Know Cancer

or
forgot password

A Randomized Phase I/II Study of ABT-888 in Combination With Temozolomide in Recurrent (Temozolomide Resistant) Glioblastoma


Phase 1/Phase 2
18 Years
N/A
Open (Enrolling)
Both
Brain and Central Nervous System Tumors

Thank you

Trial Information

A Randomized Phase I/II Study of ABT-888 in Combination With Temozolomide in Recurrent (Temozolomide Resistant) Glioblastoma


OBJECTIVES:

Primary

- To define the maximum-tolerated dose of the combination of temozolomide and veliparib
in patients with recurrent glioblastoma previously or not treated with temozolomide.
(Phase I*)

- To determine the efficacy of the combination of temozolomide and veliparib (using a
5-day vs 21-day schedule) as measured by the 6-month progression-free survival rate in
patients with recurrent glioblastoma previously treated with temozolomide. (Phase II*)

Secondary

- To characterize the safety profile of the combination of temozolomide and veliparib.
(Phase I*)

- To determine the adverse event profile and tolerability of the combination of
temozolomide and veliparib (using a 5-day vs 21-day schedule) in patients with
recurrent glioblastoma. (Phase II*)

- To determine the efficacy of the combination of temozolomide and veliparib (using a
5-day vs 21-day schedule) as measured by objective response in patients with measurable
disease. (Phase II*)

- To determine the overall survival of patients with measurable disease treated with the
combination of temozolomide and veliparib (using a 5-day vs 21-day schedule). (Phase
II*) NOTE: *Phase I was closed and phase II was opened on 3/6/12.

OUTLINE: This is a multicenter, phase I* dose-escalation study followed by a phase II*
randomized study. Patients enrolled in the phase II portion are stratified according to
bevacizumab status (bevacizumab-naive vs bevacizumab-failure), age (< 50 years vs ≥ 50
years), Karnofsky performance status (70-80% vs 90-100%), and recent resection (yes vs
no/biopsy only).

- Phase I:* Patients receive oral temozolomide once daily and oral veliparib twice daily
on days 1-21. Courses repeat every 28 days in the absence of disease progression or
unacceptable toxicity.

- Phase II:* Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients receive temozolomide and veliparib as in phase I.

- Arm II: Patients receive oral temozolomide once daily and oral veliparib twice
daily on days 1-5. Courses repeat every 28 days in the absence of disease
progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 12 weeks for 1 year,
every 26 weeks for 2 years, and then annually thereafter.

NOTE: *Phase I was closed and phase II was opened on 3/6/12.

PROJECTED ACCRUAL: A total of 240 patients (28 for phase I* and 212 for phase II*) will be
accrued for this study.

NOTE: *Phase I was closed and phase II was opened on 3/6/12.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed diagnosis of 1 of the following:

- Any intracranial high-grade glioma (phase I*)

- Glioblastoma or gliosarcoma (phase II*)

- Patients whose original histology was low-grade glioma are eligible provided they
were subsequently diagnosed with glioblastoma or gliosarcoma

- Unequivocal radiographic evidence for tumor progression by MRI within 14 days prior
to registration and with a stable or decreasing dose of steroids at least 5 days
prior to scanning OR recent resection (registration within 30 days of resection) as
long as all of the following conditions are met:

- Patients must have recovered from the effects of surgery

- Residual disease following resection of recurrent glioblastoma is not mandated
for eligibility into the study; to best assess the extent of residual disease
post-operatively, a post-operative MRI scan should be performed within 28 days
prior to registration and within 96 hours post surgery (although 24 hours would
be optimum)

- Prior radiation is required for the phase I* arm

- Patients must have completed a course of radiation therapy and at least 2
consecutive adjuvant cycles of temozolomide (phase II*)

- A stable or decreasing dose of steroids at least 5 days prior to scanning is not
mandated for patients who had a recent resection

- No evidence of acute (i.e., new and active) intratumoral hemorrhage on MRI

- Patients with MRI demonstrating old hemorrhage or subacute blood after a
neurosurgical procedure (biopsy or resection) are eligible NOTE: *Phase I was
closed and phase II was opened on 3/6/12.

PATIENT CHARACTERISTICS:

- Karnofsky performance status 70-100%

- WBC ≥ 3,000/mm^3

- ANC ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- Hemoglobin ≥ 10.0 g/dL (transfusion or other intervention allowed)

- SGOT ≤ 3.0 times upper limit of normal (ULN)

- SGPT ≤ 3.0 times ULN

- Bilirubin ≤ 1.25 times ULN

- Creatinine < 1.7 mg/dL OR estimated GFR ≥ 30 mL/min

- Urine protein:creatinine ratio ≤ 0.5 OR urine protein < 1,000 mg by 24-hour urine
collection**

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for ≥ 6 months after
completion of study therapy

- Able to undergo brain MRI scans with IV gadolinium

- Able to swallow oral medications

- Patients with a history of seizure, or new onset of seizures, should be clinically
controlled with no seizures for at least 14 days prior to registration

- No other prior invasive malignancy (except for nonmelanomatous skin cancer or
carcinoma in situ of the cervix) unless the patient has been disease-free and off
therapy for that disease for ≥ 3 years

- No severe, active comorbidity, including any of the following:

- Transmural myocardial infarction or unstable angina within the past 6 months

- Evidence of recent myocardial infarction or ischemia as indicated by S-T
elevations of ≥ 2 mm on EKG performed within the past 14 days

- NYHA class II-IV congestive heart failure requiring hospitalization within the
past 12 months

- Stroke or transient ischemic attack within the past 6 months

- Cerebral vascular accident within the past 6 months

- Serious and inadequately controlled cardiac arrhythmia

- Clinically significant peripheral vascular disease

- Evidence of bleeding diathesis or coagulopathy

- Serious non-healing would, ulcer, or bone fracture

- Abdominal fistula, gastrointestinal (GI) perforation, or intra-abdominal abscess
within the past 28 days

- Significant traumatic injury within the past 28 days

- Acute bacterial or fungal infection requiring IV antibiotics at the time of
study registration

- Chronic obstructive pulmonary disease exacerbation or other respiratory illness
requiring hospitalization or precluding study therapy within the past 14 days

- AIDS based upon current CDC definition (HIV testing is not required)

- No condition that would impair the ability to swallow pills (e.g., GI tract disease
resulting in an inability to take oral medication or a requirement for IV
alimentation, prior surgical procedures affecting absorption, or active peptic ulcer
disease)

- No disease that would obscure toxicity or dangerously alter drug metabolism

- Not on dialysis

- No history of chronic hepatitis B or C NOTE: **Required for patients who received
prior bevacizumab and developed known clinically significant nephrotic syndrome
during treatment and whose baseline values have not returned to normal.

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- Recovered from the toxic effects of prior therapy

- Prior interstitial brachytherapy, Gliadel wafer, or stereotactic radiosurgery allowed
provided there is confirmation of progressive disease by PET scan, thallium scan, MRI
spectroscopy, perfusion MRI, or surgical documentation

- No more than 3 prior treatment regimens (phase I*)

- No more than 2 prior treatment regimens for recurrent glioblastoma/gliosarcoma (phase
II*)

- More than 28 days since prior major surgical procedure or open biopsy (with the
exception of craniotomy)

- At least 28 days since prior investigational agents or cytotoxic agents (42 days for
nitrosoureas, 21 days for procarbazine, and 14 days for vincristine)

- At least 14 days since prior non-cytotoxic agents (e.g., bevacizumab, interferon,
tamoxifen, thalidomide, isotretinoin, or tyrosine kinase inhibitors)

- No concurrent highly-active antiretroviral therapy

- No concurrent herbal products of unknown constitution

- No concurrent major surgical procedures NOTE: *Phase I was closed and phase II was
opened on 3/6/12.

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Dose-limiting toxicity (Phase I)

Outcome Time Frame:

The first 8 weeks.

Safety Issue:

Yes

Principal Investigator

H. I. Robins, MD, PhD

Investigator Role:

Study Chair

Investigator Affiliation:

University of Wisconsin, Madison

Authority:

United States: Food and Drug Administration

Study ID:

RTOG-0929

NCT ID:

NCT01026493

Start Date:

July 2010

Completion Date:

Related Keywords:

  • Brain and Central Nervous System Tumors
  • adult giant cell glioblastoma
  • adult glioblastoma
  • adult gliosarcoma
  • recurrent adult brain tumor
  • adult anaplastic astrocytoma
  • adult anaplastic ependymoma
  • adult anaplastic oligodendroglioma
  • adult brain stem glioma
  • adult mixed glioma
  • adult pineal gland astrocytoma
  • Glioblastoma
  • Nervous System Neoplasms
  • Central Nervous System Neoplasms

Name

Location

University of Chicago Cancer Research Center Chicago, Illinois  60637
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire  03756-0002
Cedars-Sinai Medical Center Los Angeles, California  90048
Cancer Research Center of Hawaii Honolulu, Hawaii  96813
Rebecca and John Moores UCSD Cancer Center La Jolla, California  92093-0658
Central Baptist Hospital Lexington, Kentucky  40503
James P. Wilmot Cancer Center at University of Rochester Medical Center Rochester, New York  14642
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School New Brunswick, New Jersey  08903
Highland Hospital of Rochester Rochester, New York  14620
Regional Cancer Center at Singing River Hospital Pascagoula, Mississippi  39581
Legacy Good Samaritan Hospital & Comprehensive Cancer Center Portland, Oregon  97210
Queen's Cancer Institute at Queen's Medical Center Honolulu, Hawaii  96813
Louisville Oncology at Norton Cancer Institute - Louisville Louisville, Kentucky  40202
Hawaii Medical Center - East Honolulu, Hawaii  96817
CCOP - Kansas City Prairie Village, Kansas  66208
Renown Institute for Cancer at Renown Regional Medical Center Reno, Nevada  89502
Leeward Radiation Oncology Ewa Beach, Hawaii  96706