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Iodine I 131 Monoclonal Antibody TNT-1/B in Treating Patients With Progressive or Recurrent Glioblastoma Multiforme

Primary Purpose

Brain and Central Nervous System Tumors

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
iodine I 131 monoclonal antibody TNT-1/B
Sponsored by
Abramson Cancer Center at Penn Medicine
About
Eligibility
Locations
Outcomes
Full info

About this trial

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

Eligibility Criteria

18 Years - 120 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed glioblastoma multiforme Focal disease Progressive or recurrent disease after prior treatment with radiotherapy and/or chemotherapy Low-grade astrocytoma that progressed to glioblastoma multiforme after prior radiotherapy and/or chemotherapy allowed Gross tumor volume 5-60 mL No intraventricular tumor, infratentorial tumor, or tumor that communicates with the ventricles No bilateral non-contiguous gadolinium-enhancing tumor No diffuse disease, defined as any satellite lesion > 1.5 cm from the anticipated location of a catheter tip OR > 2 satellite lesions No ventricular invasion outside the anticipated radiotherapy volume PATIENT CHARACTERISTICS: Age 18 and over Performance status Karnofsky 60-100% Life expectancy Not specified Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 9.0 g/dL Hepatic Bilirubin ≤ 1.5 mg/dL AST and ALT ≤ 2.5 times upper limit of normal (ULN) Hepatitis B negative No evidence of active hepatitis Renal Creatinine ≤ 1.7 mg/dL BUN ≤ 2 times ULN Cardiovascular No uncontrolled hypertension No unstable angina pectoris No uncontrolled cardiac dysrhythmia Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Able to undergo MRI Mini Mental State Exam score ≥ 15 No serious infection No other medical illness that would preclude study participation No other malignancy within the past 5 years except curatively treated carcinoma in situ or basal cell skin cancer No psychological or sociological condition, addictive disorder, or other condition that would preclude study compliance No known or suspected allergy to study drug or iodine No known HIV positivity PRIOR CONCURRENT THERAPY: Biologic therapy No prior monoclonal antibodies No prior local immunotherapy or treatment with the following biologic agents: Immunotoxins Immunoconjugates Antiangiogenesis compounds Antisense agents Peptide receptor antagonist Interferons Interleukins Tumor infiltrating lymphocytes Lymphokine-activated killer cells Gene therapy Chemotherapy See Disease Characteristics At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas) At least 3 months since prior polifeprosan 20 with carmustine implant (Gliadel wafer^® ) Endocrine therapy Must be maintained on a stable corticosteroid dose (approximately 4 mg) for ≥ 2 weeks before study entry Radiotherapy See Disease Characteristics At least 3 months since prior radiotherapy No prior brachytherapy or radiosurgery Surgery At least 4 weeks since prior surgery Other Recovered from all prior therapy At least 1 month since prior investigational agents No more than 2 prior treatment regimens No other prior local therapy

Sites / Locations

  • Lurleen Wallace Comprehensive Cancer at University of Alabama-Birmingham
  • Winship Cancer Institute of Emory University
  • Wake Forest University Comprehensive Cancer Center
  • Abramson Cancer Center of the University of Pennsylvania

Outcomes

Primary Outcome Measures

Maximum tolerated dose based on CTCAE v3.0 weekly for 8 weeks then every 8 weeks

Secondary Outcome Measures

Biodistribution and radiation dosimetry by blood, urine, and whole body scans daily for 10 days
Toxicity by CTCAE v3.0 weekly for 12 weeks then every 8 weeks
Overall survival, median time of survival, and percent alive at 6 months

Full Information

First Posted
August 8, 2005
Last Updated
February 17, 2016
Sponsor
Abramson Cancer Center at Penn Medicine
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00128635
Brief Title
Iodine I 131 Monoclonal Antibody TNT-1/B in Treating Patients With Progressive or Recurrent Glioblastoma Multiforme
Official Title
An Open-Label, Dose Confirmation and Dosimetry Study of Interstitial 131 I-chTNT-1/B MAb (COTARA(TM)) For the Treatment of Glioblastoma Multiforme (GBM) at 1st or 2nd Relapse
Study Type
Interventional

2. Study Status

Record Verification Date
May 2007
Overall Recruitment Status
Completed
Study Start Date
October 2005 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
October 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Abramson Cancer Center at Penn Medicine
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Radiolabeled monoclonal antibodies, such as iodine I 131 monoclonal antibody TNT-1/B (^131I MOAB TNT-1/B), can find tumor cells and carry tumor-killing substances to them without harming normal cells. This may be an effective treatment for glioblastoma multiforme. PURPOSE: This phase I trial is studying the side effects and best dose of ^131I MOAB TNT-1/B in treating patients with progressive or recurrent glioblastoma multiforme.
Detailed Description
OBJECTIVES: Primary Determine the maximum tolerated dose of iodine I 131 monoclonal antibody TNT-1/B in patients with progressive or recurrent glioblastoma multiforme. Secondary Determine the biodistribution and radiation dosimetry of this drug in these patients. Determine the toxicity and tolerability of this drug in these patients. Determine the overall survival, median time of survival, and 6-month survival of patients treated with this drug. OUTLINE: This is an open-label, multicenter, dose-escalation study of therapeutic doses of iodine I 131 monoclonal antibody TNT-1/B (^131I MOAB TNT-1/B). The first 12 patients accrued to the study undergo stereotactic placement of 2 catheters within the contrast-enhancing tumor on day 0. These patients then receive an imaging dose of ^131I MOAB TNT-1/B interstitially over approximately 25 hours on day 1 followed by dosimetry, biodistribution evaluations, and whole body imaging over an 8-10 day period. Beginning at least 2 weeks, but no more than 4 weeks later, all patients undergo catheter placement as above. One day later, patients receive a therapeutic dose of ^131I MOAB TNT-1/B interstitially over approximately 25 hours. Cohorts of 3-6 patients receive escalating therapeutic doses of ^131I MOAB TNT-1/B until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. An additional 10 patients are treated at the MTD. After completion of study treatment, patients are followed weekly for 3 weeks, at 6 weeks, at 4, 8, and 12 weeks (for the first 12 patients accrued to the study), every 4 weeks until disease progression, and then every 8 weeks thereafter. PROJECTED ACCRUAL: Approximately 22 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 glioblastoma, adult gliosarcoma, adult giant cell glioblastoma, recurrent adult brain tumor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Masking
None (Open Label)
Enrollment
22 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Radiation
Intervention Name(s)
iodine I 131 monoclonal antibody TNT-1/B
Primary Outcome Measure Information:
Title
Maximum tolerated dose based on CTCAE v3.0 weekly for 8 weeks then every 8 weeks
Secondary Outcome Measure Information:
Title
Biodistribution and radiation dosimetry by blood, urine, and whole body scans daily for 10 days
Title
Toxicity by CTCAE v3.0 weekly for 12 weeks then every 8 weeks
Title
Overall survival, median time of survival, and percent alive at 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
120 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed glioblastoma multiforme Focal disease Progressive or recurrent disease after prior treatment with radiotherapy and/or chemotherapy Low-grade astrocytoma that progressed to glioblastoma multiforme after prior radiotherapy and/or chemotherapy allowed Gross tumor volume 5-60 mL No intraventricular tumor, infratentorial tumor, or tumor that communicates with the ventricles No bilateral non-contiguous gadolinium-enhancing tumor No diffuse disease, defined as any satellite lesion > 1.5 cm from the anticipated location of a catheter tip OR > 2 satellite lesions No ventricular invasion outside the anticipated radiotherapy volume PATIENT CHARACTERISTICS: Age 18 and over Performance status Karnofsky 60-100% Life expectancy Not specified Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 9.0 g/dL Hepatic Bilirubin ≤ 1.5 mg/dL AST and ALT ≤ 2.5 times upper limit of normal (ULN) Hepatitis B negative No evidence of active hepatitis Renal Creatinine ≤ 1.7 mg/dL BUN ≤ 2 times ULN Cardiovascular No uncontrolled hypertension No unstable angina pectoris No uncontrolled cardiac dysrhythmia Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Able to undergo MRI Mini Mental State Exam score ≥ 15 No serious infection No other medical illness that would preclude study participation No other malignancy within the past 5 years except curatively treated carcinoma in situ or basal cell skin cancer No psychological or sociological condition, addictive disorder, or other condition that would preclude study compliance No known or suspected allergy to study drug or iodine No known HIV positivity PRIOR CONCURRENT THERAPY: Biologic therapy No prior monoclonal antibodies No prior local immunotherapy or treatment with the following biologic agents: Immunotoxins Immunoconjugates Antiangiogenesis compounds Antisense agents Peptide receptor antagonist Interferons Interleukins Tumor infiltrating lymphocytes Lymphokine-activated killer cells Gene therapy Chemotherapy See Disease Characteristics At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas) At least 3 months since prior polifeprosan 20 with carmustine implant (Gliadel wafer^® ) Endocrine therapy Must be maintained on a stable corticosteroid dose (approximately 4 mg) for ≥ 2 weeks before study entry Radiotherapy See Disease Characteristics At least 3 months since prior radiotherapy No prior brachytherapy or radiosurgery Surgery At least 4 weeks since prior surgery Other Recovered from all prior therapy At least 1 month since prior investigational agents No more than 2 prior treatment regimens No other prior local therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert A. Lustig, MD
Organizational Affiliation
Abramson Cancer Center at Penn Medicine
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Kevin Judy, MD
Organizational Affiliation
Abramson Cancer Center at Penn Medicine
Facility Information:
Facility Name
Lurleen Wallace Comprehensive Cancer at University of Alabama-Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Winship Cancer Institute of Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Wake Forest University Comprehensive Cancer Center
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157-1096
Country
United States
Facility Name
Abramson Cancer Center of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104-4283
Country
United States

12. IPD Sharing Statement

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Iodine I 131 Monoclonal Antibody TNT-1/B in Treating Patients With Progressive or Recurrent Glioblastoma Multiforme

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