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Prospective Phase 2 Trial of Cabazitaxel in Patients With Temozolomide Refractory Glioblastoma Multiforme

Primary Purpose

Glioblastoma Multiforme (GBM) WHO Grade IV

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Cabazitaxel
Sponsored by
University of Ulm
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glioblastoma Multiforme (GBM) WHO Grade IV

Eligibility Criteria

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

Inclusion Criteria:

  • Both female and male patients meeting the mentioned inclusion and exclusion criteria will be included in this clinical trial. Patients must meet ALL of the following inclusion criteria to be eligible for enrollment into the study:

    • Patients with diagnosis glioblastoma multiforme (GBM) WHO grade IV (histologically confirmed by a pathologist)
    • Progression during or within 6 months after last temozolomide treatment
    • Time since last temozolomide > 21 days
    • Prior external beam radiotherapy (54 to 62 Gy), no option for subsequent radiotherapy
    • No clinical and radiological signs of intracerebral inflammation (in pre-study MRI not older than 4 weeks)
    • Patients > 18 years of age.
    • ECOG performance status of ≤ 2 (stable over 4 weeks prior to study entrance)
    • Female patients of childbearing potential with a negative pregnancy test within 7 days of initiation of study treatment. Postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential.
    • Male and female patients of reproductive potential who agree to employ an effective method of birth control throughout the study and for up to 6 months following discontinuation of study drug.
    • Signed informed consent prior to initiation of any study procedure (Must understand, voluntarily sign the informed consent form and be able to adhere to the study visit schedule and other protocol requirements.)

Exclusion Criteria:

  • The presence of ANY of the following criteria will exclude a patient from study enrollment:

    • Female patients who are pregnant or breast-feeding
    • History of severe hypersensitivity reaction (≥grade 3) to any component of the investigational drugs or excipients (allergy to or other intolerability of gadolinium, docetaxel, cabazitaxel or polysorbate 80 containing drugs)
    • Unable to undergo Gd-MRI
    • Time since external beam radiotherapy <12 weeks
    • Patients who have been treated with any investigational agent(s) within 28 days of the first day of administration of study drug.
    • Current active second malignancy other than non-melanoma skin cancers and post-treatment of localized prostate cancer. Patients are not considered to have a currently active malignancy if they are in complete remission for > 3 years prior to study
    • Uncontrolled severe illness or medical condition (including uncontrolled diabetes mellitus)
    • Known HIV infection, active Hepatitis B or C infection
    • Any serious and/or unstable pre-existing psychiatric or other condition that could interfere with subject's safety, provision of informed consent, or compliance to study procedures
    • Any ongoing toxicity from prior anti-cancer therapy that is > grade 1 and/or that is progressing in severity (except alopecia) and delayed hematological recovery following last temozolomide cycle
    • Additional anti-cancer treatment for GBM other than study drug and supportive measures (i.e. dexamethasone)
    • Inadequate organ and bone marrow function as evidenced by:

      1. Hemoglobin <9.0 g/dL
      2. Absolute neutrophil count <1.5 x 109/L,
      3. Platelet count <100 x 109/L,
      4. AST/SGOT and/or ALT/SGPT >1.5 x ULN;
      5. Total bilirubin >1.0 x ULN,
      6. Serum creatinine >1.5 x ULN. If creatinine 1.0 - 1.5 x ULN, creatinine clearance will be calculated according to CKD-EPI formula and patients with creatinine clearance <60 mL/min should be excluded

Sites / Locations

  • Hämatologisch onkologische Praxis
  • Stiftungsklinikum Mittelrhein GmbH
  • Lars Bullinger, MD

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cabazitaxel

Arm Description

Cabazitaxel will be given at a dose of 25mg/m² as 1h infusion every 3 weeks

Outcomes

Primary Outcome Measures

Response including SD, PR or CR determined by MRI (modified RANO criteria)
• Response after 12 weeks

Secondary Outcome Measures

Overall and progression-free survival
Safety and tolerability
Rates of deaths within 12 weeks Hematological and non hematological toxicity grade ≥ 2 according to CTCAE V4.0
Pharmacokinetics data concerning drug interactions (i.e. CYP3A induction)
Pharmacokinetics of cabazitaxel in patients with and without concomitant anticonvulsive medication with respect to induction of CYP3A
Quality of life and neurocognitive functioning
Assessment of quality of life, determined by assessment with EORTC QLQ questionnaires (C30 and BN20), and neurocognitive functioning, determined by repeated standardized measurements using MMSE

Full Information

First Posted
May 22, 2013
Last Updated
October 25, 2017
Sponsor
University of Ulm
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1. Study Identification

Unique Protocol Identification Number
NCT01866449
Brief Title
Prospective Phase 2 Trial of Cabazitaxel in Patients With Temozolomide Refractory Glioblastoma Multiforme
Official Title
Prospective Controlled Phase 2 Trial of Cabazitaxel in Patients With Temozolomide Refractory Glioblastoma Multiforme (GBM)- The C-GBM Study -
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
October 2013 (undefined)
Primary Completion Date
December 2016 (Actual)
Study Completion Date
August 25, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Ulm

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The proposed study is an open-label, single-arm, Phase- II trial to assess the efficacy of cabazitaxel in GBM WHO grade IV patients with a progression during or within 6 months after last temozolomide treatment (Figure 1). Cabazitaxel will be given at a dose of 25mg/m² as 1h infusion every 3 weeks with standard concomitant medication (as outlined below): On Day 1 of each cycle, patients will receive cabazitaxel at a dose of 25mg/m², administered by i.v. route in 1 hour. Cycle length for cabazitaxel is 3 weeks (21 days). New cycles of therapy may not begin until Absolute Neutrophil Count (ANC) ≥1500/mm3, platelet count ≥75 000/mm3, and non-hematological toxicities (except alopecia) have recovered to baseline. A maximum of 2 weeks (14 days) delay is allowed between 2 treatment cycles. Patients should come off treatment if treatment delay is more than 2 weeks. At least 30 minutes prior to each administration of cabazitaxel, patients will receive i.v. premedication including: An antihistamine (dexchlorpheniramine 5mg, diphenhydramine 25mg, or equivalent). In case of i.v. antihistamine other than promethazine is not being available, local practice should be followed. Corticosteroid (dexamethasone 8mg or equivalent) H2 antagonist (ranitidine or equivalent). Antiemetic prophylaxis is recommended and can be given orally or intravenously if necessary. Primary prophylaxis with Granulocyte Colony-Stimulating Factor (G-CSF) should be given on day 4 of each treatment cycle as per ASCO and ESMO guidelines.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma Multiforme (GBM) WHO Grade IV

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Cabazitaxel
Arm Type
Experimental
Arm Description
Cabazitaxel will be given at a dose of 25mg/m² as 1h infusion every 3 weeks
Intervention Type
Drug
Intervention Name(s)
Cabazitaxel
Other Intervention Name(s)
Jevtane
Primary Outcome Measure Information:
Title
Response including SD, PR or CR determined by MRI (modified RANO criteria)
Description
• Response after 12 weeks
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Overall and progression-free survival
Time Frame
3 years
Title
Safety and tolerability
Description
Rates of deaths within 12 weeks Hematological and non hematological toxicity grade ≥ 2 according to CTCAE V4.0
Time Frame
3 years
Title
Pharmacokinetics data concerning drug interactions (i.e. CYP3A induction)
Description
Pharmacokinetics of cabazitaxel in patients with and without concomitant anticonvulsive medication with respect to induction of CYP3A
Time Frame
3 years
Title
Quality of life and neurocognitive functioning
Description
Assessment of quality of life, determined by assessment with EORTC QLQ questionnaires (C30 and BN20), and neurocognitive functioning, determined by repeated standardized measurements using MMSE
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Both female and male patients meeting the mentioned inclusion and exclusion criteria will be included in this clinical trial. Patients must meet ALL of the following inclusion criteria to be eligible for enrollment into the study: Patients with diagnosis glioblastoma multiforme (GBM) WHO grade IV (histologically confirmed by a pathologist) Progression during or within 6 months after last temozolomide treatment Time since last temozolomide > 21 days Prior external beam radiotherapy (54 to 62 Gy), no option for subsequent radiotherapy No clinical and radiological signs of intracerebral inflammation (in pre-study MRI not older than 4 weeks) Patients > 18 years of age. ECOG performance status of ≤ 2 (stable over 4 weeks prior to study entrance) Female patients of childbearing potential with a negative pregnancy test within 7 days of initiation of study treatment. Postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. Male and female patients of reproductive potential who agree to employ an effective method of birth control throughout the study and for up to 6 months following discontinuation of study drug. Signed informed consent prior to initiation of any study procedure (Must understand, voluntarily sign the informed consent form and be able to adhere to the study visit schedule and other protocol requirements.) Exclusion Criteria: The presence of ANY of the following criteria will exclude a patient from study enrollment: Female patients who are pregnant or breast-feeding History of severe hypersensitivity reaction (≥grade 3) to any component of the investigational drugs or excipients (allergy to or other intolerability of gadolinium, docetaxel, cabazitaxel or polysorbate 80 containing drugs) Unable to undergo Gd-MRI Time since external beam radiotherapy <12 weeks Patients who have been treated with any investigational agent(s) within 28 days of the first day of administration of study drug. Current active second malignancy other than non-melanoma skin cancers and post-treatment of localized prostate cancer. Patients are not considered to have a currently active malignancy if they are in complete remission for > 3 years prior to study Uncontrolled severe illness or medical condition (including uncontrolled diabetes mellitus) Known HIV infection, active Hepatitis B or C infection Any serious and/or unstable pre-existing psychiatric or other condition that could interfere with subject's safety, provision of informed consent, or compliance to study procedures Any ongoing toxicity from prior anti-cancer therapy that is > grade 1 and/or that is progressing in severity (except alopecia) and delayed hematological recovery following last temozolomide cycle Additional anti-cancer treatment for GBM other than study drug and supportive measures (i.e. dexamethasone) Inadequate organ and bone marrow function as evidenced by: Hemoglobin <9.0 g/dL Absolute neutrophil count <1.5 x 109/L, Platelet count <100 x 109/L, AST/SGOT and/or ALT/SGPT >1.5 x ULN; Total bilirubin >1.0 x ULN, Serum creatinine >1.5 x ULN. If creatinine 1.0 - 1.5 x ULN, creatinine clearance will be calculated according to CKD-EPI formula and patients with creatinine clearance <60 mL/min should be excluded
Facility Information:
Facility Name
Hämatologisch onkologische Praxis
City
Augsburg
ZIP/Postal Code
86150
Country
Germany
Facility Name
Stiftungsklinikum Mittelrhein GmbH
City
Koblenz
ZIP/Postal Code
56068
Country
Germany
Facility Name
Lars Bullinger, MD
City
Ulm
ZIP/Postal Code
89081
Country
Germany

12. IPD Sharing Statement

Learn more about this trial

Prospective Phase 2 Trial of Cabazitaxel in Patients With Temozolomide Refractory Glioblastoma Multiforme

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