Veliparib, Paclitaxel, and Carboplatin in Treating Patients With Solid Tumors That Are Metastatic or Cannot Be Removed by Surgery and Liver or Kidney Dysfunction

• MTD of veliparib in combination with carboplatin and paclitaxel using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v4.0 [ Time Frame: Up to day 21 ] [ Designated as safety issue: Yes ]
• Pharmacokinetics and pharmacodynamics of veliparib in patients with varying degrees of renal or hepatic dysfunction [ Time Frame: Day -6 and 3 (of course 1 after veliparib dosing) ] [ Designated as safety issue: No ]
  The effect of dysfunction on pharmacokinetics will be explored by comparing each pharmacokinetic parameter across all cohorts using one-way analysis (ANOVA) or Kruskal-Wallis test. The level of each protein will be compared between responders and non-responders using the Wilcoxon signed rank test.

• MTD of veliparib in combination with carboplatin and paclitaxel in these patients [ Designated as safety issue: Yes ]
• Pharmacokinetics and pharmacodynamics of veliparib in patients with varying degrees of renal or hepatic dysfunction [ Designated as safety issue: No ]

• DLT and other toxicities as assessed by NCI CTCAE v4.0 [ Time Frame: Up to day 21 ] [ Designated as safety issue: Yes ]
• Response and incidence of stable disease of patients with varying degrees of renal or hepatic dysfunction proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]
  Responses and incidence of stable disease will be tabulated by disease diagnosis and by dose level. We will also report 95% confidence limits on the response rates.
• Time to progression of patients with varying degrees of renal or hepatic dysfunction [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]

• DLT and other toxicities as assessed by NCI CTCAE v. 4.0 [ Designated as safety issue: Yes ]
• Response and incidence of stable disease of patients with varying degrees of renal or hepatic dysfunction [ Designated as safety issue: No ]
• Time to progression of patients with varying degrees of renal or hepatic dysfunction [ Designated as safety issue: No ]

This phase I trial studies the best dose of veliparib when given together with paclitaxel and carboplatin in treating patients with solid tumors that are metastatic or cannot be removed by surgery and liver or kidney dysfunction. Veliparib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as paclitaxel and carboplatin, work in different ways to stop the growth of tumor cells either by killing the cells or by stopping them from dividing. Giving veliparib together with paclitaxel and carboplatin may kill more tumor cells.

PRIMARY OBJECTIVES:

I. To determine the pharmacokinetics and pharmacodynamics of ABT-888 (veliparib) in patients with varying degrees of renal or hepatic dysfunction.

II. To determine the maximum-tolerated dose (MTD) of ABT-888 in combination with carboplatin and paclitaxel for patients with varying degrees of liver or kidney dysfunction.

III. To provide dosing recommendations for ABT-888 in combination with carboplatin and paclitaxel based on degree of hepatic and renal impairment.

SECONDARY OBJECTIVES:

I. To define the dose-limiting toxicity (DLT) and other toxicities associated with the use of this combination in patients with varying degrees of renal or hepatic dysfunction.

II. To evaluate the pharmacokinetic parameters of ABT-888, carboplatin, and paclitaxel when administered as a combination in patients with varying degrees of renal of hepatic dysfunction.

III. To evaluate the pharmacodynamic measurement of poly-ADP-ribosylated (PAR) and platinum adducts in tumor cells associated with the use of this combination in patients with varying degrees of renal or hepatic dysfunction.

OUTLINE: This is a multicenter, dose-escalation study of veliparib. Patients are stratified according to degree of renal dysfunction (normal vs moderate vs severe vs very severe) or hepatic dysfunction (mild vs mild with transaminase elevation vs moderately severe vs severe).

Patients receive veliparib* orally (PO) twice daily (BID) on days 1-7 and paclitaxel intravenously (IV) over 3 hours and carboplatin IV over 30 minutes on day 3. Courses repeat every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity.

Blood and hair follicle samples are collected at baseline, on days -5 or -6, and on day 3 of course 1 for pharmacokinetic and pharmacodynamic studies. Tumor tissue biopsies may also be collected at baseline and on day 3.

After completion of study therapy, patients are followed up for 4 weeks.

NOTE: * All patients receive a single dose of veliparib PO on day -6 before course 1 (except patients with very severe renal dysfunction who receive veliparib on day -5 or -6 to coincide with a dialysis day).

• Extensive Stage Small Cell Lung Cancer
• Recurrent Borderline Ovarian Surface Epithelial-stromal Tumor
• Recurrent Breast Cancer
• Recurrent Melanoma
• Recurrent Non-small Cell Lung Cancer
• Recurrent Ovarian Epithelial Cancer
• Recurrent Ovarian Germ Cell Tumor
• Recurrent Small Cell Lung Cancer
• Stage IV Borderline Ovarian Surface Epithelial-stromal Tumor
• Stage IV Breast Cancer
• Stage IV Melanoma
• Stage IV Non-small Cell Lung Cancer
• Stage IV Ovarian Epithelial Cancer
• Stage IV Ovarian Germ Cell Tumor
• Unspecified Adult Solid Tumor, Protocol Specific

• Drug: veliparib
  Given PO
  Other Name: ABT-888
• Drug: paclitaxel
  Given IV
  Other Names:

  • Anzatax
  • Asotax
  • TAX
  • Taxol
• Drug: carboplatin
  Given IV
  Other Names:

  • Carboplat
  • CBDCA
  • JM-8
  • Paraplat
  • Paraplatin
• Other: laboratory biomarker analysis
  Correlative studies
• Other: pharmacological study
  Correlative studies
  Other Name: pharmacological studies

Inclusion Criteria:

• Patients must have histologically confirmed malignancy that is radiologically evaluable and metastatic or unresectable, for which standard curative or palliative measures do not exist or are no longer effective, and for which there is expectation of response to the combination of carboplatin/paclitaxel (i.e., lung, ovarian, breast, melanoma, head and neck, endometrial, urothelial, testicular, esophageal, carcinoma of unknown primary); or indications not listed, eligibility based on disease must be verified by the principal Investigator before they are considered
• Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 60%)
• Life expectancy of greater than 12 weeks
• Absolute neutrophil count (ANC) >= 1,500/mcL
• Platelets >= 100,000/mcL
• Hemoglobin >= 8.0 g/dL

• Patients with all degrees of renal dysfunction are allowed, including patients on hemodialysis; patients with mild to severe hepatic dysfunction are allowed as defined below:

  • Total bilirubin =< 5 x upper limit of normal (ULN) AND aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 10 x ULN For patients with a recently placed biliary stent, patients should have consistent results within a hepatic group from two laboratory readings within 3 days apart, taken at least 10 days following biliary stent placement; for patients with a biliary stent placed over 2 months ago, no obstruction or blockage can have occurred within the last 2 months
• 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 participating in this study, she should inform her treating physician immediately
• Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

• Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those whose adverse event due to agents administered more than 4 weeks earlier have not resolved or stabilized; patients who have been administered ABT-888 as part of a single or combination, Phase 0 or I study, should not necessarily be excluded from participating in this study solely because of receiving prior ABT-888
• Patients may not be receiving any other investigational agents
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to ABT-888 or other agents used in study
• Peripheral neuropathy of severity greater than grade 1
• Inability to take oral medications on a continuous basis
• Evidence of bleeding diathesis
• Patients with central nervous system (CNS) metastases must be stable after therapy for CNS metastases (such as surgery, radiotherapy or stereotactic radiosurgery) for at least 3 months and must be off steroid treatment prior to study enrollment
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated with ABT-888; these potential risks may also apply to other agents used in this study
• Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy are ineligible; however, HIV-positive patients without an acquired immune deficiency syndrome (AIDS)-defining diagnosis who are not receiving agents with the potential for pharmacokinetic (PK) interactions with ABT-888 may be eligible
• Patients with both hepatic and renal dysfunction will also be excluded
• Patients who received and progressed on the combination of carboplatin/paclitaxel will not be eligible
• Active seizure or history of seizure disorder