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Ph I Dose Escalation Trial of Vandetanib in Combo w Etoposide for Malignant Gliomas
This study is currently recruiting participants.
Verified by Duke University, November 2008
Sponsors and Collaborators: Duke University
AstraZeneca
Information provided by: Duke University
ClinicalTrials.gov Identifier: NCT00613223
  Purpose

Primary Objective To determine maximum tolerated dose & dose limiting toxicity of vandetanib when combo w standard dosing of etoposide among pts w recurrent malignant glioma who are on & not on enzyme-inducing anti-epileptic drugs Secondary Objectives To assess safety & tolerability of vandetanib + etoposide in population To evaluate pharmacokinetics of vandetanib among malignant glioma pts on & not on EIAEDs when combo w etoposide Exploratory Objective To evaluate for evidence of anti-tumor activity of study regimen among recurrent malignant glioma pts including radiographic response rate, 6-month progression free survival rate & median PFS


Condition Intervention Phase
Gliosarcoma
Glioblastoma
Drug: Vandetanib and Etoposide
Phase I

MedlinePlus related topics: Cancer
Drug Information available for: Etoposide Etoposide phosphate Vandetanib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Active Control, Single Group Assignment, Safety/Efficacy Study
Official Title: Phase I Dose Escalation of Vandetanib (Zactima, ZD6474) in Combination With Etoposide for Malignant Gliomas

Further study details as provided by Duke University:

Primary Outcome Measures:
  • Safety, tolerability, biologic activity, & pharmacokinetic profile of vandetanib when used in combo w etoposide [ Time Frame: 6-month progression free survival ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 48
Study Start Date: February 2008
Estimated Study Completion Date: February 2012
Estimated Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
Pts taking EIAEDs
Drug: Vandetanib and Etoposide
Vandetanib will be given orally once day. Swallow tablet with 240 ml of non-carbonated water. Initial dose is 50 mg/day for stratum 1 & 200 mg/day for stratum 2. Etoposide will be taken by mouth in capsule form at dose of 50 mg/day for 1st 21 days of 28-day cycle. You will not take etoposide for following 7 days of the cycle. Everyone in study will receive dose of etoposide which is based on height & weight.
2: Experimental
Pts not taking EIAEDs
Drug: Vandetanib and Etoposide
Vandetanib will be given orally once day. Swallow tablet with 240 ml of non-carbonated water. Initial dose is 50 mg/day for stratum 1 & 200 mg/day for stratum 2. Etoposide will be taken by mouth in capsule form at dose of 50 mg/day for 1st 21 days of 28-day cycle. You will not take etoposide for following 7 days of the cycle. Everyone in study will receive dose of etoposide which is based on height & weight.

Detailed Description:

This is open-label, single center, 2-arm phase I dose-escalation study of vandetanib administered orally on continuous daily dosing schedule + oral etoposide among adult pts w recurrent/relapsing MG. Pts will be stratified based on whether they are receiving EIAEDs & each stratum will independently dose escalate. Dose of vandetanib will be increased in successive cohorts of patients. Etoposide will be given daily at dose of 50mg/day for 21 days followed by 7 days with no etoposide. Cohorts of 3-6 subjects will accrue at each dose level until MTD is defined. Subjects will be adult pts w histologically confirmed malignant glioma who are presenting at time of recurrence/relapse. Up to 48 subjects will be enrolled.

Sample size will be based on modified, classical "3+3" dose escalation design. Primary safety & efficacy analysis will be conducted on all subject data at time all subjects who are still receiving study drug will have completed at least 4 cycles of treatment. Most common AEs associated w vandetanib are rash, diarrhea, & asymptomatic QTc prolongation. Protracted oral dosing of etoposide is associated w toxicity that is mild in most pts & consists mainly of myelosuppression & diarrhea. Less commonly, protracted etoposide dosing has been associated w more significant hematologic toxicity.

  Eligibility

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

Inclusion Criteria:

Pts have baseline evaluations ≤14days prior to 1st dose of study drug unless otherwise specified

  • Pts w confirmed MG who are recurrence/relapse
  • Pts may not have stereotactic tumor biopsy <2wk/surgical resection/open biopsy <4wks before starting study drug
  • For stratum of non-EIAED pts, each pt must be off all EIAEDs for >2wks prior to starting study drug; similarly for stratum of EIAED pts, each pt must be on EIAED for >2 wks prior to starting study drug
  • Pts should be on non-increasing dose of steroids for >7 days prior to obtaining baseline Gd-MRI of brain
  • Pts should be on non-increasing dose of steroids for >7 days prior to starting study drug
  • Multifocal disease is eligible
  • Age ≥18yrs
  • KPS >70
  • Absolute Neutrophil Count >1.0 x 10 9/L
  • Hgb >9 g/dL
  • Platelets >100 x 10 9/L
  • Serum creatinine >1.5 x ULN or measured 24-hr CrCl >50mL/min/1.73m2
  • Life expectancy ≥12wks
  • Written informed consent obtained prior to screening procedures
  • Negative Beta-HCG pregnancy test for women of child-bearing potential

Exclusion Criteria:

  • Serum direct bilirubin >1.5 x ULN of reference range
  • Serum creatinine >1.5 x ULRR & CrCl <30 mL/min
  • Potassium, <4.0 mmol/L despite supplementation; serum calcium, /Mg out of normal range despite supplementation, Sodium <130 mmol/L
  • ALT or AST > 2.5 x ULRR or > 5 x ULRR if judged by investigator to be related to liver metastases
  • PT or PTT >1.5 x ULN of reference range

    -Evidence of severe/uncontrolled systemic disease or any concurrent condition which in Investigator's opinion makes it undesirable for pt to participate in trial/which would jeopardize compliance w protocol

  • Clinically significant cardiovascular event such as myocardial infarction, superior vena cava syndrome, New York Heart Association classification of heart disease >2 within 3 months before entry; or presence of cardiac disease that, in opinion of Investigator, increases risk of ventricular arrhythmia
  • History of arrhythmia which is symptomatic/requires treatment/asymptomatic sustained ventricular tachycardia. Atrial fibrillation, controlled on medication is not excluded
  • Previous history of QTc prolongation as result from other medication that required discontinuation of that medication
  • Congenital long QT syndrome, or 1st degree relative w unexplained sudden death <40yrs
  • Presence of left bundle branch block
  • Any concomitant medication that may cause QTc prolongation, induce Torsades de Pointes/induce CYP3A4 function except for EIAEDs
  • Hypertension not controlled by medical therapy
  • Currently active diarrhea that may affect ability of pt to absorb study regimen/tolerate diarrhea
  • Women who are currently pregnant/breast feeding
  • Previous/current malignancies of other histologies <5yrs, w exception of cervical carcinoma in situ & adequately treated basal cell/ squamous cell carcinoma of skin
  • Receipt of any investigational agents <30 days prior to commencing study treatment unless pt has recovered from all anticipated toxicities of investigational agent
  • Last dose of prior chemo discontinued <4wks before start of study therapy unless pt has recovered from all anticipated toxicities of chemo
  • Last XRT <4wks before start of study therapy, unless pt has recovered from all anticipated toxicities of XRT
  • Any unresolved toxicity >CTC gr1 from previous anti-cancer therapy
  • Previous enrollment/randomization of treatment in present study
  • Major surgery <4wks/incompletely healed surgical incision before starting study therapy
  • Pts taking warfarin sodium
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00613223

Contacts
Contact: James J Vredenburgh, MD (919) 681-3824 james.vredenburgh@duke.edu
Contact: Julie Norfleet (919) 668-0673 julie.norfleet@duke.edu

Locations
United States, North Carolina
Duke University Health System Recruiting
Durham, North Carolina, United States, 27710
Contact: James J Vredenburgh, MD     919-681-3824     james.vredenburgh@duke.edu    
Contact: Julie Norfleet     (919) 668-0673     julie.norfleet@duke.edu    
Principal Investigator: James J Vredenburgh, MD            
Sponsors and Collaborators
Duke University
AstraZeneca
Investigators
Principal Investigator: James J Vredenburgh, MD Duke University Health System
  More Information

The Preston Robert Tisch Brain Tumor Center at DUKE  This link exits the ClinicalTrials.gov site

Responsible Party: Duke University Health System ( James J Vredenburgh )
Study ID Numbers: 00001919
Study First Received: January 29, 2008
Last Updated: November 6, 2008
ClinicalTrials.gov Identifier: NCT00613223  
Health Authority: United States: Food and Drug Administration

Keywords provided by Duke University:
Gliosarcoma
Malignant Gliomas
Etopophos
Toposar
VePesid
Etoposide
Vandetanib
Zactima
ZD6474
VP-16
Brain Tumor
Recurring Malignant Brain Tumor
Glioblastoma
Glioma
Malignant Glioma
GBM

Study placed in the following topic categories:
Neuroectodermal Tumors
Brain Neoplasms
Glioblastoma
Astrocytoma
Neoplasms, Germ Cell and Embryonal
Neuroepithelioma
Glioma
Gliosarcoma
Etoposide phosphate
Etoposide
Recurrence
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Histologic Type
Antineoplastic Agents
Therapeutic Uses
Neoplasms, Nerve Tissue
Neoplasms, Neuroepithelial
Antineoplastic Agents, Phytogenic
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009