Trial of AEO in New Glioblastoma (GBM) (AEO)
Primary Purpose
Glioblastoma Multiforme
Status
Unknown status
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Anhydrous Enol-Oxaloacetate (AEO)
Standard of Care
Sponsored by
About this trial
This is an interventional treatment trial for Glioblastoma Multiforme focused on measuring Glioblastoma, Oxaloacetate, Seizures, Warburg
Eligibility Criteria
Inclusion Criteria:
• Histopathologic diagnosis of glioblastoma multiforme
- Standard of care maximal feasible surgical resection of the glioma
- Post-operative pre-enrollment MRI-Note: measurable disease is not required
- Concomitant anti-epileptic drugs
- Hemoglobin >9 g/dL
- Platelets >100,000/microliter (mcL)
- <3.0 Upper Limit of Normal Range (ULN) for Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and/or Alkaline Phosphatase
- <2.0 Upper Limit of Normal Range (ULN) for serum creatinine
- Karnofsky performance status >70
- Mentally competent to follow study procedures
- Male and female patients of childbearing potential must agree to use a dual method of contraception (a highly effective method of contraception in conjunction with barrier contraception) consistently and correctly from the first dose of study drug until 90 days after the last dose of study drug
- Able to answer questions on the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire
- Subject is willing and able to give informed consent and to follow instructions as per the protocol
Exclusion Criteria:
• Concomitant treatment with carmustine wafers or tumor-treating electric fields (TTFields)
- QT Interval corrected with the fridericia formula (QTcF) >480ms
- Significant concurrent illness / disease
- Predicted life expectancy < 6 months from date of randomization
- Pregnancy
- Enrollment in another clinical trial during the course of the study
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Experimental
Arm Label
Standard of Care
AEO with Standard of Care
Arm Description
Current GBM Treatment of surgery, radiation and chemotherapy with temozolomide.
Anhydrous Enol-Oxaloacetate added to the Standard of Care (surgery, radiation and chemotherapy with temozolomide).
Outcomes
Primary Outcome Measures
Overall Survival
Measurement of Overall Survival
Progression Free Survival-6
Survival at 6 months
Secondary Outcome Measures
Seizures
Time from randomization to first seizure
Chalfont-National Hospital Seizure Severity
Measure of Seizure Severity Ranging from a minimum of 1 to a maximum of 27 with higher score indicating worse outcome
PROMIS-Cancer - Fatigue
Measure of Fatigue Ranging from a minimum of 0 to a maximum of 95 with the higher score indicating worse outcome.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04450160
Brief Title
Trial of AEO in New Glioblastoma (GBM)
Acronym
AEO
Official Title
A Phase 2, Randomized, Open-Label Study of Anhydrous Enol-Oxaloacetate in Subjects With Newly Diagnosed Glioblastoma Multiforme
Study Type
Interventional
2. Study Status
Record Verification Date
June 2020
Overall Recruitment Status
Unknown status
Study Start Date
December 2020 (Anticipated)
Primary Completion Date
July 2022 (Anticipated)
Study Completion Date
September 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MetVital, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
This is a multicenter, Phase 2, Proof-of-concept study in subjects with newly diagnosed glioblastoma multiforme (GBM).
All subjects will receive standard of care therapy for the treatment of their GBM and any Anti-Epileptic Drug (AED) deemed necessary for their surgical resection of the GBM. Patients who are taking concomitant AEDs will be eligible for the study. Treatment with Anhydrous Enol-Oxaloacetate will be added to the Standard of Care.
This study is testing adjuvant Anhydrous Enol-Oxaloacetate (AEO) in GBM, an orally active drug candidate which in animal studies has demonstrated decreased tumor growth rate and increased survival.
Detailed Description
Currently, the multidisciplinary Standard of Care treatment for Glioblastoma multiforme includes maximal surgical resection of the tumor followed by radiotherapy plus concomitant and maintenance temozolomide chemotherapy.This study will treat newly diagnosed GBM patients by adding Anhydrous Enol-Oxaloacetate treatment to their current Standard of Care.
In the body, Anhydrous Enol-Oxaloacetate (AEO) converts into "Oxaloacetate", a metabolite important for many biochemical reactions in the body. On a cellular level, oxaloacetate treatment has been found to modify cancer metabolism in GBM cells, reversing the "Warburg Effect", reducing glycolysis and reducing lactate production. In animals, oxaloacetate treatment has increased survival and reduced tumor growth of implanted GBM tumors.
In other animal studies, oxaloacetate has also shown to have neuo-protective effects including positive effects on seizure development.
.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma Multiforme
Keywords
Glioblastoma, Oxaloacetate, Seizures, Warburg
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
80 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Standard of Care
Arm Type
Placebo Comparator
Arm Description
Current GBM Treatment of surgery, radiation and chemotherapy with temozolomide.
Arm Title
AEO with Standard of Care
Arm Type
Experimental
Arm Description
Anhydrous Enol-Oxaloacetate added to the Standard of Care (surgery, radiation and chemotherapy with temozolomide).
Intervention Type
Drug
Intervention Name(s)
Anhydrous Enol-Oxaloacetate (AEO)
Intervention Description
Oral supplementation with AEO along with the Standard of Care (Temozolomide)
Intervention Type
Other
Intervention Name(s)
Standard of Care
Other Intervention Name(s)
Chemotherapy with Temozolomide
Intervention Description
Standard of Care Temozolomide
Primary Outcome Measure Information:
Title
Overall Survival
Description
Measurement of Overall Survival
Time Frame
6 months
Title
Progression Free Survival-6
Description
Survival at 6 months
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Seizures
Description
Time from randomization to first seizure
Time Frame
6 months
Title
Chalfont-National Hospital Seizure Severity
Description
Measure of Seizure Severity Ranging from a minimum of 1 to a maximum of 27 with higher score indicating worse outcome
Time Frame
6 months
Title
PROMIS-Cancer - Fatigue
Description
Measure of Fatigue Ranging from a minimum of 0 to a maximum of 95 with the higher score indicating worse outcome.
Time Frame
6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
• Histopathologic diagnosis of glioblastoma multiforme
Standard of care maximal feasible surgical resection of the glioma
Post-operative pre-enrollment MRI-Note: measurable disease is not required
Concomitant anti-epileptic drugs
Hemoglobin >9 g/dL
Platelets >100,000/microliter (mcL)
<3.0 Upper Limit of Normal Range (ULN) for Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and/or Alkaline Phosphatase
<2.0 Upper Limit of Normal Range (ULN) for serum creatinine
Karnofsky performance status >70
Mentally competent to follow study procedures
Male and female patients of childbearing potential must agree to use a dual method of contraception (a highly effective method of contraception in conjunction with barrier contraception) consistently and correctly from the first dose of study drug until 90 days after the last dose of study drug
Able to answer questions on the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire
Subject is willing and able to give informed consent and to follow instructions as per the protocol
Exclusion Criteria:
• Concomitant treatment with carmustine wafers or tumor-treating electric fields (TTFields)
QT Interval corrected with the fridericia formula (QTcF) >480ms
Significant concurrent illness / disease
Predicted life expectancy < 6 months from date of randomization
Pregnancy
Enrollment in another clinical trial during the course of the study
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Alan B Cash, MS
Phone
858-947-5722
Email
acash@MetVital.com
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
30349820
Citation
Augur ZM, Doyle CM, Li M, Mukherjee P, Seyfried TN. Nontoxic Targeting of Energy Metabolism in Preclinical VM-M3 Experimental Glioblastoma. Front Nutr. 2018 Oct 5;5:91. doi: 10.3389/fnut.2018.00091. eCollection 2018.
Results Reference
background
PubMed Identifier
22392507
Citation
Ruban A, Berkutzki T, Cooper I, Mohar B, Teichberg VI. Blood glutamate scavengers prolong the survival of rats and mice with brain-implanted gliomas. Invest New Drugs. 2012 Dec;30(6):2226-35. doi: 10.1007/s10637-012-9799-5.
Results Reference
background
PubMed Identifier
12749815
Citation
Yamamoto HA, Mohanan PV. Effect of alpha-ketoglutarate and oxaloacetate on brain mitochondrial DNA damage and seizures induced by kainic acid in mice. Toxicol Lett. 2003 Jul 20;143(2):115-22. doi: 10.1016/s0378-4274(03)00114-0.
Results Reference
background
Links:
URL
http://doi.org/10.1093/neuonc/noz175.171
Description
Oxaloacetate alters glucose metabolism in Glioblastoma
URL
http://doi.org/10.1093/neuonc/nox168.238
Description
Oxaloacetate increases survival in GBM implanted mice
URL
http://doi.org/10.1093/neuonc/noy148.1154
Description
New Bioanalytical method and single-dose pharmacokinetics for oxaloacetate
Learn more about this trial
Trial of AEO in New Glioblastoma (GBM)
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