Armodafinil in Treating Fatigue Caused By Radiation Therapy in Patients With Primary Brain Tumors

This is an interventional supportive care trial for Brain Tumors focused on measuring fatigue, cognitive/functional effects, adult giant cell glioblastoma, adult glioblastoma, adult gliosarcoma, adult anaplastic astrocytoma, adult anaplastic oligodendroglioma, adult mixed glioma, adult diffuse astrocytoma, adult pilocytic astrocytoma, adult pineal gland astrocytoma, adult subependymal giant cell astrocytoma, adult oligodendroglioma, adult anaplastic ependymoma, adult ependymoma, adult myxopapillary ependymoma, adult subependymoma, adult anaplastic meningioma, adult grade I meningioma, adult grade II meningioma, adult grade III meningioma, adult papillary meningioma, adult brain stem glioma Read More

Inclusion Criteria

• Histologically confirmed primary brain tumor, including any of the following:

  • Glioblastoma multiforme
  • Anaplastic astrocytoma
  • Anaplastic oligodendroglioma
  • Anaplastic mixed oligoastrocytoma
  • Low-grade glioma
  • Meningioma
  • Ependymoma
  • Other primary brain tumor histologies

• Planning to undergo external-beam cranial radiotherapy (partial- or whole-brain radiotherapy) meeting all of the following criteria:

  • Total dose ≥ 4,500 cGy
  • Total number of fractions ≥ 25 fractions
  • Dose per fraction ≥ 150 cGy

PATIENT CHARACTERISTICS:

• Karnofsky performance status 60-100%
• Hemoglobin ≥ 10.0 g/dL (erythropoietin or transfusion allowed for symptomatically anemic patients with a hemoglobin < 10 g/dL)
• Creatinine ≤ 2 mg/dL
• Total bilirubin ≤ 2 times upper limit of normal (ULN)
• SGOT and SGPT ≤ 3 times ULN
• Not pregnant or nursing
• Negative pregnancy test

• Sexually active women of childbearing potential must use a reliable method of birth control

  • It is recommended that patients use non-hormonal contraceptives, in addition to or in place of hormonal contraceptives, during and for one month following treatment with armodafinil
• Prior malignancies allowed

Exclusion Criteria:

• No baseline headaches (i.e., headaches occurring in the week before baseline assessment) of grade 4 severity (defined as severe and disabling headaches, requiring analgesics, and interfering with and preventing function or activities of daily living)

• No concurrent uncontrolled illness that may cause fatigue; interfere with drug absorption, distribution, metabolism, or excretion; or limit compliance with study requirements including, but not limited to, any of the following:

  • Ongoing or active infection
  • Chronic renal insufficiency
  • Psychiatric illness (psychosis, psychotic disorder, history of suicide attempt, or actively suicidal)
  • Extreme social situations (e.g., transportation issues that would preclude study compliance)
• Patients with a history of cardiac issues (symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia) should not use armodafinil as it may cause chest pain, palpitations, dyspnea, and transient ischemic T-wave changes on ECG
• No history of allergic reaction attributed to modafinil or armodafinil
• No anticipated or planned excessive consumption of coffee, tea, and/or caffeine-containing beverages averaging > 600 mg of caffeine/day (i.e., approximately 6 cups of coffee/day, 12 cups of hot tea/day, or 12 cans of cola/day)

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No prior fractionated external-beam cranial radiotherapy
• More than 30 days since prior monoamine oxidate inhibitors or investigational drugs
• More than 2 weeks since prior and no concurrent modafinil (Provigil), donepezil (Aricept), memantine hydrochloride (Namenda), methylphenidate (Ritalin), dextroamphetamine-amphetamine (Adderall), ginkgo biloba, or any other cognitive function-enhancing drugs
• At least 4 weeks since prior and no concurrent interstitial or intracavitary chemotherapy and/or radiotherapy or stereotactic radiosurgery (i.e., Gamma Knife, Linac, or Cyberknife)
• No concurrent erythropoietin, transfusion, or iron therapy (unless patient is symptomatically anemic with hemoglobin < 10 g/dL)
• Concurrent chemotherapy allowed

• Concurrent hormonal therapy for other malignancies allowed

  • No concurrent non-hormonal therapy (e.g., Herceptin and other targeted agents), or cytotoxic chemotherapy
• No concurrent clopidogrel bisulfate (Plavix)