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Azeliragon and Chemoradiotherapy in Newly Diagnosed Glioblastoma

Primary Purpose

Glioblastoma

Status
Recruiting
Phase
Phase 1
Locations
Spain
Study Type
Interventional
Intervention
Azeliragon 5 mg
Azeliragon 10 mg
Azeliragon 20 mg
Sponsored by
Cantex Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glioblastoma focused on measuring Azeliragon, Newly diagnosed glioblastoma, Dose finding, Temozolomide, Radiotherapy

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Patient must have histologically confirmed newly diagnosed glioblastoma (GBM, world health organization (WHO) grade IV). The histological diagnosis must have been made after biopsy or neurosurgical tumor resection. Note: Patients should be isocitrate dehydrogenase (IDH) wild type diagnosed locally The local O-6-Methylguanine-DNA Methyltransferase (MGMT) report determination should be available and should be uploaded to the electronic case report form (eCRF). Patient should have had a gross total or subtotal resection performed < 7 weeks prior to enrollment, documented at postoperative MRI. Patients who have had a biopsy only without resection are not eligible. Patient deemed suitable by the treating physician to receive the standard radiotherapy regimen in combination with temozolomide. Male or non-pregnant and non-lactating female and ≥ 18 to ≤ 70 years of age. Patient may have received and continue to receive corticosteroids, but must be on a stable or decreasing dose for at least 14 days prior to first dose of study treatment. Patient has not received prior chemotherapy or radiotherapy. Patient has adequate biological parameters as demonstrated by the following blood counts at Screening (obtained ≤ 14 days prior to enrollment) and at Baseline-Day 0: Absolute neutrophil count (ANC) ≥ 1.0 × 109/L; Platelet count ≥ 75,000/mm3 (75 × 109/L); Hemoglobin (Hgb) ≥ 9 g/dL without transfusion or growth factor support Patient has the following blood chemistry levels at Screening (obtained ≤ 14 days prior to enrollment) and at Baseline-Day 0: aspartate amino-transferase (AST)(SGOT), alanine transferase (ALT)(SGPT) ≤ 2.5 × upper limit of normal range (ULN). Total bilirubin ≤ 1.5 × ULN. Estimated creatinine clearance of > 60 mL/min (per Cockcroft -Gault formula) Patients with a QTC of ≤ 480 msec Patient has ECOG performance status of ≤ 2 Patient has been informed about the nature of the study, and has agreed to participate in the study, and signed the Informed Consent Form (ICF) prior to participation in any study-related activities. Exclusion Criteria: Patients with a history of other malignancies, except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, or other solid tumors curatively treated with no evidence of disease for > 5 years Patients with a serious active infection (such as a wound infection requiring parenteral antibiotics) at the time of inclusion or other serious underlying medical conditions that would impair the ability of the patient to receive protocol treatment Patients with any condition (e.g. psychological, geographical, etc.) that does not permit compliance with the protocol. Patients who have had treatment with any investigational cancer drug prior to the first dose of study treatment. Patient has experienced an increase of ECOG to > 2 between Screening and the time of first dose with azeliragon. Patients receiving CYP2C8 inhibitors Patient is unwilling or unable to comply with study procedures, including, but not limited to self-administration of oral medication. Patients with a gastrointestinal condition that could interfere with swallowing or absorption. Females of childbearing potential who are sexually active or males with female partners of childbearing potential, where either the female or the male is unwilling to use a highly effective method of contraception during the trial and for 6 months after the last administration of azeliragon. Patients with concurrent participation in another interventional clinical trial or use of another investigational agent within 14 days of starting azeliragon. Patients who are participating in non-interventional clinical trials (e.g., QOL, imaging, observational, follow-up studies, etc.) are eligible, regardless of the timing of participation.

Sites / Locations

  • Hospital del MarRecruiting
  • Hospital Clínic de BarcelonaRecruiting
  • Hospital Universitario Ramon y CajalRecruiting
  • Hospital Universitario 12 de OctubreRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Experimental arm

Arm Description

Patients will receive azeliragon for up to 2 years or as long as the patient and study investigator feel that a therapeutic benefit is possible. Patients will receive involved field radiation therapy and temozolomide consisting of fractionated focal irradiation in daily fractions of 2 Gy given 5 days/week for 6 weeks, for a total of 60 Gy, plus concomitant daily temozolomide (TMZ; 75 mg/m2/day, 7 days/week from the first to the last day of radiotherapy), followed by six cycles of adjuvant TMZ (150-200 mg/m2/day for 5 days during each of six 28-day cycles.

Outcomes

Primary Outcome Measures

Recommended phase 2/3 dose
To assess the recommended phase 2/3 dose (RP2/3D) in mg/day of azeliragon in patients with newly diagnosed glioblastoma receiving concurrent radiation and temozolomide. Dose limiting toxicities were defined as listed AEs, dose-reductions, treatment interruptions, or discontinuation occurring during the DLT period (28 days), which are attributable (definite, probable, possible) to azeliragon will be classified as a DLT. 6 patients must be treated at that dose level with ≤ 1 DLT observed

Secondary Outcome Measures

Incidence of adverse events (AEs)
Percentage of patients experiencing an adverse event
Incidence of serious adverse events (SAEs)
Percentage of patients experiencing a serious adverse event
Disease control rate (DCR)
Percentage of patients who experience a complete response, partial response or stable disease according to Response Assessment in Neuro-Oncology (RANO) criteria as their best response throughout the study
Progression-free survival (PFS)
PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first
Overall survival (OS)
Defined as the duration of time from start of treatment to time of death
Patients with changes in the Eastern Cooperative Oncology Group (ECOG) performance status
Percentage of patients who experience a change in ECOG status through the study
S100A9 expression levels
Expression levels of the S100A9 molecular biomarker in blood samples from patients. Samples will be taken at baseline, Week 10 and after progression

Full Information

First Posted
November 23, 2022
Last Updated
October 9, 2023
Sponsor
Cantex Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT05635734
Brief Title
Azeliragon and Chemoradiotherapy in Newly Diagnosed Glioblastoma
Official Title
A Phase I/II Open Label Study to Assess Safety and Preliminary Evidence of a Therapeutic Effect of Azeliragon Combined With Conventional Concurrent Radiation and Temozolomide in Patients With Newly Diagnosed Glioblastoma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 5, 2023 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

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

4. Oversight

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

5. Study Description

Brief Summary
This is an open label study to determine the safety and preliminary evidence of a therapeutic effect of azeliragon in patients with newly diagnosed glioblastoma receiving concurrent radiation and temozolomide.
Detailed Description
Patients will receive involved field radiation therapy and temozolomide consisting of fractionated focal irradiation in daily fractions of 2 Gy given 5 days/week for 6 weeks, for a total of 60 Gy, plus concomitant daily temozolomide (TMZ; 75 mg/m2/day, 7 days/week from the first to the last day of radiotherapy), followed by six cycles of adjuvant TMZ (150-200 mg/m2/day for 5 days during each of six 28-day cycles. Patients will receive azeliragon for up to 2 years or as long as the patient and study investigator feel that a therapeutic benefit is possible. Patients will be accrued in groups of six starting with Dose Level 1. Escalation will continue as described in Table 2 until stopping rules are met or the highest defined dose level is reached. If Dose Level 1 is deemed intolerable, the trial will be closed to accrual. The dose limiting toxicities (DLT) evaluation period will be defined as 28 days from initiation of dosing. The severity of adverse events will be graded according to CTCAE v 5.0. For the purpose of dose-finding, any listed AEs occurring during the DLT period, which are attributable (definite, probable, possible) to azeliragon will be classified as a DLT. In addition, the RP2/3D will take into account dose-reductions, treatment interruptions, discontinuation, and toxicities after the DLT period. RP2/3D was defined as the dose with 6 patients treated at that dose level with ≤ 1 DLT observed.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma
Keywords
Azeliragon, Newly diagnosed glioblastoma, Dose finding, Temozolomide, Radiotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Experimental arm
Arm Type
Experimental
Arm Description
Patients will receive azeliragon for up to 2 years or as long as the patient and study investigator feel that a therapeutic benefit is possible. Patients will receive involved field radiation therapy and temozolomide consisting of fractionated focal irradiation in daily fractions of 2 Gy given 5 days/week for 6 weeks, for a total of 60 Gy, plus concomitant daily temozolomide (TMZ; 75 mg/m2/day, 7 days/week from the first to the last day of radiotherapy), followed by six cycles of adjuvant TMZ (150-200 mg/m2/day for 5 days during each of six 28-day cycles.
Intervention Type
Drug
Intervention Name(s)
Azeliragon 5 mg
Intervention Description
Azeliragon 5 mg once a day (loading initial dose for 6 days of 10 mg daily). Patients will receive azeliragon for up to 2 years or as long as the patient and study investigator feel that a therapeutic benefit is possible. Patients will receive involved field radiation therapy and temozolomide consisting of fractionated focal irradiation in daily fractions of 2 Gy given 5 days/week for 6 weeks, for a total of 60 Gy, plus concomitant daily temozolomide (TMZ; 75 mg/m2/day, 7 days/week from the first to the last day of radiotherapy), followed by six cycles of adjuvant TMZ (150-200 mg/m2/day for 5 days during each of six 28-day cycles.
Intervention Type
Drug
Intervention Name(s)
Azeliragon 10 mg
Intervention Description
Azeliragon 10 mg once a day (loading initial dose for 6 days of 15 mg twice a day). Patients will receive azeliragon for up to 2 years or as long as the patient and study investigator feel that a therapeutic benefit is possible. Patients will receive involved field radiation therapy and temozolomide consisting of fractionated focal irradiation in daily fractions of 2 Gy given 5 days/week for 6 weeks, for a total of 60 Gy, plus concomitant daily temozolomide (TMZ; 75 mg/m2/day, 7 days/week from the first to the last day of radiotherapy), followed by six cycles of adjuvant TMZ (150-200 mg/m2/day for 5 days during each of six 28-day cycles.
Intervention Type
Drug
Intervention Name(s)
Azeliragon 20 mg
Intervention Description
Azeliragon 20 mg once a day (loading initial dose for 6 days of 30 mg twice a day). Patients will receive azeliragon for up to 2 years or as long as the patient and study investigator feel that a therapeutic benefit is possible. Patients will receive involved field radiation therapy and temozolomide consisting of fractionated focal irradiation in daily fractions of 2 Gy given 5 days/week for 6 weeks, for a total of 60 Gy, plus concomitant daily temozolomide (TMZ; 75 mg/m2/day, 7 days/week from the first to the last day of radiotherapy), followed by six cycles of adjuvant TMZ (150-200 mg/m2/day for 5 days during each of six 28-day cycles.
Primary Outcome Measure Information:
Title
Recommended phase 2/3 dose
Description
To assess the recommended phase 2/3 dose (RP2/3D) in mg/day of azeliragon in patients with newly diagnosed glioblastoma receiving concurrent radiation and temozolomide. Dose limiting toxicities were defined as listed AEs, dose-reductions, treatment interruptions, or discontinuation occurring during the DLT period (28 days), which are attributable (definite, probable, possible) to azeliragon will be classified as a DLT. 6 patients must be treated at that dose level with ≤ 1 DLT observed
Time Frame
Throughout the DLT observation period, approximately 28 days per patient
Secondary Outcome Measure Information:
Title
Incidence of adverse events (AEs)
Description
Percentage of patients experiencing an adverse event
Time Frame
Throughout the study period, approximately 2 years per patient
Title
Incidence of serious adverse events (SAEs)
Description
Percentage of patients experiencing a serious adverse event
Time Frame
Throughout the study period, approximately 2 years per patient
Title
Disease control rate (DCR)
Description
Percentage of patients who experience a complete response, partial response or stable disease according to Response Assessment in Neuro-Oncology (RANO) criteria as their best response throughout the study
Time Frame
Throughout the study period, approximately 2 years per patient
Title
Progression-free survival (PFS)
Description
PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first
Time Frame
Throughout the study period, approximately 2 years per patient
Title
Overall survival (OS)
Description
Defined as the duration of time from start of treatment to time of death
Time Frame
Throughout the study period, approximately 2 years per patient
Title
Patients with changes in the Eastern Cooperative Oncology Group (ECOG) performance status
Description
Percentage of patients who experience a change in ECOG status through the study
Time Frame
Throughout the study period, approximately 2 years per patient
Title
S100A9 expression levels
Description
Expression levels of the S100A9 molecular biomarker in blood samples from patients. Samples will be taken at baseline, Week 10 and after progression
Time Frame
Throughout the study period, approximately 2 years per patient in 3 occasions for each patient

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient must have histologically confirmed newly diagnosed glioblastoma (GBM, world health organization (WHO) grade IV). The histological diagnosis must have been made after biopsy or neurosurgical tumor resection. Note: Patients should be isocitrate dehydrogenase (IDH) wild type diagnosed locally The local O-6-Methylguanine-DNA Methyltransferase (MGMT) report determination should be available and should be uploaded to the electronic case report form (eCRF). Patient should have had a gross total or subtotal resection performed < 7 weeks prior to enrollment, documented at postoperative MRI. Patients who have had a biopsy only without resection are not eligible. Patient deemed suitable by the treating physician to receive the standard radiotherapy regimen in combination with temozolomide. Male or non-pregnant and non-lactating female and ≥ 18 to ≤ 70 years of age. Patient may have received and continue to receive corticosteroids, but must be on a stable or decreasing dose for at least 14 days prior to first dose of study treatment. Patient has not received prior chemotherapy or radiotherapy. Patient has adequate biological parameters as demonstrated by the following blood counts at Screening (obtained ≤ 14 days prior to enrollment) and at Baseline-Day 0: Absolute neutrophil count (ANC) ≥ 1.0 × 109/L; Platelet count ≥ 75,000/mm3 (75 × 109/L); Hemoglobin (Hgb) ≥ 9 g/dL without transfusion or growth factor support Patient has the following blood chemistry levels at Screening (obtained ≤ 14 days prior to enrollment) and at Baseline-Day 0: aspartate amino-transferase (AST)(SGOT), alanine transferase (ALT)(SGPT) ≤ 2.5 × upper limit of normal range (ULN). Total bilirubin ≤ 1.5 × ULN. Estimated creatinine clearance of > 60 mL/min (per Cockcroft -Gault formula) Patients with a QTC of ≤ 480 msec Patient has ECOG performance status of ≤ 2 Patient has been informed about the nature of the study, and has agreed to participate in the study, and signed the Informed Consent Form (ICF) prior to participation in any study-related activities. Exclusion Criteria: Patients with a history of other malignancies, except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, or other solid tumors curatively treated with no evidence of disease for > 5 years Patients with a serious active infection (such as a wound infection requiring parenteral antibiotics) at the time of inclusion or other serious underlying medical conditions that would impair the ability of the patient to receive protocol treatment Patients with any condition (e.g. psychological, geographical, etc.) that does not permit compliance with the protocol. Patients who have had treatment with any investigational cancer drug prior to the first dose of study treatment. Patient has experienced an increase of ECOG to > 2 between Screening and the time of first dose with azeliragon. Patients receiving CYP2C8 inhibitors Patient is unwilling or unable to comply with study procedures, including, but not limited to self-administration of oral medication. Patients with a gastrointestinal condition that could interfere with swallowing or absorption. Females of childbearing potential who are sexually active or males with female partners of childbearing potential, where either the female or the male is unwilling to use a highly effective method of contraception during the trial and for 6 months after the last administration of azeliragon. Patients with concurrent participation in another interventional clinical trial or use of another investigational agent within 14 days of starting azeliragon. Patients who are participating in non-interventional clinical trials (e.g., QOL, imaging, observational, follow-up studies, etc.) are eligible, regardless of the timing of participation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
A responsible person Designated by the Sponsor
Phone
+34 93 434 44 12
Email
investigacion@mfar.net
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Juan Sepúlveda
Organizational Affiliation
Hospital Universitario 12 de Octubre
Official's Role
Study Chair
Facility Information:
Facility Name
Hospital del Mar
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
A responsible person Designated by the sponsor
Phone
+34 93 434 44 12
Email
investigacion@mfar.net
First Name & Middle Initial & Last Name & Degree
Principal Investigator Designated by the sponsor, M.D.
Facility Name
Hospital Clínic de Barcelona
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
A responsible person Designated by the Sponsor
Phone
+34 93 434 44 12
Email
investigacion@mfar.net
First Name & Middle Initial & Last Name & Degree
Principal Investigator Designated by the sponsor, M.D.
Facility Name
Hospital Universitario Ramon y Cajal
City
Madrid
ZIP/Postal Code
28034
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
A responsible person Designated by the sponsor
Phone
+34 93 434 44 12
Email
investigacion@mfar.net
First Name & Middle Initial & Last Name & Degree
Principal Investigator Designated by the sponsor, M.D.
Facility Name
Hospital Universitario 12 de Octubre
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
A responsible person Designated by the sponsor
Phone
+34 93 434 44 12
Email
investigacion@mfar.net
First Name & Middle Initial & Last Name & Degree
Principal Investigator Designated by the sponsor, M.D.

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
The individual participant data (IPD) anonymized could be shared upon request if the use is within the scope and protection level authorized by the patients by the signature of the informed consent

Learn more about this trial

Azeliragon and Chemoradiotherapy in Newly Diagnosed Glioblastoma

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