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Vorinostat and Bortezomib in Treating Patients With Progressive, Recurrent Glioblastoma Multiforme
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), January 2009
Sponsors and Collaborators: North Central Cancer Treatment Group
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00641706
  Purpose

RATIONALE: Vorinostat and bortezomib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving vorinostat together with bortezomib may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving vorinostat together with bortezomib works in treating patients with progressive, recurrent glioblastoma multiforme.


Condition Intervention Phase
Brain and Central Nervous System Tumors
Drug: bortezomib
Drug: vorinostat
Procedure: therapeutic conventional surgery
Phase II

MedlinePlus related topics: Cancer
Drug Information available for: Suberoylanilide hydroxamic acid Bortezomib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase II Study of Vorinostat (SAHA) in Combination With Bortezomib (PS-341) in Patients With Recurrent Glioblastoma Multiforme

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

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

Secondary Outcome Measures:
  • Overall survival [ Designated as safety issue: No ]
  • Progression-free survival at 12 and 18 months [ Designated as safety issue: No ]
  • Confirmed tumor response (complete response, partial response, or regular response on two consecutive evaluations over at least 6 weeks) [ Designated as safety issue: No ]

Estimated Enrollment: 68
Study Start Date: July 2008
Estimated Primary Completion Date: August 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Stratum 1 (not undergoing surgery): Experimental
Patients receive oral vorinostat (SAHA) once daily on days 1-14 and bortezomib IV on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Drug: bortezomib
Vorinostat given orally. Bortezomib given IV
Drug: vorinostat
Vorinostat given orally. Bortezomib given IV
Stratum 2 (undergoing surgery): Experimental
Patients receive oral SAHA once daily for 2 days prior to surgery and then on the day of surgery. Patients also receive bortezomib IV on the day of surgery. After receiving the 3rd dose of SAHA, patients undergo surgery to remove the tumor. Beginning at least 7 days after surgery, patients receive SAHA and bortezomib as in stratum 1.
Drug: bortezomib
Vorinostat given orally. Bortezomib given IV
Drug: vorinostat
Vorinostat given orally. Bortezomib given IV
Procedure: therapeutic conventional surgery
Patient undergoes surgery

Detailed Description:

OBJECTIVES:

Primary

  • To determine the clinical efficacy of vorinostat (SAHA) and bortezomib, in terms of progression-free survival (PFS) at 6 months, in patients with progressive, recurrent glioblastoma multiforme.

Secondary

  • To determine the clinical efficacy of this regimen, in terms of overall survival, PFS at 12 months, time to progression, and objective response rate, in these patients.
  • To identify molecular predictors of response in baseline tumor specimens from these patients.
  • To determine molecular changes in response to this regimen in tumor specimens from patients undergoing surgery.

OUTLINE: This is a multicenter study. Patients are stratified according to planned surgery (no [stratum 1] vs yes [stratum 2]).

  • Stratum 1 (not undergoing surgery): Patients receive oral vorinostat (SAHA) once daily on days 1-14 and bortezomib IV on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
  • Stratum 2 (undergoing surgery): Patients receive oral SAHA once daily for 2 days prior to surgery and then on the day of surgery. Patients also receive bortezomib IV on the day of surgery. After receiving the 3rd dose of SAHA, patients undergo surgery to remove the tumor. Beginning at least 7 days after surgery, patients receive SAHA and bortezomib as in stratum 1.

Tumor tissue samples are collected at baseline and during surgery (stratum 2) for correlative laboratory studies. Tissue samples are analyzed for baseline total and phosphorylated AKT and p27^KIp1 expression by IHC. Tissue samples from patients in stratum 2 are also analyzed for histone acetylation status; markers of proteasome inhibition; total and phosphorylated Bax expression by IHC; and gene expression profiles.

After completion of study therapy, patients are followed every 3 months for 2 years and then every 6 months for up to 13 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed glioblastoma multiforme

    • Gliosarcoma or other grade 4 astrocytoma variant (e.g., giant cell glioblastoma) allowed
    • Recurrent disease
  • Must have evidence of tumor progression by MRI or CT scan after radiotherapy or after the most recent antitumor therapy
  • Bidimensionally measurable or evaluable disease by MRI or CT scan

    • Patients receiving corticosteroids must be on a fixed dose for at least 1 week prior to baseline scan

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • WBC ≥ 3,000/mm³
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 9 g/dL
  • Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • AST ≤ 3 times ULN
  • Creatinine normal
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 6 months after the last dose of vorinostat
  • Willing to provide mandatory correlative laboratory tissue samples
  • Able to take oral medications
  • No uncontrolled infection
  • No known hypersensitivity to any of the components of vorinostat or bortezomib
  • No myocardial infarction or unstable angina within the past 6 months
  • No congestive heart failure requiring use of ongoing maintenance therapy or history of life-threatening ventricular arrhythmias
  • No concurrent uncontrolled illness including, but not limited to, any of the following:

    • Ongoing or active infection
    • Psychiatric illness or social situation that would limit compliance with study requirements
  • No other active malignancy within the past 3 years except nonmelanoma skin cancer or carcinoma in situ of the cervix
  • No comorbid systemic illness or other severe concurrent disease that, in the judgment of the investigator, would preclude study entry or significantly interfere with proper assessment of safety and toxicity of the prescribed study regimens
  • Not immunocompromised

    • Patients known to be HIV positive are eligible provided there is no clinical evidence of an immunocompromised state
  • No peripheral neuropathy ≥ grade 2
  • No peripheral neuropathy with pain ≥ grade 1
  • No congenital long QT syndrome
  • No prolonged OTC interval (> 450 msec)

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • At least 8 weeks since prior radiotherapy
  • More than 6 weeks since prior stereotactic radiosurgery or interstitial brachytherapy, unless there is a separate lesion on MRI that is not part of the prior treatment field
  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas)
  • No more than 1 prior chemotherapy regimen* for progressive/recurrent disease (stratum 1)

    • Patients in stratum 2 may have received any number of prior chemotherapy regimens* for progressive/recurrent disease
  • More than 2 weeks since prior valproic acid
  • More than 2 weeks since prior small molecule cell cycle inhibitors
  • More than 7 days since prior category I drugs that are generally accepted to have a risk of causing Torsades de Pointes including:

    • Quinidine, procainamide, disopyramide
    • Amiodarone, sotalol, ibutilide, dofetilide
    • Erythromycin, clarithromycin
    • Chlorpromazine, haloperidol, mesoridazine, thioridazine, pimozide
    • Cisapride, bepridil, droperidol, methadone, arsenic, chloroquine, domperidone, halofantrine, levomethadyl, pentamidine, sparfloxacin, lidoflazine
  • More than 4 weeks since prior bevacizumab
  • No prior treatment with vorinostat or botezomib
  • No concurrent enzyme-inducing antiepileptic drugs (e.g., phenytoin, fosphenytoin, carbamazepine, phenobarbital, or primidone)
  • No other concurrent potent CYP3A4 inducer (e.g., rifampin or St. John's wort)
  • No other concurrent investigational therapy for the primary neoplasm
  • No other concurrent anticancer therapy (other than hormonal therapy) NOTE: *Prior adjuvant therapy allowed; adjuvant therapy does not count towards the number of prior chemotherapy regimens for progressive/recurrent disease
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00641706

  Show 202 Study Locations
Sponsors and Collaborators
North Central Cancer Treatment Group
Investigators
Study Chair: Evanthia Galanis, MD Mayo Clinic
  More Information

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

Study ID Numbers: CDR0000590113, NCCTG-N0779
Study First Received: March 21, 2008
Last Updated: January 15, 2009
ClinicalTrials.gov Identifier: NCT00641706  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
adult gliosarcoma
adult glioblastoma
recurrent adult brain tumor
adult giant cell glioblastoma

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

Additional relevant MeSH terms:
Anticarcinogenic Agents
Anti-Inflammatory Agents
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Neoplasms, Nerve Tissue
Nervous System Diseases
Physiological Effects of Drugs
Enzyme Inhibitors
Protective Agents
Pharmacologic Actions
Protease Inhibitors
Neoplasms
Neoplasms by Site
Analgesics, Non-Narcotic
Sensory System Agents
Therapeutic Uses
Anti-Inflammatory Agents, Non-Steroidal
Analgesics
Peripheral Nervous System Agents
Antirheumatic Agents
Neoplasms, Neuroepithelial
Central Nervous System Agents

ClinicalTrials.gov processed this record on January 16, 2009