Modafinil in Treating Children With Memory and Attention Problems Caused by Cancer Treatment for a Brain Tumor
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Purpose
RATIONALE: Modafinil may help improve memory, attention, and fatigue caused by cancer treatment.
PURPOSE: This phase II randomized trial studies how well modafinil works in treating children with memory and attention problems caused by cancer treatment for a brain tumor.
| Condition | Intervention | Phase |
|---|---|---|
|
Brain and Central Nervous System Tumors Cognitive/Functional Effects Fatigue Neurotoxicity Psychosocial Effects of Cancer and Its Treatment |
Drug: modafinil Other: placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Supportive Care |
| Official Title: | A Phase II Placebo-Controlled Trial of Modafinil to Improve Neurocognitive Deficits in Children Treated for a Primary Brain Tumor |
- Change in age-adjusted scores at week six from baseline in any of the 5 questionnaires [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
- Safety and toxicity of modafinil [ Time Frame: 30 days post intervention ] [ Designated as safety issue: Yes ]
- Improved executive function (apart from working memory) as assessed by BRIEF and CogState [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
- Reduced fatigue as assessed by PedsQL [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 228 |
| Study Start Date: | August 2011 |
| Estimated Primary Completion Date: | June 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm I
Participants receive modafinil orally (PO) once daily (QD) on days 1-42.
|
Drug: modafinil
Given PO
|
|
Placebo Comparator: Arm II
Participants receive placebo PO QD on days 1-42.
|
Other: placebo
Given PO
|
Detailed Description:
OBJECTIVES:
Primary
- Determine whether a 6-week drug trial of modafinil, compared to placebo, is associated with improvement in neurocognitive function as defined by parent report of inattention or working memory deficits or by direct assessment of attention, working memory, or processing speed in children with cognitive impairment after treatment for a primary brain tumor.
Secondary
- Determine whether modafinil, compared to placebo, is associated with improved executive function (apart from working memory), as assessed using the BRIEF executive function and hippocampal learning and executive function tasks from the CogState battery.
- Determine whether modafinil, compared to placebo, is associated with reduced fatigue as assessed using the PedsQL Multidimensional Fatigue Scale.
- Evaluate the safety of modafinil in this population.
OUTLINE: This is a multicenter study. Participants are randomized to 1 of 2 treatment arms.
- Arm I: Participants receive modafinil orally (PO) once daily (QD) on days 1-42.
- Arm II: Participants receive placebo PO QD on days 1-42. Participants complete a semi-automated, computerized cognitive-testing system (CogState) designed to assess psychomotor, attention/vigilance, memory, and other components of executive function by presenting different tasks, each with its own set of rules, at baseline and after completion of study therapy. Participants also complete the PedsQL Multidimensional Fatigue Scale (Peds QL-MFS).
Parents or legal guardians complete the PedsQL-MFS, the Conners Parent Reported Scale (CPR-3), and the Behavior Rating Inventory of Executive Function (BRIEF) at baseline and after completion of study therapy.
Clinical and/or research staff administer the Systematic Assessment for Treatment Emergency Events (SAFTEE), a semi-structured interview designed to elicit adverse events, at baseline and periodically during study.
After completion of study therapy, participants are followed up for 30 days.
Eligibility| Ages Eligible for Study: | 6 Years to 17 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
INCLUSION CRITERIA:
- Age ≥ 6 years and ≤ 17 years 10 months at the time of study entry (so that participants will be < 18 at the 6 week evaluation, which is the upper age limit for which the included instruments are valid).
Diagnosis of a primary brain tumor treated with at least one of the following:
- neurosurgical resection of the brain tumor;
- cranial irradiation; or
- any chemotherapy to treat the brain tumor.
- Off-treatment and progression-free for at least 12 months and ≤ 84 months. Treatment cessation is defined as the final dose of chemotherapy, the last dose (fraction) of radiation or date of surgery, whichever occurred last.
- Parent/Legal Guardian and child able to read English.
- Vision and hearing (eyeglasses and/or hearing aid permissible) sufficient for valid test administration and cooperation with examinations.
- Availability of a reliable parent or legal guardian who is willing and able to complete all of the outcome measures and fulfill the requirements of the study, including administration of medications and accompanying the participant to all study visits.
- Females of childbearing potential must have a negative pregnancy test result and must agree to use a medically acceptable method of contraception throughout the entire study period and for 30 days after the last dose of study drug.
- Childbearing potential is defined as girls who are >Tanner stage 2, except for those who have documented pan pituitary insufficiency or other hormonal state incompatible with pregnancy.
- Urine pregnancy tests are acceptable.
EXCLUSION CRITERIA:
- Off treatment > 84 months
- Inability to perform the testing procedure (for example, because of aphasia, motor deficits affecting the dominant hand, or IQ < 70)
- Known cardiac disorders including arrhythmias, hypertension requiring treatment or structural heart disease
- Diagnosis of narcolepsy, sick sinus syndrome, arrhythmia or prolonged QTc
- History of stroke or head injury associated with loss of consciousness within 12 months of registration
- History of grade 2 depression or anxiety or treatment with antidepressants, antipsychotics or MAO inhibitors within 30 days of registration
- Concurrent treatment with any medications or substances that are potent inhibitors or inducers of CYP3A4, hepatic enzyme inducing antiepileptic drugs (EIAEDs),or other drugs known to affect the metabolism of modafinil. Examples include but are not limited to itraconazole, ketoconazole, doxycycline, rifampin, St. John's wort, phenytoin, phenobarbital, diazepam, tricyclic antidepressants.
- If patients were previously taking, EIAEDs, they must be off for > 2 weeks prior to study enrollment.
- Treatment with other stimulant medications within 14 days of registration; however, a diagnosis of ADHD does NOT exclude a child from participation
- Participants with known hypersensitivity to modafinil, armodafinil or any of its components
Contacts and Locations
Show 35 Study Locations| Study Chair: | Jeffrey P. Krischer, MD, PhD | University of South Florida |
| Study Chair: | Nicole J. Ullrich, MD, PhD | Children's Hospital Boston |
More Information
Additional Information:
No publications provided
| Responsible Party: | University of South Florida |
| ClinicalTrials.gov Identifier: | NCT01381718 History of Changes |
| Other Study ID Numbers: | SCUSF 0901, SCUSF-0901, ACCL0922, 5U10CA081920-11 |
| Study First Received: | June 23, 2011 |
| Last Updated: | May 20, 2013 |
| Health Authority: | United States: Data and Safety Monitoring Board United States: Institutional Review Board |
Keywords provided by University of South Florida:
|
childhood brain tumor neurotoxicity fatigue cognitive/functional effects psychosocial effects of cancer and its treatment |
Additional relevant MeSH terms:
|
Brain Neoplasms Fatigue Nervous System Neoplasms Central Nervous System Neoplasms Neurotoxicity Syndromes Neoplasms by Site Neoplasms Brain Diseases Central Nervous System Diseases Nervous System Diseases Signs and Symptoms |
Poisoning Substance-Related Disorders Modafinil Central Nervous System Stimulants Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Neuroprotective Agents Protective Agents |
ClinicalTrials.gov processed this record on June 17, 2013