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Phase I Newly Diagnosed GBM With Temozolomide, Radiation, and Minocycline Followed by Adjuvant Minocycline/Temozolomide (D-TERMINED) (D-TERMINED)

Primary Purpose

Newly Diagnosed High Grade Glioma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Minocycline with chemoradiation (temozolomide and radiation therapy)
Sponsored by
University of Utah
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Newly Diagnosed High Grade Glioma

Eligibility Criteria

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

Inclusion Criteria:

Male or female patients greater than or equal to 18 years old Histopathologically proven diagnosis of glioblastoma (GBM) or gliosarcoma or anaplastic astrocytoma(AA) A diagnostic contrast-enhanced MRI or CT scan of the brain must be performed preoperatively and postoperatively (preferably within 96 hours of surgery), prior to the initiation of radiotherapy. The post-operative MRI must be within 35 days prior to study registration.

Patients unable to undergo MR imaging because of non-compatible devices can be enrolled, provided pre- and post-operative contrast-enhanced CT scans are obtained and are of sufficient quality.

Radiation therapy planned to start less than or equal to 6 weeks after surgery and at least 7 days after the start of minocycline Women of child-bearing potential must have a negative pregnancy test within 7 days of initiation of dosing and must agree to use an acceptable method of birth control while on study drug and for 3 months after the last dose. Women of non-childbearing potential may be included if they are either surgically sterile or have been postmenopausal for greater than or equal to1 year. Men of child-bearing potential must also agree to use an acceptable method of birth control while on study drug, and for 3 months after the last dose.

Karnofsky performance status of greater than or equal to 70 Adequate bone marrow function, coagulation, hepatic, and renal function as defined by lab testing.

Exclusion Criteria:

Prior radiation or chemotherapy for high grade glioma Prior invasive cancer (except nonmelanoma skin cancer) unless disease free for at least 2 years or life expectancy without treatment is greater than 2 years, e.g., low risk localized prostate cancer.

Prior radiation to the head or neck with overlapping radiation fields Patients who had a stereotactic needle biopsy Unstable angina and/or decompensated congestive heart failure in the last 6 months, transmural myocardial infarction within the last 6 months, New York Heart Association grade II or higher congestive heart failure requiring hospitalization within 12 months prior to registration, serious or inadequately controlled cardiac arrhythmia, significant vascular and peripheral vascular disease, evidence of bleeding diathesis or coagulopathy.

History of stroke, cerebral vascular accident (CVA) or transient ischemic attack within 6 months Active (acute or chronic) or uncontrolled severe infections requiring intravenous antibiotics Liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis Acquired immune deficiency syndrome (AIDS) based upon current CDC definition or known HIV seropositivity; note, however, that HIV testing is not required for entry into this protocol. The need to exclude patients with HIV/AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive.

Active connective tissue disorders, such as lupus or scleroderma Patients with history of allergic reaction to minocycline or to any of the tetracyclines Patients with history of erosive esophagitis should be excluded from the study Patients that are on anticonvulsant medications would be switched, when possible, to a non-enzyme-inducing antiepileptic drug (non-EIAED). However, if that is not possible, they will not be excluded from the study.

Other major medical illnesses or psychiatric impairments that in the investigator's opinion will prevent administration or completion of protocol therapy Women who are breast feeding, due to possible adverse effects on the infant Prior allergic reaction to temozolomide

Sites / Locations

  • Huntsman Cancer Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment with Study Agent Combination

Arm Description

Radiation Therapy 2.0GyX30fx, 5 days per week for a total of 60 Gy Temozolomide 75mg/m2 daily throughout radiation Minocycline begins one week prior to chemoradiation, and continues twice a day throughout radiation Arm -2:100mg PO BID Arm -1:150mgPO BID Arm 0: 200mg PO BID Arm 1: 400mg PO BID Arm 1a: 300mg PO BID Followed by 28 day break followed by Temozolomide 150-200mg/m2 on days 1-5 out of 28 for up to12 cycles Minocycline taken twice a day throughout each 28 day cycle for up to 12 cycles: Arm -2:100mg PO BID Arm -1:150mgPO BID Arm 0: 200mg PO BID Arm 1: 400mg PO BID Arm 1a: 300mg PO BID

Outcomes

Primary Outcome Measures

Safety and tolerability of minocycline combined with standard radiation and chemotherapy
The adverse event rate and maximum tolerated dose of minocycline (up to a maximum dose of 800 mg/day) when combined with concurrent radiation and temozolomide in newly diagnosed high grade glioma is being explored.

Secondary Outcome Measures

Full Information

First Posted
October 20, 2014
Last Updated
June 18, 2019
Sponsor
University of Utah
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1. Study Identification

Unique Protocol Identification Number
NCT02272270
Brief Title
Phase I Newly Diagnosed GBM With Temozolomide, Radiation, and Minocycline Followed by Adjuvant Minocycline/Temozolomide (D-TERMINED)
Acronym
D-TERMINED
Official Title
Phase 1 Trial in Newly Diagnosed High Grade Glioma With Temozolomide, Radiation, and Minocycline Followed by Adjuvant Minocycline/Temozolomide. (D-TERMINED)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2019
Overall Recruitment Status
Completed
Study Start Date
October 27, 2014 (Actual)
Primary Completion Date
March 8, 2017 (Actual)
Study Completion Date
February 18, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Utah

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This will be an open label, single arm study. Subjects with newly diagnosed high grade glioma will begin minocycline one week prior to beginning postoperative chemoradiation and continue it until progression, intolerance, or the end of adjuvant temozolomide, whichever comes first.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Newly Diagnosed High Grade Glioma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment with Study Agent Combination
Arm Type
Experimental
Arm Description
Radiation Therapy 2.0GyX30fx, 5 days per week for a total of 60 Gy Temozolomide 75mg/m2 daily throughout radiation Minocycline begins one week prior to chemoradiation, and continues twice a day throughout radiation Arm -2:100mg PO BID Arm -1:150mgPO BID Arm 0: 200mg PO BID Arm 1: 400mg PO BID Arm 1a: 300mg PO BID Followed by 28 day break followed by Temozolomide 150-200mg/m2 on days 1-5 out of 28 for up to12 cycles Minocycline taken twice a day throughout each 28 day cycle for up to 12 cycles: Arm -2:100mg PO BID Arm -1:150mgPO BID Arm 0: 200mg PO BID Arm 1: 400mg PO BID Arm 1a: 300mg PO BID
Intervention Type
Drug
Intervention Name(s)
Minocycline with chemoradiation (temozolomide and radiation therapy)
Intervention Description
Patients receive minocycline in conjunction with standard chemoradiation and then they receive minocycline with standard chemotherapy.
Primary Outcome Measure Information:
Title
Safety and tolerability of minocycline combined with standard radiation and chemotherapy
Description
The adverse event rate and maximum tolerated dose of minocycline (up to a maximum dose of 800 mg/day) when combined with concurrent radiation and temozolomide in newly diagnosed high grade glioma is being explored.
Time Frame
Patient safety will be evaluated throughout the treatment period (treatment with Temozolomide, Radiation, and Minocycline followed by Adjuvant Minocycline/Temozolomide) which is expected to last about and up to 14 months for each patient

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients greater than or equal to 18 years old Histopathologically proven diagnosis of glioblastoma (GBM) or gliosarcoma or anaplastic astrocytoma(AA) A diagnostic contrast-enhanced MRI or CT scan of the brain must be performed preoperatively and postoperatively (preferably within 96 hours of surgery), prior to the initiation of radiotherapy. The post-operative MRI must be within 35 days prior to study registration. Patients unable to undergo MR imaging because of non-compatible devices can be enrolled, provided pre- and post-operative contrast-enhanced CT scans are obtained and are of sufficient quality. Radiation therapy planned to start less than or equal to 6 weeks after surgery and at least 7 days after the start of minocycline Women of child-bearing potential must have a negative pregnancy test within 7 days of initiation of dosing and must agree to use an acceptable method of birth control while on study drug and for 3 months after the last dose. Women of non-childbearing potential may be included if they are either surgically sterile or have been postmenopausal for greater than or equal to1 year. Men of child-bearing potential must also agree to use an acceptable method of birth control while on study drug, and for 3 months after the last dose. Karnofsky performance status of greater than or equal to 70 Adequate bone marrow function, coagulation, hepatic, and renal function as defined by lab testing. Exclusion Criteria: Prior radiation or chemotherapy for high grade glioma Prior invasive cancer (except nonmelanoma skin cancer) unless disease free for at least 2 years or life expectancy without treatment is greater than 2 years, e.g., low risk localized prostate cancer. Prior radiation to the head or neck with overlapping radiation fields Patients who had a stereotactic needle biopsy Unstable angina and/or decompensated congestive heart failure in the last 6 months, transmural myocardial infarction within the last 6 months, New York Heart Association grade II or higher congestive heart failure requiring hospitalization within 12 months prior to registration, serious or inadequately controlled cardiac arrhythmia, significant vascular and peripheral vascular disease, evidence of bleeding diathesis or coagulopathy. History of stroke, cerebral vascular accident (CVA) or transient ischemic attack within 6 months Active (acute or chronic) or uncontrolled severe infections requiring intravenous antibiotics Liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis Acquired immune deficiency syndrome (AIDS) based upon current CDC definition or known HIV seropositivity; note, however, that HIV testing is not required for entry into this protocol. The need to exclude patients with HIV/AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive. Active connective tissue disorders, such as lupus or scleroderma Patients with history of allergic reaction to minocycline or to any of the tetracyclines Patients with history of erosive esophagitis should be excluded from the study Patients that are on anticonvulsant medications would be switched, when possible, to a non-enzyme-inducing antiepileptic drug (non-EIAED). However, if that is not possible, they will not be excluded from the study. Other major medical illnesses or psychiatric impairments that in the investigator's opinion will prevent administration or completion of protocol therapy Women who are breast feeding, due to possible adverse effects on the infant Prior allergic reaction to temozolomide
Facility Information:
Facility Name
Huntsman Cancer Institute
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84112
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Phase I Newly Diagnosed GBM With Temozolomide, Radiation, and Minocycline Followed by Adjuvant Minocycline/Temozolomide (D-TERMINED)

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