search
Back to results

A Study to Evaluate the Safety of LAM561 Added to Standard of Care in Newly-diagnosed Glioblastoma Patients

Primary Purpose

Glioblastoma (GBM)

Status
Completed
Phase
Phase 1
Locations
Spain
Study Type
Interventional
Intervention
LAM561
RT
TMZ
Sponsored by
Laminar Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glioblastoma (GBM)

Eligibility Criteria

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

Inclusion Criteria:

  1. Glioblastoma (GBM) according to 2016 World Health Organization (WHO) Classification.
  2. Must have had a partial or complete surgical resection of the Grade 4 astrocytic tumor.
  3. Subjects in Arm 1 must have had no previous treatment except surgery (ie, no previous RT, local CT, or systemic therapy). Subjects must meet certain other eligibility requirements.
  4. Subjects in Arm 2 must have completed a standard first line regimen of concurrent TMZ and RT for newly diagnosed GBM patients, followed by a rest phase, and have not had any other previous CT except surgery (including any other regimens of RT and local or systemic CT). Progression and/or pseudoprogression should have been ruled out before starting Arm 2 as per usual clinical practice, with correct laboratory results (absolute neutrophile count ≥1.5 x 109/L, platelet count ≥ 100 x 109/L, non-haematological toxicity grade ≤ 2) at screening. Subjects must meet certain other eligibility requirements.
  5. Subjects must be able to undergo serial MRIs (computerized tomography may not be a substitute for magnetic resonance imaging [MRI]).
  6. Male or female ≥ 18 years old.
  7. Must have a Karnofsky performance status of ≥ 70% and the ability to swallow oral medication.
  8. Must have no other diagnosis of cancer malignancy (except surgically excised nonmelanoma skin cancer or carcinoma in situ of the cervix, or treated early stage prostate cancer, or a malignancy diagnosed ≥ 5 years previously with no current evidence of disease and no therapy within two years prior to enrolment on this study).
  9. Must be capable of understanding and complying with the protocol requirements.
  10. Contraception: All female patients will be considered to be of childbearing potential unless they are postmenopausal (at least 12 months consecutive amenorrhea, in the appropriate age group and without other known or suspected cause), or have been sterilized surgically. Female patients of childbearing potential must agree to use two forms of highly effective contraception methods (a primary and a secondary method) during the study and for a period of 6 months following the last administration of the study drug. Male patients and their female partners, who are of childbearing potential and are not practicing total abstinence, must agree to use two forms of highly effective contraception methods (a primary and a secondary method) during the study and for a period of 6 months following the last administration of the study drug These contraception methods include oral, transdermal, systemic or implant contraception birth control, intra-uterine devices (IUD), abstinence and double barrier method such as diaphragm with spermicidal gel or other recommended double barrier methods screening.
  11. Written informed consent form signed before any study test or procedure.

Exclusion Criteria:

  1. Subject has received prior systemic CT or RT (Arm 1) or prior systemic CT other than TMZ (Arm 2), biologic agents, or any other type of investigational agent for the treatment of brain tumors.
  2. Subjects who have progressed on TMZ are not eligible (pseudoprogression ruled out as per usual clinical practice).
  3. Subject has evidence of acute intracranial or intratumoral hemorrhage > Grade 1 by MRI. Subjects with resolving hemorrhage changes, punctate hemorrhage, or hemosiderin may enter the study.
  4. Subject has serious intercurrent illness such as: hypertension despite optimal treatment, or significant cardiac arrhythmias; or a recent history of serious disease such as symptomatic congestive heart failure, or abdominal fistula or gastrointestinal (GI) perforation within 6 months, prior to starting study treatment.
  5. Subject has had major surgery within 28 days prior to starting study treatment (except cancer resection surgery in arm 1), or had non water-tight dural closure during previous surgery, or has unhealed wounds from previous surgery.
  6. Subject has inherited bleeding diathesis or coagulopathy with the risk of bleeding.
  7. Subject is pregnant or breastfeeding.
  8. Subject is known to be positive for the human immunodeficiency virus (HIV) (a test for HIV at screening is not required).
  9. Subject has a previously-identified allergy or hypersensitivity to components of either the 2-OHOA or TMZ formulations.
  10. Subject is unable or unwilling to abide by the study protocol or cooperate fully with the investigator or designee.

Sites / Locations

  • Institut Catala d'Oncologia, Hospital Germans Trias I Pujol
  • Hospital Universitari de Girona Dr. Josep Trueta, Institut Català d'Oncologia
  • Hospital Duran i Reynals, Institut Català d'Oncologia

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Arm 1 (chemoradiation phase)

Arm 2 (maintenance phase)

Arm Description

Radiotherapy (RT) + temozolomide (TMZ) + LAM561 (during Concurrent phase - duration 6 weeks)*: LAM561 will be initiated at the start of the concurrent phase and will be administered on a continuous daily basis together with TMZ and RT for 6 weeks at the selected dose, either 12 g/day (4 g tid), 8 g/day (4 g bid) or 4 g/day (4 g od). RT will be administered only during the concurrent phase, consisting of fractionated focal irradiation administered using 1.8- 2 Gy/fraction, daily for 5 days/week for 6 weeks, for a total dose of up to 60 Gy. TMZ will be administered during the concurrent phase at a starting dose of 75 mg/m2/day given daily for 6 weeks. * One extra week may be allowed.

TMZ + LAM561 (during Maintenance phase with TMZ 200 mg/m2/day at Cycle 2 - duration 8 weeks): LAM561 will be initiated on day 2 of Cycle 2 of the maintenance phase, when TMZ 200 mg/m2/day is given and administered on a continuous basis for two 28-day cycles. LAM561 will be administered at the selected dose, either 12 g/day (4 g tid), 8 g/day (4 g bid) or 4 g/day (4 g od). TMZ will be administered at 200 mg/m2/day given daily the first 5 days for two 28-day cycles (if no toxicity is seen). In case of toxicity, TMZ dose may be reduced to 150 mg/m2/day at Cycle 3 to allow for recovery. Both arms will be followed by a 4-week safety follow-up

Outcomes

Primary Outcome Measures

Safety and Tolerability of LAM561 in association with Standard of Care (Stupp Protocol)
Incidence of Treatment-Emergent Adverse Events.
Maximum Tolerated dose (MTD)
MTD of LAM561 administered with Standard of Care

Secondary Outcome Measures

Plasma concentration of temozolomide (TMZ).
To verify that the administration of LAM561 is not modifying the exposition of patients to TMZ.

Full Information

First Posted
January 3, 2019
Last Updated
February 17, 2023
Sponsor
Laminar Pharmaceuticals
search

1. Study Identification

Unique Protocol Identification Number
NCT03867123
Brief Title
A Study to Evaluate the Safety of LAM561 Added to Standard of Care in Newly-diagnosed Glioblastoma Patients
Official Title
A Phase 1B Study of the Safety of LAM561 Administered Orally in Combination With Temozolomide (TMZ) and Radiation Therapy or With TMZ Alone in the First Line Treatment of Subjects With Glioblastoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Completed
Study Start Date
December 4, 2018 (Actual)
Primary Completion Date
July 1, 2020 (Actual)
Study Completion Date
July 1, 2020 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the safety and tolerability of LAM561 added to first-line treatment for subjects with newly diagnosed glioblastoma (GBM), and to determine the highest safe dose of LAM561 administered orally when added to the concurrent phase of treatment with temozolomide (TMZ) and radiation therapy (RT) or when added to the maintenance phase of treatment with TMZ (once TMZ 200 g/m2/day is started).
Detailed Description
This is a Phase IB, open-label, dose-finding study. A de-escalation process has been selected for the study with a 3+3 design to establish the Maximum Tolerated Dose (MTD). The first group of 3 subjects (within each arm), where all 3 subjects may be started at the same time, will receive LAM561 at the starting dose of 12 g/day (4 g tid). If 0-1 Dose-Limiting Toxicities (DLTs) in the first 3 patients, then a new cohort with 3 more patients is started at 12 g/day (4 g tid). If 2 or more patients out of 3 or 6 patients experience DLT(s) the dose is deescalated. De-escalation doses are from 12 g/day (4 g tid) to 8 g/day (4 g bid) and from 8 g/day (4 g bid) to 4 g/day (4 g od). This procedure must be applied to the two arms of the study described below. Both arms will be independent, and will run in parallel, therefore none of the patients from Arm 1 may enter Arm 2.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1 (chemoradiation phase)
Arm Type
Experimental
Arm Description
Radiotherapy (RT) + temozolomide (TMZ) + LAM561 (during Concurrent phase - duration 6 weeks)*: LAM561 will be initiated at the start of the concurrent phase and will be administered on a continuous daily basis together with TMZ and RT for 6 weeks at the selected dose, either 12 g/day (4 g tid), 8 g/day (4 g bid) or 4 g/day (4 g od). RT will be administered only during the concurrent phase, consisting of fractionated focal irradiation administered using 1.8- 2 Gy/fraction, daily for 5 days/week for 6 weeks, for a total dose of up to 60 Gy. TMZ will be administered during the concurrent phase at a starting dose of 75 mg/m2/day given daily for 6 weeks. * One extra week may be allowed.
Arm Title
Arm 2 (maintenance phase)
Arm Type
Experimental
Arm Description
TMZ + LAM561 (during Maintenance phase with TMZ 200 mg/m2/day at Cycle 2 - duration 8 weeks): LAM561 will be initiated on day 2 of Cycle 2 of the maintenance phase, when TMZ 200 mg/m2/day is given and administered on a continuous basis for two 28-day cycles. LAM561 will be administered at the selected dose, either 12 g/day (4 g tid), 8 g/day (4 g bid) or 4 g/day (4 g od). TMZ will be administered at 200 mg/m2/day given daily the first 5 days for two 28-day cycles (if no toxicity is seen). In case of toxicity, TMZ dose may be reduced to 150 mg/m2/day at Cycle 3 to allow for recovery. Both arms will be followed by a 4-week safety follow-up
Intervention Type
Drug
Intervention Name(s)
LAM561
Intervention Description
Arm 1: Daily for 6 weeks. Arm 2: daily, two 28-day cycles
Intervention Type
Radiation
Intervention Name(s)
RT
Other Intervention Name(s)
radiotherapy
Intervention Description
In Arm 1: Fractionated focal irradiation of 1.8-2 Gy/fraction/day, 5 days/week, 6 weeks. Total dose up to 60 Gy
Intervention Type
Drug
Intervention Name(s)
TMZ
Other Intervention Name(s)
temozolomide
Intervention Description
Arm 1: 75 mg/m2/day, daily, 6 weeks Arm 2: 200 mg/m2/day, daily the first 5 days of two 28-day cycles (in case of toxicity, TMZ dose may be reduced to 150 mg/m2/day at Cycle 3 to allow for recovery)
Primary Outcome Measure Information:
Title
Safety and Tolerability of LAM561 in association with Standard of Care (Stupp Protocol)
Description
Incidence of Treatment-Emergent Adverse Events.
Time Frame
10 to 12 weeks
Title
Maximum Tolerated dose (MTD)
Description
MTD of LAM561 administered with Standard of Care
Time Frame
10 to 12 months
Secondary Outcome Measure Information:
Title
Plasma concentration of temozolomide (TMZ).
Description
To verify that the administration of LAM561 is not modifying the exposition of patients to TMZ.
Time Frame
First five days of cycle 2 of maintenance phase (each cycle is 4 weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Glioblastoma (GBM) according to 2016 World Health Organization (WHO) Classification. Must have had a partial or complete surgical resection of the Grade 4 astrocytic tumor. Subjects in Arm 1 must have had no previous treatment except surgery (ie, no previous RT, local CT, or systemic therapy). Subjects must meet certain other eligibility requirements. Subjects in Arm 2 must have completed a standard first line regimen of concurrent TMZ and RT for newly diagnosed GBM patients, followed by a rest phase, and have not had any other previous CT except surgery (including any other regimens of RT and local or systemic CT). Progression and/or pseudoprogression should have been ruled out before starting Arm 2 as per usual clinical practice, with correct laboratory results (absolute neutrophile count ≥1.5 x 109/L, platelet count ≥ 100 x 109/L, non-haematological toxicity grade ≤ 2) at screening. Subjects must meet certain other eligibility requirements. Subjects must be able to undergo serial MRIs (computerized tomography may not be a substitute for magnetic resonance imaging [MRI]). Male or female ≥ 18 years old. Must have a Karnofsky performance status of ≥ 70% and the ability to swallow oral medication. Must have no other diagnosis of cancer malignancy (except surgically excised nonmelanoma skin cancer or carcinoma in situ of the cervix, or treated early stage prostate cancer, or a malignancy diagnosed ≥ 5 years previously with no current evidence of disease and no therapy within two years prior to enrolment on this study). Must be capable of understanding and complying with the protocol requirements. Contraception: All female patients will be considered to be of childbearing potential unless they are postmenopausal (at least 12 months consecutive amenorrhea, in the appropriate age group and without other known or suspected cause), or have been sterilized surgically. Female patients of childbearing potential must agree to use two forms of highly effective contraception methods (a primary and a secondary method) during the study and for a period of 6 months following the last administration of the study drug. Male patients and their female partners, who are of childbearing potential and are not practicing total abstinence, must agree to use two forms of highly effective contraception methods (a primary and a secondary method) during the study and for a period of 6 months following the last administration of the study drug These contraception methods include oral, transdermal, systemic or implant contraception birth control, intra-uterine devices (IUD), abstinence and double barrier method such as diaphragm with spermicidal gel or other recommended double barrier methods screening. Written informed consent form signed before any study test or procedure. Exclusion Criteria: Subject has received prior systemic CT or RT (Arm 1) or prior systemic CT other than TMZ (Arm 2), biologic agents, or any other type of investigational agent for the treatment of brain tumors. Subjects who have progressed on TMZ are not eligible (pseudoprogression ruled out as per usual clinical practice). Subject has evidence of acute intracranial or intratumoral hemorrhage > Grade 1 by MRI. Subjects with resolving hemorrhage changes, punctate hemorrhage, or hemosiderin may enter the study. Subject has serious intercurrent illness such as: hypertension despite optimal treatment, or significant cardiac arrhythmias; or a recent history of serious disease such as symptomatic congestive heart failure, or abdominal fistula or gastrointestinal (GI) perforation within 6 months, prior to starting study treatment. Subject has had major surgery within 28 days prior to starting study treatment (except cancer resection surgery in arm 1), or had non water-tight dural closure during previous surgery, or has unhealed wounds from previous surgery. Subject has inherited bleeding diathesis or coagulopathy with the risk of bleeding. Subject is pregnant or breastfeeding. Subject is known to be positive for the human immunodeficiency virus (HIV) (a test for HIV at screening is not required). Subject has a previously-identified allergy or hypersensitivity to components of either the LAM561 or TMZ formulations. Subject is unable or unwilling to abide by the study protocol or cooperate fully with the investigator or designee.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jordi Roma, MD
Organizational Affiliation
cro
Official's Role
Study Director
Facility Information:
Facility Name
Institut Catala d'Oncologia, Hospital Germans Trias I Pujol
City
Badalona
State/Province
Cataluña
ZIP/Postal Code
08916
Country
Spain
Facility Name
Hospital Universitari de Girona Dr. Josep Trueta, Institut Català d'Oncologia
City
Girona
State/Province
Cataluña
ZIP/Postal Code
17007
Country
Spain
Facility Name
Hospital Duran i Reynals, Institut Català d'Oncologia
City
L'Hospitalet De Llobregat
State/Province
Cataluña
ZIP/Postal Code
08908
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

A Study to Evaluate the Safety of LAM561 Added to Standard of Care in Newly-diagnosed Glioblastoma Patients

We'll reach out to this number within 24 hrs