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FR901228 in Treating Patients With Recurrent High-Grade Gliomas
This study has been completed.
Sponsors and Collaborators: North American Brain Tumor Consortium
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00085540
  Purpose

RATIONALE: FR901228 may stop the growth of tumor cells by blocking the enzymes necessary for their growth.

PURPOSE: This phase I/II trial is studying the side effects and best dose of FR901228 and to see how well it works in treating patients with recurrent high-grade gliomas.


Condition Intervention Phase
Brain and Central Nervous System Tumors
Drug: romidepsin
Phase I
Phase II

MedlinePlus related topics: Cancer
Drug Information available for: FR 901228
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I-II Trial of Depsipeptide in Patients With Recurrent High-Grade Gliomas

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Progression-free survival at 6 months [ Designated as safety issue: No ]

Estimated Enrollment: 80
Study Start Date: July 2004
Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Group B (phase I): Experimental
Patients receive FR901228 (depsipeptide) IV over 4 hours on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: romidepsin
Given IV
Group A (phase II): Experimental
Patients receive FR901228 as in phase I at dose level 1.
Drug: romidepsin
Given IV
Group B (phase II): Experimental
Patients receive FR901228 as in phase I at the MTD.
Drug: romidepsin
Given IV

Detailed Description:

OBJECTIVES:

Phase I

  • Determine the maximum tolerated dose (MTD) of FR901228 (depsipeptide) in patients with recurrent malignant gliomas who are taking enzyme-inducing antiepileptic drugs (EIAEDs).
  • Determine the safety profile of this drug in these patients.
  • Determine the pharmacokinetics and pharmacodynamics of this drug in these patients.

Phase II

  • Determine the clinical efficacy of this drug, as measured by 6-month progression-free survival and objective tumor response, in these patients.
  • Determine the safety profile of this drug when administered at the phase I MTD concurrently with or without EIAEDs in these patients.

OUTLINE: This is a multicenter, phase I, dose-escalation study followed by a phase II study. Patients are stratified according to study phase (I vs II), concurrent use of enzyme-inducing anti-epileptic drugs (EIAEDs) (yes vs no), histology (recurrent glioblastoma multiforme/gliosarcoma vs recurrent anaplastic glioma), pre-operative candidacy (yes vs no), and measurable/evaluable disease (yes vs no). Patients are assigned to 1 of 2 treatment groups (group A: no EIAEDs or group B: concurrent use of EIAEDs).

  • Phase I (group B only): Patients receive FR901228 (depsipeptide) IV over 4 hours on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of FR901228 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of up to 6 patients experience dose-limiting toxicity.

  • Phase II (groups A and B):

    • Group A (phase II): Patients receive FR901228 as in phase I at dose level 1.
    • Group B (phase II): Patients receive FR901228 as in phase I at the MTD.

PROJECTED ACCRUAL: A total of 3-30 patients will be accrued for the phase I portion of this study within 8 months. A total of 50 patients (32 with recurrent glioblastoma multiforme and 18 with recurrent anaplastic gliomas) will be accrued to the phase II portion of this study within 6-8 months.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Phase I and phase II:

    • Histologically confirmed recurrent intracranial malignant glioma, including any of the following:

      • Glioblastoma multiforme
      • Gliosarcoma
      • Anaplastic astrocytoma
      • Anaplastic oligodendroglioma
      • Anaplastic mixed oligoastrocytoma
      • Malignant astrocytoma not otherwise specified
  • Unequivocal evidence of tumor progression by MRI or CT scan while on a steroid dosage that has been stable for at least 5 days
  • Patients previously treated with interstitial brachytherapy or stereotactic radiosurgery must have confirmation of true progressive disease (rather than radiation necrosis) by positron-emission tomography, thallium scan, magnetic resonance spectroscopy, or surgical documentation
  • Must have failed prior radiotherapy that was completed at least 6 weeks ago
  • No more than 2 prior therapies (initial treatment and treatment for 1 relapse)*

    • Surgical resection for relapsed disease with no anticancer therapy for up to 12 weeks, followed by a second surgical resection, is considered treatment for 1 relapse NOTE: *For patients who had prior therapy for a low-grade glioma, the surgical diagnosis of a high-grade glioma will be considered the first relapse
  • Patients in group B must have been receiving enzyme-inducing antiepileptic drugs (EIAEDs) for at least the past 2 weeks

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • Karnofsky 60-100%

Life expectancy

  • More than 8 weeks

Hematopoietic

  • WBC ≥ 3,000/mm^3
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 10 g/dL (transfusions allowed)

Hepatic

  • SGOT < 2 times upper limit of normal (ULN)
  • Bilirubin < 2 times ULN

Renal

  • Creatinine < 1.5 mg/dL

Cardiovascular

  • No congestive heart failure (i.e., New York Heart Association class II-IV, ejection fraction < 40% by MUGA scan or < 50% by echocardiogram and/or MRI)
  • No myocardial infarction within the past year
  • No uncontrolled dysrhythmias
  • No poorly controlled angina
  • No significant left ventricular hypertrophy by EKG
  • No cardiac ischemia (ST depression of 2 mm) by EKG
  • No hypertrophic or restrictive cardiomyopathy from prior treatment or other causes
  • No uncontrolled hypertension (i.e., blood pressure ≥ 160/95 mm Hg)
  • No cardiac arrhythmia requiring antiarrhythmic medication
  • No known cardiac abnormalities (e.g., congenital long QT syndrome and QTc interval > 480 milliseconds)
  • No history of sustained ventricular tachycardia, ventricular fibrillation, Torsade de Pointes, or cardiac arrest unless controlled with concurrent automatic implantable cardioverter defibrillator
  • No known history of coronary artery disease (e.g., Canadian class II-IV angina)
  • No other significant cardiac disease

Other

  • No other malignancy within the past 3 years except nonmelanoma skin cancer or carcinoma in situ of the cervix
  • No active infection
  • No significant uncontrolled medical illness that would preclude study participation
  • No disease that would obscure toxicity or dangerously alter drug metabolism
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception during and for at least 2 weeks after study participation

    • Fertile male patients must continue barrier contraception for 3 months after study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • At least 1 week since prior interferon or thalidomide
  • No concurrent prophylactic filgrastim (G-CSF)
  • No concurrent anticancer immunotherapy

Chemotherapy

  • At least 2 weeks since prior vincristine
  • At least 6 weeks since prior nitrosoureas
  • At least 3 weeks since prior procarbazine
  • No prior FR901228 (depsipeptide)
  • No other concurrent anticancer chemotherapy

Endocrine therapy

  • See Disease Characteristics
  • At least 1 week since prior tamoxifen
  • No concurrent anticancer hormonal therapy

Radiotherapy

  • See Disease Characteristics
  • No concurrent anticancer radiotherapy

Surgery

  • See Disease Characteristics
  • Prior recent resection of recurrent or progressive tumor allowed if patient has recovered

Other

  • Recovered from all prior therapy
  • At least 2 weeks since prior EIAEDs (patients in Group A only)
  • At least 4 weeks since prior cytotoxic therapy
  • At least 4 weeks since prior investigational agents
  • At least 1 week since prior isotretinoin
  • At least 1 week since other prior non-cytotoxic therapy (except radiosensitizers)
  • No concurrent valproic acid
  • No concurrent hydrochlorothiazide
  • No concurrent medication that causes QTc prolongation
  • No other concurrent anticancer therapy
  • No other concurrent investigational drugs
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00085540

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, 94143
United States, Massachusetts
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
Boston, Massachusetts, United States, 02115
United States, New York
Memorial Sloan - Kettering Cancer Center
New York, New York, United States, 10021
United States, North Carolina
Duke Comprehensive Cancer Center
Durham, North Carolina, United States, 27710
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
University of Texas Health Science Center at San Antonio
San Antonio, Texas, United States, 78284-6220
United States, Wisconsin
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
Madison, Wisconsin, United States, 53792-6164
Sponsors and Collaborators
North American Brain Tumor Consortium
Investigators
Study Chair: Howard A. Fine, MD NCI - Neuro-Oncology Branch
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site
Web site for additional information  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000370817, NABTC-0303, NCI-05-C-0098
Study First Received: June 10, 2004
Last Updated: December 25, 2008
ClinicalTrials.gov Identifier: NCT00085540  
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
recurrent adult brain tumor
adult anaplastic oligodendroglioma
adult anaplastic astrocytoma
adult mixed glioma
adult gliosarcoma
adult giant cell glioblastoma

Study placed in the following topic categories:
Glioblastoma
Astrocytoma
Romidepsin
Central Nervous System Neoplasms
Recurrence
Brain Neoplasms
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neuroepithelioma
Oligodendroglioma
Glioma
Gliosarcoma
Nervous System Neoplasms
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site
Neoplasms by Histologic Type
Antineoplastic Agents
Therapeutic Uses
Nervous System Diseases
Neoplasms, Nerve Tissue
Antibiotics, Antineoplastic
Neoplasms, Neuroepithelial
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009