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Dose-Intense Temozolomide in Recurrent Glioblastoma

Primary Purpose

Glioblastoma, Gliosarcoma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Temozolomide
Sponsored by
Patrick Y. Wen, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glioblastoma focused on measuring recurrent glioblastoma, temodar, temozolomide

Eligibility Criteria

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

Inclusion Criteria:

  • Must provide independent consent or must demonstrate willingness to participate in the study and to adhere to dose and visit schedules.
  • 18 years of age or older (of either sex, and of any race)
  • Histologic diagnosis of GBM or gliosarcoma with an unequivocal progression by MRI or CT scan
  • Must have received standard combined modality therapy as first-line treatment consisting of RT plus concomitant temozolomide followed by adjuvant temozolomide (at least 2 cycles of adjuvant temozolomide)
  • Gadolinium MRI or contrast CT scan must be obtained within 14 days prior to registration, and must be on a steroid dose that has been stable for at least 5 days.
  • Karnofsky Performance status of 60 or greater
  • Life expectancy of at least 8 weeks
  • Recovered from the toxic effects of prior therapy, and 21 days must have elapsed since prior treatment with temozolomide

    o If a patient has residual toxicity from any previous treatment, toxicity must be ≤ Grade 1

  • Laboratory tests within parameters outlined in the protocol
  • Female subjects of childbearing potential & male subjects with female partner of childbearing potential must agree to use a medically accepted method of contraception or be surgically sterilized prior to Screening, while receiving protocol-specified medication, and for 30 days after stopping the study medication
  • Negative pregnancy test within 48 hours prior to dosing with the study drug (for female subjects of childbearing potential)
  • Free of any clinically relevant disease that would, in the Principal Investigator's opinion, interfere with the conduct of the study or study evaluations
  • Must be able to adhere to the dosing and visit schedules, and agree to record medication times, concomitant medications, and adverse events (AEs) accurately and consistently in a daily diary
  • Unstained slides (at least 15 of 10 micron thickness, or 20 when < 10 micron thickness)or 1 tissue block must be available from the original diagnostic biopsy/surgery or from the biopsy/surgery recurrence
  • Participants who have undergone recent resection of recurrent or progressive tumor will be eligible provided at least 2 weeks has elapsed since surgery, and subjects have recovered from surgical-related trauma
  • Residual disease following resection of recurrent GBM or gliosarcoma is not mandated for eligibility into the study.

Exclusion Criteria:

  • Participant has received a dosing schedule of temozolomide other than 75 mg/m2/day for 42 days during RT followed by adjuvant temozolomide at a dose of 150-200 mg/m2/day for 5 days of a 28-day schedule (standard dose adjustments for toxicity are allowed)
  • Any other anti-tumor agent other than standard surgical resection, RT and temozolomide prior to enrollment or during the study period
  • Received treatment with BCNU (Gliadel) wafers or GliaSite
  • Progressed prior to receiving at least 2 cycles of adjuvant temozolomide
  • Pregnant or intending to become pregnant during the study
  • In a situation or condition that, in the opinion of the Investigator, may interfere with optimal participation in the study
  • Participating in any other clinical study in which an investigational drug is prescribed
  • Allergic to or has sensitivity to the study drug or its excipients
  • History of any other cancer (except non-melanoma skin cancer or carcinoma in situ of the cervix), unless he/she is in complete remission and has not received treatment for that particular disease for the past 3 or more years

Sites / Locations

  • Tufts Medical Center
  • Massachusetts General Hospital
  • Dana-Farber Cancer Institute
  • Dartmouth-Hitchcock Medical Center
  • Wake Forest Univsersity
  • University Of Pennsylvania

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single-Arm Study

Arm Description

Outcomes

Primary Outcome Measures

6 Month Progression Free Survival
Progression is defined using Modified Macdonald Criteria , using a >/= 25% increase in the sum of products of all measurable lesions over smallest sum observed (over baseline if no decrease) using the same techniques as baseline, OR clear worsening of any evaluable disease, OR appearance of any new lesion/site, OR clear clinical worsening or failure to return for evaluation due to death or deteriorating condition (unless clearly unrelated to this cancer).

Secondary Outcome Measures

Overall Survival
Radiographic Response
Responders on study are those with a best response of either CR or PR. Per Modified Macdonald Criteria for lesions assessed by MRI/CT: Complete Response (CR) = Complete disappearance of all measurable and evaluable disease, no new lesions, no evidence of non-evaluable disease, with no steroids. Partial Response (PR) >/= 50% decrease under baseline in the sum of products of perpendicular diameters of all measurable lesions, no progression of evaluable disease, no new lesions, with steroid dose @ time of response </= max dose w/in the first 8 weeks of therapy.
Time to Progression.
Progression is defined using Modified Macdonald Criteria , using a >/= 25% increase in the sum of products of all measurable lesions over smallest sum observed (over baseline if no decrease) using the same techniques as baseline, OR clear worsening of any evaluable disease, OR appearance of any new lesion/site, OR clear clinical worsening or failure to return for evaluation due to death or deteriorating condition (unless clearly unrelated to this cancer).

Full Information

First Posted
April 8, 2008
Last Updated
February 13, 2014
Sponsor
Patrick Y. Wen, MD
Collaborators
Brigham and Women's Hospital, Massachusetts General Hospital, University of Pennsylvania, Wake Forest University Health Sciences, Tufts Medical Center, Dartmouth-Hitchcock Medical Center, Schering-Plough
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1. Study Identification

Unique Protocol Identification Number
NCT00657267
Brief Title
Dose-Intense Temozolomide in Recurrent Glioblastoma
Official Title
Phase 2 Study of Dose-Intense Temozolomide in Recurrent Glioblastoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2014
Overall Recruitment Status
Completed
Study Start Date
May 2008 (undefined)
Primary Completion Date
November 2011 (Actual)
Study Completion Date
October 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Patrick Y. Wen, MD
Collaborators
Brigham and Women's Hospital, Massachusetts General Hospital, University of Pennsylvania, Wake Forest University Health Sciences, Tufts Medical Center, Dartmouth-Hitchcock Medical Center, Schering-Plough

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Temozolomide (Temodar) is an FDA approved medication for the treatment of newly diagnosed glioblastomas. In this study, we will be using temozolomide to treat recurrent glioblastomas. We will be using a different dose and schedule than the FDA approved dose and schedule. The purpose of this study is to determine if patients that have failed standard temozolomide treatment will respond to temozolomide when given at a different dose and schedule (21 days every 28 days).
Detailed Description
Participants will be given a medication-dosing calendar for each treatment cycle. Each treatment cycle lasts 4 weeks (28 days) during which time they will be taking temozolomide orally once a day for the first three weeks. At the end of each cycle (day 28, +/- 2 days), the following procedures will be performed: Complete physical examination including a neurological exam; vital signs; a review of current medications and symptoms; blood samples; a pregnancy test for women of child-bearing potential; self-administered quality of life questionnaire; brain MRI or CT scan. Participants may continue taking temozolomide until their tumor grows or if they experience unacceptable side effects.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma, Gliosarcoma
Keywords
recurrent glioblastoma, temodar, temozolomide

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Single-Arm Study
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Temozolomide
Other Intervention Name(s)
Temodar
Intervention Description
Taken orally daily for the first three weeks of a four-week cycle.
Primary Outcome Measure Information:
Title
6 Month Progression Free Survival
Description
Progression is defined using Modified Macdonald Criteria , using a >/= 25% increase in the sum of products of all measurable lesions over smallest sum observed (over baseline if no decrease) using the same techniques as baseline, OR clear worsening of any evaluable disease, OR appearance of any new lesion/site, OR clear clinical worsening or failure to return for evaluation due to death or deteriorating condition (unless clearly unrelated to this cancer).
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Overall Survival
Time Frame
From patient registration until end of study, assessed up to 54 months
Title
Radiographic Response
Description
Responders on study are those with a best response of either CR or PR. Per Modified Macdonald Criteria for lesions assessed by MRI/CT: Complete Response (CR) = Complete disappearance of all measurable and evaluable disease, no new lesions, no evidence of non-evaluable disease, with no steroids. Partial Response (PR) >/= 50% decrease under baseline in the sum of products of perpendicular diameters of all measurable lesions, no progression of evaluable disease, no new lesions, with steroid dose @ time of response </= max dose w/in the first 8 weeks of therapy.
Time Frame
From patient registration until end of study, assessed up to 54 months
Title
Time to Progression.
Description
Progression is defined using Modified Macdonald Criteria , using a >/= 25% increase in the sum of products of all measurable lesions over smallest sum observed (over baseline if no decrease) using the same techniques as baseline, OR clear worsening of any evaluable disease, OR appearance of any new lesion/site, OR clear clinical worsening or failure to return for evaluation due to death or deteriorating condition (unless clearly unrelated to this cancer).
Time Frame
From patient registration until end of study, assessed up to 54 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must provide independent consent or must demonstrate willingness to participate in the study and to adhere to dose and visit schedules. 18 years of age or older (of either sex, and of any race) Histologic diagnosis of GBM or gliosarcoma with an unequivocal progression by MRI or CT scan Must have received standard combined modality therapy as first-line treatment consisting of RT plus concomitant temozolomide followed by adjuvant temozolomide (at least 2 cycles of adjuvant temozolomide) Gadolinium MRI or contrast CT scan must be obtained within 14 days prior to registration, and must be on a steroid dose that has been stable for at least 5 days. Karnofsky Performance status of 60 or greater Life expectancy of at least 8 weeks Recovered from the toxic effects of prior therapy, and 21 days must have elapsed since prior treatment with temozolomide o If a patient has residual toxicity from any previous treatment, toxicity must be ≤ Grade 1 Laboratory tests within parameters outlined in the protocol Female subjects of childbearing potential & male subjects with female partner of childbearing potential must agree to use a medically accepted method of contraception or be surgically sterilized prior to Screening, while receiving protocol-specified medication, and for 30 days after stopping the study medication Negative pregnancy test within 48 hours prior to dosing with the study drug (for female subjects of childbearing potential) Free of any clinically relevant disease that would, in the Principal Investigator's opinion, interfere with the conduct of the study or study evaluations Must be able to adhere to the dosing and visit schedules, and agree to record medication times, concomitant medications, and adverse events (AEs) accurately and consistently in a daily diary Unstained slides (at least 15 of 10 micron thickness, or 20 when < 10 micron thickness)or 1 tissue block must be available from the original diagnostic biopsy/surgery or from the biopsy/surgery recurrence Participants who have undergone recent resection of recurrent or progressive tumor will be eligible provided at least 2 weeks has elapsed since surgery, and subjects have recovered from surgical-related trauma Residual disease following resection of recurrent GBM or gliosarcoma is not mandated for eligibility into the study. Exclusion Criteria: Participant has received a dosing schedule of temozolomide other than 75 mg/m2/day for 42 days during RT followed by adjuvant temozolomide at a dose of 150-200 mg/m2/day for 5 days of a 28-day schedule (standard dose adjustments for toxicity are allowed) Any other anti-tumor agent other than standard surgical resection, RT and temozolomide prior to enrollment or during the study period Received treatment with BCNU (Gliadel) wafers or GliaSite Progressed prior to receiving at least 2 cycles of adjuvant temozolomide Pregnant or intending to become pregnant during the study In a situation or condition that, in the opinion of the Investigator, may interfere with optimal participation in the study Participating in any other clinical study in which an investigational drug is prescribed Allergic to or has sensitivity to the study drug or its excipients History of any other cancer (except non-melanoma skin cancer or carcinoma in situ of the cervix), unless he/she is in complete remission and has not received treatment for that particular disease for the past 3 or more years
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrick Wen, MD
Organizational Affiliation
Dana-Farber Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tufts Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Dartmouth-Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
Wake Forest Univsersity
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
University Of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

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Dose-Intense Temozolomide in Recurrent Glioblastoma

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