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Mebendazole in Newly Diagnosed High-Grade Glioma Patients Receiving Temozolomide (Mebendazole)

Primary Purpose

Newly Diagnosed High-Grade Glioma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Mebendazole
Sponsored by
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Newly Diagnosed High-Grade Glioma focused on measuring Glioblastoma, mebendazole, temozolomide

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients must have histologically confirmed newly diagnosed high-grade glioma(WHO Grade III or IV)
  2. Age ≥18 years
  3. Karnofsky Performance Score (KPS) ≥ 60%
  4. Life expectancy greater than 12 weeks
  5. Patients must have adequate organ and marrow function
  6. Completed >80% of the prescribed radiation therapy and concurrent temozolomide according to the Stupp regimen without grade 3 or 4 hematologic toxicity
  7. Patients may have received Gliadel during surgery
  8. Ability to swallow pills and keep medication record
  9. women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) for the duration of study participation.
  10. Ability to understand and willingness to sign a written informed consent document
  11. Be able to comply with treatment plan, study procedures and follow-up examinations

Exclusion Criteria:

  1. Patients must not have received prior therapy other than standard chemoradiation according to Stupp et al and Gliadel.
  2. Patients may not be receiving any other investigational agents while on study
  3. Patients who have known allergy to mebendazole or benzimidazole
  4. Patients who have previously had a severe side effect, such as agranulocytosis and neutropenia, in conjunction with previous mebendazole or benzimidazole class drug for a parasitic infection
  5. Patients who are taking metronidazole and cannot be safely moved to a different antibiotic greater than 7 days prior to starting mebendazole therapy
  6. Patients who have taken any benzimidazole (ABZ, flubendazole, thiabendazole, fenbendazole, triclabendazole, etc.) within the last 3 months
  7. Patients who are taking any anti-convulsant medication that interferes with the cytochrome P450 pathway (e.g. phenytoin, phenobarbital, carbamazepine, etc.)
  8. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, uncontrolled hypertension, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, chronic hepatitis, acute hepatitis, or psychiatric illness/social situation that would limit compliance with study requirements
  9. Pregnant women are excluded
  10. Patients with human immunodeficiency virus (HIV), hepatitis B surface antigen or hepatitis C positive; or with a history of chronic active hepatitis or cirrhosis
  11. Patients with a history of any medical or psychiatric condition or laboratory abnormality that in the opinion of the investigator may increase the risks associated with the study participation or investigational product administration or may interfere with the interpretation of the results
  12. Patients who are not available for follow-up assessments or unable to comply with study requirements

Sites / Locations

  • The Johs Hopkins Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Mebendazole

Arm Description

All study participants will receive study drug; Mebendazole.

Outcomes

Primary Outcome Measures

maximum tolerated dose (MTD) of mebendazole
To determine the maximum tolerated dose (MTD) of mebendazole in combination with temozolomide (TMZ) given after surgery and the standard radiation and TMZ treatment in patients with newly diagnosed malignant gliomas.

Secondary Outcome Measures

Overall Survival
Overall survival in years.

Full Information

First Posted
November 13, 2012
Last Updated
May 6, 2021
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Accelerate Brain Cancer Cure
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1. Study Identification

Unique Protocol Identification Number
NCT01729260
Brief Title
Mebendazole in Newly Diagnosed High-Grade Glioma Patients Receiving Temozolomide
Acronym
Mebendazole
Official Title
Phase I Study of Mebendazole in Newly Diagnosed High-Grade Glioma Patients Receiving Temozolomide
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
April 4, 2013 (Actual)
Primary Completion Date
September 2016 (Actual)
Study Completion Date
April 16, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
Accelerate Brain Cancer Cure

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to find the highest dose of mebendazole (MBZ) that can be safely given to people with malignant brain tumors in combination with the current standard of care (temozolomide) without causing severe side effects. We also want to find out if MBZ can slow the growth of the brain tumor. The study doctors have found that MBZ is effective against malignant brain tumors in the laboratory and animal models of brain tumors.
Detailed Description
Glioblastoma (GBM) is the most common and aggressive brain cancer, and despite significant advances in treatment the majority of patients die within two years of diagnosis. During routine animal studies we serendipitously observed that fenbendazole, a benzimidazole antihelminthic used for pinworms, prevented tumor engraftment. Subsequent in vitro and in vivo experiments with benzimidazoles identified mebendazole as the drug having the best results in preclinical testing 1. In GBM cell lines, mebendazole displayed cytotoxicity with IC50s ranging from 0.1-0.3 μM. Mebendazole disrupted microtubule formation in GBM cells and it's in vitro activity was correlated with reduced tubulin polymerization. In two orthotopic mouse glioma models, one syngeneic and one xenograft, mebendazole significantly extended average survival up to 63% compared to untreated controls 1. Mebendazole is an FDA approved antiparasitic agent with a well-established side effect and safety record and was effective in our animal models in dosing schedules that are documented as safe in humans. Therefore, mebendazole is a possible anti-cancer therapeutic with pre-clinical safety and efficacy and provides a promising opportunity for a clinical trial in patients with malignant gliomas. In addition, a recently published case report case report from the University of Michigan documented successful long term control in metastatic adrenocortical adenocarcinoma using mebendazole 2. Mebendazole was well tolerated at 200 mg/day and used as the sole treatment after the patient failed other chemotherapies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Newly Diagnosed High-Grade Glioma
Keywords
Glioblastoma, mebendazole, temozolomide

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Mebendazole
Arm Type
Experimental
Arm Description
All study participants will receive study drug; Mebendazole.
Intervention Type
Drug
Intervention Name(s)
Mebendazole
Other Intervention Name(s)
Brand name: Vermox
Intervention Description
The mebendazole will be given by mouth three times every day on a 28 day cycle. it's in the form of 500 mg chewable tablets, to be taken with meals.
Primary Outcome Measure Information:
Title
maximum tolerated dose (MTD) of mebendazole
Description
To determine the maximum tolerated dose (MTD) of mebendazole in combination with temozolomide (TMZ) given after surgery and the standard radiation and TMZ treatment in patients with newly diagnosed malignant gliomas.
Time Frame
8 months
Secondary Outcome Measure Information:
Title
Overall Survival
Description
Overall survival in years.
Time Frame
10 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have histologically confirmed newly diagnosed high-grade glioma(WHO Grade III or IV) Age ≥18 years Karnofsky Performance Score (KPS) ≥ 60% Life expectancy greater than 12 weeks Patients must have adequate organ and marrow function Completed >80% of the prescribed radiation therapy and concurrent temozolomide according to the Stupp regimen without grade 3 or 4 hematologic toxicity Patients may have received Gliadel during surgery Ability to swallow pills and keep medication record women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) for the duration of study participation. Ability to understand and willingness to sign a written informed consent document Be able to comply with treatment plan, study procedures and follow-up examinations Exclusion Criteria: Patients must not have received prior therapy other than standard chemoradiation according to Stupp et al and Gliadel. Patients may not be receiving any other investigational agents while on study Patients who have known allergy to mebendazole or benzimidazole Patients who have previously had a severe side effect, such as agranulocytosis and neutropenia, in conjunction with previous mebendazole or benzimidazole class drug for a parasitic infection Patients who are taking metronidazole and cannot be safely moved to a different antibiotic greater than 7 days prior to starting mebendazole therapy Patients who have taken any benzimidazole (ABZ, flubendazole, thiabendazole, fenbendazole, triclabendazole, etc.) within the last 3 months Patients who are taking any anti-convulsant medication that interferes with the cytochrome P450 pathway (e.g. phenytoin, phenobarbital, carbamazepine, etc.) Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, uncontrolled hypertension, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, chronic hepatitis, acute hepatitis, or psychiatric illness/social situation that would limit compliance with study requirements Pregnant women are excluded Patients with human immunodeficiency virus (HIV), hepatitis B surface antigen or hepatitis C positive; or with a history of chronic active hepatitis or cirrhosis Patients with a history of any medical or psychiatric condition or laboratory abnormality that in the opinion of the investigator may increase the risks associated with the study participation or investigational product administration or may interfere with the interpretation of the results Patients who are not available for follow-up assessments or unable to comply with study requirements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gary Gallia, MD
Organizational Affiliation
Johns Hopkins University School of Medicine, Department of Neurosurgery
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Johs Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States

12. IPD Sharing Statement

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Mebendazole in Newly Diagnosed High-Grade Glioma Patients Receiving Temozolomide

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