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Phase I/II Randomized Study of Temozolomide and Radiotherapy With or Without Vatalanib in Patients With Newly Diagnosed Glioblastoma Multiforme
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outcomes Outline Published Results Trial Contact Information Registry Information
Alternate Title
Temozolomide and Radiation Therapy With or Without Vatalanib in Treating Patients With Newly Diagnosed Glioblastoma Multiforme
Basic Trial Information
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Phase
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Type
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Status
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Age
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Sponsor
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Protocol IDs
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Phase II, Phase I
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Treatment
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Closed
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18 to 69
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Other
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EORTC-26041 EORTC-22041, EUDRACT-2004-003896-35, NCT00128700
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Objectives Primary - Determine the maximum tolerated dose and recommended phase II dose of vatalanib when given in combination with temozolomide and radiotherapy in patients with newly diagnosed glioblastoma multiforme. (Phase I)
- Determine the safety and tolerability of this regimen in these patients. (Phase I)
- Determine the 6-month progression-free survival of patients treated with chemoradiotherapy comprising temozolomide and radiotherapy with or without vatalanib followed by adjuvant therapy comprising temozolomide and vatalanib or temozolomide alone with or without maintenance therapy comprising vatalanib alone. (Phase II)
Secondary - Determine 12-month overall survival of patients treated with these regimens. (Phase II)
- Determine the toxicity profile of these regimens in these patients. (Phase II)
- Correlate expression of angiogenesis and hypoxia markers and MGMT methylation status with clinical outcome in patients treated with these regimens.
Entry Criteria Disease Characteristics:
- Histologically confirmed glioblastoma multiforme
- Deemed to be amenable to concurrent and adjuvant temozolomide treatment by the principal investigator
Prior/Concurrent Therapy:
Biologic therapy - No prior anti-vascular endothelial growth factor therapy
Chemotherapy Endocrine therapy - Concurrent corticosteroids allowed provided the patient is on stable or decreasing doses for ≥ 2 weeks before study entry
Radiotherapy Surgery - More than 8 days, but < 6 weeks, since prior surgery or biopsy
Other - No prior randomization on this study
- No concurrent warfarin, warfarin-derived drugs, or similar anticoagulants
- No other concurrent anticancer therapy
- No other concurrent investigational agents
- No concurrent enzyme inducing antiepileptic drugs, including any of the following:
- Carbamazepine
- Fosphenytoin
- Oxcarbazepine
- Phenobarbital
- Phenytoin
- Primidone
- No concurrent grapefruit or grapefruit juice
Patient Characteristics:
Age Performance status Life expectancy Hematopoietic - Absolute neutrophil count ≥ 1,500/mm3
- Platelet count ≥ 100,000/mm3
Hepatic - Bilirubin < 1.5 times upper limit of normal (ULN)
- Alkaline phosphatase < 2.5 times ULN
- ALT and AST < 2.5 times ULN
Renal Cardiovascular - Cardiac function clinically normal
- 12-lead ECG normal
- No ischemic heart disease within the past 6 months
- No uncontrolled cardiac arrhythmia
- No uncontrolled hypertension
- No history of stroke
- No history of congenital long QT syndrome
- QTc interval ≤ 450 msec for males or ≤ 470 msec for females by 12-lead ECG
Other - Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No other malignancy except adequately treated basal cell or squamous cell skin cancer or cone biopsied carcinoma in situ of the cervix
- No active uncontrolled infection
- No other unstable systemic disease
- No psychological, familial, sociological, or geographical condition that would preclude study compliance or follow-up schedule
Expected Enrollment 219Approximately 3-18 patients will be accrued for the phase I portion of this study. A total of 201 patients (67 per treatment arm) will be accrued for the phase II portion of this study. Outcomes Primary Outcome(s)Dose-limiting toxicity and maximum tolerated dose of vatalanib as determined by CTCAE v3.0 during phase I Progression-free survival at 6 months during phase II
Secondary Outcome(s)Severe toxic events as assessed by CTCAE v3.0 at weeks 3 and 6 (concomitant treatment), weeks 2 and 4 after radiotherapy, before each course of adjuvant treatment, monthly during maintenance treatment, and every 3 months during follow-up in phase II Overall survival at 1 year during phase II Correlation of angiogenesis and hypoxia markers expression and O-6-methylguanine DNA methyltransferase (MGMT) methylation status with clinical outcome during phase II
Outline This is a phase I, multicenter, open-label, non-randomized, dose-escalation study of vatalanib followed by a phase II, randomized, controlled study. Patients enrolled in the phase II portion of the study are stratified according to participating center, age (< 50 years vs ≥ 50 years), corticosteroid intake (yes vs no), and mini-mental status evaluation score (< 27 vs 27-29 vs 30). - Phase II: Patients are randomized to 1 of 3 treatment arms.
- Arm I:
- Chemoradiotherapy: Patients receive oral temozolomide once daily for 6-7 weeks and undergo radiotherapy once daily, 5 days a week, for 6 weeks. Four weeks after the completion of chemoradiotherapy, patients proceed to adjuvant therapy.
- Adjuvant therapy: Patients receive oral temozolomide once daily on days 1-5. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
- Arm II:
- Chemoradiotherapy: Patients receive temozolomide and undergo radiotherapy as in arm I. Patients also receive vatalanib twice daily for 6 weeks at the MTD determined in phase I. Four weeks after the completion of chemoradiotherapy, patients proceed to adjuvant therapy. During the 4-week period between chemoradiotherapy and adjuvant therapy, patients continue to receive oral vatalanib twice daily.
- Adjuvant therapy: Patients receive temozolomide and vatalanib as in phase I adjuvant therapy. Patients then proceed to maintenance therapy.
- Maintenance therapy: Patients continue to receive vatalanib as in phase I maintenance therapy.
- Arm III:
- Chemoradiotherapy: Patients receive temozolomide and undergo radiotherapy as in arm I. Four weeks after the completion of chemoradiotherapy, patients proceed to adjuvant therapy. During the 4-week period between chemoradiotherapy and adjuvant therapy, patients receive oral vatalanib twice daily.
- Adjuvant therapy: Patients receive temozolomide and vatalanib as in phase I adjuvant therapy. Patients then proceed to maintenance therapy.
- Maintenance therapy: Patients continue to receive vatalanib as in phase I maintenance therapy.
After completion of study treatment, patients are followed every 3 months for survival. Published ResultsBrandes AA, Stupp R, Hau P, et al.: EORTC Study 26041-22041: phase I/II study on concomitant and adjuvant temozolomide (TMZ) and radiotherapy (RT) with or without PTK787/ZK222584 (PTK/ZK) in newly diagnosed glioblastoma: results of a phase I trial. [Abstract] J Clin Oncol 25 (Suppl 18): A-2026, 2007.
Trial Contact Information
Trial Lead Organizations European Organization for Research and Treatment of Cancer | | | Alba Brandes, MD, Protocol chair | | | |
Registry Information | | Official Title | | Phase I/II Study on Concomitant and Adjuvant Temozolomide and Radiotherapy With or Without PTK787/ZK222584 in Newly Diagnosed GBM | | Trial Start Date | | 2005-06-07 | | Trial Completion Date | | 2007-11-05 | | Registered in ClinicalTrials.gov | | NCT00128700 | | Date Submitted to PDQ | | 2005-06-14 | | Information Last Verified | | 2007-10-07 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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