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Bevacizumab in Treating Patients With Recurrent or Progressive Glioma

Primary Purpose

Brain and Central Nervous System Tumors

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
bevacizumab
Sponsored by
Northwestern University
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 adult glioblastoma, adult gliosarcoma, recurrent adult brain tumor, adult anaplastic astrocytoma, adult giant cell glioblastoma

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed malignant glioma, including the following: Glioblastoma multiforme Gliosarcoma Anaplastic astrocytoma or anaplastic glioma Malignant glioma not otherwise specified Evidence of tumor recurrence or progression by MRI or CT scan with contrast CT scan or MRI must be performed ≤ 96 hours post-operatively (≤ 2 weeks prior to study registration) or 4-6 weeks post-operatively to assess residual disease in patients who have undergone recent resection of recurrent or progressive tumor Steroid dosage must have been stable for ≥ 5 days Failed ≥ 1 prior systemic treatment with chemotherapy or biologic agents (excluding polifeprosan 20 with carmustine implant [Gliadel wafers]) Failed prior external-beam radiotherapy If received prior interstitial brachytherapy or stereotactic radiosurgery, true progressive disease (rather than radiation necrosis) must be confirmed by positron emission tomography, single-photon emission computer tomography with thallium, magnetic resonance (MR) spectroscopy, MR perfusion, or surgical documentation PATIENT CHARACTERISTICS: Karnofsky performance status 70-100% Life expectancy > 8 weeks WBC > 3,000/mm³ Absolute neutrophil count > 1,500/mm³ Platelet count > 100,000/mm³ Hemoglobin > 10 g/dL (transfusion allowed) SGOT and SGPT < 1.5 times upper limit of normal (ULN) Bilirubin < 1.5 times ULN Creatinine < 1.5 mg/dL Blood pressure ≤ 150/100 mm Hg No unstable angina No New York Heart Association class II-IV congestive heart failure No stroke or myocardial infarction within the past 6 months No clinically significant peripheral vascular disease No evidence of bleeding diathesis or coagulopathy Urine protein:creatinine ratio < 1.0 No significant medical illness that would preclude study participation or cannot be adequately controlled with appropriate therapy No other serious medical illness or infection No disease that would obscure toxicity or dangerously alter drug metabolism No significant traumatic injury within the past 28 days No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months No serious, nonhealing wound, ulcer, or bone fracture No history of any other cancer (except nonmelanoma skin cancer or carcinoma in situ of the cervix) unless cancer is in complete remission and patient is off all therapy for that cancer for ≥ 3 years Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: See Disease Characteristics More than 4 weeks since prior surgery for recurrent or progressive disease and recovered More than 28 days since prior major surgical procedure or open biopsy At least 4 weeks since prior cytotoxic therapy (6 weeks for nitrosoureas) At least 2 weeks since prior vincristine At least 3 weeks since prior procarbazine hydrochloride At least 1 week since prior noncytotoxic agents (e.g., interferon, tamoxifen, thalidomide, or isotretinoin) Radiosensitizer does not count At least 4 weeks since prior experimental biologic agents (e.g., epidermal growth factor receptor [EGFR] inhibitors) More than 7 days since prior minor surgery, such as fine-needle aspirations or core biopsies No concurrent combination anti-retroviral therapy for HIV-positive patients No concurrent enzyme-inducing anticonvulsants (EIACs) Patients on EIACs must switch to nonenzyme-inducing convulsants ≥ 2 weeks prior to study enrollment

Sites / Locations

  • Hematology-Oncology Associates of Illinois
  • Robert H. Lurie Comprehensive Cancer Center at Northwestern University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Avastin

Arm Description

Outcomes

Primary Outcome Measures

Safety of Treatment
Safety of treatment will be defined by the number of patients that experience grade 3 and 4 adverse events where causal relationship with bevacizumab cannot be completely ruled out. Adverse events will be graded using Common Terminology Criteria for Adverse Events v3.0 (CTCAE) where: Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE
Progression-free Survival at 6 Months
The number of patients experiencing progression free survival (PFS) was calculated at the 6-month time point.
Tumoral Blood Flow Changes
To assess changes in tumoral blood flow based on MR Perfusion and tissue changes by MR spectroscopy.

Secondary Outcome Measures

Full Information

First Posted
June 13, 2006
Last Updated
January 28, 2020
Sponsor
Northwestern University
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00337207
Brief Title
Bevacizumab in Treating Patients With Recurrent or Progressive Glioma
Official Title
A Phase II Safety Study of Bevacizumab in Patients With Multiple Recurrent or Progressive Malignant Gliomas
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
March 2006 (Actual)
Primary Completion Date
November 2008 (Actual)
Study Completion Date
May 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Northwestern University
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. PURPOSE: This phase II trial is studying how well bevacizumab works in treating patients with recurrent or progressive glioma.
Detailed Description
OBJECTIVES: Determine the safety of single-agent bevacizumab in the treatment of patients with recurrent or progressive malignant glioma. Determine the efficacy of bevacizumab, in terms of progression-free survival at 6 months, in these patients. Assess changes in tumoral blood flow based on magnetic resonance (MR) perfusion and tissue changes by MR spectroscopy. OUTLINE: This is a pilot study. Patients receive bevacizumab IV over 30-90 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed periodically. PROJECTED ACCRUAL: A total of 55 patients 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
Brain and Central Nervous System Tumors
Keywords
adult glioblastoma, adult gliosarcoma, recurrent adult brain tumor, adult anaplastic astrocytoma, adult giant cell glioblastoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Avastin
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
bevacizumab
Intervention Description
Bevacizumab 15 mg/kg every 3 weeks over 30 to 90 minutes. One cycle = 3 weeks. Treatment continues until progressive disease or unacceptable toxicity.
Primary Outcome Measure Information:
Title
Safety of Treatment
Description
Safety of treatment will be defined by the number of patients that experience grade 3 and 4 adverse events where causal relationship with bevacizumab cannot be completely ruled out. Adverse events will be graded using Common Terminology Criteria for Adverse Events v3.0 (CTCAE) where: Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE
Time Frame
From treatment initiation, throughout treatment and up to 30 days post-treatment, for up to 1 year.
Title
Progression-free Survival at 6 Months
Description
The number of patients experiencing progression free survival (PFS) was calculated at the 6-month time point.
Time Frame
After all patients have surpassed the 6 month post-treatment timepoint
Title
Tumoral Blood Flow Changes
Description
To assess changes in tumoral blood flow based on MR Perfusion and tissue changes by MR spectroscopy.
Time Frame
Before and after treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed malignant glioma, including the following: Glioblastoma multiforme Gliosarcoma Anaplastic astrocytoma or anaplastic glioma Malignant glioma not otherwise specified Evidence of tumor recurrence or progression by MRI or CT scan with contrast CT scan or MRI must be performed ≤ 96 hours post-operatively (≤ 2 weeks prior to study registration) or 4-6 weeks post-operatively to assess residual disease in patients who have undergone recent resection of recurrent or progressive tumor Steroid dosage must have been stable for ≥ 5 days Failed ≥ 1 prior systemic treatment with chemotherapy or biologic agents (excluding polifeprosan 20 with carmustine implant [Gliadel wafers]) Failed prior external-beam radiotherapy If received prior interstitial brachytherapy or stereotactic radiosurgery, true progressive disease (rather than radiation necrosis) must be confirmed by positron emission tomography, single-photon emission computer tomography with thallium, magnetic resonance (MR) spectroscopy, MR perfusion, or surgical documentation PATIENT CHARACTERISTICS: Karnofsky performance status 70-100% Life expectancy > 8 weeks WBC > 3,000/mm³ Absolute neutrophil count > 1,500/mm³ Platelet count > 100,000/mm³ Hemoglobin > 10 g/dL (transfusion allowed) SGOT and SGPT < 1.5 times upper limit of normal (ULN) Bilirubin < 1.5 times ULN Creatinine < 1.5 mg/dL Blood pressure ≤ 150/100 mm Hg No unstable angina No New York Heart Association class II-IV congestive heart failure No stroke or myocardial infarction within the past 6 months No clinically significant peripheral vascular disease No evidence of bleeding diathesis or coagulopathy Urine protein:creatinine ratio < 1.0 No significant medical illness that would preclude study participation or cannot be adequately controlled with appropriate therapy No other serious medical illness or infection No disease that would obscure toxicity or dangerously alter drug metabolism No significant traumatic injury within the past 28 days No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months No serious, nonhealing wound, ulcer, or bone fracture No history of any other cancer (except nonmelanoma skin cancer or carcinoma in situ of the cervix) unless cancer is in complete remission and patient is off all therapy for that cancer for ≥ 3 years Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: See Disease Characteristics More than 4 weeks since prior surgery for recurrent or progressive disease and recovered More than 28 days since prior major surgical procedure or open biopsy At least 4 weeks since prior cytotoxic therapy (6 weeks for nitrosoureas) At least 2 weeks since prior vincristine At least 3 weeks since prior procarbazine hydrochloride At least 1 week since prior noncytotoxic agents (e.g., interferon, tamoxifen, thalidomide, or isotretinoin) Radiosensitizer does not count At least 4 weeks since prior experimental biologic agents (e.g., epidermal growth factor receptor [EGFR] inhibitors) More than 7 days since prior minor surgery, such as fine-needle aspirations or core biopsies No concurrent combination anti-retroviral therapy for HIV-positive patients No concurrent enzyme-inducing anticonvulsants (EIACs) Patients on EIACs must switch to nonenzyme-inducing convulsants ≥ 2 weeks prior to study enrollment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeffrey J. Raizer, MD
Organizational Affiliation
Robert H. Lurie Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hematology-Oncology Associates of Illinois
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611-2998
Country
United States
Facility Name
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611-3013
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Raizer JJ, Gallot L, Cohn R, et al.: A phase II safety study of bevacizumab in patients with multiple recurrent or progressive malignant gliomas. [Abstract] J Clin Oncol 25 (Suppl 18): A-2079, 94s, 2007.
Results Reference
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Bevacizumab in Treating Patients With Recurrent or Progressive Glioma

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