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Phase II Imatinib + Hydroxyurea in Treatment of Patients With Recurrent/Progressive Grade II Low-Grade Glioma (LGG)
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: Duke University
Novartis Pharmaceuticals
Information provided by: Duke University
ClinicalTrials.gov Identifier: NCT00615927
  Purpose

Primary objective:

  • To evaluate activity of imatinib mesylate and hydroxyurea among patients with progressive/recurrent grade II low-grade glioma (LGG) as measured by 12-month progression free survival

Secondary objectives:

  • To evaluate time to progression, overall survival and objective response rate among patients with progressive/recurrent grade II LGG treated with imatinib mesylate plus hydroxyurea
  • To assess safety and tolerability of imatinib mesylate + hydroxyurea in this population

Condition Intervention Phase
Glioblastoma
Gliosarcoma
Drug: Imatinib Mesylate & Hydroxyurea
Phase II

MedlinePlus related topics: Cancer
Drug Information available for: Hydroxyurea Imatinib Imatinib mesylate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Active Control, Single Group Assignment, Efficacy Study
Official Title: Phase II Study of Imatinib Mesylate Plus Hydroxyurea in the Treatment of Patients With Recurrent / Progressive Grade II Low-Grade Glioma

Further study details as provided by Duke University:

Primary Outcome Measures:
  • 12 month progression free survival [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • PI or his/her designee will analyze data [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  • Data summarized to demographic & baseline characteristics, efficacy observations & measurements, safety observations & measurements, & pharmacokinetic measurements [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
  • Safety & efficacy analysis [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 64
Study Start Date: February 2006
Estimated Study Completion Date: December 2009
Estimated Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
A: Experimental
Pts w gr II astrocytoma
Drug: Imatinib Mesylate & Hydroxyurea

Imatinib administered orally on daily. Imatinib is local irritant & must be taken in sitting position; mini of 2hrs should be allowed between last drug intake & going to bed. Imatinib doses 400mg/600mg administered once daily, whereas daily doses of 800mg/> administered as equally divided dose taken twice day. Dose for imatinib: Pts not receiving p450-inducing antiepileptic drugs: 400 mg/day. Pts receiving p450-inducing antiepileptic drugs: 500 mg twice day. It is recommended that pts take their prescribed imatinib mesylate at same time that they take their prescribed hydroxyurea, however, 30-60min interval between agents is acceptable if required for practical/other compliance issues.

Hydroxyurea administered orally twice day. Dosing will begin on day 1 of cycle 1 & continue daily. Drug is approximately 80 percent bioavailable. Dose will be 500mg twice day for all pts.

B: Experimental
Pts w oligodendroglioma/oligoastrocytomas
Drug: Imatinib Mesylate & Hydroxyurea

Imatinib administered orally on daily. Imatinib is local irritant & must be taken in sitting position; mini of 2hrs should be allowed between last drug intake & going to bed. Imatinib doses 400mg/600mg administered once daily, whereas daily doses of 800mg/> administered as equally divided dose taken twice day. Dose for imatinib: Pts not receiving p450-inducing antiepileptic drugs: 400 mg/day. Pts receiving p450-inducing antiepileptic drugs: 500 mg twice day. It is recommended that pts take their prescribed imatinib mesylate at same time that they take their prescribed hydroxyurea, however, 30-60min interval between agents is acceptable if required for practical/other compliance issues.

Hydroxyurea administered orally twice day. Dosing will begin on day 1 of cycle 1 & continue daily. Drug is approximately 80 percent bioavailable. Dose will be 500mg twice day for all pts.


Detailed Description:

This is an open-label, single stage, uncontrolled, non-randomized ph II study of continuous, daily doses of imatinib mesylate & hydroxyurea in adult pts w progressive/recurrent gr II LGG. Treatment cycle is defined as imatinib mesylate & hydroxyurea administered daily for 28 days for purpose of scheduling evaluations. All pts who receive 1/>doses of either imatinib mesylate/hydroxyurea will be evaluable for toxicity, whereas all pts who receive mini of 14 consecutive days of study regimen will be evaluable for response. Pts who discontinue therapy prior to receiving 14 consecutive days of study regimen will be regarded as ineligible for evaluation of response & will be replaced.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Pts w gr II LGG that is recurrent/progressive following prior surgical resection while on non-decreasing dose of corticosteroids
  • >25percent enlargement of bidimensional measure/new lesions on sequential imaging new &/or worsening neurologic deficits
  • Pts w progressive/recurrent optic pathway tumors
  • Pts have measurable disease on MRI/CT
  • Interval of >4 wks between prior XRT/chemo,& enrollment on protocol unless there is unequivocal evidence of tumor progression & pt has recovered from all expected toxicities associated w prior therapy. Pts treated w chemo agents such as VP-16 who would normally be retreated after shorter intervals may be treated at usual starting time even if <4 wks from last prior dose of chemo
  • Pts not have had tumor biopsy <1 wk/surgical resection <2 wks prior to starting study drug
  • Pts enrolling on arm B must be on >1 enzyme inducing anticonvulsants 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 >18 yrs
  • KPS of >60
  • ANC >1.5 x 10 9/L
  • Hgb >9 g/dL
  • Platelets >100 x 10 9/L
  • K ≥LLN/correctable w supplements
  • Ca ≥LLN/correctable w supplements
  • P ≥LLN/correctable w supplements
  • AST/SGOT & ALT/SGPT <2.5 x ULN
  • Serum bilirubin <1.5 x ULN
  • Serum creatinine <1.5 x ULN/measured 24hr CrCl >50 mL/min/1.73m2
  • Life expectancy ≥12wks
  • Written informed consent obtained prior to screening procedures

Exclusion Criteria:

  • Prior progressive disease/toxicity gr ≥3 w prior hydroxyurea therapy
  • Prior treatment w imatinib/other PDGF-directed therapy
  • Excessive risk of bleeding as defined by stroke <6 mths, history of CNS/intraocular bleed, or septic endocarditis
  • Evidence of intratumor hemorrhage on pretreatment diagnostic imaging, except for stable post-operative gr1 hemorrhage
  • Pregnant/breast feeding, /adults of reproductive potential not employing effective method of birth control
  • Concurrent severe and/or uncontrolled medical disease that could compromise participation in study
  • Acute/chronic liver disease
  • Confirmed diagnosis of HIV infection
  • Impairment of GI function/GI disease that may significantly alter absorption of imatinib
  • Pts taking Coumadin
  • Pts have received investigational drugs <2wks prior to entry on study/have not recovered from toxic effects of such therapy
  • Pts have received biologic, immunotherapeutic/cytostatic agents <1 wk prior to entry on study/have not recovered from toxic effects of such therapy
  • Pt >5 yrs free of another primary malignancy except: if other primary malignancy is not currently clinically significant/requiring active intervention, or if other primary malignancy is basal cell skin cancer/ cervical carcinoma in situ. Existence of any other malignant disease is not allowed
  • Pts have had any surgery other than resection of brain tumor <2 wks prior to entry on study/have not recovered from side effects of such therapy
  • Pts unwilling to/unable to comply w protocol
  • Active systemic bleeding, such as GI bleeding/gross hematuria
  • Gr2 /> peripheral edema/central/systemic fluid collections
  • Pts who enroll on arm A must have not received any EIAC for >2 wks prior to starting study regimen
  • Any of following exclusion criteria to MRI imaging:Cardiac pacemaker, Ferromagnetic metal implants other than those approved as safe for use in MR scanners, Claustrophobia, Obesity
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00615927

Locations
United States, North Carolina
Duke University Health System
Durham, North Carolina, United States, 27710
Sponsors and Collaborators
Duke University
Novartis Pharmaceuticals
Investigators
Principal Investigator: David A. Reardon, 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 ( David A. Reardon, MD )
Study ID Numbers: 7262-07-7R2
Study First Received: February 3, 2008
Last Updated: November 23, 2008
ClinicalTrials.gov Identifier: NCT00615927  
Health Authority: United States: Institutional Review Board

Keywords provided by Duke University:
Gliosarcoma
Glioblastoma
GBM
Imatinib Mesylate
Gleevec
Hydroxyurea
Droxia
Hydrea
Hydroxycarbamide
Imatinib
Brain tumor
Malignant brain tumor
Recurrent glioblastoma multiforme
Progressive glioblastoma multiforme

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

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Antisickling Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Neoplasms, Nerve Tissue
Hematologic Agents
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions
Neoplasms
Therapeutic Uses
Neoplasms, Neuroepithelial
Nucleic Acid Synthesis Inhibitors

ClinicalTrials.gov processed this record on January 16, 2009