Olaparib and Temozolomide in Treating Patients With Relapsed Glioblastoma

This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring adult glioblastoma, adult giant cell glioblastoma, adult gliosarcoma, recurrent adult brain tumor Read More

DISEASE CHARACTERISTICS:

• Histologically confirmed grade IV glioblastoma
• Radiological diagnosis of recurrent or progressive disease according to Response Assessment in Neuro-Oncology Working Group (RANO) criteria, which is suitable for palliative resection
• Must have an adequate amount of tumor tissue available

• Previously received first-line treatment with radical radiotherapy, or chemoradiation followed by adjuvant chemotherapy

  • No prior chemotherapy for recurrent disease

PATIENT CHARACTERISTICS:

• WHO performance status 0-2
• Life expectancy > 12 weeks
• Hemoglobin ≥ 10.0 g/dL
• Absolute neutrophil count ≥ 1.5 x 10^9/L
• Platelet count ≥ 100 x 10^9/L
• Serum bilirubin ≤ 1.5 times upper limit of normal (ULN)
• ALT or AST ≤ 2.5 times ULN
• Calculated creatinine clearance ≥ 50 mL/min OR isotope clearance measurement ≥ 50 mL/min (uncorrected)
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use one (male) or two (female) highly effective forms of contraception 4 weeks prior to, during, and for 6 months after completion of study therapy
• Able to swallow and retain oral medications
• Not at high medical risk due to non-malignant systemic disease, including active uncontrolled infection
• No known hepatitis B, hepatitis C, or HIV seropositivity
• No concurrent congestive heart failure, prior history of NYHA class III-IV cardiac disease, prior history of cardiac ischemia, or prior history of cardiac arrhythmia within the past 12 months
• No grand mal seizures occurring ≥ 3 times per week over the past month
• No gastrointestinal disorders likely to interfere with absorption of the study medication
• No known hypersensitivity to any of the components of olaparib
• No known hypersensitivity to temozolomide (TMZ) or any of its components, or to dacarbazine (DTIC) (for patients enrolled in stage 2 study only)
• No known lactose intolerance (for patients enrolled in the stage 2 study only)
• No metal fragments in the eyes (shrapnel or bullet injuries are excluded on the basis of their unsuitability to undergo MRI scans)
• No other condition which, in the Investigator's opinion, would not make the patient a good candidate for the clinical trial

EXCLUSION CRITERIA:

• See Disease Characteristics
• No ongoing toxic manifestations from previous treatments except for alopecia or grade 1 toxicities which, in the opinion of the Investigator and the Drug Development Office (DDO), should not exclude the patient
• At least 12 weeks since prior radiotherapy, endocrine therapy, or immunotherapy
• At least 6 weeks since prior major surgery
• At least 4 weeks since prior chemotherapy
• At least 4 weeks since prior immunizations with live vaccines (or expected to receive vaccines during the trial and up to at least 6 months after receiving last study treatment), including BCG and yellow fever vaccines
• No prior PARP inhibitors, including olaparib
• No prior major thoracic or abdominal surgery from which the patient has not yet recovered
• No prior heart surgery
• No pacemakers
• No change to systemic steroids dose within 5 days prior to enrollment (i.e., must be on a stable dose at time of enrollment and remain on a stable dose throughout the treatment period)
• No herbal supplements and/or ingestion of foods known to modulate CYP3A4 enzyme activity from time entered on screening period until 28 days after the last dose of study medication
• No concurrent drugs known to be potent inducers of CYP3A4, including phenytoin, carbamazepine, phenobarbital, rifampicin, rifapentine, rifabutin, nevirapine, modafinil, or St. John wort (wash-out period for phenobarbital is 5 weeks, 3 weeks for all others)
• No concurrent drugs known to be potent inhibitors of CYP3A4, including ketoconazole, itraconazole, ritonavir, indinavir, saquinavir, telithromycin, clarithromycin, or nelfinavir (wash-out period is 1 week)

• No concurrent or planned participation in another interventional clinical study

  • Participation in an observational study is acceptable
• No concurrent warfarin (patients requiring anticoagulation should be given subcutaneous low molecular weight heparin)

• No other concurrent anticancer therapy (including radiotherapy) or investigational drugs

  • No blood transfusions within 4 weeks prior to study start of features suggestive of myelodysplasia or AML