Randomized, Phase II, Double-Blind, Placebo-Controlled Trial of Conventional Chemoradiation and Adjuvant Temozolomide Plus Cediranib Versus Conventional Chemoradiation and Adjuvant Temozolomide Plus Placebo in Patients With Newly Diagnosed Glioblastoma
PRIMARY OBJECTIVES:
I. To determine if the addition of cediranib to chemoradiation treatment enhances treatment
efficacy as measured by the 6-month progression-free survival rate.
II. To assess the association between overall survival and change in each of the following
markers: Ktrans, gradient echo CBV, and [18F]FLT Ki and K1, from T0 to T1.
SECONDARY OBJECTIVES:
I. To determine if the addition of cediranib to chemoradiation treatment enhances treatment
efficacy as measured by overall survival.
II. To determine if the addition of cediranib to chemoradiation treatment enhances treatment
efficacy as measured by progression-free survival.
III. To determine if there is an association between tumor MGMT gene methylation status and
treatment response and outcome.
IV. To compare and record the toxicities of the cediranib + chemoradiation arm versus the
chemoradiation arm.
V. To evaluate whether 6-month progression-free survival is associated with overall
survival.
VI. To assess the association between progression-free survival and change in each of the
following markers: Ktrans, gradient echo CBV, and [18F]FLT Ki and K1 from T0 to T1.
VII. To assess the association between overall survival and change in each of the following
markers: Ktrans, gradient echo CBV, and [18F]FLT Ki and K1 from T1 to T3.
VIII. To assess the association between progression-free survival and change in each of the
following markers: Ktrans, gradient echo CBV, and [18F]FLT Ki and K1, from T1 to T3.
IX. To assess the association between overall and progression-free survival and the T0
values of each of the following markers: Ktrans, gradient echo CBV, and [18F]FLT Ki and K1.
X. To assess the relationship between [18F]FLT Ki and K1 and markers of tumor proliferation,
both cross-sectionally and longitudinally.
XI. To evaluate the reproducibility of [18F]FLT Ki and K1 measurements. XII. To assess the
association between overall and progression-free survival and the change in the "vascular
normalization index" between T0 and T1.
OUTLINE: This is a multicenter study. Patients are stratified according to recursive
partitioning analysis class (III vs IV vs V) and MGMT methylation status (methylated vs
unmethylated vs invalid). Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive cediranib maleate orally (PO) once daily (QD) for 3 days. Patients
then undergo radiotherapy (intensity-modulated radiotherapy or 3-dimensional conformal
radiotherapy) QD, 5 days a week, for 6 weeks and receive temozolomide PO QD and cediranib
maleate PO QD for 6 weeks. Patients then receive cediranib maleate PO alone QD for 28 days.
Patients then receive temozolomide PO QD for 5 days and cediranib maleate PO QD for 28 days.
Treatment with temozolomide and cediranib maleate repeats every 28 days for up to 12
courses in the absence of disease progression or unacceptable toxicity.
ARM II: Patients receive placebo PO QD for 3 days. Patients then undergo radiotherapy
(intensity-modulated radiotherapy or 3-dimensional conformal radiotherapy) QD, 5 days a
week, for 6 weeks and receive temozolomide PO QD and placebo PO QD for 6 weeks. Patients
then receive placebo PO alone QD for 28 days. Patients then receive temozolomide PO QD for 5
days and placebo PO QD for 28 days. Treatment with temozolomide and placebo repeats every 28
days for up to 12 courses in the absence of disease progression or unacceptable toxicity.
Some patients undergo advanced imaging studies including magnetic resonance spectroscopy,
dynamic contrast-enhanced MRI, dynamic susceptibility-contrast MRI, and/or
3'-deoxy-3'-[18F]fluorothymidine positron emission tomography at baseline and periodically
during study.
After completion of study therapy, patients are followed up every 3 months for 1 year, every
4 months for 1 year, and then every 6 months thereafter.
Interventional
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
6-month PFS as assessed using MacDonald criteria and Response Evaluation Criteria in Solid Tumors (RECIST)
Standard MRI exams will be submitted to the ACRIN Imaging Core Laboratory for determination of progression-free survival by two readers. Images will be assessed using MacDonald criteria for progression versus response on 2D T1 and T2 weighted images. The primary measure of response will be by serial measures of the product of the two largest cross-sectional diameters. Progression (P): A > 25% increase in tumor area (two diameters) provided that the patient has not had his/her dose of steroids decreased since the last evaluation period.
From registration to 6 months
No
Tracy Batchelor
Principal Investigator
Radiation Therapy Oncology Group
United States: Food and Drug Administration
NCI-2011-02012
NCT01062425
February 2010
Name | Location |
---|---|
Akron City Hospital | Akron, Ohio 44304 |
Washington University School of Medicine | Saint Louis, Missouri 63110 |
Abington Memorial Hospital | Abington, Pennsylvania 19001 |
Medical University of South Carolina | Charleston, South Carolina 29425-0721 |
University of Washington Medical Center | Seattle, Washington 98195-6043 |
West Michigan Cancer Center | Kalamazoo, Michigan 49007-3731 |
United Hospital | St. Paul, Minnesota 55102 |
Massachusetts General Hospital Cancer Center | Boston, Massachusetts 02114 |
Rapid City Regional Hospital | Rapid City, South Dakota 57709 |
Henry Ford Hospital | Detroit, Michigan 48202 |
Akron General Medical Center | Akron, Ohio 44302 |
Reading Hospital and Medical Center | Reading, Pennsylvania 19612-6052 |
University of Texas Medical Branch | Galveston, Texas 77555-1329 |
LDS Hospital | Salt Lake City, Utah 84143 |
Rush University Medical Center | Chicago, Illinois 60612-3824 |
University of Kansas Medical Center | Kansas City, Kansas 66160-7353 |
Bay Medical Center | Panama City, Florida 32401 |
Carolinas Medical Center | Charlotte, North Carolina 28232-2861 |
Inova Fairfax Hospital | Falls Church, Virginia 22042-3300 |
University of Wisconsin Hospital and Clinics | Madison, Wisconsin 53792-0001 |
Central Baptist Hospital | Lexington, Kentucky 40503 |
McKay-Dee Hospital Center | Ogden, Utah 84403 |
Brigham and Women's Hospital | Boston, Massachusetts 02115 |
Methodist Estabrook Cancer Center | Omaha, Nebraska 68114-4199 |
Paoli Memorial Hospital | Paoli, Pennsylvania 19301-1792 |
Bryn Mawr Hospital | Bryn Mawr, Pennsylvania 19010 |
Mercy Hospital | Coon Rapids, Minnesota 55433 |
Poudre Valley Radiation Oncology | Fort Collins, Colorado 80528 |
Saint Joseph Mercy Hospital | Ann Arbor, Michigan 48106 |
Regions Hospital | Saint Paul, Minnesota 55101 |
Cancer Treatment Center | Wooster, Ohio 44691 |
Allegheny Cancer Center at Allegheny General Hospital | Pittsburgh, Pennsylvania 15212 |
Spartanburg Regional Medical Center | Spartanburg, South Carolina 29303 |
Genesys Regional Medical Center | Grand Blanc, Michigan 48439-8066 |
Arizona Oncology Services Foundation | Phoenix, Arizona 85013 |
City of Hope | Duarte, California 91010 |
Queen's Medical Center | Honolulu, Hawaii 96813 |
University of Alabama at Birmingham | Birmingham, Alabama 35294-3300 |
Northwestern University | Chicago, Illinois 60611 |
Northwest Cancer Specialists | Vancouver, Washington 98664 |
Cancer Care Center, Incorporated | Salem, Ohio 44460 |
University of Rochester | Rochester, New York 14642 |
Saint Alphonsus Regional Medical Center | Boise, Idaho 83706 |
Yale University | New Haven, Connecticut 06520 |
Emory University | Atlanta, Georgia 30322 |
Ohio State University Medical Center | Columbus, Ohio 43210 |
University of Arizona Health Sciences Center | Tucson, Arizona 85724 |
Radiation Therapy Oncology Group | Philadelphia, Pennsylvania 19107 |
Providence Portland Medical Center | Portland, Oregon 97213-3635 |
University of Texas Southwestern Medical Center | Dallas, Texas |
University of Kentucky | Lexington, Kentucky 40536-0098 |
Virginia Mason CCOP | Seattle, Washington 98101 |
Thomas Jefferson University Hospital | Philadelphia, Pennsylvania 19131 |
Lankenau Hospital | Wynnewood, Pennsylvania 19096 |
Florida Hospital | Orlando, Florida 32803 |
University of Cincinnati | Cincinnati, Ohio 45267-0502 |
Hawaii Medical Center East | Honolulu, Hawaii 96817 |
Penn State Milton S Hershey Medical Center | Hershey, Pennsylvania 17033 |
Clackamas Radiation Oncology Center | Clackamas, Oregon 97015 |
Froedtert and the Medical College of Wisconsin | Milwaukee, Wisconsin 53226 |
Wake Forest University Health Sciences | Winston-Salem, North Carolina 27157 |
OSF Saint Francis Medical Center | Peoria, Illinois 61637 |
Saint Joseph Hospital | Orange, California 92868 |
Saint Francis Hospital and Medical Center | Hartford, Connecticut 06105 |
The Hospital of Central Connecticut | New Britain, Connecticut 06050 |
University of Hawaii | Honolulu, Hawaii 96813 |
Carle Foundation dba Carle Cancer Center | Urbana, Illinois 61801 |
Saint John Hospital and Medical Center | Detroit, Michigan 48236 |
Sparrow Hospital | Lansing, Michigan 48912 |
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 |
Minnesota Oncology Hematology PA-Maplewood | Maplewood, Minnesota 55109 |
Sparta Cancer Treatment Center | Sparta, New Jersey 07871 |
Summa Barberton Hospital | Barberton, Ohio 44203 |
Natalie W Bryant Cancer Center | Tulsa, Oklahoma 74136 |
Legacy Good Samaritan Hospital and Medical Center | Portland, Oregon 97210 |
Providence Saint Vincent Medical Center | Portland, Oregon 97225 |
Saint Luke's Hospital | Bethlehem, Pennsylvania 18015 |
Swedish Medical Center-First Hill | Seattle, Washington 98122-4307 |
Wheeling Hospital | Wheeling, West Virginia 26003 |
Aspirus Regional Cancer Center | Wausau, Wisconsin 54401 |
University of Maryland Greenebaum Cancer Center | Baltimore, Maryland 21201 |
Northeast Radiation Oncology Center | Dunmore, Pennsylvania 18512 |
Henry Ford Macomb Hospital | Clinton Township, Michigan 48038 |
Christiana Healthcare Services - Christian Hospital | Newark, Delaware 19718 |
Maine Medical Center- Scarborough Campus | Scarborough, Maine 04074 |
Intermountain Medical Center | Murray, Utah 84157 |
Utah Valley Regional Medical Center | Provo, Utah 84603 |
Dixie Medical Center Regional Cancer Center | Saint George, Utah 84770 |
Utah Cancer Specialists-Salt Lake City | Salt Lake City, Utah 84106 |
Crawford-Long Hospital of Emory University | Atlanta, Georgia 30308 |
Kansas City CCOP | Prairie Village, Kansas 66208 |
Forsyth Memorial Hospital | Winston-Salem, North Carolina 27103 |
Robinson Radiation Oncology | Ravenna, Ohio 44266 |
Dana-Farber Harvard Cancer Center | Boston, Massachusetts 02115 |
The Kirklin Clinic at Acton Road | Birmingham, Alabama 35243 |
Radiation Oncology Associates PC | Fort Wayne, Indiana 46804 |
Parkview Memorial Hospital | Fort Wayne, Indiana 46805 |
Clarian Health - Methodist Hospital | Indianapolis, Indiana 46202 |
University Pointe | West Chester, Ohio 45069 |