BPM31510 in Treating Patients With Recurrent High-Grade Glioma Previously Treated With Bevacizumab
Primary Purpose
Gliosarcoma, Recurrent Glioblastoma, Astrocytoma of Brain
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Laboratory Biomarker Analysis
Pharmacological Study
Ubidecarenone Injectable Nanosuspension
Sponsored by
About this trial
This is an interventional treatment trial for Gliosarcoma
Eligibility Criteria
Inclusion Criteria:
- Be ≥ 18 years of age
- Have a life expectancy ≥ 6 weeks
- Have a Karnofsky Performance Score (KPS) ≥ 60
- Have pathologically proven GB, gliosarcoma (WHO IV), or anaplastic astrocytoma (WHO III) in recurrence after treatment with bevacizumab
- Be at least 14 days from the last administration of bevacizumab
- Be at least 28 days from last administration of cytotoxic chemotherapy or other investigational agent
- Have received radiation therapy with concurrent temozolomide. Total radiation dosage can range from 5400 to 6000 cGy administered in daily fractions of 150 to 200 cGy over 6 weeks, or the equivalent in a hypofractionated protocol (for example, 4000cGy in 15 fractions or 2500cGy in 5 fractions). Patients who are MGMT negative do not need to have received temozolomide.
Have adequate organ and marrow function as follows (all required):
- ANC ≥ 1500 mm3
- Platelets ≥ 100,000/mm3
- Hemoglobin ≥ 9 g/dL
- Serum creatinine ≤ 1.8 mg/dL or creatinine clearance > 50 mL/min Bilirubin ≤ 1.5 mg/dL
- Alanine aminotransferase (ALT) ≤ 2.5 x upper limit of normal (ULN)
- Aspartate transaminase (AST) ≤ 2.5 x ULN
- Prothrombin time (PT) ≤ 1.5 x ULN
- International Normalized Ratio (INR) ≤ 1.5 x ULN
- Partial thromboplastin time (PTT) ≤ 1.5 x ULN
- Subjects of childbearing potential must agree to use hormonal or barrier birth control with spermicidal gel to avoid pregnancy during the study
- Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria:
- Has a history of spontaneous or tumor related cerebral hemorrhage; or has cerebral hemorrhage as determined by the screening FDG PET CT and MRI. This does not include stable post operative blood products seen on a gradient echo MRI sequence.
Has the any of the following cardiac history:
- Active heart disease including myocardial infarction within previous 3 months
- Symptomatic coronary artery disease
- Arrhythmias not controlled by medication
- Unstable angina pectoris
- Uncontrolled or symptomatic congestive heart failure (NYHA class III and IV) 3.2.3 Uncontrolled or severe coagulopathies or a history of clinically significant bleeding within the past 6 months, including any of the following, but not limited to:
- Epistaxis
- Hemoptysis
- Hematochezia
- Hematuria
- Gastrointestinal bleeding
- Spontaneous or tumor related intracranial hemorrhage
- Known predisposition for bleeding such as von Willebrand's disease or other such condition(s)
Uncontrolled concurrent illness that would limit compliance with study requirements, including any of the following, but limited to:
- Uncontrolled infection.
- Psychiatric illness/social situations
- Prior malignancy except for non melanoma skin cancer and carcinoma in situ (of the cervix or bladder), unless diagnosed and definitively treated more than 3 years prior to 1st dose of investigational drug
Receiving any of the following medications:
- Therapeutic doses of any anticoagulant, including low molecular weight heparin (LMWH). Concomitant use of warfarin, even at prophylactic doses, is prohibited
- Digoxin, digitoxin, lanatoside C, or any type of digitalis alkaloids.
- Colony stimulating factors (CSFs) that cannot be held during the monitoring period for dose limiting toxicities (DLT)
- Has significant toxicities from prior treatment that have not resolved or stabilized
- Known allergy to Coenzyme Q10
- Known allergy or adverse reaction to oral, subcutaneous, or intravenous vitamin K
- Is pregnant or lactating
- Known to be positive for the human immunodeficiency virus (HIV). Note: HIV testing is not required for eligibility, but if performed previously and was positive, the subject is ineligible.
Sites / Locations
- Stanford University, School of Medicine
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Treatment (BPM31510)
Arm Description
Patients receive ubidecarenone injectable nanosuspension IV over 72 hours twice weekly. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Outcomes
Primary Outcome Measures
Percentage of patients with dose-limiting toxicities defined as thrombocytopenia >= grade 3, hemorrhage >= grade 3, and INR elevation >= grade 2 assessed by CTCAE v4.03
Will be tabulated at each dose, along with the result of the pooled adjacent violators algorithm as implemented in the Modified Toxicity Probability Interval (equal weights, and the weighted mean solver).
Secondary Outcome Measures
Incidence of adverse events graded according to the Common Toxicity Criteria for Adverse Events (CTCAE) version (v)4.03
Will be tabulated separately for each dose cohort, by Medical Dictionary for Regulatory Activities (MedDRA) major organ system and severity.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03020602
Brief Title
BPM31510 in Treating Patients With Recurrent High-Grade Glioma Previously Treated With Bevacizumab
Official Title
A Phase I Study of BPM31510 Plus Vitamin K in Subjects With High-Grade Glioma That Has Recurred on a Bevacizumab Containing Regimen
Study Type
Interventional
2. Study Status
Record Verification Date
August 2021
Overall Recruitment Status
Completed
Study Start Date
January 4, 2017 (Actual)
Primary Completion Date
April 4, 2019 (Actual)
Study Completion Date
June 26, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Seema Nagpal
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This phase I trial studies the side effects and best dose of ubidecarenone injectable nanosuspension (BPM31510) in treating patients with high-grade glioma (anaplastic astrocytoma or glioblastoma) that has come back and have been previously treated with bevacizumab. BPM31510 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
Detailed Description
Primary Objective:
Assess the safety and tolerability of BPM31510 plus vitamin K in subjects with high-grade glioma(HGG), defined as anaplastic astrocytoma (AA) or glioblastoma (GB) that has recurred on a BEV containing regimen.
Secondary Objectives:
To evaluate plasma pharmacokinetics (PK) when BPM31510 plus vitamin K is given to subjects with HGG recurrent on a BEV containing regimen.
Exploratory Objectives:
Estimate the overall survival in subjects with HGG recurrent on a BEV containing regimen from the 1st day of infusion of BPM31510 plus vitamin K to death.
To evaluate the effects of BPM31510 plus vitamin K on shifting HGG metabolism to aerobic respiration by PET imaging.
To evaluate the effects of BPM1510 plus vitamin K on MRI imaging by Response Assessment in Neuro Oncology (RANO) criteria [specifically progression free survival (PFS) and response rate (RR)].
To evaluate plasma pharmacodynamics (PD) when BPM31510 plus vitamin K is given to subjects with HGG recurrent on a BEV containing regimen.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gliosarcoma, Recurrent Glioblastoma, Astrocytoma of Brain, Glioblastoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Treatment (BPM31510)
Arm Type
Experimental
Arm Description
Patients receive ubidecarenone injectable nanosuspension IV over 72 hours twice weekly. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Other
Intervention Name(s)
Laboratory Biomarker Analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
Pharmacological Study
Intervention Description
Correlative studies
Intervention Type
Drug
Intervention Name(s)
Ubidecarenone Injectable Nanosuspension
Other Intervention Name(s)
BP31510, Coenzyme Q10 Injectable Nanosuspension, Ubiquinone Injectable Nanosuspension
Intervention Description
Given IV
Primary Outcome Measure Information:
Title
Percentage of patients with dose-limiting toxicities defined as thrombocytopenia >= grade 3, hemorrhage >= grade 3, and INR elevation >= grade 2 assessed by CTCAE v4.03
Description
Will be tabulated at each dose, along with the result of the pooled adjacent violators algorithm as implemented in the Modified Toxicity Probability Interval (equal weights, and the weighted mean solver).
Time Frame
Up to 28 days
Secondary Outcome Measure Information:
Title
Incidence of adverse events graded according to the Common Toxicity Criteria for Adverse Events (CTCAE) version (v)4.03
Description
Will be tabulated separately for each dose cohort, by Medical Dictionary for Regulatory Activities (MedDRA) major organ system and severity.
Time Frame
Up to 30 days after last dose of BPM3150
Other Pre-specified Outcome Measures:
Title
Brain tumor metabolism as measured by PET
Description
Standardized uptake value (SUV) of the HGG will be measured. SUV is the standard PET measure.
Time Frame
Up to 8 weeks
Title
Overall survival (OS)
Description
Kaplan-Meier survival estimates for OS will be presented for data at the maximum tolerated dose, with a 95% confidence interval using Greenwood's formula at 3.5 months and 7 months.
Time Frame
From the date of BPM31510 initiation to death, assessed for up to 3 years
Title
PFS assessed by RANO criteria
Time Frame
Up to 3 years
Title
Response rate assessed by RANO criteria
Time Frame
Up to 3 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Be ≥ 18 years of age
Have a life expectancy ≥ 6 weeks
Have a Karnofsky Performance Score (KPS) ≥ 60
Have pathologically proven GB, gliosarcoma (WHO IV), or anaplastic astrocytoma (WHO III) in recurrence after treatment with bevacizumab
Be at least 14 days from the last administration of bevacizumab
Be at least 28 days from last administration of cytotoxic chemotherapy or other investigational agent
Have received radiation therapy with concurrent temozolomide. Total radiation dosage can range from 5400 to 6000 cGy administered in daily fractions of 150 to 200 cGy over 6 weeks, or the equivalent in a hypofractionated protocol (for example, 4000cGy in 15 fractions or 2500cGy in 5 fractions). Patients who are MGMT negative do not need to have received temozolomide.
Have adequate organ and marrow function as follows (all required):
ANC ≥ 1500 mm3
Platelets ≥ 100,000/mm3
Hemoglobin ≥ 9 g/dL
Serum creatinine ≤ 1.8 mg/dL or creatinine clearance > 50 mL/min Bilirubin ≤ 1.5 mg/dL
Alanine aminotransferase (ALT) ≤ 2.5 x upper limit of normal (ULN)
Aspartate transaminase (AST) ≤ 2.5 x ULN
Prothrombin time (PT) ≤ 1.5 x ULN
International Normalized Ratio (INR) ≤ 1.5 x ULN
Partial thromboplastin time (PTT) ≤ 1.5 x ULN
Subjects of childbearing potential must agree to use hormonal or barrier birth control with spermicidal gel to avoid pregnancy during the study
Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria:
Has a history of spontaneous or tumor related cerebral hemorrhage; or has cerebral hemorrhage as determined by the screening FDG PET CT and MRI. This does not include stable post operative blood products seen on a gradient echo MRI sequence.
Has the any of the following cardiac history:
Active heart disease including myocardial infarction within previous 3 months
Symptomatic coronary artery disease
Arrhythmias not controlled by medication
Unstable angina pectoris
Uncontrolled or symptomatic congestive heart failure (NYHA class III and IV) 3.2.3 Uncontrolled or severe coagulopathies or a history of clinically significant bleeding within the past 6 months, including any of the following, but not limited to:
Epistaxis
Hemoptysis
Hematochezia
Hematuria
Gastrointestinal bleeding
Spontaneous or tumor related intracranial hemorrhage
Known predisposition for bleeding such as von Willebrand's disease or other such condition(s)
Uncontrolled concurrent illness that would limit compliance with study requirements, including any of the following, but limited to:
Uncontrolled infection.
Psychiatric illness/social situations
Prior malignancy except for non melanoma skin cancer and carcinoma in situ (of the cervix or bladder), unless diagnosed and definitively treated more than 3 years prior to 1st dose of investigational drug
Receiving any of the following medications:
Therapeutic doses of any anticoagulant, including low molecular weight heparin (LMWH). Concomitant use of warfarin, even at prophylactic doses, is prohibited
Digoxin, digitoxin, lanatoside C, or any type of digitalis alkaloids.
Colony stimulating factors (CSFs) that cannot be held during the monitoring period for dose limiting toxicities (DLT)
Has significant toxicities from prior treatment that have not resolved or stabilized
Known allergy to Coenzyme Q10
Known allergy or adverse reaction to oral, subcutaneous, or intravenous vitamin K
Is pregnant or lactating
Known to be positive for the human immunodeficiency virus (HIV). Note: HIV testing is not required for eligibility, but if performed previously and was positive, the subject is ineligible.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Seema Nagpal
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University, School of Medicine
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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BPM31510 in Treating Patients With Recurrent High-Grade Glioma Previously Treated With Bevacizumab
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