Vitamin D for Treatment of Glioblastoma Multiforme
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Purpose
This is non-randomized phase 2 study to assess efficacy and toxicity of long term high dose vitamin D3 given concurrently with chemo-radiotherapy (CCRT) containing temozolomide followed by adjuvant chemotherapy (ACT) with temozolomide in patients with newly diagnosed glioblastoma multiforme GBM). Preoperative diagnosis of GBM will be based on magnetic resonance imaging (MRI) brain scan. All patient will underwent craniotomy with partial or total resection of a visible tumour mass. All patients will be planned for postoperative three-dimensional conformal RT (3-DCRT) or intensity-modulated RT (IMRT) to residual tumour and/or resection bed. A total RT dose of 54-60 Gy will be delivered using 2 Gy daily fractions given over 5 days a week. Daily chemotherapy with temozolomide in the dose of 75 mg/m2/day will be started at the first day of RT, and will be continued for entire period of RT inclusive week-end breaks. ACT will contain 6 cycles of oral temozolomide 150-200 mg/m2/day given for 5 days every 4 weeks. Oral vitamin D3 will be administered in daily dose of 4000 IU. Vitamin D3 therapy will be started 1 week prior to commencing CCRT, and will be terminated immediately after completing last cycle of ACT. MRI scan of the brain will be performed at 4 months after completing CCRT, and than will be repeated every 4 months for first 2 years, and every 6 months for subsequent years. The study participants will be followed until disease progression or death. The study is expected to complete within 4 years.
| Condition | Intervention | Phase |
|---|---|---|
|
Glioblastoma Multiforme |
Other: Surgery Radiation: Radiotherapy to tumour bed and/or residual tumour Drug: Temozolomide Drug: Vitamin D3 |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | High-Dose Vitamin D in Combination With Chemoradiotherapy in the Treatment of Glioblastoma Multiforme |
- Progression free survival [ Time Frame: long term ] [ Designated as safety issue: Yes ]
- Overall survival [ Time Frame: long term ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 20 |
| Study Start Date: | March 2011 |
| Estimated Study Completion Date: | March 2014 |
| Estimated Primary Completion Date: | March 2013 (Final data collection date for primary outcome measure) |
-
Other: Surgery
- 75 mg/m2/day for entire period of radiotherapy
- 150-200 mg/m2/day for 5 days every 28 days, 6 cycles total
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age > 18 years
- Newly-diagnosed, histologically confirmed GBM
- Surgical procedures: craniotomy with gross tumour resection or maximal debulking
- Brain lesion suitable suitable for radical 3-DCRT/IMRT according to tumour location and size.
- Karnofsky performance status (KPS) > 70 (ECOG/WHO 0-1)
- No previous RT to brain
- No serious comorbid condition
- No treatment with biological response modifiers or cytotoxic agents within four weeks prior to study entry
- No participation in clinical trial using any investigational drug or device within four weeks prior to study entry
- No serious complication of malignant condition
- No previous or concurrent malignancy at other sites, except cone biopsied in situ carcinoma of the uterine cervix and adequately treated basal cell or squamous cell carcinoma of the skin
Adequate organ function as evidenced by the following peripheral blood counts or serum chemistries at study entry:
- Hemoglobin > 9.0 Gm/dL
- WBC count > 4.0x109/L
- Neutrophile count > 1.5 cells x 109/L,
- Platelet count > 100 x 109/L,
- Creatinine < 1.5 mg/dL
- Total bilirubin < ULN (upper limit of normal)
- AST/SGOT < ULN
- Calcium < ULN
- Ability to sign informed consent
- Ability to attend follow-up visits
Exclusion Criteria:
- Surgical procedures: only stereotactic biopsy
- Brain lesion not suitable for 3-DCRT/IMRT
- KPS < 70 (ECOG/WHO <2)
- Previous RT to brain
- Treatment with biological response modifiers or cytotoxic agents within four weeks prior to study entry
- Participation in clinical trial using any investigational drug or device within 7 weeks prior to study entry
- Major surgical procedure within two weeks prior to study entry
- Serious comorbid condition, inclusive but not limited to myocardial infarction within previous six months, uncontrolled cardiac arrhythmias, uncontrolled angina pectoris, active infection including acute hepatitis
- Serious complication of malignant condition
- Previous or concurrent malignancy
- Known hypersensitivity to vitamin D
Inadequate organ function as evidenced by the following peripheral blood counts or serum chemistries at study entry:
- Hemoglobin < 9.0 Gm/dL
- WBC count < 4.0x109/L
- Neutrophile count < 1.5 cells x 109/L,
- Platelet count < 100 x 109/L,
- Creatinine > 1.5 mg/dL
- Total bilirubin > ULN (upper limit of normal)
- AST/SGOT > ULN
- Calcium > ULN
- Inability to sign informed consent
- Psychological, familial, sociological or geographical conditions which do not permit regular medical follow-up and compliance with the protocol.
Contacts and Locations| Contact: Konstantin Lavrenkov, MD, PhD | +97286400537 | constant@bgu.ac.il |
| Contact: Olga Belochitski, MD | +97286400537 | olgab@clalit.org.il |
| Israel | |
| Soroka University Medical Center | Recruiting |
| Beer Sheva, Israel, 84101 | |
| Contact: Konstantin Lavrenkov, MD, PhD +97286400537 constant@bgu.ac.il | |
| Contact: Olga Belochitski, MD +97286400537 olgab@clalit.org.il | |
| Sub-Investigator: Vladimir Gavrilov, MD, PhD | |
| Sub-Investigator: Olga Belochitski, MD | |
| Sub-Investigator: Vladimir Merkin, MD | |
| Principal Investigator: | Konstantin Lavrenkov, MD, PhD | Soroka University Miedical Center |
More Information
No publications provided
| Responsible Party: | Konstantin Lavrenkov, MD, PhD, Soroka University Medical Center |
| ClinicalTrials.gov Identifier: | NCT01181193 History of Changes |
| Other Study ID Numbers: | SOR504110CTIL |
| Study First Received: | July 18, 2010 |
| Last Updated: | March 27, 2011 |
| Health Authority: | Israel: Ministry of Health |
Keywords provided by Soroka University Medical Center:
|
glioblastoma multiforme chemoradiotherapy vitamin D |
Additional relevant MeSH terms:
|
Glioblastoma Astrocytoma Glioma Neoplasms, Neuroepithelial Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms Neoplasms, Glandular and Epithelial Neoplasms, Nerve Tissue Cholecalciferol Vitamin D Ergocalciferols |
Vitamins Temozolomide Micronutrients Growth Substances Physiological Effects of Drugs Pharmacologic Actions Bone Density Conservation Agents Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 23, 2013