Phase I Trial of Aflibercept (VEGF-Trap) With Radiation Therapy and Concomitant and Adjuvant Temozolomide in Patients With Malignant Glioma
PRIMARY OBJECTIVES:
I. To define the maximum tolerated dose (MTD) of aflibercept (VEGF Trap) with radiotherapy
(RT) and concurrent temozolomide (TMZ) when administered in patients with newly-diagnosed
glioblastoma (GBM) or gliosarcoma.
II. To define the MTD of aflibercept with adjuvant TMZ administered at 150mg/m2once daily
for 5 days every 28 days in patients with stable or recurrent malignant glioma (MG) after
RT.
III. To define the MTD of aflibercept with adjuvant TMZ administered at 100 mg/m2 once daily
for 21 days every 28 days in patients with stable or recurrent MG after RT.
IV. To characterize the safety profile of aflibercept in combination with RT and concomitant
TMZ in patients with newly-diagnosed GBM.
V. To characterize the safety profile of aflibercept in combination with adjuvant TMZ in
patients with stable or recurrent MG after RT.
SECONDARY OBJECTIVE:
I. To characterize the pharmacokinetic profiles of free and bound aflibercept and TMZ in
these patients
OUTLINE: This is a multicenter, dose-escalation study of aflibercept. Patients are assigned
to 1 of 3 treatment groups according to prior treatment and diagnosis.
Group 1 (newly diagnosed glioblastoma multiforme or gliosarcoma): Patients undergo involved
field partial brain radiotherapy (RT) once daily, 5 days a week (total of 30 fractions) and
receive concurrent oral temozolomide (TMZ) once daily for 6 weeks. Beginning 2 weeks after
the initiation of RT patients also receive aflibercept IV over 1 hour on days 1 and 15 and
continue until the end of RT. Beginning 4 weeks after completion of radiotherapy, patients
receive adjuvant oral TMZ once daily on days 1-5. Treatment with adjuvant TMZ repeats every
28 days for up to 12 courses.
Group 2 (stable or recurrent malignant glioma): Patients undergo radiotherapy as in group 1.
Patients receive oral TMZ on days 1-5. Treatment repeats every 28 days for up to 12*
courses. Patients also receive aflibercept IV over 1 hour on days 1 and 15 beginning on the
first day of TMZ treatment.
[Note: *The 12 course maximum includes adjuvant TMZ courses administered prior to
enrollment.]
Group 3 (stable or recurrent malignant glioma): Patients undergo radiotherapy as in group 1.
Patients receive oral TMZ on days 1-5. Treatment repeats every 21 days for up to 12*
courses. Patients also receive aflibercept IV over 1 hour on days 1 and 15 beginning on the
first day of TMZ treatment.
[Note: *The 12 course maximum includes adjuvant TMZ courses administered prior to
enrollment.]
In all groups, treatment continues in the absence of disease progression or unacceptable
toxicity.
Blood samples are collected periodically for analysis of pharmacokinetics by ELISA. Tumor
biomarkers and plasma angiogenic peptides are analyzed for correlation with response, and
tumor MGMT promoter methylation status is determined using methylation-specific PCR.
After completion of study treatment, patients are followed every 3 months.
Interventional
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Maximum tolerated dose of aflibercept defined as the dose at which fewer than one-third of patients experience DLT based on the CTC severity grading
28 days
Yes
Patrick Wen
Principal Investigator
National Cancer Institute (NCI)
United States: Food and Drug Administration
NCI-2009-00678
NCT00650923
July 2008
Name | Location |
---|---|
Dana-Farber Cancer Institute | Boston, Massachusetts 02115 |
Massachusetts General Hospital | Boston, Massachusetts 02114-2617 |
University of Pittsburgh | Pittsburgh, Pennsylvania 15261 |
M D Anderson Cancer Center | Houston, Texas 77030 |
University of California San Francisco Medical Center-Mount Zion | San Francisco, California 94115 |
University of California at Los Angeles (UCLA ) | Los Angeles, California 90095 |
University of California San Francisco Medical Center-Parnassus | San Francisco, California 94143 |
Adult Brain Tumor Consortium | Baltimore, Maryland 21231-1000 |