Preoperative Ceritinib (LDK378) in Glioblastoma Multiforme and CNS Metastasis
Glioblastoma, Brain Metastases
About this trial
This is an interventional other trial for Glioblastoma
Eligibility Criteria
Inclusion Criteria:
- One prior resection of GBM or MRI evidence of solid tumor CNS metastasis
- All GBM and NSLC metastases must be ALK+
- Eastern Cooperative Oncology Group performance status ≤2
- Archival tumor tissue block available for research use
- Ability to understand written informed consent
- Recovery from toxicities related to prior anticancer therapies to ≤ grade 2 (CTCAE v 4.03). Exception: patients with any grade alopecia
The following lab criteria are met:
- Absolute neutrophil count ≥ 1.5 x 10(9th power)/L
- Hemoglobin ≥ 8 g/dL
- Platelets ≥ 75 x 10(9th power)/L
- Serum total bilirubin ≤ 1.5 x upper limit of normal(ULN), except for patients with Gilbert's syndrome who may be included if total bilirubin ≤ 3.0 x ULN and direct bilirubin ≤ 1.5 x ULN
- Aspartate transaminase (AST) < 3.0 x ULN, except for patients with liver metastasis, who are only included if AST < 5 x ULN; alanine transaminase (ALT) < 3.0 x ULN, except for patients with liver metastasis, who are only included if ALT < 5 x ULN
- Creatinine clearance ≥ 30 mL/min
Patient has following lab values or has lab values corrected with supplements to be within normal limits at screening:
- Potassium ≥ LLN
- Magnesium ≥ LLN
- Phosphorus ≥ LLN
- Total calcium (corrected for serum albumin) ≥ LLN
Exclusion Criteria:
- Co-morbid condition(s) that prevent safe surgical treatment
- Active infection or fever > 38.5°C
- Patients with known hypersensitivity to any excipients of ceritinib
- Prior therapy with ceritinib
- Patients with known history of extensive disseminated bilateral interstitial fibrosis or interstitial lung disease, including a history of pneumonitis, hypersensitivity pneumonitis, interstitial pneumonia, obliterative bronchiolitis, and clinically significant radiation pneumonitis (affecting activities of daily living or requiring therapeutic intervention)
Clinically significant uncontrolled heart disease and/or recent cardiac event (within 6 months), such as:
- history of documented congestive heart failure (New York Heart Association functional classification III-IV);
- uncontrolled hypertension defined by a Systolic Blood Pressure ≥ 160 mm Hg and/or Diastolic Blood Pressure ≥ 100 mm Hg, with or without antihypertensive medication
- initiation or adjustment of antihypertensive medication(s) is allowed prior to screening;
- ventricular arrhythmias; supraventricular and nodal arrhythmias not controlled with medication;
- other cardiac arrhythmia not controlled with medication;
- corrected QTc > 450 msec using Fridericia correction on the screening ECG
- Impaired GI function or GI disease that may alter absorption of ceritinib or inability to swallow up to five ceritinib capsules daily
- Ongoing GI adverse events > grade 2 (e.g. nausea, vomiting, or diarrhea) at the start of the study
Receiving medications that meet 1 of the following criteria and cannot be discontinued at least 1 week prior to start of treatment with ceritinib and for the duration of participation:
- Medication with a known risk of prolonging the QT interval or inducing Torsades de Pointes
- Strong inhibitors or strong inducers of CYP3A4/5
- Medications with a low therapeutic index that are primarily metabolized by CYP3A4/5, CYP2C8 and/or CYP2C9
- Therapeutic doses of warfarin sodium (Coumadin) or any other coumadin-derived anti-coagulant. Anticoagulants not derived from warfarin are allowed
- Pregnant or nursing (lactating) women.
- Women of child-bearing potential, unless they are using highly effective methods of contraception during dosing and for 3 months after the last dose of study treatment.
Sites / Locations
- Barrow Brain and Spine
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
2-4 hours
4-8 hours
22-26 hours
All patients will be orally-administered 10-14 doses of ceritinib 750mg with the final dose occurring at one of three intervals before brain tumor resection. This arm has the last ceritinib dose 2-4 hours prior to craniotomy for tumor resection.
All patients will be orally-administered 10-14 doses of ceritinib 750mg with the final dose occurring at one of three intervals before brain tumor resection. This arm has the last ceritinib dose 4-8 hours prior to craniotomy for tumor resection.
All patients will be orally-administered 10-14 doses of ceritinib 750mg with the final dose occurring at one of three intervals before brain tumor resection. This arm has the last ceritinib dose 22-26 hours prior to craniotomy for tumor resection.