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Cilengitide in Treating Patients Who Are Undergoing Surgery for Recurrent or Progressive Glioblastoma Multiforme

Primary Purpose

Adult Giant Cell Glioblastoma, Adult Glioblastoma, Adult Gliosarcoma

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
cilengitide
therapeutic conventional surgery
pharmacological study
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

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

Inclusion Criteria: Histologically confirmed intracranial glioblastoma multiforme (GBM) Original diagnosis of low-grade glioma with subsequent histological confirmation of GBM allowed Recurrent disease Failed prior radiotherapy Must require a surgical procedure (gross total or near gross total resection) for tumor removal Performance status - Karnofsky 60-100% White Blood Count (WBC) ≥ 3,000/mm^3 Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 10 g/dL (transfusion allowed) Serum glutamic oxaloacetic transaminase (SGOT) < 2 times upper limit of normal (ULN) Bilirubin < 2 times ULN Creatinine < 1.5 mg/dL Not pregnant or nursing Negative pregnancy test Fertile patients must use effective barrier contraception during and for ≥ 2 weeks after study participation (for female patients) or for 3 months after study participation (for male patients) No other malignancy within the past 3 years except nonmelanoma skin cancer or carcinoma in situ of the cervix No active infection No other significant uncontrolled medical illness that would preclude study participation At least 3 weeks since prior interferon No prior cilengitide No other prior targeted antiangiogenic treatment (e.g., vatalanib, SU5416, or thalidomide) No concurrent anticancer immunotherapy No concurrent routine prophylactic filgrastim (G-CSF) At least 2 weeks since prior vincristine At least 3 weeks since prior procarbazine At least 6 weeks since prior nitrosoureas No concurrent anticancer chemotherapy At least 3 weeks since prior tamoxifen No concurrent anticancer hormonal therapy See Disease Characteristics At least 4 weeks since prior radiotherapy No concurrent anticancer radiotherapy Recovered from all prior therapies No more than 3 prior treatments for GBM (1 initial treatment; and treatment for 2 relapses) For patients who received prior therapy for low-grade glioma, a subsequent surgical diagnosis of high-grade glioma is considered the first relapse At least 4 weeks since prior investigational agents At least 4 weeks since prior cytotoxic therapy At least 3 weeks since other prior non-cytotoxic therapy (e.g., isotretinoin), except radiosensitizers No other concurrent anticancer therapy No other concurrent investigational agents

Sites / Locations

  • North American Brain Tumor Consortium

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Group I (high-dose cilengitide) 2000mg

Group II (low-dose cilengitide) 500mg

Arm Description

Preoperative Treatment: Patients receive high-dose cilengitide IV over 1 hour on days -8, -4, and -1. (High dose 2000mg) Resection: All patients undergo tumor resection on day 0. Postoperative Treatment: Beginning within 2 weeks after surgery, all patients receive high-dose cilengitide IV over 1 hour twice weekly for 4 weeks. Treatment repeats every 4 weeks for up to 24 courses in the absence of disease progression or unacceptable toxicity.

Preoperative Treatment: Patients receive low-dose cilengitide IV over 1 hour on days -8, -4, and -1. (500mg) Resection: All patients undergo tumor resection on day 0. Postoperative Treatment: Beginning within 2 weeks after surgery, all patients receive high-dose cilengitide IV over 1 hour twice weekly for 4 weeks. Treatment repeats every 4 weeks for up to 24 courses in the absence of disease progression or unacceptable toxicity

Outcomes

Primary Outcome Measures

6m-Progression-free Survival
progression within 6 months (26 weeks) of treatment

Secondary Outcome Measures

Changes in avb3 Integrin Expression on Tumor Cells and Endothelial Cells
Will be performed between the untreated matched control tumor tissue and the tissue obtained from the post-treatment tumors using either a Fisher's Exact test or the Wilcoxon rank sum test depending on whether the assay provides a measurement or is yes/no.
Changes in Vitronectin Expression
Will be performed between the untreated matched control tumor tissue and the tissue obtained from the post-treatment tumors using either a Fisher's Exact test or the Wilcoxon rank sum test depending on whether the assay provides a measurement or is yes/no.
Changes in Tumor Cell Apoptosis
Will be performed between the untreated matched control tumor tissue and the tissue obtained from the post-treatment tumors using either a Fisher's Exact test or the Wilcoxon rank sum test depending on whether the assay provides a measurement or is yes/no.
Changes in Tumor Cell Proliferation
Will be performed between the untreated matched control tumor tissue and the tissue obtained from the post-treatment tumors using either a Fisher's Exact test or the Wilcoxon rank sum test depending on whether the assay provides a measurement or is yes/no.
Changes in Endothelial Cell Apoptosis
Will be performed between the untreated matched control tumor tissue and the tissue obtained from the post-treatment tumors using either a Fisher's Exact test or the Wilcoxon rank sum test depending on whether the assay provides a measurement or is yes/no.
Plasma Concentration of EMD 121974
24 hour post dose concentration plasma, at time of resection
Tumor Tissue Concentrations
a section of tumor of approximately 500mg will be snap frozen (immediately prepared and frozen) once removed from brain for analysis of the drug concentration in contrast -enhancing tumor.

Full Information

First Posted
June 2, 2005
Last Updated
May 16, 2017
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00112866
Brief Title
Cilengitide in Treating Patients Who Are Undergoing Surgery for Recurrent or Progressive Glioblastoma Multiforme
Official Title
Phase II Trial of EMD 121974 for Recurrent Glioblastoma: A Clinical Trial With Tissue Correlates of Response
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Terminated
Why Stopped
due to poor accrual
Study Start Date
January 2005 (undefined)
Primary Completion Date
December 2008 (Actual)
Study Completion Date
March 2009 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Cilengitide may stop the growth of glioblastoma multiforme by blocking blood flow to the tumor. Giving cilengitide before and after surgery may be an effective treatment for glioblastoma multiforme. This phase II trial is studying how well cilengitide works in treating patients who are undergoing surgery for recurrent or progressive glioblastoma multiforme.
Detailed Description
PRIMARY OBJECTIVES: I. Determine the 6-month progression-free survival rate in operative patients with recurrent or progressive glioblastoma multiforme treated with cilengitide. SECONDARY OBJECTIVES: I. Determine the safety and toxicity of this drug in these patients. OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment groups for the preoperative treatment component. Preoperative Treatment Group I: Patients receive high-dose cilengitide IV over 1 hour on days -8, -4, and -1. Preoperative Treatment Group II: Patients receive low-dose cilengitide IV over 1 hour on days -8, -4, and -1. Resection: All patients undergo tumor resection on day 0. Postoperative Treatment: Beginning within 2 weeks after surgery, all patients receive high-dose cilengitide IV over 1 hour twice weekly for 4 weeks. Treatment repeats every 4 weeks for up to 24 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed every 3 months. PROJECTED ACCRUAL: A total of 44 patients (22 per preoperative treatment group) will be accrued for this study.

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, Recurrent Adult Brain Tumor

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Group I (high-dose cilengitide) 2000mg
Arm Type
Experimental
Arm Description
Preoperative Treatment: Patients receive high-dose cilengitide IV over 1 hour on days -8, -4, and -1. (High dose 2000mg) Resection: All patients undergo tumor resection on day 0. Postoperative Treatment: Beginning within 2 weeks after surgery, all patients receive high-dose cilengitide IV over 1 hour twice weekly for 4 weeks. Treatment repeats every 4 weeks for up to 24 courses in the absence of disease progression or unacceptable toxicity.
Arm Title
Group II (low-dose cilengitide) 500mg
Arm Type
Experimental
Arm Description
Preoperative Treatment: Patients receive low-dose cilengitide IV over 1 hour on days -8, -4, and -1. (500mg) Resection: All patients undergo tumor resection on day 0. Postoperative Treatment: Beginning within 2 weeks after surgery, all patients receive high-dose cilengitide IV over 1 hour twice weekly for 4 weeks. Treatment repeats every 4 weeks for up to 24 courses in the absence of disease progression or unacceptable toxicity
Intervention Type
Drug
Intervention Name(s)
cilengitide
Other Intervention Name(s)
EMD 121974
Intervention Description
Given IV
Intervention Type
Procedure
Intervention Name(s)
therapeutic conventional surgery
Intervention Description
Undergo tumor resection
Intervention Type
Other
Intervention Name(s)
pharmacological study
Other Intervention Name(s)
pharmacological studies
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
6m-Progression-free Survival
Description
progression within 6 months (26 weeks) of treatment
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Changes in avb3 Integrin Expression on Tumor Cells and Endothelial Cells
Description
Will be performed between the untreated matched control tumor tissue and the tissue obtained from the post-treatment tumors using either a Fisher's Exact test or the Wilcoxon rank sum test depending on whether the assay provides a measurement or is yes/no.
Time Frame
Baseline and time of surgery
Title
Changes in Vitronectin Expression
Description
Will be performed between the untreated matched control tumor tissue and the tissue obtained from the post-treatment tumors using either a Fisher's Exact test or the Wilcoxon rank sum test depending on whether the assay provides a measurement or is yes/no.
Time Frame
Baseline and time of surgery
Title
Changes in Tumor Cell Apoptosis
Description
Will be performed between the untreated matched control tumor tissue and the tissue obtained from the post-treatment tumors using either a Fisher's Exact test or the Wilcoxon rank sum test depending on whether the assay provides a measurement or is yes/no.
Time Frame
Baseline and time of surgery
Title
Changes in Tumor Cell Proliferation
Description
Will be performed between the untreated matched control tumor tissue and the tissue obtained from the post-treatment tumors using either a Fisher's Exact test or the Wilcoxon rank sum test depending on whether the assay provides a measurement or is yes/no.
Time Frame
Baseline and time of surgery
Title
Changes in Endothelial Cell Apoptosis
Description
Will be performed between the untreated matched control tumor tissue and the tissue obtained from the post-treatment tumors using either a Fisher's Exact test or the Wilcoxon rank sum test depending on whether the assay provides a measurement or is yes/no.
Time Frame
Baseline and up to 4 years
Title
Plasma Concentration of EMD 121974
Description
24 hour post dose concentration plasma, at time of resection
Time Frame
24 hour post concentration
Title
Tumor Tissue Concentrations
Description
a section of tumor of approximately 500mg will be snap frozen (immediately prepared and frozen) once removed from brain for analysis of the drug concentration in contrast -enhancing tumor.
Time Frame
at time of surgery
Other Pre-specified Outcome Measures:
Title
Overall Progression Free Survival
Description
Kaplan-meier curve
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed intracranial glioblastoma multiforme (GBM) Original diagnosis of low-grade glioma with subsequent histological confirmation of GBM allowed Recurrent disease Failed prior radiotherapy Must require a surgical procedure (gross total or near gross total resection) for tumor removal Performance status - Karnofsky 60-100% White Blood Count (WBC) ≥ 3,000/mm^3 Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 10 g/dL (transfusion allowed) Serum glutamic oxaloacetic transaminase (SGOT) < 2 times upper limit of normal (ULN) Bilirubin < 2 times ULN Creatinine < 1.5 mg/dL Not pregnant or nursing Negative pregnancy test Fertile patients must use effective barrier contraception during and for ≥ 2 weeks after study participation (for female patients) or for 3 months after study participation (for male patients) No other malignancy within the past 3 years except nonmelanoma skin cancer or carcinoma in situ of the cervix No active infection No other significant uncontrolled medical illness that would preclude study participation At least 3 weeks since prior interferon No prior cilengitide No other prior targeted antiangiogenic treatment (e.g., vatalanib, SU5416, or thalidomide) No concurrent anticancer immunotherapy No concurrent routine prophylactic filgrastim (G-CSF) At least 2 weeks since prior vincristine At least 3 weeks since prior procarbazine At least 6 weeks since prior nitrosoureas No concurrent anticancer chemotherapy At least 3 weeks since prior tamoxifen No concurrent anticancer hormonal therapy See Disease Characteristics At least 4 weeks since prior radiotherapy No concurrent anticancer radiotherapy Recovered from all prior therapies No more than 3 prior treatments for GBM (1 initial treatment; and treatment for 2 relapses) For patients who received prior therapy for low-grade glioma, a subsequent surgical diagnosis of high-grade glioma is considered the first relapse At least 4 weeks since prior investigational agents At least 4 weeks since prior cytotoxic therapy At least 3 weeks since other prior non-cytotoxic therapy (e.g., isotretinoin), except radiosensitizers No other concurrent anticancer therapy No other concurrent investigational agents
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Gilbert
Organizational Affiliation
North American Brain Tumor Consortium
Official's Role
Principal Investigator
Facility Information:
Facility Name
North American Brain Tumor Consortium
City
Watertown
State/Province
Massachusetts
ZIP/Postal Code
02472
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Cilengitide in Treating Patients Who Are Undergoing Surgery for Recurrent or Progressive Glioblastoma Multiforme

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