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Monthly SOM230C for Recurrent or Progressive Meningioma

Primary Purpose

Meningioma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
SOM230C
Sponsored by
Patrick Y. Wen, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Meningioma focused on measuring recurrent intracranial meningioma(s), progressive intracranial meningioma(s)

Eligibility Criteria

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

Inclusion Criteria:

  • 18 years of age or older
  • Radiographically measurable disease on contrast-enhanced MRI or CT images
  • Karnofsky Performance status of 60 or greater
  • Life expectancy of at least 3 months
  • Histologically confirmed diagnosis of recurrent or progressive intracranial meningioma(s). This includes benign, atypical, or malignant meningioma; patients with neurofibromatosis type 1 or 2 may participate. Participants without histological confirmation but a classic radiographic picture of meningioma may also enroll. Patients with neurofibromatosis type 2 and a classic radiographic picture of meningioma may also enroll without histological confirmation
  • At least ten unstained standard (4-5 micron) paraffin slides for immunohistochemistry. Participants who have not had a surgical procedure are exempt from this requirement
  • Unequivocal evidence for tumor progression by MRI (or CT scan if MRI is contraindicated)
  • MRI or CT must be performed within 14 days of registration
  • Patients with malignant meningiomas who require corticosteroids must be on a stable dose for at least 5 days prior to baseline imaging.
  • For patients who have been treated with external beam radiation, interstitial brachytherapy, or radiosurgery, an interval of 4 or more weeks must have elapses from the completion of radiation therapy to study drug administration, and there must be evidence of tumor progression.
  • There is no limit on the number of prior therapies

Exclusion Criteria:

  • Any cytotoxic chemotherapy, radiation, immunotherapy, or experimental therapy within 4 weeks prior to study drug administration
  • Prior therapy with somatostatin, andy somatostatin analogue, or any other hormonal treatment prescribed for the purpose of treating meningioma
  • Major surgery within 4 weeks prior to study drug administration
  • Malabsorption syndrome, short bowel or chologenic diarrhea not controlled by specific therapeutic means
  • Poorly controlled diabetes mellitus
  • Symptomatic cholelithiasis
  • Congestive heart failure, unstable angina, sustained ventricular tachycardia, ventricular fibrillation, clinically significant bradycardia, advanced heart block or a history of acute myocardial infarction within the six months preceding enrollment
  • QTc > 450 msec
  • Risk factors for Torsades de Pointes such as hypokalemia (< 3.5 mmol/L) not corrected by treatment, hypomagnesemia (< 0.7 mmol/L or < 1.6 mg/dL) not corrected by treatment, cardiac failure, clinically significant/symptomatic bradycardia, or high-grade AV block
  • Concomitant disease(s) that could prolong QT such as autonomic neuropathy (caused by diabetes, or Parkinson's disease), HIV, cirrhosis, uncontrolled hypothyroidism or cardiac failure
  • Concomitant medication(s) known to increase the QT interval within 4 weeks prior to study drug administration
  • Liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis with serum bilirubin > 2x ULN, serum albumin < 0.67 LLN, or ALT or AST more than 2 x ULN
  • Any other primary malignancy within the past 3 years (with the exception of basal cell carcinoma or carcinoma in situ of the cervix)
  • Active or suspected acute or chronic, uncontrolled infection or any history of immunocompromise, including any positive HIV test result
  • Abnormal coagulation studies (PT or PTT elevated by 30% above normal limits)
  • Use of anticoagulant medications (not including anti-platelet medications)
  • Lab values as specified in the protocol
  • Any current or prior medical condition that may interfere with the conduct of the study or the evaluation of its results in the opinion of the investigator
  • Pregnancy or lactation, or failure to practice a medically acceptable method of birth control
  • History of alcohol or drug abuse in the 6 month period before study enrollment
  • Participation in any clinical investigation with an investigational drug within 1 month prior to study drug administration
  • Known hypersensitivity to somatostatin analogues or any component of the pasireotide or octreotide LAR os s.c. formulations

Sites / Locations

  • Cedars-Sinai Medical Center
  • Northwestern University
  • Massachusetts General Hospital
  • Beth Israel Deaconess Medical Center
  • Dana-Farber Cancer Institute
  • Memorial Sloan Kettering Cancer Center
  • Duke University Medical Center, Preston Robert Tisch Brain Tumor Center
  • Wake Forest University Baptist Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SOM230C

Arm Description

Monthly SOM230C (pasireotide LAR) - 60 mg intramuscularly (Single-Arm Trial)

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

Response Rate
Number of participants to experience complete or partial response on study treatment. For response per Modified Macdonald Criteria, all measurable and evaluable lesions and sites must be assessed using the same techniques as baseline. Complete Response (CR): Complete disappearance of all measurable and evaluable disease. No new lesions. No evidence of non-evaluable disease. Patients must be on no steroids. Partial Response (PR): Greater than or equal to 50% decrease under baseline in the sum of products of perpendicular diameters of all measurable lesions. No progression of evaluable disease. No new lesions. The steroid dose at the time of the scan evaluation should be no greater than the maximum dose used in the first 8 weeks from initiation of therapy.
Treatment-related Events
All Grade 3-4-5 adverse events with a treatment attribution of probable, possible or definite based on CTCAE (v3.0) as reported on case report forms
Median Progression-Free Survival
Median Time to Progression
Per protocol, the study's secondary objectives are to be evaluated "for the estimate of median ... PFS ... at time of interest." At this time, all study participants have been followed for progression for a minimum of 34 months (final patient to accrue to study was registered to trial on 06/14/2011), and study manuscript is currently being written-up with this information.
Overall Survival
Percentage of participants alive 34 months after initiating study treatment. Median Overall Survival has not yet been reached for one study group; therefore, we are reporting Overall Survival rates by the end of the study time frame.

Full Information

First Posted
March 9, 2009
Last Updated
September 26, 2017
Sponsor
Patrick Y. Wen, MD
Collaborators
Brigham and Women's Hospital, Massachusetts General Hospital, Beth Israel Deaconess Medical Center, Memorial Sloan Kettering Cancer Center, Wake Forest University Health Sciences, Duke University, Cedars-Sinai Medical Center, Northwestern University, Novartis
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1. Study Identification

Unique Protocol Identification Number
NCT00859040
Brief Title
Monthly SOM230C for Recurrent or Progressive Meningioma
Official Title
Phase II Study of Monthly SOM230C for Recurrent or Progressive Meningioma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
March 2009 (undefined)
Primary Completion Date
December 2011 (Actual)
Study Completion Date
January 2016 (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, Beth Israel Deaconess Medical Center, Memorial Sloan Kettering Cancer Center, Wake Forest University Health Sciences, Duke University, Cedars-Sinai Medical Center, Northwestern University, Novartis

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this research study is to evaluate the effectiveness and safety of SOM230C in treating recurrent meningiomas. SOM230C is a newly discovered drug that may stop meningioma cells from growing abnormally. This drug has been used in treatment of other tumors, and information from those other research studies suggests that SOM230C may help to stop the growth of meningiomas.
Detailed Description
To enroll in the study, a sample of the participant's tumor tissue, stored from an earlier study, must be sent to a lab at the Dana-Farber/Harvard Cancer Center for diagnosis and special testing. Prior to starting the study medication, participants will undergo a Octreotide scan. This is a special type of scan used to obtain information about certain tumors. Participants will receive the study medication, SOM230C, via an injection into the buttocks every 28 days. Therefore, each treatment cycle lasts 28 days. The following tests and procedures will be done prior to the first, second and third treatment cycles, and every three treatment cycles thereafter: Complete physical examination including neurological exam; vital signs; current medication and symptom review; blood samples and a pregnancy test (for women of child-bearing potential). About 2/3 through the first treatment cycle (around day 22), participants will visit the research doctor for a complete physical examination including a neurological exam and blood work. Participants will have ECGs done prior to their first treatment cycle, about 2/3 through the first and third treatment cycles (around day 22), prior to their sixth treatment cycle, and every three treatment cycles thereafter.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Meningioma
Keywords
recurrent intracranial meningioma(s), progressive intracranial meningioma(s)

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
SOM230C
Arm Type
Experimental
Arm Description
Monthly SOM230C (pasireotide LAR) - 60 mg intramuscularly (Single-Arm Trial)
Intervention Type
Drug
Intervention Name(s)
SOM230C
Other Intervention Name(s)
pasireotide LAR
Intervention Description
Injection in the buttocks every 28 days
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
Response Rate
Description
Number of participants to experience complete or partial response on study treatment. For response per Modified Macdonald Criteria, all measurable and evaluable lesions and sites must be assessed using the same techniques as baseline. Complete Response (CR): Complete disappearance of all measurable and evaluable disease. No new lesions. No evidence of non-evaluable disease. Patients must be on no steroids. Partial Response (PR): Greater than or equal to 50% decrease under baseline in the sum of products of perpendicular diameters of all measurable lesions. No progression of evaluable disease. No new lesions. The steroid dose at the time of the scan evaluation should be no greater than the maximum dose used in the first 8 weeks from initiation of therapy.
Time Frame
5 years
Title
Treatment-related Events
Description
All Grade 3-4-5 adverse events with a treatment attribution of probable, possible or definite based on CTCAE (v3.0) as reported on case report forms
Time Frame
5 years
Title
Median Progression-Free Survival
Time Frame
5 years
Title
Median Time to Progression
Description
Per protocol, the study's secondary objectives are to be evaluated "for the estimate of median ... PFS ... at time of interest." At this time, all study participants have been followed for progression for a minimum of 34 months (final patient to accrue to study was registered to trial on 06/14/2011), and study manuscript is currently being written-up with this information.
Time Frame
34 months
Title
Overall Survival
Description
Percentage of participants alive 34 months after initiating study treatment. Median Overall Survival has not yet been reached for one study group; therefore, we are reporting Overall Survival rates by the end of the study time frame.
Time Frame
34 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 years of age or older Radiographically measurable disease on contrast-enhanced MRI or CT images Karnofsky Performance status of 60 or greater Life expectancy of at least 3 months Histologically confirmed diagnosis of recurrent or progressive intracranial meningioma(s). This includes benign, atypical, or malignant meningioma; patients with neurofibromatosis type 1 or 2 may participate. Participants without histological confirmation but a classic radiographic picture of meningioma may also enroll. Patients with neurofibromatosis type 2 and a classic radiographic picture of meningioma may also enroll without histological confirmation At least ten unstained standard (4-5 micron) paraffin slides for immunohistochemistry. Participants who have not had a surgical procedure are exempt from this requirement Unequivocal evidence for tumor progression by MRI (or CT scan if MRI is contraindicated) MRI or CT must be performed within 14 days of registration Patients with malignant meningiomas who require corticosteroids must be on a stable dose for at least 5 days prior to baseline imaging. For patients who have been treated with external beam radiation, interstitial brachytherapy, or radiosurgery, an interval of 4 or more weeks must have elapses from the completion of radiation therapy to study drug administration, and there must be evidence of tumor progression. There is no limit on the number of prior therapies Exclusion Criteria: Any cytotoxic chemotherapy, radiation, immunotherapy, or experimental therapy within 4 weeks prior to study drug administration Prior therapy with somatostatin, andy somatostatin analogue, or any other hormonal treatment prescribed for the purpose of treating meningioma Major surgery within 4 weeks prior to study drug administration Malabsorption syndrome, short bowel or chologenic diarrhea not controlled by specific therapeutic means Poorly controlled diabetes mellitus Symptomatic cholelithiasis Congestive heart failure, unstable angina, sustained ventricular tachycardia, ventricular fibrillation, clinically significant bradycardia, advanced heart block or a history of acute myocardial infarction within the six months preceding enrollment QTc > 450 msec Risk factors for Torsades de Pointes such as hypokalemia (< 3.5 mmol/L) not corrected by treatment, hypomagnesemia (< 0.7 mmol/L or < 1.6 mg/dL) not corrected by treatment, cardiac failure, clinically significant/symptomatic bradycardia, or high-grade AV block Concomitant disease(s) that could prolong QT such as autonomic neuropathy (caused by diabetes, or Parkinson's disease), HIV, cirrhosis, uncontrolled hypothyroidism or cardiac failure Concomitant medication(s) known to increase the QT interval within 4 weeks prior to study drug administration Liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis with serum bilirubin > 2x ULN, serum albumin < 0.67 LLN, or ALT or AST more than 2 x ULN Any other primary malignancy within the past 3 years (with the exception of basal cell carcinoma or carcinoma in situ of the cervix) Active or suspected acute or chronic, uncontrolled infection or any history of immunocompromise, including any positive HIV test result Abnormal coagulation studies (PT or PTT elevated by 30% above normal limits) Use of anticoagulant medications (not including anti-platelet medications) Lab values as specified in the protocol Any current or prior medical condition that may interfere with the conduct of the study or the evaluation of its results in the opinion of the investigator Pregnancy or lactation, or failure to practice a medically acceptable method of birth control History of alcohol or drug abuse in the 6 month period before study enrollment Participation in any clinical investigation with an investigational drug within 1 month prior to study drug administration Known hypersensitivity to somatostatin analogues or any component of the pasireotide or octreotide LAR os s.c. formulations
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrick Y. Wen, MD
Organizational Affiliation
Dana-Farber Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Duke University Medical Center, Preston Robert Tisch Brain Tumor Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Wake Forest University Baptist Medical Center
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States

12. IPD Sharing Statement

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