search
Back to results

Gefitinib in Treating Patients With Recurrent or Progressive CNS Tumors

Primary Purpose

Brain and Central Nervous System Tumors

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
gefitinib
Sponsored by
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring recurrent adult brain tumor, adult meningioma, adult glioblastoma, adult anaplastic astrocytoma, adult anaplastic oligodendroglioma, adult pilocytic astrocytoma, adult subependymoma, adult mixed glioma, adult meningeal hemangiopericytoma, adult grade III meningioma, adult giant cell glioblastoma, adult gliosarcoma, adult grade I meningioma, adult grade II meningioma

Eligibility Criteria

18 Years - 120 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Diagnosis of 1 of the following: Histologically confirmed supratentorial malignant primary glioma Glioblastoma multiforme Anaplastic astrocytoma Anaplastic oligodendroglioma Anaplastic mixed oligoastrocytoma Malignant astrocytoma not otherwise specified Histologically confirmed or radiographically defined recurrent or progressive brain or spinal meningioma, including base of skull or cavernous sinus meningiomas Benign, malignant, or atypical May include neurofibromatosis type I or II Hemangiopericytoma allowed Recurrent or progressive disease by MRI or CT scan Evidence of true progressive disease by PET or thallium scan, MR spectroscopy, or surgical documentation required if patient received prior interstitial brachytherapy or stereotactic radiosurgery (to the target lesion for meningioma and hemangiopericytoma) Steroid dosage must be stable for at least 5 days prior to scan No limitations on the number of prior surgeries, radiotherapy or chemotherapy regimens, or radiosurgery treatments for patients with meningioma or hemangiopericytoma and may include standard external beam radiotherapy, interstitial brachytherapy, or gamma-knife radiosurgery in any combination Patients with glioma must have failed prior radiotherapy Original histology of low-grade glioma allowed if subsequent confirmation of malignant glioma is made at time of recurrence Phase I (closed to accrual as of 09/19/2003): Prior treatment for no more than 3 prior relapses in patients with glioma Phase II: Measurable disease after prior surgical resection of recurrent or progressive disease Prior treatment for no more than 2 prior relapses in patients with glioma PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 60-100% Life expectancy: More than 8 weeks Hematopoietic: WBC at least 3,000/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 120,000/mm^3 Hemoglobin at least 10 g/dL (transfusion allowed) Hepatic: Bilirubin less than 1.5 times upper limit of normal (ULN) SGOT less than 1.5 times ULN Renal: Creatinine less than 1.5 mg/dL OR Creatinine clearance at least 60 mL/min Cardiovascular: No significant cardiac risk factors within the past 6 months Other: Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No gastrointestinal risk factors (e.g., active ulcerative colitis) within the past 6 months No active infection No concurrent disease that would obscure toxicity or dangerously alter drug metabolism No other significant medical illness that would preclude study No other malignancy within the past 3 years except non-melanoma skin cancer or carcinoma in situ of the cervix PRIOR CONCURRENT THERAPY: Biologic therapy: At least 1 week since prior interferon or thalidomide No concurrent filgrastim (G-CSF) Chemotherapy: See Disease Characteristics At least 2 weeks since prior vincristine At least 6 weeks since prior nitrosoureas At least 3 weeks since prior procarbazine Endocrine therapy: At least 1 week since prior tamoxifen Radiotherapy: See Disease Characteristics At least 4 weeks since prior radiotherapy Surgery: See Disease Characteristics At least 7 days since prior surgery for recurrent or progressive tumor and recovered Other: Recovered from prior therapy No prior gefitinib or other epidermal growth factor receptor inhibitor At least 1 week since prior isotretinoin At least 1 week since other prior noncytotoxic agents (except radiosensitizers) At least 4 weeks since prior investigational agents Concurrent low-molecular weight heparin or warfarin for deep vein thrombosis or pulmonary embolism allowed

Sites / Locations

  • Jonsson Comprehensive Cancer Center at UCLA
  • UCSF Comprehensive Cancer Center
  • Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
  • NCI - Neuro-Oncology Branch
  • Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
  • University of Michigan Comprehensive Cancer Center
  • Memorial Sloan-Kettering Cancer Center
  • Hillman Cancer Center at University of Pittsburgh Cancer Institute
  • Simmons Cancer Center at University of Texas Southwestern Medical Center - Dallas
  • M.D. Anderson Cancer Center at University of Texas
  • University of Texas Health Science Center at San Antonio
  • University of Wisconsin Comprehensive Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

p450

nonp450

Arm Description

p450 inhibitor

not on p450 inhibitor

Outcomes

Primary Outcome Measures

Progression-free survival at 6 months

Secondary Outcome Measures

Full Information

First Posted
October 11, 2001
Last Updated
June 22, 2018
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
National Cancer Institute (NCI)
search

1. Study Identification

Unique Protocol Identification Number
NCT00025675
Brief Title
Gefitinib in Treating Patients With Recurrent or Progressive CNS Tumors
Official Title
ZD1839 FOR Treatment Of Recurrent Or Progressive Malignant Astrocytoma Or Glioblastoma And Recurrent Or Progressive Meningioma: A Phase II Study With A Phase I Component For Patients Receiving EIAEDs
Study Type
Interventional

2. Study Status

Record Verification Date
June 2018
Overall Recruitment Status
Completed
Study Start Date
October 9, 2001 (Actual)
Primary Completion Date
July 5, 2006 (Actual)
Study Completion Date
January 2, 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Biological therapies such as gefitinib may interfere with the growth of tumor cells and slow the growth of CNS tumors. PURPOSE: Phase II trial to study the effectiveness of gefitinib in treating patients who have recurrent or progressive CNS tumors.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose of gefitinib in patients with recurrent or progressive supratentorial malignant gliomas or brain or spinal meningiomas receiving enzyme-inducing antiepileptic drugs (EIAEDs). (Phase I of the study closed to accrual as of 09/19/2003). Determine the toxic effects of this drug in these patients. Determine the pharmacokinetics of this drug in patients receiving EIAEDs. Determine the efficacy of this drug in terms of 6-month progression-free survival of these patients. Determine the safety profile of the phase II dose of this drug in these patients. OUTLINE: This is a multicenter, dose-escalation study. Patients are stratified according to concurrent enzyme-inducing antiepileptic drugs (EIAEDs) (yes vs no) and disease type (for phase II only) (benign meningioma vs malignant meningioma vs hemangiopericytoma vs glioblastoma vs other anaplastic glioma). (Phase I closed to accrual as of 09/19/2003). Patients receive oral gefitinib once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients (who are receiving EIAEDs) receive escalating doses of gefitinib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Patients are followed at 2 weeks. PROJECTED ACCRUAL: A minimum of 30 patients will be accrued for the phase I portion of this study within 10 months . (Phase I closed to accrual as of 09/19/2003). A total of 48 patients will be accrued for the phase II portion of this study within 6-8 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain and Central Nervous System Tumors
Keywords
recurrent adult brain tumor, adult meningioma, adult glioblastoma, adult anaplastic astrocytoma, adult anaplastic oligodendroglioma, adult pilocytic astrocytoma, adult subependymoma, adult mixed glioma, adult meningeal hemangiopericytoma, adult grade III meningioma, adult giant cell glioblastoma, adult gliosarcoma, adult grade I meningioma, adult grade II meningioma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
105 (Actual)

8. Arms, Groups, and Interventions

Arm Title
p450
Arm Type
Active Comparator
Arm Description
p450 inhibitor
Arm Title
nonp450
Arm Type
Active Comparator
Arm Description
not on p450 inhibitor
Intervention Type
Drug
Intervention Name(s)
gefitinib
Primary Outcome Measure Information:
Title
Progression-free survival at 6 months
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
120 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of 1 of the following: Histologically confirmed supratentorial malignant primary glioma Glioblastoma multiforme Anaplastic astrocytoma Anaplastic oligodendroglioma Anaplastic mixed oligoastrocytoma Malignant astrocytoma not otherwise specified Histologically confirmed or radiographically defined recurrent or progressive brain or spinal meningioma, including base of skull or cavernous sinus meningiomas Benign, malignant, or atypical May include neurofibromatosis type I or II Hemangiopericytoma allowed Recurrent or progressive disease by MRI or CT scan Evidence of true progressive disease by PET or thallium scan, MR spectroscopy, or surgical documentation required if patient received prior interstitial brachytherapy or stereotactic radiosurgery (to the target lesion for meningioma and hemangiopericytoma) Steroid dosage must be stable for at least 5 days prior to scan No limitations on the number of prior surgeries, radiotherapy or chemotherapy regimens, or radiosurgery treatments for patients with meningioma or hemangiopericytoma and may include standard external beam radiotherapy, interstitial brachytherapy, or gamma-knife radiosurgery in any combination Patients with glioma must have failed prior radiotherapy Original histology of low-grade glioma allowed if subsequent confirmation of malignant glioma is made at time of recurrence Phase I (closed to accrual as of 09/19/2003): Prior treatment for no more than 3 prior relapses in patients with glioma Phase II: Measurable disease after prior surgical resection of recurrent or progressive disease Prior treatment for no more than 2 prior relapses in patients with glioma PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 60-100% Life expectancy: More than 8 weeks Hematopoietic: WBC at least 3,000/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 120,000/mm^3 Hemoglobin at least 10 g/dL (transfusion allowed) Hepatic: Bilirubin less than 1.5 times upper limit of normal (ULN) SGOT less than 1.5 times ULN Renal: Creatinine less than 1.5 mg/dL OR Creatinine clearance at least 60 mL/min Cardiovascular: No significant cardiac risk factors within the past 6 months Other: Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No gastrointestinal risk factors (e.g., active ulcerative colitis) within the past 6 months No active infection No concurrent disease that would obscure toxicity or dangerously alter drug metabolism No other significant medical illness that would preclude study No other malignancy within the past 3 years except non-melanoma skin cancer or carcinoma in situ of the cervix PRIOR CONCURRENT THERAPY: Biologic therapy: At least 1 week since prior interferon or thalidomide No concurrent filgrastim (G-CSF) Chemotherapy: See Disease Characteristics At least 2 weeks since prior vincristine At least 6 weeks since prior nitrosoureas At least 3 weeks since prior procarbazine Endocrine therapy: At least 1 week since prior tamoxifen Radiotherapy: See Disease Characteristics At least 4 weeks since prior radiotherapy Surgery: See Disease Characteristics At least 7 days since prior surgery for recurrent or progressive tumor and recovered Other: Recovered from prior therapy No prior gefitinib or other epidermal growth factor receptor inhibitor At least 1 week since prior isotretinoin At least 1 week since other prior noncytotoxic agents (except radiosensitizers) At least 4 weeks since prior investigational agents Concurrent low-molecular weight heparin or warfarin for deep vein thrombosis or pulmonary embolism allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Frank S. Lieberman, MD
Organizational Affiliation
University of Pittsburgh
Official's Role
Study Chair
Facility Information:
Facility Name
Jonsson Comprehensive Cancer Center at UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
UCSF Comprehensive Cancer Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-1182
Country
United States
Facility Name
NCI - Neuro-Oncology Branch
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-8200
Country
United States
Facility Name
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
University of Michigan Comprehensive Cancer Center
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109-0316
Country
United States
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Hillman Cancer Center at University of Pittsburgh Cancer Institute
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
Facility Name
Simmons Cancer Center at University of Texas Southwestern Medical Center - Dallas
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390-9154
Country
United States
Facility Name
M.D. Anderson Cancer Center at University of Texas
City
Houston
State/Province
Texas
ZIP/Postal Code
77030-4009
Country
United States
Facility Name
University of Texas Health Science Center at San Antonio
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78284-6220
Country
United States
Facility Name
University of Wisconsin Comprehensive Cancer Center
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
19562255
Citation
Norden AD, Raizer JJ, Abrey LE, Lamborn KR, Lassman AB, Chang SM, Yung WK, Gilbert MR, Fine HA, Mehta M, Deangelis LM, Cloughesy TF, Robins HI, Aldape K, Dancey J, Prados MD, Lieberman F, Wen PY. Phase II trials of erlotinib or gefitinib in patients with recurrent meningioma. J Neurooncol. 2010 Jan;96(2):211-7. doi: 10.1007/s11060-009-9948-7. Epub 2009 Jun 28.
Results Reference
background
PubMed Identifier
16278407
Citation
Lassman AB, Rossi MR, Raizer JJ, Abrey LE, Lieberman FS, Grefe CN, Lamborn K, Pao W, Shih AH, Kuhn JG, Wilson R, Nowak NJ, Cowell JK, DeAngelis LM, Wen P, Gilbert MR, Chang S, Yung WA, Prados M, Holland EC. Molecular study of malignant gliomas treated with epidermal growth factor receptor inhibitors: tissue analysis from North American Brain Tumor Consortium Trials 01-03 and 00-01. Clin Cancer Res. 2005 Nov 1;11(21):7841-50. doi: 10.1158/1078-0432.CCR-05-0421. Erratum In: Clin Cancer Res. 2006 Jan 1;12(1):322. Razier, Jeffrey R [corrected to Raizer, Jeffrey J].
Results Reference
background

Learn more about this trial

Gefitinib in Treating Patients With Recurrent or Progressive CNS Tumors

We'll reach out to this number within 24 hrs