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Arsenic Trioxide and Radiation Therapy in Treating Young Patients With Newly Diagnosed Gliomas

Primary Purpose

Brain and Central Nervous System Tumors

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
arsenic trioxide
radiation therapy
Sponsored by
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring untreated childhood brain stem glioma, childhood high-grade cerebral astrocytoma

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Diagnosis of 1 of the following: Clinical and neuroradiographic findings consistent with intrinsic pontine glioma Histologically confirmed anaplastic astrocytoma, glioblastoma multiforme, or gliosarcoma Multifocal high-grade gliomas allowed No exophytic tumors No focal lesions No underlying diagnosis of neurofibromatosis No tumors originating in anatomic structures adjacent to the cerebellar peduncle or cervical medullary junction PATIENT CHARACTERISTICS: Age 3 to 21 Performance status Karnofsky 60-100% OR Lansky 60-100% Life expectancy Not specified Hematopoietic Absolute neutrophil count > 1,500/mm^3 Hemoglobin > 10 g/dL Platelet count > 100,000/mm^3 Hepatic Bilirubin < 2.0 mg/dL Alkaline phosphatase < 2.5 times upper limit of normal (ULN) Transaminases < 2.5 times ULN Renal Creatinine < 2.0 times ULN Cardiovascular No second-degree heart block No absolute QTc interval > 500 msec with normal potassium and magnesium levels Other Not pregnant or nursing Negative pregnancy test No other malignancy within the past 5 years except curatively treated basal cell or squamous cell skin cancer or carcinoma in situ No other serious medical illness Able to undergo MRI PRIOR CONCURRENT THERAPY: Biologic therapy More than 28 days since prior biologic therapy No concurrent prophylactic growth factors (e.g., filgrastim [G-CSF] or sargramostim [GM-CSF]) Chemotherapy No prior arsenic trioxide Endocrine therapy Not specified Radiotherapy Not specified Surgery Prior surgery for the brain tumor allowed Other No other prior therapy for the brain tumor More than 28 days since prior investigational drugs or devices No concurrent amphotericin B

Sites / Locations

  • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Outcomes

Primary Outcome Measures

Maximum tolerated dose as assessed by NCI CTCAE v. 3.0 following study completion
Safety as assessed by NCI CTCAE v. 3.0 following study completion

Secondary Outcome Measures

Full Information

First Posted
November 9, 2004
Last Updated
April 21, 2011
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00095771
Brief Title
Arsenic Trioxide and Radiation Therapy in Treating Young Patients With Newly Diagnosed Gliomas
Official Title
A Phase I Trial of Arsenic Trioxide in the Treatment of Infiltrating Gliomas of Childhood
Study Type
Interventional

2. Study Status

Record Verification Date
April 2011
Overall Recruitment Status
Completed
Study Start Date
November 2004 (undefined)
Primary Completion Date
January 2011 (Actual)
Study Completion Date
January 2011 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as arsenic trioxide, work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells and may be an effective treatment for patients with glioma. Drugs such as arsenic trioxide may also make the tumor cells more sensitive to radiation therapy. Combining arsenic trioxide with radiation therapy may kill more tumor cells. PURPOSE: Phase I trial to study the effectiveness of combining arsenic trioxide with radiation therapy in treating patients who have newly diagnosed gliomas.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose of arsenic trioxide when administered with radiotherapy in pediatric patients with newly diagnosed anaplastic astrocytoma, glioblastoma multiforme, gliosarcoma, or intrinsic pontine glioma. Determine the toxicity of this regimen in these patients. OUTLINE: This is a dose-escalation study of arsenic trioxide (ATO). Patients undergo radiotherapy once daily, 5 days a week, for approximately 6 weeks. Patients concurrently receive ATO IV over 1 hour, 1-5 times weekly, for approximately 6 weeks in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of ATO until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Patients are followed every 2 months. PROJECTED ACCRUAL: A total of 3-36 patients will be accrued for this study within 3-36 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
untreated childhood brain stem glioma, childhood high-grade cerebral astrocytoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Enrollment
36 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
arsenic trioxide
Intervention Type
Radiation
Intervention Name(s)
radiation therapy
Primary Outcome Measure Information:
Title
Maximum tolerated dose as assessed by NCI CTCAE v. 3.0 following study completion
Title
Safety as assessed by NCI CTCAE v. 3.0 following study completion

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Years
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of 1 of the following: Clinical and neuroradiographic findings consistent with intrinsic pontine glioma Histologically confirmed anaplastic astrocytoma, glioblastoma multiforme, or gliosarcoma Multifocal high-grade gliomas allowed No exophytic tumors No focal lesions No underlying diagnosis of neurofibromatosis No tumors originating in anatomic structures adjacent to the cerebellar peduncle or cervical medullary junction PATIENT CHARACTERISTICS: Age 3 to 21 Performance status Karnofsky 60-100% OR Lansky 60-100% Life expectancy Not specified Hematopoietic Absolute neutrophil count > 1,500/mm^3 Hemoglobin > 10 g/dL Platelet count > 100,000/mm^3 Hepatic Bilirubin < 2.0 mg/dL Alkaline phosphatase < 2.5 times upper limit of normal (ULN) Transaminases < 2.5 times ULN Renal Creatinine < 2.0 times ULN Cardiovascular No second-degree heart block No absolute QTc interval > 500 msec with normal potassium and magnesium levels Other Not pregnant or nursing Negative pregnancy test No other malignancy within the past 5 years except curatively treated basal cell or squamous cell skin cancer or carcinoma in situ No other serious medical illness Able to undergo MRI PRIOR CONCURRENT THERAPY: Biologic therapy More than 28 days since prior biologic therapy No concurrent prophylactic growth factors (e.g., filgrastim [G-CSF] or sargramostim [GM-CSF]) Chemotherapy No prior arsenic trioxide Endocrine therapy Not specified Radiotherapy Not specified Surgery Prior surgery for the brain tumor allowed Other No other prior therapy for the brain tumor More than 28 days since prior investigational drugs or devices No concurrent amphotericin B
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kenneth J. Cohen, MD, MBA
Organizational Affiliation
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Official's Role
Study Chair
Facility Information:
Facility Name
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231-2410
Country
United States

12. IPD Sharing Statement

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Arsenic Trioxide and Radiation Therapy in Treating Young Patients With Newly Diagnosed Gliomas

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