Imatinib Mesylate in Treating Patients With Recurrent Malignant Glioma or Meningioma
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Purpose
RATIONALE: Imatinib mesylate may interfere with the growth of tumor cells and may be an effective treatment for recurrent glioma and meningioma.
PURPOSE: Phase I/II trial to study the effectiveness of imatinib mesylate in treating patients who have progressive, recurrent, or unresectable malignant glioma or meningioma.
| Condition | Intervention | Phase |
|---|---|---|
|
Brain and Central Nervous System Tumors |
Drug: imatinib mesylate |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Primary Purpose: Treatment |
| Official Title: | Phase I/II Trial of STI571 (NSC 716051) in Patients With Recurrent Malignant Gliomas |
| Study Start Date: | November 2002 |
OBJECTIVES:
- Determine the maximum tolerated dose of imatinib mesylate in patients with recurrent malignant glioma or meningioma.
- Determine the safety profile of this drug in these patients.
- Determine the pharmacokinetics of this drug, with or without concurrent enzyme-inducing anti-epileptic drugs (EIAEDs), in these patients. (Stratum of patients currently taking EIAEDs closed to accrual as of 05/15/2003 for phase I and phase II)
- Determine angiogenic activity in vivo using functional neuro-imaging studies and in vitro with assays of serum angiogenic peptides.
- Determine the efficacy of this drug, in terms of 6-month progression-free survival and objective tumor response, in these patients.
OUTLINE: This is a multicenter, dose-escalation study. Patients are stratified according to concurrent enzyme-inducing anti-epileptic drug use (yes [stratum closed to accrual as of 05/15/2003 for phase I and phase II] vs no).
- Phase I (patients with glioma or meningioma) Patients in cohorts 1 and 2 receive oral imatinib mesylate (STI571) once daily on days 1-28. Patients in cohorts 3-5 receive oral STI571 twice daily on days 1 and 3-28 of the first course and on days 1-28 of subsequent courses. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of STI571 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.
- Phase II (patients with glioma) (glioblastoma multiforme patients excluded as of 05/15/2003) Patients receive oral STI571 at the MTD determined in phase I, 1-2 times daily for 4 weeks. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.
Patients are followed for survival.
PROJECTED ACCRUAL: A total of 36 patients will be accrued for phase I of the study within 6 months and a total of 39 patients will be accrued for phase II of the study within 6-8 months. (Glioblastoma multiforme patients excluded from phase II as of 05/13/2003).
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically confirmed recurrent or unresectable malignant glioma
- Glioblastoma multiforme (phase I only)
- Anaplastic astrocytoma
- Anaplastic oligodendroglioma
- Anaplastic mixed oligoastrocytoma
- Malignant astrocytoma not otherwise specified
- Gliosarcoma
- Low-grade histology with subsequent diagnosis of malignant glioma allowed (phase I only) OR
- Histologically confirmed recurrent or unresectable benign or malignant meningioma (phase I only)
- No prior intracranial hemorrhage
- Failed prior radiotherapy
Progressive or recurrent disease by MRI or CT scan and/or resection
- PET or thallium scan, MR spectroscopy, or surgical documentation required in patients who have received prior interstitial brachytherapy or stereotactic radiosurgery
- Stable dose of steroids for 5-7 days prior to MRI or CT scan
PATIENT CHARACTERISTICS:
Age:
- 18 and over
Performance status:
- Karnofsky 60-100%
Life expectancy:
- More than 8 weeks
Hematopoietic:
- Absolute neutrophil count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
- Hemoglobin at least 10 g/dL (transfusion allowed)
Hepatic:
- Bilirubin less than 2 times upper limit of normal (ULN)
- SGOT less than 2 times ULN
- No significant hepatic disease
Renal:
- Creatinine less than 1.5 mg/dL
- Creatinine clearance at least 60 mL/min
- No significant renal disease
Cardiovascular:
- No significant cardiac disease
- No deep venous or arterial thrombosis within the past 6 weeks
Pulmonary:
- No pulmonary embolism within the past 6 weeks
Other:
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective barrier contraception during and for up to 6 months after study participation
- No other serious concurrent medical illness
- No serious active infection
- No concurrent disease that would obscure toxicity or alter drug metabolism
- No other malignancy within the past 3 years except nonmelanoma skin cancer or carcinoma in situ of the cervix
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- At least 1 week since prior interferon or thalidomide and recovered
- No concurrent immunotherapy
- No concurrent prophylactic filgrastim (G-CSF)
Chemotherapy:
- Recovered from prior chemotherapy
- At least 4 weeks since prior cytotoxic therapy
- At least 2 weeks since prior vincristine
- At least 6 weeks since prior nitrosoureas
- At least 4 weeks since prior temozolomide
- At least 3 weeks since prior procarbazine
- Prior polifeprosan 20 with carmustine implant (Gliadel wafer) allowed
- Prior radiosensitizers allowed
- No other concurrent chemotherapy
Phase I only:
- Prior chemotherapy required for anaplastic astrocytoma, anaplastic oligodendroglioma, and anaplastic mixed oligoastrocytoma
- Prior treatment for up to 3 relapses allowed
Phase II only:
- Prior chemotherapy not required
- Prior treatment for up to 2 relapses allowed
Endocrine therapy:
- See Disease Characteristics
- At least 1 week since prior tamoxifen and recovered
- No concurrent anticancer hormonal therapy
Radiotherapy:
- See Disease Characteristics
- At least 4 weeks since prior radiotherapy
- No concurrent radiotherapy
Surgery:
- See Disease Characteristics
- Recovered from prior surgical resection of recurrent or progressive disease
Other:
- At least 1 week since prior non-cytotoxic agents and recovered
- At least 1 week since prior tretinoin and recovered
- At least 2 weeks since prior drugs that affect hepatic metabolism
- No other concurrent investigational agents
- No concurrent warfarin
Contacts and Locations| United States, California | |
| Jonsson Comprehensive Cancer Center, UCLA | |
| Los Angeles, California, United States, 90095-1781 | |
| UCSF Comprehensive Cancer Center | |
| San Francisco, California, United States, 94143-0128 | |
| United States, Maryland | |
| Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support | |
| Bethesda, Maryland, United States, 20892-1182 | |
| United States, Massachusetts | |
| Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute | |
| Boston, Massachusetts, United States, 02115 | |
| United States, Michigan | |
| University of Michigan Comprehensive Cancer Center | |
| Ann Arbor, Michigan, United States, 48109-0316 | |
| United States, New York | |
| Memorial Sloan-Kettering Cancer Center | |
| New York, New York, United States, 10021 | |
| United States, Pennsylvania | |
| Hillman Cancer Center at University of Pittsburgh Cancer Institute | |
| Pittsburgh, Pennsylvania, United States, 15232 | |
| United States, Texas | |
| Simmons Cancer Center at University of Texas Southwestern Medical Center - Dallas | |
| Dallas, Texas, United States, 75390-9154 | |
| University of Texas - MD Anderson Cancer Center | |
| Houston, Texas, United States, 77030-4009 | |
| University of Texas Health Science Center at San Antonio | |
| San Antonio, Texas, United States, 78284-6220 | |
| United States, Wisconsin | |
| University of Wisconsin Comprehensive Cancer Center | |
| Madison, Wisconsin, United States, 53792 | |
| Study Chair: | Patrick Y. Wen, MD | Dana-Farber Cancer Institute |
More Information
Additional Information:
Publications:
| ClinicalTrials.gov Identifier: | NCT00010049 History of Changes |
| Obsolete Identifiers: | NCT00023179 |
| Other Study ID Numbers: | CDR0000068437, NABTC-9908, NCI-01-C-0243, UCLA-0101024 |
| Study First Received: | February 2, 2001 |
| Last Updated: | July 31, 2010 |
| Health Authority: | United States: Federal Government |
Keywords provided by National Cancer Institute (NCI):
|
recurrent adult brain tumor adult meningioma adult glioblastoma adult anaplastic astrocytoma adult anaplastic oligodendroglioma adult mixed glioma |
adult pilocytic astrocytoma adult subependymoma adult grade III meningioma adult giant cell glioblastoma adult gliosarcoma |
Additional relevant MeSH terms:
|
Glioma Meningioma Nervous System Neoplasms Central Nervous System Neoplasms Neoplasms, Neuroepithelial Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms Neoplasms, Glandular and Epithelial Neoplasms, Nerve Tissue |
Neoplasms, Vascular Tissue Meningeal Neoplasms Neoplasms by Site Nervous System Diseases Imatinib Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Protein Kinase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 16, 2013