cardiac abnormalities are eligible)

          -  Have had prescription or non-prescription drugs or other products (i.e., grapefruit
             juice) known to be sensitive to CYP3A4 substrates or CYP3A4 substrates with a narrow
             therapeutic index, or to be moderate to strong inhibitors or inducers of CYP3A4, which
             cannot be discontinued 2 weeks before Day 1 of dosing and withheld throughout the
             study until 2 weeks after the last dose of study drug

          -  Co-administration of aprepitant and fosaprepitant during this study is prohibited

          -  AZD1775 is an inhibitor of breast cancer resistance protein (BCRP). The use of statins
             including Atorvastatin which are substrates for BCRP are therefore prohibited and
             patients should be moved on to non-BCRP alternatives

          -  Herbal preparations are not allowed throughout the study. These herbal medications
             include, but are not limited to: St. John's wort, kava, ephedra (ma huang), gingko
             biloba, dehydroepiandrosterone (DHEA), yohimbe, saw palmetto, and ginseng

          -  History of Torsades de pointes unless all risk factors that contributed to Torsades
             have been corrected

          -  Mean resting corrected QTc interval using the Fridericia formula (QTcF) >450 msec/male
             and >470 msec/female (as calculated per institutional standards) obtained from 1
             electrocardiograms (ECGs).