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Bafetinib in Treating Patients With Recurrent High-Grade Glioma or Brain Metastases

Primary Purpose

Adult Anaplastic Astrocytoma, Adult Anaplastic Ependymoma, Adult Anaplastic Oligodendroglioma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
bafetinib
microdialysis
pharmacological study
liquid chromatography
mass spectrometry
laboratory biomarker analysis
protein expression analysis
western blotting
immunohistochemistry staining method
therapeutic conventional surgery
Sponsored by
City of Hope Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adult Anaplastic Astrocytoma focused on measuring Los Angeles

Eligibility Criteria

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

Inclusion Criteria:

  • Patients must have radiographic findings consistent with either:

    • Recurrent high-grade glioma, or
    • Metastatic disease to the brain that has progressed after treatment with whole brain radiation therapy or stereotactic radiosurgery; patients who have a resectable brain metastasis as the only site of disease (i.e., no evidence of systemic disease), are not eligible to participate
  • Patients who are in need of a surgical debulking or a stereotactic biopsy for the purpose of diagnosis or differentiating between tumor progression versus treatment-induced effects following radiation therapy +/- chemotherapy will be eligible to participate in the microdialysis part of the study prior to beginning cycle 1 of bafetinib if the study neurosurgeon thinks there is a likelihood of being able to place the microdialysis catheter into residual tumor (enhancing brain tissue)
  • Patients who choose not to participate in the microdialysis part of the study may enroll in the study and start treatment at cycle 1 of bafetinib
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for 3 months following duration of study participation; should a woman become pregnant or suspect that she is pregnant while participating on the trial, she should inform her treating physician immediately
  • Patients must have a Karnofsky Performance Status (KPS) >= 60%
  • If corticosteroids are required for controlling cerebral edema, patients must be on a stable dose for at least 1 week prior to enrollment
  • Patients must not be taking any hepatic enzyme-inducing anticonvulsants (phenytoin, carbamazepine, phenobarbital, primidone, oxcarbazepine) for at least 2 weeks prior to enrollment
  • Absolute neutrophil count >= 1500 cells/mm^3
  • Platelet count >= 100,000 cells/mm^3
  • Total bilirubin =< 2.0 mg/dl
  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) =< 3 times the institutional upper limit of normal
  • Alanine aminotransferase (ALT) (serum glutamic pyruvate transaminase [SGPT]) =< 3 times the institutional upper limit of normal
  • Serum creatinine =< 1.5 x the institutional upper limit of normal
  • QTc interval < 480 msec on electrocardiogram (ECG)
  • All subjects must have the ability to understand and the willingness to sign a written informed consent
  • Patients must have recovered from any toxicity of prior therapies (including brain radiation); an interval of at least 6 weeks must have elapsed since the completion of a nitrosourea-containing chemotherapy regimen; patients who have undergone a recent craniotomy cannot begin bafetinib until at least 2 weeks after the surgery

Exclusion Criteria:

  • Patients who are currently receiving chemotherapy or are enrolled in another treatment clinical trial
  • Patients with a coagulopathy or bleeding disorder
  • Patients on anticoagulant drug therapy or medications that inhibit platelet function, such as ibuprofen or other non-steroidal anti-inflammatory drugs
  • Clinically evident congestive heart failure > class II of the New York Heart Association (NYHA) guidelines
  • Clinically significant cardiac arrhythmias
  • Patients taking a drug that can prolong the QT interval; if a potential study patient is taking one of the prohibited drugs but s/he can safely stop it, then a washout period of >= 7 days is required prior to starting bafetinib
  • History or signs of active coronary artery disease with or without angina pectoris
  • Patients who have a serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol or may not be able to comply with the safety monitoring requirements of the study
  • Human immunodeficiency virus (HIV)-positive patients receiving anti-retroviral therapy are excluded from the study due to the possibility of pharmacokinetic (PK) interactions with bafetinib; however, patients will not be routinely screened for HIV
  • Female patients who are pregnant or breast-feeding
  • Active, clinically significant serious infection requiring treatment with antibiotics, anti-virals or anti-fungals
  • Patients who have not recovered from the toxicities of prior chemotherapy or radiotherapy

Sites / Locations

  • City of Hope Medical Center
  • South Pasadena Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm I

Arm Description

Patients undergo intracerebral microdialysis during debulking craniotomy or stereotactic biopsy. Beginning 24 hours later, patients receive oral bafetinib twice daily for 1 day. Beginning at least 2 weeks after surgery, patients continue to receive oral bafetinib twice daily in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Area-under-the-concentration-time-curve (AUC) of bafetinib in dialysate
Peak concentration (Cmax) of bafetinib in dialysate
AUC of bafetinib in plasma
Cmax of bafetinib in plasma

Secondary Outcome Measures

Determination of adverse events associated with bafetinib in patient with recurrent malignant brain tumors
Response rate in patients with malignant brain tumors treated with bafetinib
Progression-free survival in patients with malignant brain tumors treated with bafetinib
Overall survival in patients with malignant brain tumors treated with bafetinib
Assessment for expression of Lyn and Fyn kinases and phosphorylation status in pre-treatment tumor samples.

Full Information

First Posted
September 28, 2010
Last Updated
April 12, 2018
Sponsor
City of Hope Medical Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT01234740
Brief Title
Bafetinib in Treating Patients With Recurrent High-Grade Glioma or Brain Metastases
Official Title
BAFETINIB-P1-GBM-01: A Pilot Study Using Intracerebral Microdialysis to Determine the Neuropharmacokinetics of Bafetinib in Patients With Recurrent Brain Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
December 2010 (undefined)
Primary Completion Date
March 2013 (Actual)
Study Completion Date
March 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
City of Hope Medical Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Bafetinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. PURPOSE: This clinical trial studies bafetinib in treating patients with recurrent high-grade glioma or brain metastases.
Detailed Description
PRIMARY OBJECTIVES: I. To determine the neuropharmacokinetics (nPK) and systemic levels of bafetinib in patients with recurrent malignant brain tumors. SECONDARY OBJECTIVES: I. To investigate the intrapatient variability of nPK parameters as assessed by intracerebral microdialysis. II. To document the toxicity of bafetinib in this cohort of patients. III. To describe the response rate, progression-free survival, and overall survival in patients with malignant brain tumors treated with bafetinib. IV. To assess for the expression of Lyn and Fyn kinases and phosphorylation status in pre-treatment tumor samples. OUTLINE:Patients undergo intracerebral microdialysis during debulking craniotomy or stereotactic biopsy. Beginning 24 hours later, patients receive oral bafetinib twice daily for 1 day. Beginning at least 2 weeks after craniotomy or 1 week after biopsy, patients continue to receive oral bafetinib twice daily in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for 30 days and then every 8 weeks thereafter.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adult Anaplastic Astrocytoma, Adult Anaplastic Ependymoma, Adult Anaplastic Oligodendroglioma, Adult Giant Cell Glioblastoma, Adult Glioblastoma, Adult Gliosarcoma, Adult Mixed Glioma, Recurrent Adult Brain Tumor, Tumors Metastatic to Brain, Adult Anaplastic Oligoastrocytoma
Keywords
Los Angeles

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Experimental
Arm Description
Patients undergo intracerebral microdialysis during debulking craniotomy or stereotactic biopsy. Beginning 24 hours later, patients receive oral bafetinib twice daily for 1 day. Beginning at least 2 weeks after surgery, patients continue to receive oral bafetinib twice daily in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
bafetinib
Other Intervention Name(s)
dual Bcr-Abl/Lyn tyrosine kinase inhibitor INNO-406, INNO-406, NS-187
Intervention Description
Given orally
Intervention Type
Procedure
Intervention Name(s)
microdialysis
Intervention Description
Catheter placed intracerebrally during debulking craniotomy or stereotactic biopsy
Intervention Type
Other
Intervention Name(s)
pharmacological study
Other Intervention Name(s)
pharmacological studies
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
liquid chromatography
Other Intervention Name(s)
LC
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
mass spectrometry
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Intervention Type
Genetic
Intervention Name(s)
protein expression analysis
Intervention Description
Correlative studies
Intervention Type
Genetic
Intervention Name(s)
western blotting
Other Intervention Name(s)
Blotting, Western, Western Blot
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
immunohistochemistry staining method
Other Intervention Name(s)
immunohistochemistry
Intervention Description
Correlative studies
Intervention Type
Procedure
Intervention Name(s)
therapeutic conventional surgery
Intervention Description
debulking craniotomy
Primary Outcome Measure Information:
Title
Area-under-the-concentration-time-curve (AUC) of bafetinib in dialysate
Time Frame
every hour for 24 hours after first dose of bafetinib
Title
Peak concentration (Cmax) of bafetinib in dialysate
Time Frame
every hour for 24 hours after first dose of bafetinib
Title
AUC of bafetinib in plasma
Time Frame
1, 2, 3, 4, 6, 8, and 12 hours after the first dose of bafetinib and then 1, 2, 3, 4, 6, 8, and 12 hours after the second dose of bafetinib
Title
Cmax of bafetinib in plasma
Time Frame
1, 2, 3, 4, 6, 8, and 12 hours after the first dose of bafetinib and then 1, 2, 3, 4, 6, 8, and 12 hours after the second dose of bafetinib
Secondary Outcome Measure Information:
Title
Determination of adverse events associated with bafetinib in patient with recurrent malignant brain tumors
Time Frame
30 days after last dose of bafetinib
Title
Response rate in patients with malignant brain tumors treated with bafetinib
Time Frame
30 days after last dose of bafetinib
Title
Progression-free survival in patients with malignant brain tumors treated with bafetinib
Time Frame
1 year after last dose of bafetinib
Title
Overall survival in patients with malignant brain tumors treated with bafetinib
Time Frame
2 years after last dose of bafetinib
Title
Assessment for expression of Lyn and Fyn kinases and phosphorylation status in pre-treatment tumor samples.
Time Frame
Pre-treatment tumor samples

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have radiographic findings consistent with either: Recurrent high-grade glioma, or Metastatic disease to the brain that has progressed after treatment with whole brain radiation therapy or stereotactic radiosurgery; patients who have a resectable brain metastasis as the only site of disease (i.e., no evidence of systemic disease), are not eligible to participate Patients who are in need of a surgical debulking or a stereotactic biopsy for the purpose of diagnosis or differentiating between tumor progression versus treatment-induced effects following radiation therapy +/- chemotherapy will be eligible to participate in the microdialysis part of the study prior to beginning cycle 1 of bafetinib if the study neurosurgeon thinks there is a likelihood of being able to place the microdialysis catheter into residual tumor (enhancing brain tissue) Patients who choose not to participate in the microdialysis part of the study may enroll in the study and start treatment at cycle 1 of bafetinib Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for 3 months following duration of study participation; should a woman become pregnant or suspect that she is pregnant while participating on the trial, she should inform her treating physician immediately Patients must have a Karnofsky Performance Status (KPS) >= 60% If corticosteroids are required for controlling cerebral edema, patients must be on a stable dose for at least 1 week prior to enrollment Patients must not be taking any hepatic enzyme-inducing anticonvulsants (phenytoin, carbamazepine, phenobarbital, primidone, oxcarbazepine) for at least 2 weeks prior to enrollment Absolute neutrophil count >= 1500 cells/mm^3 Platelet count >= 100,000 cells/mm^3 Total bilirubin =< 2.0 mg/dl Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) =< 3 times the institutional upper limit of normal Alanine aminotransferase (ALT) (serum glutamic pyruvate transaminase [SGPT]) =< 3 times the institutional upper limit of normal Serum creatinine =< 1.5 x the institutional upper limit of normal QTc interval < 480 msec on electrocardiogram (ECG) All subjects must have the ability to understand and the willingness to sign a written informed consent Patients must have recovered from any toxicity of prior therapies (including brain radiation); an interval of at least 6 weeks must have elapsed since the completion of a nitrosourea-containing chemotherapy regimen; patients who have undergone a recent craniotomy cannot begin bafetinib until at least 2 weeks after the surgery Exclusion Criteria: Patients who are currently receiving chemotherapy or are enrolled in another treatment clinical trial Patients with a coagulopathy or bleeding disorder Patients on anticoagulant drug therapy or medications that inhibit platelet function, such as ibuprofen or other non-steroidal anti-inflammatory drugs Clinically evident congestive heart failure > class II of the New York Heart Association (NYHA) guidelines Clinically significant cardiac arrhythmias Patients taking a drug that can prolong the QT interval; if a potential study patient is taking one of the prohibited drugs but s/he can safely stop it, then a washout period of >= 7 days is required prior to starting bafetinib History or signs of active coronary artery disease with or without angina pectoris Patients who have a serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol or may not be able to comply with the safety monitoring requirements of the study Human immunodeficiency virus (HIV)-positive patients receiving anti-retroviral therapy are excluded from the study due to the possibility of pharmacokinetic (PK) interactions with bafetinib; however, patients will not be routinely screened for HIV Female patients who are pregnant or breast-feeding Active, clinically significant serious infection requiring treatment with antibiotics, anti-virals or anti-fungals Patients who have not recovered from the toxicities of prior chemotherapy or radiotherapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jana Portnow
Organizational Affiliation
City of Hope Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
City of Hope Medical Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
South Pasadena Cancer Center
City
South Pasadena
State/Province
California
ZIP/Postal Code
91030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23380277
Citation
Portnow J, Badie B, Markel S, Liu A, D'Apuzzo M, Frankel P, Jandial R, Synold TW. A neuropharmacokinetic assessment of bafetinib, a second generation dual BCR-Abl/Lyn tyrosine kinase inhibitor, in patients with recurrent high-grade gliomas. Eur J Cancer. 2013 May;49(7):1634-40. doi: 10.1016/j.ejca.2013.01.001. Epub 2013 Feb 4.
Results Reference
derived

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Bafetinib in Treating Patients With Recurrent High-Grade Glioma or Brain Metastases

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