Trial of Newly Diagnosed High Grade Glioma Treated With Concurrent Radiation Therapy, Temozolomide and BMX-001 (BMX-HGG)
High Grade Glioma, Astrocytoma, Grade III, Glioblastoma
About this trial
This is an interventional treatment trial for High Grade Glioma
Eligibility Criteria
Inclusion Criteria:
- Subjects must have histologically confirmed diagnosis of World Health Organization (WHO) grade III or IV malignant glioma
- Subjects must be planning to start standard of care radiation therapy and chemotherapy
- Subjects must be within 12 weeks of last major neurosurgical procedure for the high-grade glioma (craniotomy, open biopsy, or stereotactic biopsy)
- Subjects must have had a definitive resection with residual radiographic contrast enhancement on post-resection CT or MRI of less than or equal to 3 cm in any two perpendicular planes on any images
- Age * 18 years
- Karnofsky Performance Status (KPS) ≥ 70%
- Hemoglobin ≥ 9.0 g/dl, absolute neutrophil count (ANC) ≥ 1,500 cells/µl, platelets ≥ 125,000 cells/µl
- Serum creatinine ≤ 1.5 mg/dl, serum glutamate oxaloacetate transaminase (SGOT) and bilirubin ≤ 1.5 times upper limit of normal
- Signed informed consent approved by the Institutional Review Board
- If sexually active, patients must agree to use appropriate contraceptive measures for the duration of the study and for 12 months afterwards as stated in the informed consent
- Stable and/or decreasing dose of corticosteroids for greater than or equal to 7 days.
Exclusion Criteria:
- Pregnancy or breast-feeding
- Active infection requiring IV antibiotics 7 days before enrollment
- Signs of wound-healing problems or infection at the craniotomy/biopsy site.
- Prior, unrelated malignancy requiring current active treatment with the exception of cervical carcinoma in situ and adequately treated basal cell or squamous cell carcinoma of the skin
- Co-medication that may interfere with study results; e.g. immuno-suppressive agents other than corticosteroids
- Prior treatment with radiotherapy or chemotherapy for a brain tumor, irrespective of the grade of the tumor
- Evidence of > grade 1 CNS hemorrhage on baseline MRI on CT scan
- Systemic treatment with inducers or strong inhibitors of cytochrome P450 within four days before enrollment or planned treatment during the time period of the study.
- Metal in the body (except dental fillings) e.g., pacemaker, infusion pump, metal aneurysm clip, metal prosthesis, joint, rod or plate.
- Severe allergy to contrast agent.
- Inadequately controlled hypertension
- Active or history of postural hypotension and autonomic dysfunction
- Clinically significant (i.e. active) cardiovascular disease or cerebrovascular disease, for example cerebrovascular accidents ≤ 6 months prior to study enrollment, myocardial infarction ≤ 6 months prior to study enrollment, unstable angina, New York Heart Association (NYHA) Grade II or greater congestive heart failure (CHF), or serious cardiac arrhythmia uncontrolled by medication or potentially interfering with protocol treatment
- History or evidence upon physical/neurological examination of central nervous system disease (e.g. seizures) unrelated to cancer unless adequately controlled by medication or potentially interfering with protocol treatment
- Significant vascular disease (e.g., aortic aneurysm requiring surgical repair or recent arterial thrombosis) within 6 months prior to start of study treatment
- A marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval >480 milliseconds (ms) (CTCAE grade 1)
- A known history of additional risk factors for Torsades de Pointes (TdP) (e.g., congestive heart failure, hypokalemia, known family history of Long QT Syndrome).
Sites / Locations
- University of Alabama- Birmingham
- University of California San Francisco
- University of Kentucky
- St. Luke's Hospital
- University of Nebraska Medical Center
- Duke Cancer Institute
- Ohio State University
- Huntsman Cancer Institute
- University of Washington
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Radiation Therapy, TMZ and BMX-001
Radiation Therapy and TMZ
Patients will receive standard of care radiation therapy plus temozolomide (TMZ). BMX-001 will be given by subcutaneous injection with a loading dose of 28 mg/subject given within 4 days prior to initiation of radiation therapy and followed by biweekly maintenance doses at half the loading dose for a total of 8 weeks. A total of 80 subjects will receive BMX-001 in this phase.
In this arm, one-half of the study subjects will not receive BMX-001 but will undergo all components of standard therapy (radiation therapy plus temozolomide [TMZ]). A total of 80 subjects will be in this study arm.