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Gefitinib and Radiation Therapy in Treating Patients With Glioblastoma Multiforme

Primary Purpose

Adult Giant Cell Glioblastoma, Adult Glioblastoma, Adult Gliosarcoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
gefitinib
radiation therapy
laboratory biomarker analysis
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adult Giant Cell Glioblastoma

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histopathologically confirmed glioblastoma multiforme (with areas of necrosis) Diagnosis must be made by surgical biopsy or excision The tumor must be supratentorial in location The patient must have recovered from the effects of surgery, post-operative infection, or other complications before study entry Radiotherapy must begin =< five weeks after surgery, and Iressa (gefitinib) must begin one week prior to radiotherapy Patients must have an estimated survival of at least 8 weeks Zubrod performance status of 0-1 A diagnostic contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) scan must be performed preoperatively and postoperatively prior to the initiation of radiotherapy; preoperative and postoperative scans must be the same type Patients diagnosed only by stereotactic biopsy do not require the postoperative scan Patients unable to undergo magnetic resonance (MR) imaging because of non-compatible devices can be enrolled, provided pre and postoperative CT scans are obtained and are of sufficient quality Hemoglobin >= 10 grams Absolute neutrophil count >= 1500 (ANC) per mm^3 Platelets >= 100,000 per mm^3 Blood urea nitrogen (BUN) =< 25 mg Creatinine =< 1.5 mg Bilirubin =< 2.0 mg Serum glutamate pyruvate transaminase (SGPT) or serum glutamic oxaloacetic transaminase (SGOT) =< 2 x normal range Patients must consent to submission of their tissue/serum The patient must sign a study-specific informed consent prior to study entry; if the patient's mental status precludes his/her giving informed consent, written informed consent may be given by the responsible family member Exclusion Criteria: Recurrent or multifocal malignant gliomas Metastases detected below the tentorium or beyond the cranial vault Major medical illnesses or psychiatric impairments which, in the investigator's opinion, will prevent administration or completion of protocol therapy Previous radiotherapy to the head or neck (except for T1 glottic cancer), resulting in overlap of radiation fields Active connective tissue disorders, such as lupus or scleroderma which, in the opinion of the treating physician, may put the patient at high risk for radiation toxicity Previous malignancies, except for non-melanomatous skin cancers and carcinoma in situ of the uterine cervix or bladder, unless disease-free for >= 3 years Prior chemotherapy or radiosensitizers for cancers of the head and neck region Patients with known acquired immune deficiency (AIDS); patients with AIDS require complex therapeutic regimens; the pharmacokinetic interactions of these regimens with ZD 1839 are unknown and therefore, pose a safety risk related to excess toxicity or interference with anti-viral effectiveness Patients with known multiple sclerosis, as these patients may have decreased tolerance for radiation therapy to the brain Pregnant or lactating women, due to possible adverse effects on the developing fetus or infant due to study drug Patients treated on any other clinical protocols within 30 days prior to study entry or during participation in the study

Sites / Locations

  • Radiation Therapy Oncology Group

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (gefitinib, radiation therapy)

Arm Description

Patients receive gefitinib PO QD for 7 weeks. Beginning 1 week after initiation of gefitinib, patients undergo radiation therapy QD 5 days a week for 6 weeks. Treatment with gefitinib continues for up to 18 months in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Maximum tolerated dose of gefitinib defined as the dose at which no patients develop acute grade 5 toxicity and less than 30% of patients developed acute dose limiting toxicity graded by the National Cancer Institute Common Toxicity Criteria v2.0
Rate of late toxicities associated with gefitinib and standard cranial radiation, graded according to the NCI CTC v2.0
Overall survival, by EGFR status

Secondary Outcome Measures

Progression-free survival

Full Information

First Posted
January 24, 2003
Last Updated
October 29, 2020
Sponsor
National Cancer Institute (NCI)
Collaborators
NRG Oncology
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1. Study Identification

Unique Protocol Identification Number
NCT00052208
Brief Title
Gefitinib and Radiation Therapy in Treating Patients With Glioblastoma Multiforme
Official Title
A Phase I/II Study of an Oral Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR-TKI), ZD 1839 (Iressa), [NSC #715055] With Radiation Therapy in Glioblastoma Multiforme
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Completed
Study Start Date
March 2002 (undefined)
Primary Completion Date
June 2005 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)
Collaborators
NRG Oncology

4. Oversight

5. Study Description

Brief Summary
This phase I/II trial studies the side effects and best dose of gefitinib when given together with radiation therapy and to see how well it works in treating patients with glioblastoma multiforme. Gefitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Radiation therapy uses high energy x rays to kill tumor cells. Giving gefitinib together with radiation therapy may be an effective treatment for glioblastoma multiforme.
Detailed Description
PRIMARY OBJECTIVES: I. To identify the maximum tolerated dose of ZD 1839 (gefitinib) when given concurrently with cranial radiotherapy. II. To determine if ZD 1839, given orally on a daily basis starting at the time of conventional radiation therapy (RT), may improve the overall survival of adults with newly-diagnosed supratentorial glioblastoma multiforme, compared with historical controls, stratifying by epidermal growth factor receptor (EGFR) status. III. To determine, in a multi-institutional setting, the feasibility and toxicity of prescribing ZD 1839. SECONDARY OBJECTIVES: I. Whether ZD 1839 also improves progression-free survival in these patients. OUTLINE: This is a phase I, dose-escalation study of gefitinib followed by a phase II study. Patients receive gefitinib orally (PO) once daily (QD) for 7 weeks. Beginning 1 week after initiation of gefitinib, patients undergo radiation therapy QD 5 days a week for 6 weeks. Treatment with gefitinib continues for up to 18 months in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 4 months for 1 year, every 6 months for 2 years, and annually thereafter.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adult Giant Cell Glioblastoma, Adult Glioblastoma, Adult Gliosarcoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
158 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (gefitinib, radiation therapy)
Arm Type
Experimental
Arm Description
Patients receive gefitinib PO QD for 7 weeks. Beginning 1 week after initiation of gefitinib, patients undergo radiation therapy QD 5 days a week for 6 weeks. Treatment with gefitinib continues for up to 18 months in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
gefitinib
Other Intervention Name(s)
Iressa, ZD 1839
Intervention Description
Given PO
Intervention Type
Radiation
Intervention Name(s)
radiation therapy
Other Intervention Name(s)
irradiation, radiotherapy, therapy, radiation
Intervention Description
Undergo radiation therapy
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Maximum tolerated dose of gefitinib defined as the dose at which no patients develop acute grade 5 toxicity and less than 30% of patients developed acute dose limiting toxicity graded by the National Cancer Institute Common Toxicity Criteria v2.0
Time Frame
Within 90 days from the start of radiotherapy treatment
Title
Rate of late toxicities associated with gefitinib and standard cranial radiation, graded according to the NCI CTC v2.0
Time Frame
Up to 10 years
Title
Overall survival, by EGFR status
Time Frame
Up to 10 years
Secondary Outcome Measure Information:
Title
Progression-free survival
Time Frame
Up to 10 years

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histopathologically confirmed glioblastoma multiforme (with areas of necrosis) Diagnosis must be made by surgical biopsy or excision The tumor must be supratentorial in location The patient must have recovered from the effects of surgery, post-operative infection, or other complications before study entry Radiotherapy must begin =< five weeks after surgery, and Iressa (gefitinib) must begin one week prior to radiotherapy Patients must have an estimated survival of at least 8 weeks Zubrod performance status of 0-1 A diagnostic contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) scan must be performed preoperatively and postoperatively prior to the initiation of radiotherapy; preoperative and postoperative scans must be the same type Patients diagnosed only by stereotactic biopsy do not require the postoperative scan Patients unable to undergo magnetic resonance (MR) imaging because of non-compatible devices can be enrolled, provided pre and postoperative CT scans are obtained and are of sufficient quality Hemoglobin >= 10 grams Absolute neutrophil count >= 1500 (ANC) per mm^3 Platelets >= 100,000 per mm^3 Blood urea nitrogen (BUN) =< 25 mg Creatinine =< 1.5 mg Bilirubin =< 2.0 mg Serum glutamate pyruvate transaminase (SGPT) or serum glutamic oxaloacetic transaminase (SGOT) =< 2 x normal range Patients must consent to submission of their tissue/serum The patient must sign a study-specific informed consent prior to study entry; if the patient's mental status precludes his/her giving informed consent, written informed consent may be given by the responsible family member Exclusion Criteria: Recurrent or multifocal malignant gliomas Metastases detected below the tentorium or beyond the cranial vault Major medical illnesses or psychiatric impairments which, in the investigator's opinion, will prevent administration or completion of protocol therapy Previous radiotherapy to the head or neck (except for T1 glottic cancer), resulting in overlap of radiation fields Active connective tissue disorders, such as lupus or scleroderma which, in the opinion of the treating physician, may put the patient at high risk for radiation toxicity Previous malignancies, except for non-melanomatous skin cancers and carcinoma in situ of the uterine cervix or bladder, unless disease-free for >= 3 years Prior chemotherapy or radiosensitizers for cancers of the head and neck region Patients with known acquired immune deficiency (AIDS); patients with AIDS require complex therapeutic regimens; the pharmacokinetic interactions of these regimens with ZD 1839 are unknown and therefore, pose a safety risk related to excess toxicity or interference with anti-viral effectiveness Patients with known multiple sclerosis, as these patients may have decreased tolerance for radiation therapy to the brain Pregnant or lactating women, due to possible adverse effects on the developing fetus or infant due to study drug Patients treated on any other clinical protocols within 30 days prior to study entry or during participation in the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Arnab Chakravarti
Organizational Affiliation
Radiation Therapy Oncology Group
Official's Role
Principal Investigator
Facility Information:
Facility Name
Radiation Therapy Oncology Group
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19103
Country
United States

12. IPD Sharing Statement

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Gefitinib and Radiation Therapy in Treating Patients With Glioblastoma Multiforme

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