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A Safety Study of Sativex in Combination With Dose-intense Temozolomide in Patients With Recurrent Glioblastoma

Primary Purpose

Cancer

Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
Sativex
Sponsored by
Jazz Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cancer focused on measuring Cancer, Safety

Eligibility Criteria

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

Inclusion Criteria:

  • Patient is willing and able to give informed consent for participation in the study.
  • Patient is aged 18 years or above.
  • Histopathologically confirmed diagnosis of grade four Glioblastoma Multiforme as per World Health Organisation classification.
  • Evidence of patients first tumour progression (as determined by Revised Assessment in Neuro-Oncology) following radiation and first line chemotherapy with Temozolomide.
  • If taking steroids, then the dose must be stable or decreasing.
  • Karnofsky performance scale of 60% or greater.
  • Patient is able (in the investigators opinion) and willing to comply with all study requirements.
  • Patient is willing for his or her name to be notified to the responsible authorities for participation in this study, as applicable in individual countries.
  • Patient is willing to allow his or her primary care practitioner and consultant, if appropriate, to be notified of participation in the study.

Exclusion Criteria:

  • Patients with Glioblastoma Multiforme secondary to low-grade glioma or anaplastic glioma (anaplastic astrocytoma or anaplastic oligodendroglioma).
  • Patients currently receiving treatment for recurrent Glioblastoma Multiforme.
  • Less than a four week interval since prior chemotherapy.
  • Less than a 12 week interval since prior radiotherapy unless there is either: a) histopathology confirmation of recurrent tumour, or b) new enhancement on Magnetic Resonance Imaging outside of the radiotherapy treatment field.
  • Presence of extra-cranial metastatic disease.
  • Any surgery, including intracranial biopsy (not including minor diagnostic procedures such as lymph node biopsy) within two weeks of baseline disease assessments; or not fully recovered from any side effects of previous procedures.
  • Any history of a different malignancy unless the patient has remained disease-free for at least three years and are at low risk for recurrence of that malignancy (cervical cancer in situ, and basal cell or squamous cell carcinoma of the skin are exempt from this criterion if treatment has occurred).
  • Have previously received first line chemotherapy other than Temozolomide.
  • Presents with Leptomeningeal dissemination.
  • Have previously received stereotactic radiotherapy, convection enhanced delivery or brachytherapy (as gliosis/scarring from these modalities may limit delivery).
  • The patient is currently using or has used cannabis or cannabinoid based medications within 30 days of study entry and is unwilling to abstain for the duration of the study.
  • Any known or suspected history of a substance abuse/dependence disorder, current heavy alcohol consumption (>60g of pure alcohol per day for men, >40 g of pure alcohol per day for women), current use of an illicit drug or current non prescribed use of any prescription drug.
  • Any history or immediate family history of schizophrenia, other psychotic illness, severe personality disorder or other significant psychiatric disorder other than depression associated with their underlying condition.
  • Has experienced myocardial infarction or clinically significant dysfunction within the last 12 months or has a cardiac disorder that, in the opinion of the investigator would put the patient at risk of clinically significant arrhythmia or myocardial infarction.
  • Has grade 3 or above toxicity by Common Terminology Criteria for Adverse Events criteria.
  • Female patients of child bearing potential and male patients whose partner is of child bearing potential, unless willing to ensure that they or their partner use effective contraception, for example, oral contraception, double barrier, intra-uterine device, during the study and for three months thereafter (however a male condom should not be used in conjunction with a female condom).
  • Female patients who are pregnant, lactating or planning pregnancy during the course of the study and for three months thereafter.
  • Patient who have received an Investigational Medicinal Product within the four weeks prior to the screening visit.
  • Any other significant disease or disorder which, in the opinion of the investigator, may either put the patient at risk because of participation in the study, or may influence the result of the study, or the patient's ability to participate in the study.
  • Travel outside the country of residence planned during the study.
  • Patients previously enrolled into this study and received either Investigational Medicinal Product or Dose-Intense Temozolomide.
  • Any known or suspected hypersensitivity to cannabinoids or any of the excipients of the Investigational Medicinal Product.
  • Any known allergy to or other intolerability to Temozolomide.
  • Following a physical examination, the patient has any abnormalities that, in the opinion of the investigator would prevent the patient from safe participation in the study.
  • Unwilling to abstain from donation of blood during the study.

Sites / Locations

  • The Clatterbridge Cancer Centre NHS Foundation Trust
  • St James's Institute of Oncology, St James's University Hospital
  • Bristol Haematology & Oncology Centre
  • Guy's and St Thomas NHS Foundation Trust, of St Thomas' Hospital
  • The Christie NHS Foundation Trust

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sativex and Dose-Intense Temozolomide

Arm Description

Patients will received Sativex and Dose-Intense Temozolomide and in open-label manner

Outcomes

Primary Outcome Measures

The incidence of adverse events in patients receiving Sativex in combination with dose-intense Temozolomide in the open-label phase of the study
Adverse events will be coded according to the current medical dictionary for regular activities graded using the Common Terminology Criteria for Adverse Events criteria. The number of patients who experienced an adverse event whilst on treatment will be presented.

Secondary Outcome Measures

The number of patients with Progression Free Survival at six months (PFS6)
PFS6 will be assessment at Visit 11 (Day 190). Progression of disease will be determined from Response Assessment in Neuro-Oncology tumour assessment (based on Magnetic Resonance Imaging scans). The number of patients with PFS6 will be presented for the open-label phase (Part A).
Overall Survival
Overall survival will be assessed at the end of the treatment visit (Day 358 or at early termination). The number of surviving patients from the open-label phase (Part A) will be presented.

Full Information

First Posted
March 14, 2013
Last Updated
December 19, 2022
Sponsor
Jazz Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01812603
Brief Title
A Safety Study of Sativex in Combination With Dose-intense Temozolomide in Patients With Recurrent Glioblastoma
Official Title
A Two Part Study to Assess the Tolerability, Safety and Pharmacodynamics of Sativex in Combination With Dose-intense Temozolomide in Patients With Recurrent Glioblastoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
September 2013 (undefined)
Primary Completion Date
January 2015 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jazz Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
An open-label phase to assess the frequency and severity of adverse events in recurrent glioblastoma patients receiving Sativex in combination with dose-intense Temozolomide (Part A). A randomisation phase to assess the safety of Sativex compared with placebo (Part B). Part A will be reported here.
Detailed Description
Patients will receive Sativex and dose-intense Temozolomide in an open-label phase. The incidence of adverse events will be monitored (Part A). An investigator led Safety Review Team will assess the safety profile of the open-label patients and decide whether the study can progress to the randomisation phase (Part B). Patients who enrol in the randomisation phase patients will receive either Sativex or placebo. The safety of Sativex compared to placebo will be assessed by pharmacokinetic analysis of Temozolomide and its metabolites, clinical laboratory tests, adverse events and vital signs.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cancer
Keywords
Cancer, Safety

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sativex and Dose-Intense Temozolomide
Arm Type
Experimental
Arm Description
Patients will received Sativex and Dose-Intense Temozolomide and in open-label manner
Intervention Type
Drug
Intervention Name(s)
Sativex
Other Intervention Name(s)
THC/CBD spray, Nabiximols, GW-1000-02
Intervention Description
Administered orally as a spray to the cheek according to a standard dose titration regimen, until patients reach a maximum tolerated dose (maximum 12 sprays per day). Each spray delivers 100 μl (Δ9tetrahydrocannabinol (THC), 27 mg/ml: Cannabidiol (CBD), 25 mg/ml).
Primary Outcome Measure Information:
Title
The incidence of adverse events in patients receiving Sativex in combination with dose-intense Temozolomide in the open-label phase of the study
Description
Adverse events will be coded according to the current medical dictionary for regular activities graded using the Common Terminology Criteria for Adverse Events criteria. The number of patients who experienced an adverse event whilst on treatment will be presented.
Time Frame
Study Day 1 - Day 358
Secondary Outcome Measure Information:
Title
The number of patients with Progression Free Survival at six months (PFS6)
Description
PFS6 will be assessment at Visit 11 (Day 190). Progression of disease will be determined from Response Assessment in Neuro-Oncology tumour assessment (based on Magnetic Resonance Imaging scans). The number of patients with PFS6 will be presented for the open-label phase (Part A).
Time Frame
Study Day 1 - Day 190
Title
Overall Survival
Description
Overall survival will be assessed at the end of the treatment visit (Day 358 or at early termination). The number of surviving patients from the open-label phase (Part A) will be presented.
Time Frame
Study Day 1 - Day 358

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is willing and able to give informed consent for participation in the study. Patient is aged 18 years or above. Histopathologically confirmed diagnosis of grade four Glioblastoma Multiforme as per World Health Organisation classification. Evidence of patients first tumour progression (as determined by Revised Assessment in Neuro-Oncology) following radiation and first line chemotherapy with Temozolomide. If taking steroids, then the dose must be stable or decreasing. Karnofsky performance scale of 60% or greater. Patient is able (in the investigators opinion) and willing to comply with all study requirements. Patient is willing for his or her name to be notified to the responsible authorities for participation in this study, as applicable in individual countries. Patient is willing to allow his or her primary care practitioner and consultant, if appropriate, to be notified of participation in the study. Exclusion Criteria: Patients with Glioblastoma Multiforme secondary to low-grade glioma or anaplastic glioma (anaplastic astrocytoma or anaplastic oligodendroglioma). Patients currently receiving treatment for recurrent Glioblastoma Multiforme. Less than a four week interval since prior chemotherapy. Less than a 12 week interval since prior radiotherapy unless there is either: a) histopathology confirmation of recurrent tumour, or b) new enhancement on Magnetic Resonance Imaging outside of the radiotherapy treatment field. Presence of extra-cranial metastatic disease. Any surgery, including intracranial biopsy (not including minor diagnostic procedures such as lymph node biopsy) within two weeks of baseline disease assessments; or not fully recovered from any side effects of previous procedures. Any history of a different malignancy unless the patient has remained disease-free for at least three years and are at low risk for recurrence of that malignancy (cervical cancer in situ, and basal cell or squamous cell carcinoma of the skin are exempt from this criterion if treatment has occurred). Have previously received first line chemotherapy other than Temozolomide. Presents with Leptomeningeal dissemination. Have previously received stereotactic radiotherapy, convection enhanced delivery or brachytherapy (as gliosis/scarring from these modalities may limit delivery). The patient is currently using or has used cannabis or cannabinoid based medications within 30 days of study entry and is unwilling to abstain for the duration of the study. Any known or suspected history of a substance abuse/dependence disorder, current heavy alcohol consumption (>60g of pure alcohol per day for men, >40 g of pure alcohol per day for women), current use of an illicit drug or current non prescribed use of any prescription drug. Any history or immediate family history of schizophrenia, other psychotic illness, severe personality disorder or other significant psychiatric disorder other than depression associated with their underlying condition. Has experienced myocardial infarction or clinically significant dysfunction within the last 12 months or has a cardiac disorder that, in the opinion of the investigator would put the patient at risk of clinically significant arrhythmia or myocardial infarction. Has grade 3 or above toxicity by Common Terminology Criteria for Adverse Events criteria. Female patients of child bearing potential and male patients whose partner is of child bearing potential, unless willing to ensure that they or their partner use effective contraception, for example, oral contraception, double barrier, intra-uterine device, during the study and for three months thereafter (however a male condom should not be used in conjunction with a female condom). Female patients who are pregnant, lactating or planning pregnancy during the course of the study and for three months thereafter. Patient who have received an Investigational Medicinal Product within the four weeks prior to the screening visit. Any other significant disease or disorder which, in the opinion of the investigator, may either put the patient at risk because of participation in the study, or may influence the result of the study, or the patient's ability to participate in the study. Travel outside the country of residence planned during the study. Patients previously enrolled into this study and received either Investigational Medicinal Product or Dose-Intense Temozolomide. Any known or suspected hypersensitivity to cannabinoids or any of the excipients of the Investigational Medicinal Product. Any known allergy to or other intolerability to Temozolomide. Following a physical examination, the patient has any abnormalities that, in the opinion of the investigator would prevent the patient from safe participation in the study. Unwilling to abstain from donation of blood during the study.
Facility Information:
Facility Name
The Clatterbridge Cancer Centre NHS Foundation Trust
City
Bebington
State/Province
Wirral
ZIP/Postal Code
CH63 4JY
Country
United Kingdom
Facility Name
St James's Institute of Oncology, St James's University Hospital
City
Leeds
State/Province
Yorkshire
ZIP/Postal Code
LS9 7TF
Country
United Kingdom
Facility Name
Bristol Haematology & Oncology Centre
City
Bristol
ZIP/Postal Code
BS2 8ED
Country
United Kingdom
Facility Name
Guy's and St Thomas NHS Foundation Trust, of St Thomas' Hospital
City
London
ZIP/Postal Code
SE1 7EH
Country
United Kingdom
Facility Name
The Christie NHS Foundation Trust
City
Manchester
ZIP/Postal Code
M20 4BX
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
33623076
Citation
Twelves C, Sabel M, Checketts D, Miller S, Tayo B, Jove M, Brazil L, Short SC; GWCA1208 study group. A phase 1b randomised, placebo-controlled trial of nabiximols cannabinoid oromucosal spray with temozolomide in patients with recurrent glioblastoma. Br J Cancer. 2021 Apr;124(8):1379-1387. doi: 10.1038/s41416-021-01259-3. Epub 2021 Feb 24.
Results Reference
derived

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A Safety Study of Sativex in Combination With Dose-intense Temozolomide in Patients With Recurrent Glioblastoma

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