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Aflibercept, Radiation Therapy, and Temozolomide in Treating Patients With Newly Diagnosed or Recurrent Glioblastoma Multiforme, Gliosarcoma, or Other Malignant Glioma
This study is ongoing, but not recruiting participants.

First Received on April 1, 2008.   Last Updated on June 27, 2011   History of Changes
Sponsor: Sidney Kimmel Comprehensive Cancer Center
Collaborator: National Cancer Institute (NCI)
Information provided by: Sidney Kimmel Comprehensive Cancer Center
ClinicalTrials.gov Identifier: NCT00650923
  Purpose

RATIONALE: Aflibercept may stop the growth of tumor cells by blocking blood flow to the tumor. Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving aflibercept together with radiation therapy and temozolomide may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of aflibercept when given together with radiation therapy and temozolomide in treating patients with newly diagnosed or recurrent glioblastoma multiforme, gliosarcoma, or other malignant glioma.


Condition Intervention Phase
Brain and Central Nervous System Tumors
Biological: aflibercept
Drug: temozolomide
Genetic: DNA methylation analysis
Genetic: polymerase chain reaction
Other: laboratory biomarker analysis
Other: pharmacological study
Procedure: adjuvant therapy
Radiation: radiation therapy
Phase I

Study Type: Interventional
Study Design: Primary Purpose: Treatment
Official Title: Phase I Trial of Aflibercept (VEGF Trap) With Radiation Therapy and Concomitant and Adjuvant Temozolomide in Patients With Malignant Glioma

Resource links provided by NLM:


Further study details as provided by Sidney Kimmel Comprehensive Cancer Center:

Primary Outcome Measures:
  • Maximum tolerated dose of aflibercept [ Time Frame: continous ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Toxicity of aflibercept with radiotherapy and temozolomide (TMZ), as well as TMZ alone [ Time Frame: continous ] [ Designated as safety issue: Yes ]
  • Pharmacokinetics of aflibercept [ Time Frame: continous ] [ Designated as safety issue: No ]
  • Correlation of tumor genotype, tumor vascularity, VEGFR and phospho-VEGFR expression, serum free and bound VEGF levels, plasma angiogenic peptides, and tumor MGMT levels with response to therapy with aflibercept [ Time Frame: continous ] [ Designated as safety issue: No ]

Estimated Enrollment: 90
Study Start Date: July 2008
Estimated Primary Completion Date: June 2013 (Final data collection date for primary outcome measure)
  Show Detailed Description

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed intracranial glioblastoma multiforme or gliosarcoma

    • Patients with anaplastic gliomas, including anaplastic astrocytoma, anaplastic oligodendroglioma, anaplastic mixed oligoastrocytoma, or malignant astrocytoma not otherwise specified allowed (groups 2 and 3 only)
    • Newly diagnosed (group 1 only)
    • Stable or recurrent disease allowed (groups 2 and 3 only)
  • No evidence of significant intratumoral or peritumoral hemorrhage on pre-operative MRI or a large amount of peri-operative parenchymal hemorrhage on post-operative MRI

    • Post-operative intracavitary blood allowed

PATIENT CHARACTERISTICS:

  • Karnofsky performance status 60-100%
  • Life expectancy > 12 weeks
  • WBC > 3,000/μL
  • ANC > 1,500/mm³
  • Platelet count > 100,000/mm³
  • Hemoglobin > 10 g/dL (transfusion allowed)
  • SGOT and SGPT < 2 times upper limit of normal (ULN)
  • Bilirubin < 2 times ULN
  • Creatinine < 1.5 mg/dL or creatinine clearance > 60 mL/min
  • Urine protein:creatinine ratio ≤ 1 or 24-hour urine protein < 500 mg
  • INR ≤ 1.5
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception prior to, during, and for at least 6 months after completion of study treatment
  • At least 28 days since prior significant traumatic injury
  • No evidence of bleeding diathesis or coagulopathy
  • No serious or nonhealing wound, ulcer, or bone fracture
  • No significant medical illnesses that in the investigator's opinion cannot be adequately controlled with appropriate therapy or would compromise the patient's ability to tolerate therapy
  • No known hypersensitivity to CHO cell products or other recombinant human antibodies
  • No history of hypersensitivity to a recombinant protein whereby reaction occurs during or immediately after infusion
  • No history of allergic reactions attributed to compounds of similar chemical or biological composition to other study agents
  • No history of other cancer (except nonmelanoma skin cancer or carcinoma in situ of the cervix), unless in complete remission and off of all therapy for that disease for a minimum of 3 years
  • No history of abdominal fistula, gastrointestinal perforation, intra-abdominal abscess gastrointestinal bleeding or diverticulitis within the past 6 months
  • No uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness or social situation that would limit compliance with study requirements
  • No uncontrolled hypertension, defined as blood pressure (BP) > 140/90 mm Hg or systolic BP > 180 mm Hg if diastolic BP < 90 mm Hg, on 2 repeated determinations on separate days within past 3 months
  • No clinically significant cardiovascular disease within the past 6 months, including any of the following:

    • History of ischemic or hemorrhagic stroke
    • Myocardial infarction, coronary artery bypass graft, or unstable angina
    • New York Heart Association class III-IV congestive heart failure, serious cardiac arrhythmia requiring medication, or unstable angina pectoris
    • Clinically significant peripheral vascular disease
    • Pulmonary embolism, deep vein thrombosis, or other thromboembolic event
  • No disease that will obscure toxicity or dangerously alter drug metabolism

PRIOR CONCURRENT THERAPY:

  • Recovered from all prior therapy
  • More than 28 days since prior and no concurrent investigational agents
  • More than 7 days since prior core biopsy
  • At least 23 days since prior temozolomide (groups 2 and 3)
  • At least 28 days since prior major surgery or open biopsy
  • At least 21 days since prior radiotherapy (groups 2 and 3)
  • No prior Gliadel® wafers
  • No prior cranial radiotherapy (group 1 only)
  • No prior aflibercept
  • No prior treatment for brain tumors, except concurrent radiotherapy and temozolomide or 2 or fewer 28-day courses of adjuvant temozolomide (groups 2 and 3)
  • No prior or concurrent cytotoxic drug therapy, non-cytotoxic drug therapy, or experimental drug therapy for brain tumors (group 1 only)
  • No concurrent major surgery
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No concurrent full-dose anticoagulants (e.g., warfarin or low molecular-weight heparin)

    • Prophylactic doses allowed
  • No concurrent routine prophylactic use of filgrastim (G-CSF)
  • No other concurrent anticancer therapy (including chemotherapy, radiotherapy, hormonal treatment, or immunotherapy)
  • Concurrent enzyme-inducing antiepileptic drugs (EIAED) or non-EIAED allowed
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00650923

Locations
United States, California
Jonsson Comprehensive Cancer Center at UCLA
Los Angeles, California, United States, 90095-1781
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California, United States, 94115
United States, Georgia
Winship Cancer Institute of Emory University
Atlanta, Georgia, United States, 30322
United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
United States, New York
Memorial Sloan-Kettering Cancer Center
New York, New York, United States, 10021
United States, Pennsylvania
UPMC Cancer Centers
Pittsburgh, Pennsylvania, United States, 15232
United States, Texas
M.D. Anderson Cancer Center at University of Texas
Houston, Texas, United States, 77030-4009
Sponsors and Collaborators
Sidney Kimmel Comprehensive Cancer Center
Investigators
Study Chair: Patrick Y. Wen, MD Dana-Farber Cancer Institute
Study Chair: John F. deGroot, MD M.D. Anderson Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: Director, ABTC, Adult Brain Tumor Consortium
ClinicalTrials.gov Identifier: NCT00650923     History of Changes
Other Study ID Numbers: CDR0000590174, U01CA062399, ABTC-0701, NABTC-0701
Study First Received: April 1, 2008
Last Updated: June 27, 2011
Health Authority: United States: Food and Drug Administration

Keywords provided by Sidney Kimmel Comprehensive Cancer Center:
adult giant cell glioblastoma
adult glioblastoma
adult gliosarcoma
adult anaplastic astrocytoma
adult anaplastic oligodendroglioma
adult mixed glioma
recurrent adult brain tumor

Additional relevant MeSH terms:
Glioblastoma
Glioma
Nervous System Neoplasms
Central Nervous System Neoplasms
Gliosarcoma
Astrocytoma
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Neoplasms by Site
Nervous System Diseases
Adjuvants, Immunologic
Temozolomide
Dacarbazine
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on February 09, 2012