Testing the Combination of Pevonedistat With Chemotherapy for Bile Duct Cancer of the Liver

PRIMARY OBJECTIVE: I. To determine the objective response rate of pevonedistat as a single agent and in combination with carboplatin and paclitaxel in patients with unresectable intrahepatic cholangiocarcinoma. SECONDARY OBJECTIVES: I. To evaluate the safety profile of pevonedistat alone and in combination with carboplatin and paclitaxel in patients with intrahepatic cholangiocarcinoma. II. To determine the clinical benefit rate of patients with advanced intrahepatic cholangiocarcinoma (ICC) treated with pevonedistat monotherapy and in combination with carboplatin and paclitaxel. III. To determine progression-free survival of patients treated with pevonedistat monotherapy and in combination with carboplatin and paclitaxel. IV. To determine overall survival of patients treated with pevonedistat monotherapy and in combination with carboplatin and paclitaxel. EXPLORATORY OBJECTIVES: I. To determine whether overexpression of NEDD8, NAE1, and UBC12 predict response to treatment. II. To identify the mutation profile of those cholangiocarcinomas with overexpression of the neddylation pathway. III. To bank specimens for further future investigations. OUTLINE: Patients are randomized to 1 of 2 arms. ARM A: Patients receive pevonedistat intravenously (IV) over 60 minutes on days 1, 3, and 5. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. ARM B: Patients receive pevonedistat IV over 1 hour on days 1, 3, and 5, paclitaxel IV over 3 hours on day 1, and carboplatin IV over 15-60 minutes on day 1. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Starting cycle 5, patients may receive pevonedistat monotherapy at the discretion of treating physician. After completion of study treatment, patients are followed up at 30 days after last dose of study treatment, then every 3 months for the first year and every 6 months for years 2-3.