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A PHASE I/II TRIAL OF TEMOZOLOMIDE, MOTEXAFIN GADOLINIUM, AND 60 GY FRACTIONATED RADIATION FOR NEWLY DIAGNOSED SUPRATENTORIAL GLIOBLASTOMA MULTIFORME


Phase 1/Phase 2
18 Years
N/A
Not Enrolling
Both
Adult Giant Cell Glioblastoma, Adult Glioblastoma, Adult Gliosarcoma

Thank you

Trial Information

A PHASE I/II TRIAL OF TEMOZOLOMIDE, MOTEXAFIN GADOLINIUM, AND 60 GY FRACTIONATED RADIATION FOR NEWLY DIAGNOSED SUPRATENTORIAL GLIOBLASTOMA MULTIFORME


PRIMARY OBJECTIVES:

I. Determine the maximum tolerated dose of motexafin gadolinium (MGd) when given
concurrently with temozolomide and radiotherapy in patients with newly diagnosed
supratentorial glioblastoma multiforme (GBM) or gliosarcoma.

II. Estimate the overall survival of patients treated with concurrent radiotherapy,
temozolomide, and MGd followed by post-radiation temozolomide.

III. Determine the short- and long-term adverse effects in patients treated with this
treatment.

IV. Estimate the progression-free survival of patients with newly diagnosed supratentorial
GBM or gliosarcoma treated with this regimen.

OUTLINE: This is a multicenter, dose-escalation study of motexafin gadolinium (MGd).

PHASE I: Patients undergo radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33,
and 36-40. Beginning the night before the first dose of radiotherapy and ending the night
before the last dose of radiotherapy, patients receive concurrent oral temozolomide once
daily on days 0-39. Patients also receive MGd IV over 30 minutes prior to radiotherapy once
daily on days 1-5 and 8-12 and then on days 15, 17, 19, 22, 24, 26, 29, 31, 33, 36, 38, and
40. Beginning 28 days after the completion of radiotherapy, patients receive oral
temozolomide once daily on days 1-5. Treatment repeats every 28 days for up to 12 courses in
the absence of disease progression or unacceptable toxicity.

Cohorts of 3-7 patients receive escalating doses of MGd until the maximum tolerated dose
(MTD) is determined. The MTD is defined as the dose preceding that at which no more than 6
eligible patients experience dose-limiting toxicity.

PHASE II: Patients undergo radiotherapy and receive temozolomide as in phase I. Patients
also receive MGd as in phase I at the MTD determined in phase I.

After completion of study treatment, patients are followed every 2 months for 1 year, every
3 months for 2 years, every 6 months for 3 years, and then annually thereafter.


Inclusion Criteria:



- Histologically confirmed glioblastoma multiforme (GBM) or gliosarcoma

- Newly diagnosed by surgical biopsy or excision within the past 5 weeks

- Supratentorial location, as determined by the following:

- Contrast-enhanced MRI performed preoperatively

- MRI performed postoperatively within 28 days prior to study entry (preferably
within 72 hours of surgery)

- Postoperative scan not required if diagnosed by stereotactic biopsy and
pre-operative MRI was performed

- No gliomas graded < GBM

- No recurrent malignant gliomas

- No tumor foci detected below the tentorium or beyond the cranial vault

- No multifocal disease or leptomeningeal spread

- Zubrod performance status 0-1

- Neurologic function status 0-2

- Absolute neutrophil count ≥ 1,800 cells/mm^3

- Platelet count ≥ 100,000 cells/mm^3

- Hemoglobin ≥ 8 g/dL (transfusion allowed)

- BUN ≤ 25 mg/dL

- Creatinine ≤ 1.5 mg/dL

- Bilirubin ≤ 1.5 mg/dL

- ALT or AST ≤ 2 times upper limit of normal

- Fertile patients must use effective contraception during and for 2 months after
completion of study treatment

- Negative pregnancy test

- Not pregnant or nursing

- No prior invasive malignancies, except for nonmelanomatous skin cancer and carcinoma
in situ of the uterine cervix or bladder, unless disease-free for ≥ 3 years

- No severe, active comorbidity, defined as follows:

- Unstable angina and/or congestive heart failure requiring hospitalization within
the past 6 months

- Transmural myocardial infarction within the past 6 months

- Acute bacterial or fungal infection requiring intravenous antibiotics at study
entry

- Chronic obstructive pulmonary disease exacerbation or other respiratory illness
requiring hospitalization or precluding study therapy within 30 days prior to
study entry

- Coagulation defects

- Known AIDS

- No prior allergic reaction to the study drugs

- No history of porphyria or G6PD deficiency

- No allergy to gadolinium or contraindications to MRI

- No other concurrent chemotherapy

- Recovered from effects of surgery or postoperative infection and other complications

- No prior systemic chemotherapy, including polifeprosan 20 with carmustine implant
(Gliadel wafer), for the current GBM

- Prior chemotherapy for a different cancer allowed

- No prior radiotherapy to the head and neck (except for T1 glottic cancer) that would
result in overlap of radiation therapy fields

- No prophylactic filgrastim (G-CSF) during the first course of study treatment

- No concurrent sargramostim (GM-CSF)

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Maximum Tolerated Dose of MGd (Phase I)

Outcome Description:

Patients were to be followed for a minimum of 90 days from the start of radiation therapy (RT) and carefully evaluated with respect to treatment morbidity. A dose limiting toxicity (DLT) was defined as a grade 4 neurologic adverse event (AE) considered to be related to treatment occurring within 21 days of the conclusion of RT. For each dose level, up to seven patients were to be accrued to assure that there would be six eligible for treatment adverse event evaluation. A dose level of MGd was considered acceptable if no more than 1 patient of the 6 experience a DLT. If the current level was considered acceptable, then dose escalation occurred. Otherwise, the preceding dose level would be declared the MTD. The MTD would be used for the Phase II arm. Rating scale: 0 = not the MTD, 1 = MTD

Outcome Time Frame:

From start of radiation therapy to 90 days,

Safety Issue:

Yes

Principal Investigator

David Brachman

Investigator Role:

Principal Investigator

Investigator Affiliation:

Radiation Therapy Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-01092

NCT ID:

NCT00305864

Start Date:

February 2006

Completion Date:

Related Keywords:

  • Adult Giant Cell Glioblastoma
  • Adult Glioblastoma
  • Adult Gliosarcoma
  • Glioblastoma
  • Gliosarcoma

Name

Location

Fox Chase Cancer Center Philadelphia, Pennsylvania  19111
University of Washington Medical Center Seattle, Washington  98195-6043
Hurley Medical Center Flint, Michigan  48503
University of Texas Health Science Center at San Antonio San Antonio, Texas  78284-7811
University of Florida Health Science Center Gainesville, Florida  32610-0296
Methodist Medical Center of Illinois Peoria, Illinois  61636
Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
LDS Hospital Salt Lake City, Utah  84143
University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma  73104
Mobile Infirmary Medical Center Mobile, Alabama  36640-0460
University of Wisconsin Hospital and Clinics Madison, Wisconsin  53792-0001
American Fork Hospital American Fork, Utah  84003
Cottonwood Hospital Medical Center Murray, Utah  84107
McKay-Dee Hospital Center Ogden, Utah  84403
Paoli Memorial Hospital Paoli, Pennsylvania  19301-1792
Saint Rose Hospital Hayward, California  94545
Alta Bates Summit Medical Center - Summit Campus Oakland, California  94609
Memorial Hospital Carthage, Illinois  62321
Galesburg Cottage Hospital Galesburg, Illinois  61401
Galesburg Clinic Galesburg, Illinois  61401
Mason District Hospital Havana, Illinois  62644
Kewanee Hospital Kewanee, Illinois  61443
McDonough District Hospital Macomb, Illinois  61455
BroMenn Regional Medical Center Normal, Illinois  61761
Proctor Hospital Peoria, Illinois  61614
Perry Memorial Hospital Princeton, Illinois  61356
Valley Cancer Center Spring Valley, Illinois  61362
Bryn Mawr Hospital Bryn Mawr, Pennsylvania  19010
Eureka Hospital Eureka, Illinois  61530
Graham Hospital Association Canton, Illinois  61520
Saint Joseph Medical Center Joliet, Illinois  60435
Pekin Hospital Pekin, Illinois  61554
Saint Joseph Mercy Hospital Ann Arbor, Michigan  48106
Highland General Hospital Oakland, California  94602
Temple University Hospital Philadelphia, Pennsylvania  19140
Arizona Oncology Services Foundation Phoenix, Arizona  85013
Bay Area Tumor Institute Oakland, California  94609
East Bay Radiation Oncology Center Castro Valley, California  94546
Contra Costa Regional Medical Center Martinez, California  94553-3156
Larry G Strieff MD Medical Corporation Oakland, California  94609
University of Florida Gainesville, Florida  32610-0277
El Camino Hospital Mountain View, California  94040
University of Arizona Health Sciences Center Tucson, Arizona  85724
Indiana University Medical Center Indianapolis, Indiana  46202
Lankenau Hospital Wynnewood, Pennsylvania  19096
University of Southern California Los Angeles, California  90033
Froedtert and the Medical College of Wisconsin Milwaukee, Wisconsin  53226
OSF Saint Francis Medical Center Peoria, Illinois  61637
Valley Medical Oncology Consultants-Castro Valley Castro Valley, California  94546
Eden Hospital Medical Center Castro Valley, California  94546
Valley Medical Oncology Consultants-Fremont Fremont, California  94538
Bay Area Breast Surgeons Inc Oakland, California  94609
Tom K Lee Inc Oakland, California  94609
Valley Medical Oncology Consultants Pleasanton, California  94588
Valley Care Health System - Pleasanton Pleasanton, California  94588
Doctors Medical Center- JC Robinson Regional Cancer Center San Pablo, California  94806
Rush - Copley Medical Center Aurora, Illinois  60504
Intercommunity Cancer Center Galesburg, Illinois  61401
Hopedale Medical Complex - Hospital Hopedale, Illinois  61747
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Community Cancer Center Foundation Normal, Illinois  61761
Illinois CancerCare-Ottawa Clinic Ottawa, Illinois  61350
Ottawa Regional Hospital and Healthcare Center Ottawa, Illinois  61350
Pekin Cancer Treatment Center Pekin, Illinois  61554
Illinois Oncology Research Association CCOP Peoria, Illinois  61615
Illinois CancerCare-Peoria Peoria, Illinois  61615
Illinois Valley Hospital Peru, Illinois  61354
Saint Margaret's Hospital Spring Valley, Illinois  61362
Carle Clinic-Urbana Main Urbana, Illinois  61801
Saint Anthony Memorial Health Center Michigan City, Indiana  46360
Michigan Cancer Research Consortium Community Clinical Oncology Program Ann Arbor, Michigan  48106
Oakwood Hospital Dearborn, Michigan  48123
Saint John Hospital and Medical Center Detroit, Michigan  48236
McLaren Regional Medical Center Flint, Michigan  48532
Allegiance Health Jackson, Michigan  49201
Sparrow Hospital Lansing, Michigan  48912
Saint Mary Mercy Hospital Livonia, Michigan  48154
Saint Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Saint Joseph Mercy Port Huron Port Huron, Michigan  48060
Saint Mary's of Michigan Saginaw, Michigan  48601
Saint John Macomb-Oakland Hospital Warren, Michigan  48093
Saint John's Regional Medical Center Joplin, Missouri  64804
Good Samaritan Hospital Kearney, Nebraska  68847
Mainline Health CCOP Wynnewood, Pennsylvania  19096
Audie L Murphy Veterans Affairs Hospital San Antonio, Texas  78209
University Hospital San Antonio, Texas  78229
Wheeling Hospital Wheeling, West Virginia  26003
University of Maryland Greenebaum Cancer Center Baltimore, Maryland  21201
Denver Veterans Administration Medical Center Denver, Colorado  80220
John F Kennedy Medical Center Edison, New Jersey  08818
UMDNJ - New Jersey Medical School Newark, New Jersey  07103
Sandra L Maxwell Cancer Center Cedar City, Utah  84720
Intermountain Medical Center Murray, Utah  84157
Utah Valley Regional Medical Center Provo, Utah  84603
Dixie Medical Center Regional Cancer Center Saint George, Utah  84770
Intermountain Health Care Salt Lake City, Utah  84103
Utah Cancer Specialists-Salt Lake City Salt Lake City, Utah  84106
University of Miami Miller School of Medicine-Sylvester Cancer Center Miami, Florida  33136
Cancer Centers of North Carolina Raleigh, North Carolina  27607
OSF Saint Francis Medical Center Radiation Oncology Service at the Central Illinois Comprehensive CC Peoria, Illinois  61615-7827
Rex Hospital Raleigh, North Carolina  27606
Los Angeles County-USC Medical Center Los Angeles, California  90033
Stanford University Hospitals and Clinics Stanford, California  94305
UMDNJ - Robert Wood Johnson University Hospital New Brunswick, New Jersey  08903
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Franciscan Saint Margaret Health-Hammond Campus Hammond, Indiana  46320