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Tipifarnib in Treating Young Patients With Recurrent or Progressive High-Grade Glioma, Medulloblastoma, Primitive Neuroectodermal Tumor, or Brain Stem Glioma

Primary Purpose

Childhood High-grade Cerebral Astrocytoma, Childhood Oligodendroglioma, Recurrent Childhood Brain Stem Glioma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
tipifarnib
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Childhood High-grade Cerebral Astrocytoma

Eligibility Criteria

undefined - 21 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histologically confirmed brain tumor, including the following: Anaplastic astrocytoma Glioblastoma multiforme Gliosarcoma Anaplastic oligodendroglioma Medulloblastoma/primitive neuroectodermal tumor (PNET) Diffuse intrinsic brain stem glioma* Progressive or relapsed disease after prior conventional therapy Radiographic evidence of measurable disease Performance status - Karnofsky 60-100% (over 16 years of age) Performance status - Lansky 60-100% (16 years of age and under) Performance status - ECOG 0-2 At least 8 weeks Absolute neutrophil count at least 1,000/mm^3 Platelet count at least 100,000/mm^3 (transfusion independent) Hemoglobin at least 8.0 g/dL (red blood cell transfusions allowed) Bilirubin no greater than 1.5 times upper limit of normal (ULN) SGPT and SGOT less than 2.5 times ULN Creatinine clearance OR radioisotope glomerular filtration rate at least 70 mL/min Maximum creatinine based on age as follows: 0.8 mg/dL (5 years and under) 1.0 mg/dL (6 to 10 years) 1.2 mg/dL (11 to 15 years) 1.5 mg/dL (over 15 years) Shortening fraction at least 27% by echocardiogram Ejection fraction at least 50% by MUGA No dyspnea at rest No exercise intolerance Pulse oximetry greater than 94%* Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Seizure disorder is allowed provided it is well-controlled on non-enzyme-inducing anticonvulsants No active graft-versus-host disease No uncontrolled infection No allergy to azoles (e.g., ketoconazole, itraconazole, or fluconazole) Recovered from prior immunotherapy At least 7 days since prior antineoplastic biologic agents At least 1 month since prior autologous stem cell transplantation (SCT) At least 6 months since prior allogeneic SCT More than 1 week since prior growth factors No concurrent immunomodulating agents More than 2 weeks since prior myelosuppressive chemotherapy (4-6 weeks for nitrosoureas or temozolomide) and recovered No concurrent anticancer chemotherapy Concurrent dexamethasone allowed provided patient is on a stable or decreasing dose for at least 1 week prior to study entry Concurrent corticosteroids allowed only for treatment of increased intracranial pressure Recovered from prior radiotherapy At least 2 weeks since prior local palliative radiotherapy (small port) At least 3 months since prior craniospinal radiotherapy At least 6 weeks since other prior substantial bone marrow radiotherapy No concurrent palliative radiotherapy No prior initiation of therapy on another phase II study No concurrent participation in another therapeutic COG study No concurrent enzyme-inducing anticonvulsants No other concurrent anticancer or experimental drugs No concurrent foods or medications that interfere with CYP3A4, including any of the following: Carbamazepine Phenytoin Phenobarbital Grapefruit juice Erythromycin Azithromycin Clarithromycin Rifampin and its analogues Fluconazole Ketoconazole Itraconazole Cimetidine Cannabinoids (i.e., marijuana or dronabinol) Omeprazole Hypericum perforatum (St. John's wort) Ethosuximide Glucocorticoids Griseofulvin Nafcillin Nelfinavir Norfloxacin Norfluoxetine Nevirapine Oxcarbazepine Phenylbutazone Primidone Progesterone (all progestins) Rifabutin Rofecoxib Sulfadimidine Sulfinpyrazone Troglitazone Rifapentine Modafinil Amiodarone Anastrozole Clotrimazole Cyclosporine Danazol Delavirdine Diethyldithiocarbamate Diltiazem Dirithromycin Disulfiram Entacapone (high dose) Ethinyl estradiol Fluoxetine Fluvoxamine Gestodene Indinavir Isoniazid Metronidazole Mibefradil Miconazole Nefazodone Oxiconazole Paroxetine Propoxyphene Roxithromycin Quinidine Quinine Quinupristin and dalfopristin Ranitidine Ritonavir Saquinavir Sertindole Sertraline Troleandomycin Valproic acid Verapamil Voriconazole Zafirlukast Zileuton

Sites / Locations

  • Children's Oncology Group

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm I

Arm Description

Patients receive oral tipifarnib twice daily on days 1-21. Courses repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Best objective tumor response rates (complete and partial response), based on MRIs
Estimated ultimately as a simple binomial proportion. Estimated actuarially, using the product-limit (PL) estimate.
Time to tumor progression (TTP)
The distribution of TTP will be analyzed using PL estimate.
Time to treatment failure (TTF)
The distribution of TTF will be analyzed using PL estimate.
Time to death (TTD)
The distribution of TTD will be analyzed using PL estimate.
Incidence of adverse events graded according to NCI CTCAE version 3.0

Secondary Outcome Measures

Full Information

First Posted
October 3, 2003
Last Updated
October 7, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00070525
Brief Title
Tipifarnib in Treating Young Patients With Recurrent or Progressive High-Grade Glioma, Medulloblastoma, Primitive Neuroectodermal Tumor, or Brain Stem Glioma
Official Title
A Phase II Study of R115777 (Zarnestra) (NSC # 702818, IND# 58,359) in Children With Recurrent or Progressive: High Grade Glioma, Medulloblastoma/PNET or Brainstem Glioma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2013
Overall Recruitment Status
Completed
Study Start Date
November 2003 (undefined)
Primary Completion Date
September 2006 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

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

4. Oversight

5. Study Description

Brief Summary
This phase II trial is studying how well tipifarnib works in treating young patients with recurrent or progressive high-grade glioma, medulloblastoma, primitive neuroectodermal tumor, or brain stem glioma. Tipifarnib may stop the growth of tumor cells by blocking the enzymes necessary for their growth.
Detailed Description
OBJECTIVES: I. Determine the response rate in pediatric patients with recurrent or progressive high-grade glioma, medulloblastoma/primitive neuroectodermal tumor (PNET), or brain stem glioma treated with tipifarnib. II. Determine the distribution of time to progression, time to treatment failure, and time to death in patients treated with this drug. OUTLINE: This is an open-label, multicenter study. Patients are stratified according to disease (high-grade glioma vs recurrent or progressive medulloblastoma/primitive neuroectodermal tumor [PNET] vs progressive diffuse, intrinsic brain stem glioma). Patients receive oral tipifarnib twice daily on days 1-21. Courses repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Childhood High-grade Cerebral Astrocytoma, Childhood Oligodendroglioma, Recurrent Childhood Brain Stem Glioma, Recurrent Childhood Cerebellar Astrocytoma, Recurrent Childhood Cerebral Astrocytoma, Recurrent Childhood Medulloblastoma, Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor, Recurrent Childhood Visual Pathway and Hypothalamic Glioma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
90 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Experimental
Arm Description
Patients receive oral tipifarnib twice daily on days 1-21. Courses repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
tipifarnib
Intervention Description
Given orally
Primary Outcome Measure Information:
Title
Best objective tumor response rates (complete and partial response), based on MRIs
Description
Estimated ultimately as a simple binomial proportion. Estimated actuarially, using the product-limit (PL) estimate.
Time Frame
Up to 2 years
Title
Time to tumor progression (TTP)
Description
The distribution of TTP will be analyzed using PL estimate.
Time Frame
Time from study enrollment to radiographically determined tumor progression or recurrence, assessed up to 2 years
Title
Time to treatment failure (TTF)
Description
The distribution of TTF will be analyzed using PL estimate.
Time Frame
Time from study enrollment to tumor progression, tumor recurrence, death from any cause, or occurrence of a second malignant neoplasm, assessed up to 2 years
Title
Time to death (TTD)
Description
The distribution of TTD will be analyzed using PL estimate.
Time Frame
Time from study enrollment to death from any cause, assessed up to 2 years
Title
Incidence of adverse events graded according to NCI CTCAE version 3.0
Time Frame
Up to 2 years

10. Eligibility

Sex
All
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed brain tumor, including the following: Anaplastic astrocytoma Glioblastoma multiforme Gliosarcoma Anaplastic oligodendroglioma Medulloblastoma/primitive neuroectodermal tumor (PNET) Diffuse intrinsic brain stem glioma* Progressive or relapsed disease after prior conventional therapy Radiographic evidence of measurable disease Performance status - Karnofsky 60-100% (over 16 years of age) Performance status - Lansky 60-100% (16 years of age and under) Performance status - ECOG 0-2 At least 8 weeks Absolute neutrophil count at least 1,000/mm^3 Platelet count at least 100,000/mm^3 (transfusion independent) Hemoglobin at least 8.0 g/dL (red blood cell transfusions allowed) Bilirubin no greater than 1.5 times upper limit of normal (ULN) SGPT and SGOT less than 2.5 times ULN Creatinine clearance OR radioisotope glomerular filtration rate at least 70 mL/min Maximum creatinine based on age as follows: 0.8 mg/dL (5 years and under) 1.0 mg/dL (6 to 10 years) 1.2 mg/dL (11 to 15 years) 1.5 mg/dL (over 15 years) Shortening fraction at least 27% by echocardiogram Ejection fraction at least 50% by MUGA No dyspnea at rest No exercise intolerance Pulse oximetry greater than 94%* Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Seizure disorder is allowed provided it is well-controlled on non-enzyme-inducing anticonvulsants No active graft-versus-host disease No uncontrolled infection No allergy to azoles (e.g., ketoconazole, itraconazole, or fluconazole) Recovered from prior immunotherapy At least 7 days since prior antineoplastic biologic agents At least 1 month since prior autologous stem cell transplantation (SCT) At least 6 months since prior allogeneic SCT More than 1 week since prior growth factors No concurrent immunomodulating agents More than 2 weeks since prior myelosuppressive chemotherapy (4-6 weeks for nitrosoureas or temozolomide) and recovered No concurrent anticancer chemotherapy Concurrent dexamethasone allowed provided patient is on a stable or decreasing dose for at least 1 week prior to study entry Concurrent corticosteroids allowed only for treatment of increased intracranial pressure Recovered from prior radiotherapy At least 2 weeks since prior local palliative radiotherapy (small port) At least 3 months since prior craniospinal radiotherapy At least 6 weeks since other prior substantial bone marrow radiotherapy No concurrent palliative radiotherapy No prior initiation of therapy on another phase II study No concurrent participation in another therapeutic COG study No concurrent enzyme-inducing anticonvulsants No other concurrent anticancer or experimental drugs No concurrent foods or medications that interfere with CYP3A4, including any of the following: Carbamazepine Phenytoin Phenobarbital Grapefruit juice Erythromycin Azithromycin Clarithromycin Rifampin and its analogues Fluconazole Ketoconazole Itraconazole Cimetidine Cannabinoids (i.e., marijuana or dronabinol) Omeprazole Hypericum perforatum (St. John's wort) Ethosuximide Glucocorticoids Griseofulvin Nafcillin Nelfinavir Norfloxacin Norfluoxetine Nevirapine Oxcarbazepine Phenylbutazone Primidone Progesterone (all progestins) Rifabutin Rofecoxib Sulfadimidine Sulfinpyrazone Troglitazone Rifapentine Modafinil Amiodarone Anastrozole Clotrimazole Cyclosporine Danazol Delavirdine Diethyldithiocarbamate Diltiazem Dirithromycin Disulfiram Entacapone (high dose) Ethinyl estradiol Fluoxetine Fluvoxamine Gestodene Indinavir Isoniazid Metronidazole Mibefradil Miconazole Nefazodone Oxiconazole Paroxetine Propoxyphene Roxithromycin Quinidine Quinine Quinupristin and dalfopristin Ranitidine Ritonavir Saquinavir Sertindole Sertraline Troleandomycin Valproic acid Verapamil Voriconazole Zafirlukast Zileuton
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Maryam Fouladi
Organizational Affiliation
Children's Oncology Group
Official's Role
Principal Investigator
Facility Information:
Facility Name
Children's Oncology Group
City
Arcadia
State/Province
California
ZIP/Postal Code
91006-3776
Country
United States

12. IPD Sharing Statement

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Tipifarnib in Treating Young Patients With Recurrent or Progressive High-Grade Glioma, Medulloblastoma, Primitive Neuroectodermal Tumor, or Brain Stem Glioma

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