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ATN-161 and Carboplatin in Treating Patients With Recurrent Malignant Glioma

Primary Purpose

Brain and Central Nervous System Tumors

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ATN-161
carboplatin
Sponsored by
National Institutes of Health Clinical Center (CC)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring adult anaplastic oligodendroglioma, adult gliosarcoma, adult mixed glioma, adult anaplastic astrocytoma, recurrent adult brain tumor, adult glioblastoma, adult giant cell glioblastoma

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed intracranial malignant glioma Original low-grade glioma histology allowed provided there is subsequent histologic confirmation of malignant glioma Any of the following diagnoses: Glioblastoma multiforme Gliosarcoma Anaplastic astrocytoma Anaplastic oligodendroglioma Anaplastic mixed oligoastrocytoma Malignant astrocytoma not otherwise specified Recurrent disease Must have failed prior radiotherapy Must have confirmation of true progressive disease (rather than radiation necrosis) based upon either positron emission tomography or thallium scanning, MR spectroscopy, or surgical documentation of disease if radiographic recurrence is within the high-dose radiation field (for patients who underwent prior interstitial brachytherapy or stereotactic radiosurgery) Prior recent resection of recurrent or progressive tumors allowed if all of the following criteria are met: Recovered from prior surgery Evaluable disease after resection Unequivocal evidence of tumor progression by MRI Steroid dose must be stable for ≥ 5 days prior to MRI PATIENT CHARACTERISTICS: Karnofsky performance status 60-100% Life expectancy > 8 weeks WBC ≥ 3,000/mm³ Absolute neutrophil count ≥ 1,500/mm³ Platelet count ≥ 100,000/mm³ Hemoglobin ≥ 10 g/dL (transfusion allowed) AST < 2.5 times upper limit of normal (ULN) Bilirubin < 2.5 times ULN Creatinine < 1.5 mg/dL OR creatinine clearance ≥ 60 mL/min Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 1 month after completion of study treatment No significant medical illness that would preclude study treatment No history of other cancer (except nonmelanoma skin cancer or carcinoma in situ of the cervix) unless disease is in complete remission and off all therapy for ≥ 1 year No active infection or serious intercurrent medical illness No disease that will obscure toxicity or dangerously alter drug metabolism Able to undergo MRI scan and receive contrast agents for perfusion scanning PRIOR CONCURRENT THERAPY: See Disease Characteristics Recovered from prior therapy At least 28 days since prior cytotoxic therapy At least 14 days since prior vincristine At least 42 days since prior nitrosoureas At least 21 days since prior procarbazine At least 7 days since prior interferon, tamoxifen, thalidomide, isotretinoin, or other noncytotoxic agents (radiosensitizer does not count) At least 14 days since prior noncytotoxic investigational agents At least 42 days since prior radiotherapy No prior cisplatin, carboplatin, oxaliplatin, or platinum-containing analogue No concurrent prophylactic filgrastim (G-CSF) or sargramostim (GM-CSF) No other concurrent anticancer therapy (including chemotherapy, radiotherapy, hormonal therapy, or immunotherapy) No other concurrent investigational drugs

Sites / Locations

  • Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Phase I

Phase II

Arm Description

Patients receive ATN-161 IV over 10 minutes 3 times weekly in weeks 1-6 and carboplatin IV over 20 minutes in week 3 during course 1. Beginning in course 2, patients receive carboplatin IV over 20 minutes in week 1 and ATN-161 IV over 10 minutes 3 times weekly in weeks 1-4. Treatment repeats every 4 weeks in the absence of disease progression or unacceptable toxicity.

Patients receive carboplatin IV in week 1 and ATN-161 IV, at the MTD determined in phase I, 3 times weekly in weeks 1-4. Treatment repeats every 4 weeks for up to 12 courses in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Safety
Maximum tolerated dose (phase I)
Progression-free survival at 6 months
Response rate (phase I)
Overall survival

Secondary Outcome Measures

Efficacy
Response rate (phase II)

Full Information

First Posted
July 13, 2006
Last Updated
May 1, 2012
Sponsor
National Institutes of Health Clinical Center (CC)
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00352313
Brief Title
ATN-161 and Carboplatin in Treating Patients With Recurrent Malignant Glioma
Official Title
A Phase I/II Study of ATN-161 and Carboplatin in Adult Patients With Recurrent Intracranial Malignant Glioma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2012
Overall Recruitment Status
Completed
Study Start Date
May 2006 (undefined)
Primary Completion Date
January 2007 (Actual)
Study Completion Date
January 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Institutes of Health Clinical Center (CC)
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: ATN-161 may stop the growth of tumor cells by blocking blood flow to the tumor. Drugs used in chemotherapy, such as carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving ATN-161 together with carboplatin may kill more tumor cells. PURPOSE: This phase I/II trial is studying the side effects and best dose of ATN-161 when given together with carboplatin and to see how well they work in treating patients with recurrent malignant glioma.
Detailed Description
OBJECTIVES: Primary Establish the safety of ATN-161 and carboplatin in patients with recurrent intracranial malignant glioma. Determine the maximum tolerated dose of ATN-161 when administered with carboplatin in these patients. (phase I) Determine the antitumor activity of ATN-161 when administered with carboplatin in these patients. (phase II) Secondary Describe the effects of this regimen on potential biomarkers of activity, including functional imaging with brain perfusion scans and circulating endothelial progenitor cells. Obtain preliminary evidence of efficacy of this regimen in these patients. (phase I) Characterize the plasma concentrations of this regimen in these patients. (phase I) OUTLINE: This is an open-label, phase I dose-escalation study of ATN-161 followed by a phase II study. Patients in the phase II portion of the study are stratified according to tumor type (glioblastoma multiforme vs anaplastic glioma). Phase I: Patients receive ATN-161 IV over 10 minutes 3 times weekly in weeks 1-6 and carboplatin IV over 20 minutes in week 3 during course 1. Beginning in course 2, patients receive carboplatin IV over 20 minutes in week 1 and ATN-161 IV over 10 minutes 3 times weekly in weeks 1-4. Treatment repeats every 4 weeks in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of ATN-161 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity during the first 6 weeks of treatment. Phase II: Patients receive carboplatin IV in week 1 and ATN-161 IV, at the MTD determined in phase I, 3 times weekly in weeks 1-4. Treatment repeats every 4 weeks for up to 12 courses in the absence of disease progression or unacceptable toxicity. Patients undergo blood collection at baseline and then periodically during phase I course 1 for pharmacokinetic and pharmacodynamic analysis and at baseline and then periodically during study for biomarker (e.g., circulating endothelial progenitor cells) correlative studies. After completion of study treatment, patients are followed for 28 days. PROJECTED ACCRUAL: A total of 82 patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain and Central Nervous System Tumors
Keywords
adult anaplastic oligodendroglioma, adult gliosarcoma, adult mixed glioma, adult anaplastic astrocytoma, recurrent adult brain tumor, adult glioblastoma, adult giant cell glioblastoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Masking
None (Open Label)
Enrollment
82 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Phase I
Arm Type
Experimental
Arm Description
Patients receive ATN-161 IV over 10 minutes 3 times weekly in weeks 1-6 and carboplatin IV over 20 minutes in week 3 during course 1. Beginning in course 2, patients receive carboplatin IV over 20 minutes in week 1 and ATN-161 IV over 10 minutes 3 times weekly in weeks 1-4. Treatment repeats every 4 weeks in the absence of disease progression or unacceptable toxicity.
Arm Title
Phase II
Arm Type
Experimental
Arm Description
Patients receive carboplatin IV in week 1 and ATN-161 IV, at the MTD determined in phase I, 3 times weekly in weeks 1-4. Treatment repeats every 4 weeks for up to 12 courses in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
ATN-161
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
carboplatin
Intervention Description
Given IV
Primary Outcome Measure Information:
Title
Safety
Title
Maximum tolerated dose (phase I)
Title
Progression-free survival at 6 months
Title
Response rate (phase I)
Title
Overall survival
Secondary Outcome Measure Information:
Title
Efficacy
Title
Response rate (phase II)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed intracranial malignant glioma Original low-grade glioma histology allowed provided there is subsequent histologic confirmation of malignant glioma Any of the following diagnoses: Glioblastoma multiforme Gliosarcoma Anaplastic astrocytoma Anaplastic oligodendroglioma Anaplastic mixed oligoastrocytoma Malignant astrocytoma not otherwise specified Recurrent disease Must have failed prior radiotherapy Must have confirmation of true progressive disease (rather than radiation necrosis) based upon either positron emission tomography or thallium scanning, MR spectroscopy, or surgical documentation of disease if radiographic recurrence is within the high-dose radiation field (for patients who underwent prior interstitial brachytherapy or stereotactic radiosurgery) Prior recent resection of recurrent or progressive tumors allowed if all of the following criteria are met: Recovered from prior surgery Evaluable disease after resection Unequivocal evidence of tumor progression by MRI Steroid dose must be stable for ≥ 5 days prior to MRI PATIENT CHARACTERISTICS: Karnofsky performance status 60-100% Life expectancy > 8 weeks WBC ≥ 3,000/mm³ Absolute neutrophil count ≥ 1,500/mm³ Platelet count ≥ 100,000/mm³ Hemoglobin ≥ 10 g/dL (transfusion allowed) AST < 2.5 times upper limit of normal (ULN) Bilirubin < 2.5 times ULN Creatinine < 1.5 mg/dL OR creatinine clearance ≥ 60 mL/min Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 1 month after completion of study treatment No significant medical illness that would preclude study treatment No history of other cancer (except nonmelanoma skin cancer or carcinoma in situ of the cervix) unless disease is in complete remission and off all therapy for ≥ 1 year No active infection or serious intercurrent medical illness No disease that will obscure toxicity or dangerously alter drug metabolism Able to undergo MRI scan and receive contrast agents for perfusion scanning PRIOR CONCURRENT THERAPY: See Disease Characteristics Recovered from prior therapy At least 28 days since prior cytotoxic therapy At least 14 days since prior vincristine At least 42 days since prior nitrosoureas At least 21 days since prior procarbazine At least 7 days since prior interferon, tamoxifen, thalidomide, isotretinoin, or other noncytotoxic agents (radiosensitizer does not count) At least 14 days since prior noncytotoxic investigational agents At least 42 days since prior radiotherapy No prior cisplatin, carboplatin, oxaliplatin, or platinum-containing analogue No concurrent prophylactic filgrastim (G-CSF) or sargramostim (GM-CSF) No other concurrent anticancer therapy (including chemotherapy, radiotherapy, hormonal therapy, or immunotherapy) No other concurrent investigational drugs
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Howard A. Fine, MD
Organizational Affiliation
NCI - Neuro-Oncology Branch
Official's Role
Principal Investigator
Facility Information:
Facility Name
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-1182
Country
United States

12. IPD Sharing Statement

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ATN-161 and Carboplatin in Treating Patients With Recurrent Malignant Glioma

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