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Clinical Trial Evaluating the Combination of Vandetanib and Dasatinib During and After Radiation Therapy (RT) in Children With Newly Diagnosed Diffuse Intrinsic Pontine Glioma (DIPG)

Primary Purpose

Diffuse Intrinsic Pontine Glioma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
vandetanib and dasatinib
Sponsored by
St. Jude Children's Research Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diffuse Intrinsic Pontine Glioma

Eligibility Criteria

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

Inclusion Criteria:

  1. Age must be ≥ 18 months and < 21 years
  2. Diagnosis of DIPG or high-grade glioma originating from the brainstem.
  3. Lansky (for research participants ≤ 16 years) or Karnofsky (for research participants > 16 years) performance score ≥ 40 at the time of study enrollment
  4. Adequate organ function at the time of study enrollment as follows:

    • Bone marrow: ANC ≥ 1,000/μL, platelet count ≥ 100,000/μL (transfusion independent), hemoglobin concentration ≥ 8g/dL (may be transfused)
    • Renal: Serum creatinine concentration < 2x the institutional normal values for age or GFR > 70ml/min/1.73m2
    • Hepatic: Total bilirubin concentration < 1.5x the institutional upper limit of normal for age; SGPT < 5x the institutional upper limit of normal; albumin ≥ 2 g/dL
  5. Electrocardiogram (EKG) with an average QTc interval < 450 msec. If a research participant has QTc interval ≥ 450 msec on screening EKG, the screening EKG may be repeated twice (at least 24 hours apart). The average QTc interval from the three screening EKGs must be < 450 msec in order for the research participant to be eligible for the study. Research participants with abnormal serum electrolytes and a QTc interval ≥ 450 msec should have a repeat EKG repeated once the concentration of serum electrolyte is corrected
  6. Female research participants of childbearing age must not be pregnant (confirmed by serum or urine pregnancy test within 1 week of treatment start) or breast-feeding.
  7. Female research participants of childbearing age and male research participants of child fathering potential must agree to use safe contraceptive methods

Exclusion Criteria:

  1. Metastatic disease
  2. Use of enzyme-inducing anticonvulsants
  3. Research participants who received any other type of anticancer treatment
  4. Research participants with uncontrolled infection
  5. Research participants with any concomitant significant medical illness that in the investigator's opinion cannot be adequately controlled with appropriate therapy, or that would impair the evaluation of side effects related to this treatment, alter drug metabolism or the tolerance to this treatment
  6. QTc interval prolongation with other medications that required discontinuation of that medication
  7. Research participants with any history of cardiac arrhythmias or congenital long QT syndrome
  8. Use of any concomitant medication that may cause QT interval prolongation and/or induce Torsades de Pointes
  9. Hypertension defined as systolic and/or diastolic blood pressure > 95th percentile for age, height and gender, or blood pressure > 140/90 for research participants ≥ 18 years of age. If hypertension is detected, blood pressure values < 95th in two separate occasions need to be documented before registration. Body surface ≥ 1.8m2 for research participants enrolled on dosage levels 2, 3, and 4

Sites / Locations

  • St. Jude Children's Research Hospital

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

1

Arm Description

Outcomes

Primary Outcome Measures

To estimate the maximum tolerated dose (MTD) of the combination of vandetanib and dasatinib administered concurrently with RT in pediatric research participants with newly diagnosed DIPG

Secondary Outcome Measures

To determine the toxicities associated with the chronic use of vandetanib and dasatinib
To characterize the pharmacokinetics of vandetanib and dasatinib in pediatric research participants
To evaluate the influence of specific polymorphisms (e.g., CYP3A4/5) on the pharmacokinetics of vandetanib and dasatinib administered in combination
To explore the association between plasma angiogenic factors and response to current therapy
To evaluate the pharmacodynamics of dasatinib in target receptors and pathways in peripheral mononuclear cells
To describe the research participants' and parents' perspective of the quality of life of children with newly diagnosed DIPG enrolled on this phase I trial
To describe the quality of life of parents of pediatric research participants with newly diagnosed DIPG enrolled on this phase I trial

Full Information

First Posted
October 15, 2009
Last Updated
April 3, 2015
Sponsor
St. Jude Children's Research Hospital
Collaborators
AstraZeneca, The Cure Starts Now Foundation, Tyler's Treehouse
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1. Study Identification

Unique Protocol Identification Number
NCT00996723
Brief Title
Clinical Trial Evaluating the Combination of Vandetanib and Dasatinib During and After Radiation Therapy (RT) in Children With Newly Diagnosed Diffuse Intrinsic Pontine Glioma (DIPG)
Official Title
Phase I Study of the Combination of Vandetanib and Dasatinib Administered During and After Radiation Therapy in Children With Diffuse Intrinsic Pontine Glioma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2015
Overall Recruitment Status
Completed
Study Start Date
October 2009 (undefined)
Primary Completion Date
April 2012 (Actual)
Study Completion Date
June 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
St. Jude Children's Research Hospital
Collaborators
AstraZeneca, The Cure Starts Now Foundation, Tyler's Treehouse

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a Phase I clinical trial evaluating the combination of vandetanib and dasatinib during and after radiation therapy (RT) in children with newly diagnosed diffuse intrinsic pontine glioma (DIPG).
Detailed Description
This trial will estimate the maximum safe dose of vandetanib and dasatinib which can be administered during the 6 weeks of local RT in children with newly diagnosed DIPG.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diffuse Intrinsic Pontine Glioma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Other
Intervention Type
Drug
Intervention Name(s)
vandetanib and dasatinib
Intervention Description
Two oral investigational agents (vandetanib [VEGFR2, RET, and EGFR inhibitor] and dasatinib [bcr-abl, PDGFRA and B, src, lck, yes, and c-kit inhibitor] will be administered during and after local RT, which is the only standard therapy for children with DIPG.
Primary Outcome Measure Information:
Title
To estimate the maximum tolerated dose (MTD) of the combination of vandetanib and dasatinib administered concurrently with RT in pediatric research participants with newly diagnosed DIPG
Time Frame
April 2012
Secondary Outcome Measure Information:
Title
To determine the toxicities associated with the chronic use of vandetanib and dasatinib
Time Frame
July 2012
Title
To characterize the pharmacokinetics of vandetanib and dasatinib in pediatric research participants
Time Frame
July 2012
Title
To evaluate the influence of specific polymorphisms (e.g., CYP3A4/5) on the pharmacokinetics of vandetanib and dasatinib administered in combination
Time Frame
July 2012
Title
To explore the association between plasma angiogenic factors and response to current therapy
Time Frame
July 2012
Title
To evaluate the pharmacodynamics of dasatinib in target receptors and pathways in peripheral mononuclear cells
Time Frame
July 2012
Title
To describe the research participants' and parents' perspective of the quality of life of children with newly diagnosed DIPG enrolled on this phase I trial
Time Frame
July 2012
Title
To describe the quality of life of parents of pediatric research participants with newly diagnosed DIPG enrolled on this phase I trial
Time Frame
July 2012

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Months
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age must be ≥ 18 months and < 21 years Diagnosis of DIPG or high-grade glioma originating from the brainstem. Lansky (for research participants ≤ 16 years) or Karnofsky (for research participants > 16 years) performance score ≥ 40 at the time of study enrollment Adequate organ function at the time of study enrollment as follows: Bone marrow: ANC ≥ 1,000/μL, platelet count ≥ 100,000/μL (transfusion independent), hemoglobin concentration ≥ 8g/dL (may be transfused) Renal: Serum creatinine concentration < 2x the institutional normal values for age or GFR > 70ml/min/1.73m2 Hepatic: Total bilirubin concentration < 1.5x the institutional upper limit of normal for age; SGPT < 5x the institutional upper limit of normal; albumin ≥ 2 g/dL Electrocardiogram (EKG) with an average QTc interval < 450 msec. If a research participant has QTc interval ≥ 450 msec on screening EKG, the screening EKG may be repeated twice (at least 24 hours apart). The average QTc interval from the three screening EKGs must be < 450 msec in order for the research participant to be eligible for the study. Research participants with abnormal serum electrolytes and a QTc interval ≥ 450 msec should have a repeat EKG repeated once the concentration of serum electrolyte is corrected Female research participants of childbearing age must not be pregnant (confirmed by serum or urine pregnancy test within 1 week of treatment start) or breast-feeding. Female research participants of childbearing age and male research participants of child fathering potential must agree to use safe contraceptive methods Exclusion Criteria: Metastatic disease Use of enzyme-inducing anticonvulsants Research participants who received any other type of anticancer treatment Research participants with uncontrolled infection Research participants with any concomitant significant medical illness that in the investigator's opinion cannot be adequately controlled with appropriate therapy, or that would impair the evaluation of side effects related to this treatment, alter drug metabolism or the tolerance to this treatment QTc interval prolongation with other medications that required discontinuation of that medication Research participants with any history of cardiac arrhythmias or congenital long QT syndrome Use of any concomitant medication that may cause QT interval prolongation and/or induce Torsades de Pointes Hypertension defined as systolic and/or diastolic blood pressure > 95th percentile for age, height and gender, or blood pressure > 140/90 for research participants ≥ 18 years of age. If hypertension is detected, blood pressure values < 95th in two separate occasions need to be documented before registration. Body surface ≥ 1.8m2 for research participants enrolled on dosage levels 2, 3, and 4
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alberto Broniscer, MD
Organizational Affiliation
St. Jude Children's Research Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
St. Jude Children's Research Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38105
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.stjude.org
Description
St. Jude Children's Research Hospital
URL
http://www.stjude.org/protocols
Description
Clinical Trials Open at St. Jude

Learn more about this trial

Clinical Trial Evaluating the Combination of Vandetanib and Dasatinib During and After Radiation Therapy (RT) in Children With Newly Diagnosed Diffuse Intrinsic Pontine Glioma (DIPG)

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