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Study of Induction of Hypothyroxinemia Adjunct to Conventional Therapies in GBM Patients

Primary Purpose

Glioblastoma Multiforme (GBM)

Status
Terminated
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
Combined T3 and Methimazole treatment
Sponsored by
Musli Thyropeutics Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Glioblastoma Multiforme (GBM)

Eligibility Criteria

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

Inclusion Criteria:

  • Diagnosis of GBM, histologically or cytologically confirmed.
  • Newly-diagnosed subjects prior to beginning first-line conventional therapy.
  • Male or female subjects 18 years of age or older.
  • Ability to understand and willingness to sign a written informed consent document.
  • Ability and consent to comply with completion of a patient diary.
  • Subjects must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as ≥20 mm (≥2 cm) with conventional techniques or as ≥10 mm (≥1 cm) with spiral CT scan, MRI, or calipers by clinical exam.
  • Allowable type and amount of prior therapy and medication
  • ECOG performance status ≤2 (KPS ≥60%, see Appendix A).
  • Life expectancy of greater than 6 months
  • Subjects must have adequate bone marrow, liver and renal function as assessed by the following laboratory requirements conducted within 7 days of starting to study treatment:
  • Total bilirubin < 1.5 x the upper limit of normal (ULN).
  • Alanine transaminase (ALT) and aspartate aminotransferase (AST) < 2.5 xULN (< 5 x ULN for subjects with liver involvement of their cancer).
  • Alkaline phosphatase limit < 2.5 x ULN (<5 x ULN for subjects with liver involvement of their cancer)
  • Serum creatinine < 1.5 x the ULN. Glomerular filtration rate (GFR) ≥ 30 ml/min/1.73 m2 according to the MDRD (Modified diet in renal disease) abbreviated formula.
  • INR/PTT < 1.5 x ULN.
  • Platelet count > 100000 /mm3, Hemoglobin (Hb) > 9 g/dl, Absolute neutrophil count (ANC) > 1500/mm3
  • No significant abnormalities in serum hematology, serum chemistry and serum inflammatory / immunogenic markers according to the Principal Investigator's judgment.
  • No significant abnormalities in urinalysis according to the Principal Investigator's judgment, taking into considerations the potential effects of the tumor.
  • No significant abnormalities in ECG per investigator judgment.
  • Non-pregnant, non-lactating female subjects.
  • Women of childbearing potential and men must agree to use adequate contraception since signing of the informed consent form until at least 3 months after the last study.

Exclusion Criteria:

  • Patients unable to swallow oral medications.
  • Patients who have not recovered from adverse events due to agents administered more than 4 weeks earlier.
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days before start of study medication.
  • Patients who are receiving any other investigational agents or participating in another interventional clinical trial within 30 days prior to baseline visit (patients participating in other observational trials are allowed to be enrolled in this study).
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to anti-thyroid agent (such as methimazole or PTU) or Cytomel®, or other agents used in study.
  • Current or prior (within the last 60 days prior to screening visit) use of any medication or substance that have the potential to affect the activity or pharmacokinetics of the study agents (please refer to package inserts of study drugs).
  • Specific none-allowable type and amount of prior therapy and medication
  • Clinically significant concurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active connective tissue disorders, such as lupus or scleroderma, human immunodeficiency virus or psychiatric illness/social situations that in the opinion of the investigator, could interfere with the safety, compliance or other aspects of this study and would limit compliance with study requirements.
  • History of organ allograft.
  • Non-healing wound, ulcer, or bone fracture.
  • Renal failure requiring hemo-or peritoneal dialysis.
  • Pregnant or breast-feeding patients. Women of childbearing potential must have a pregnancy test performed a maximum of 7 days before start of treatment, and a negative result must be documented before start of treatment.
  • Evidence of uncontrolled hypertension (systolic blood pressure of >150 mm Hg, and/or diastolic blood pressure of >100 mm Hg) (at any time) when taken 3 times on the same arm with the subject in the supine position.
  • Evidence of alcohol abuse or history of alcohol abuse or illegal and/or legally prescribed drugs.
  • Inability to attend scheduled clinic visits and/or comply with the study protocol.
  • Any other factor that, in the opinion of the investigator, would prevent the patient from complying with the requirements of the protocol.
  • Any prior abnormalities related to the thyroid and /or intake of thyroid related drugs (e.g Eltroxin) in the 3 months prior to the study start.

Sites / Locations

  • Tel-Aviv Medical Center, Israel

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Hypothyroxinemia induced patients

Arm Description

Combined T3 and Methimazole treatment will be administered. This experimental treatment will be administered adjunct to standard oncological treatment for newly-diagnosed GBM patients e.g. radiation followed by Temozolomide.

Outcomes

Primary Outcome Measures

Response rate at 6 months (6 months PFS)
The primary outcome measure of the study is the ratio of patients who complete their 6-month course of chemotherapy given the IP adjunct treatment. Each patient is treated up to 6 weeks until their FT4 target is reached at which time they enter a 26 week (6 month) treatment phase during which they receive chemotherapy as per common protocol with the IP as adjunct treatment. Patients will be monitored for disease progression as per common oncological protocol (e.g. every 2 months) and those who show progression will be deemed failures. Patients with no disease progression (or partial or complete remission) at the end of the 6 month period will be considered success.

Secondary Outcome Measures

Response rate at 2 months (2 months PFS)
As a secondary outcome we will measure 2 month progression free survival as measured by RANO.
Response rate at 4 months (4 months PFS)
As a secondary outcome we will measure 4 month progression free survival as measured by RANO.
Time to disease progression or cancer-related death
Safety endpoint evaluation
Patients will be monitored throughout the study period for any Hypothyroxinemia treatment related safety issues including serious adverse events, any adverse events, vital signs, lab assessment, physical examination and lung function.

Full Information

First Posted
January 11, 2016
Last Updated
March 20, 2018
Sponsor
Musli Thyropeutics Ltd.
Collaborators
Tel-Aviv Sourasky Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT02654041
Brief Title
Study of Induction of Hypothyroxinemia Adjunct to Conventional Therapies in GBM Patients
Official Title
Phase II, Open-label, Prospective, Single-arm, Single-center Study of Induction of Hypothyroxinemia Adjunct to Conventional Therapies in GBM Patients
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Terminated
Why Stopped
Drug manufacturer no longer could supply for study
Study Start Date
March 2016 (undefined)
Primary Completion Date
June 2017 (Actual)
Study Completion Date
June 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Musli Thyropeutics Ltd.
Collaborators
Tel-Aviv Sourasky Medical Center

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of the study is to assess the safety and efficacy of treatment with hypothyroxinemia adjunct to conventional therapies in GBM patients.
Detailed Description
Since T4 (thyroxine) is a potent growth factor in numerous cancer types, the interventional approach will be to achieve thyroxine deprivation (hypothyroxinemia).This can be achieved by using a dual approach: T3 and methimazole to provide longer term inhibition of thyroid hormone synthesis.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Hypothyroxinemia induced patients
Arm Type
Experimental
Arm Description
Combined T3 and Methimazole treatment will be administered. This experimental treatment will be administered adjunct to standard oncological treatment for newly-diagnosed GBM patients e.g. radiation followed by Temozolomide.
Intervention Type
Drug
Intervention Name(s)
Combined T3 and Methimazole treatment
Intervention Description
Oral administration of T3 and Methimazole
Primary Outcome Measure Information:
Title
Response rate at 6 months (6 months PFS)
Description
The primary outcome measure of the study is the ratio of patients who complete their 6-month course of chemotherapy given the IP adjunct treatment. Each patient is treated up to 6 weeks until their FT4 target is reached at which time they enter a 26 week (6 month) treatment phase during which they receive chemotherapy as per common protocol with the IP as adjunct treatment. Patients will be monitored for disease progression as per common oncological protocol (e.g. every 2 months) and those who show progression will be deemed failures. Patients with no disease progression (or partial or complete remission) at the end of the 6 month period will be considered success.
Time Frame
32 weeks
Secondary Outcome Measure Information:
Title
Response rate at 2 months (2 months PFS)
Description
As a secondary outcome we will measure 2 month progression free survival as measured by RANO.
Time Frame
14 weeks
Title
Response rate at 4 months (4 months PFS)
Description
As a secondary outcome we will measure 4 month progression free survival as measured by RANO.
Time Frame
23 weeks
Title
Time to disease progression or cancer-related death
Time Frame
32 weeks
Title
Safety endpoint evaluation
Description
Patients will be monitored throughout the study period for any Hypothyroxinemia treatment related safety issues including serious adverse events, any adverse events, vital signs, lab assessment, physical examination and lung function.
Time Frame
32 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of GBM, histologically or cytologically confirmed. Newly-diagnosed subjects prior to beginning first-line conventional therapy. Male or female subjects 18 years of age or older. Ability to understand and willingness to sign a written informed consent document. Ability and consent to comply with completion of a patient diary. Subjects must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as ≥20 mm (≥2 cm) with conventional techniques or as ≥10 mm (≥1 cm) with spiral CT scan, MRI, or calipers by clinical exam. Allowable type and amount of prior therapy and medication ECOG performance status ≤2 (KPS ≥60%, see Appendix A). Life expectancy of greater than 6 months Subjects must have adequate bone marrow, liver and renal function as assessed by the following laboratory requirements conducted within 7 days of starting to study treatment: Total bilirubin < 1.5 x the upper limit of normal (ULN). Alanine transaminase (ALT) and aspartate aminotransferase (AST) < 2.5 xULN (< 5 x ULN for subjects with liver involvement of their cancer). Alkaline phosphatase limit < 2.5 x ULN (<5 x ULN for subjects with liver involvement of their cancer) Serum creatinine < 1.5 x the ULN. Glomerular filtration rate (GFR) ≥ 30 ml/min/1.73 m2 according to the MDRD (Modified diet in renal disease) abbreviated formula. INR/PTT < 1.5 x ULN. Platelet count > 100000 /mm3, Hemoglobin (Hb) > 9 g/dl, Absolute neutrophil count (ANC) > 1500/mm3 No significant abnormalities in serum hematology, serum chemistry and serum inflammatory / immunogenic markers according to the Principal Investigator's judgment. No significant abnormalities in urinalysis according to the Principal Investigator's judgment, taking into considerations the potential effects of the tumor. No significant abnormalities in ECG per investigator judgment. Non-pregnant, non-lactating female subjects. Women of childbearing potential and men must agree to use adequate contraception since signing of the informed consent form until at least 3 months after the last study. Exclusion Criteria: Patients unable to swallow oral medications. Patients who have not recovered from adverse events due to agents administered more than 4 weeks earlier. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days before start of study medication. Patients who are receiving any other investigational agents or participating in another interventional clinical trial within 30 days prior to baseline visit (patients participating in other observational trials are allowed to be enrolled in this study). History of allergic reactions attributed to compounds of similar chemical or biologic composition to anti-thyroid agent (such as methimazole or PTU) or Cytomel®, or other agents used in study. Current or prior (within the last 60 days prior to screening visit) use of any medication or substance that have the potential to affect the activity or pharmacokinetics of the study agents (please refer to package inserts of study drugs). Specific none-allowable type and amount of prior therapy and medication Clinically significant concurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active connective tissue disorders, such as lupus or scleroderma, human immunodeficiency virus or psychiatric illness/social situations that in the opinion of the investigator, could interfere with the safety, compliance or other aspects of this study and would limit compliance with study requirements. History of organ allograft. Non-healing wound, ulcer, or bone fracture. Renal failure requiring hemo-or peritoneal dialysis. Pregnant or breast-feeding patients. Women of childbearing potential must have a pregnancy test performed a maximum of 7 days before start of treatment, and a negative result must be documented before start of treatment. Evidence of uncontrolled hypertension (systolic blood pressure of >150 mm Hg, and/or diastolic blood pressure of >100 mm Hg) (at any time) when taken 3 times on the same arm with the subject in the supine position. Evidence of alcohol abuse or history of alcohol abuse or illegal and/or legally prescribed drugs. Inability to attend scheduled clinic visits and/or comply with the study protocol. Any other factor that, in the opinion of the investigator, would prevent the patient from complying with the requirements of the protocol. Any prior abnormalities related to the thyroid and /or intake of thyroid related drugs (e.g Eltroxin) in the 3 months prior to the study start.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Deborah T Blumenthal, MD
Organizational Affiliation
Tel-Aviv Medical Center, Israel
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tel-Aviv Medical Center, Israel
City
Tel-Aviv
ZIP/Postal Code
64239
Country
Israel

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Study of Induction of Hypothyroxinemia Adjunct to Conventional Therapies in GBM Patients

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