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Tandutinib and Bevacizumab in Treating Patients With Recurrent High-Grade Glioma
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), October 2008
First Received: April 25, 2008   Last Updated: February 6, 2009   History of Changes
Sponsored by: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00667394
  Purpose

RATIONALE: Tandutinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. Giving tandutinib together with bevacizumab may kill more tumor cells.

PURPOSE: This phase II trial is studying the side effects of giving tandutinib together with bevacizumab and to see how well it works in treating patients with recurrent high-grade glioma.


Condition Intervention Phase
Brain and Central Nervous System Tumors
Biological: bevacizumab
Drug: tandutinib
Procedure: quality-of-life assessment
Phase II

MedlinePlus related topics: Cancer
Drug Information available for: Bevacizumab Tandutinib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label
Official Title: A Phase 2 Trial of Tandutinib in Combination With Bevacizumab for 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 ]

Secondary Outcome Measures:
  • Radiographic response rate [ Designated as safety issue: No ]

Estimated Enrollment: 80
Study Start Date: January 2008
Estimated Primary Completion Date: January 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To establish data regarding the antitumor activity of the combination of tandutinib and bevacizumab in patients with recurrent high-grade gliomas, as determined by progression-free-survival.
  • To obtain information regarding the safety of the combination of tandutinib and bevacizumab administered to patients with recurrent high-grade gliomas.

Secondary

  • To estimate the objective radiographic (MRI-based) response rate to single-agent therapy with tandutinib during the first 2 weeks of treatment.
  • To estimate the objective radiographic response rate to the combination of tandutinib and bevacizumab therapy.
  • To obtain preliminary data regarding how objective radiographic response rates correlate with progression-free survival.
  • To obtain preliminary data regarding how changes in serial PET scans correlate with changes in MRI scans and with progression-free survival.
  • To obtain preliminary data regarding how response to treatment (stable disease or radiographic response) affects monthly measurements of quality of life while on study.

OUTLINE: Patients receive oral tandutinib twice daily for 2 weeks. Patients then receive oral tandutinib twice daily in weeks 1-4 and bevacizumab IV over 30-90 minutes in weeks 1 and 3. Treatment with tandutinib and bevacizumab repeats every 4 weeks in the absence of disease progression or unacceptable toxicity.

Patients complete a health-related quality of life questionnaire.

After completion of study treatment, patients are followed periodically.

  Eligibility

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

DISEASE CHARACTERISTICS:

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

    • Glioblastoma multiforme
    • Gliosarcoma
    • Anaplastic astrocytoma
    • Anaplastic oligodendroglioma
    • Anaplastic mixed oligoastrocytoma
    • Malignant astrocytoma not otherwise specified
  • Must have evidence for tumor progression by MRI or CT scan
  • Prior recent resection of recurrent or progressive tumor allowed
  • Must have disease progression after prior radiotherapy

PATIENT CHARACTERISTICS:

Inclusion criteria:

  • Karnofsky performance status 60-100%
  • Life expectancy > 8 weeks
  • WBC ≥ 3,000/μL
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 10 g/dL (transfusion allowed)
  • SGOT < 2 times upper limit of normal (ULN)
  • Bilirubin < 2 times ULN
  • Creatinine < 1.5 mg/dL OR creatinine clearance > 60 cc/min
  • Serum sodium, calcium, potassium, chloride, and magnesium within normal limits
  • Proteinuria ≤ 1+ and urine protein:creatinine ratio ≤ 1.0 OR 24-hour urine protein < 1,000 mg
  • QTc < 460 msec by ECG
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for at least 6 months after completion of study treatment
  • PT/PTT ≤ 1.5 time the upper limit of normal

Exclusion criteria:

  • Any significant medical illnesses that, in the investigator's opinion, cannot be adequately controlled with appropriate therapy or would compromise the patient's ability to tolerate this therapy
  • Significant active cardiac, hepatic, renal, or psychiatric diseases
  • Known malignancy that has required treatment in the past 12 months and/or is expected to require treatment in the next 12 months (except nonmelanoma skin cancer or carcinoma in situ of the cervix)
  • Active infection
  • Any disease that will obscure toxicity (e.g., vasculitis, congenial hypercoagubility syndromes, uncontrolled primary hypertension, or idiopathic thrombocytopenia)
  • Evidence of significant recent hemorrhage on mandatory CT scan (defined as 1 cm or more of acute blood) of the brain within 7 days of patient accrual with the following exceptions:

    • Resolving hemorrhagic changes related to surgery
    • Presence of punctate hemorrhages in the tumor
  • Serious or non-healing wound, ulcer, or bone fracture
  • History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
  • Significant traumatic injury within the past 28 days
  • Clinically significant cardiovascular disease including:

    • History of cerebrovascular accident or transient ischemic attack within the past 6 months
    • Inadequately controlled hypertension (defined as systolic blood pressure [BP] >160 mm Hg and/or diastolic BP > 100 mm Hg on antihypertensive medications)
    • Any prior history of hypertensive crisis or hypertensive encephalopathy
    • Myocardial infarction or unstable angina within the past 6 months
    • New York Heart Association class II-IV congestive heart failure
    • Serious cardiac arrhythmia requiring medication
    • Unstable angina pectoris
    • Symptomatic peripheral vascular disease
  • Known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
  • Evidence of bleeding diathesis or coagulopathy
  • Known gastrointestinal (GI) disease or history of GI surgery that could interfere with the absorption of orally administered medication
  • Ongoing vomiting
  • Active cardiac disease, as defined by the following:

    • Significant cardiac event (including symptomatic heart failure or evidence of cardiac ischemia within 3 months of first dose) or presence of any cardiac disease that, in the opinion of the investigator, increases the risk of ventricular arrhythmia
    • Clinically significant arrhythmia (multifocal premature ventricular contraction, bigeminy, trigeminy, ventricular tachycardia, bradycardia) that is symptomatic or requires treatment (i.e., CTCAE grade 3), or asymptomatic sustained ventricular tachycardia
    • Previous history of QTc prolongation with other medication
    • Congenital long QT syndrome
    • Previous history of LVEF < 45% by MUGA or ECHO in patients with previous anthracycline therapy (total dose > 450 mg/m²) or significant cardiovascular disease or chest irradiation, as determined by the investigator
    • Cardiac arrhythmia serious enough to require therapy (i.e. drugs, AID), angina, symptomatic congestive heart failure, and/or a cardiac ejection fraction < 45%
    • Prior serious cardiac disease, defined as prior myocardial infarction unless a recent cardiac evaluation (within the past 3 months) demonstrated no significant coronary artery disease (i.e., a negative stress test) and no myocardial wall dysfunction
  • Known or suspected primary muscular or neuromuscular disease (e.g., muscular dystrophy or myasthenia gravis)

    • Steroid myopathy allowed

PRIOR CONCURRENT THERAPY:

Inclusion criteria:

  • See Disease Characteristics
  • Recovered from all prior therapy
  • At least 4 weeks since prior radiotherapy
  • At least 2 weeks since prior investigational agent
  • At least 4 weeks since prior cytotoxic therapy
  • At least 2 weeks since prior vincristine
  • At least 6 weeks since prior nitrosoureas
  • At least 3 weeks since prior procarbazine
  • At least 1 week since prior non-cytotoxic agents, including interferon, tamoxifen, thalidomide, or cis-retinoic acid (radiosensitizer does not count)

Exclusion criteria:

  • Prior coronary bypass surgery
  • Prior angioplasty
  • Prior bevacizumab
  • Major surgical procedure or open biopsy within the past 28 days
  • Core biopsy within the past 7 days
  • Concurrent major surgery
  • Concurrent chemotherapy, radiotherapy, immunotherapy, or investigational agents
  • Concurrent anti-coagulation or anti-platelet medication (including acetylsalicylic acid, non-steroidal anti-inflammatories, cyclooxygenase-2 inhibitors)
  • Concurrent use of other standard chemotherapeutics or investigative agents or vasoconstrictors for the treatment of migraine (ergotamine, zolmitriptan, sumatriptan)
  • Concurrent use of other drugs that have been shown to potentially prolong the QTc interval
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00667394

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office Recruiting
Bethesda, Maryland, United States, 20892-1182
Contact: Clinical Trials Office - Warren Grant Magnusen Clinical Center     888-NCI-1937        
Sponsors and Collaborators
Investigators
Principal Investigator: Howard A. Fine, MD NCI - Neuro-Oncology Branch
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000594111, NCI-08-C-0101, P07260
Study First Received: April 25, 2008
Last Updated: February 6, 2009
ClinicalTrials.gov Identifier: NCT00667394     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
adult anaplastic astrocytoma
adult diffuse astrocytoma
adult pilocytic astrocytoma
adult subependymal giant cell astrocytoma
adult anaplastic ependymoma
adult ependymoma
adult myxopapillary ependymoma
adult subependymoma
adult anaplastic oligodendroglioma
adult brain stem glioma
adult oligodendroglioma
adult giant cell glioblastoma
adult glioblastoma
adult gliosarcoma
adult mixed glioma
recurrent adult brain tumor

Study placed in the following topic categories:
Glioblastoma
Astrocytoma
Bevacizumab
Central Nervous System Neoplasms
Angiogenesis Inhibitors
Ependymoma
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 by Histologic Type
Antineoplastic Agents
Growth Substances
Physiological Effects of Drugs
Neoplasms, Nerve Tissue
Nervous System Diseases
Central Nervous System Neoplasms
Bevacizumab
Angiogenesis Inhibitors
Pharmacologic Actions
Neuroectodermal Tumors
Neoplasms
Neoplasms by Site
Therapeutic Uses
Neoplasms, Germ Cell and Embryonal
Growth Inhibitors
Angiogenesis Modulating Agents
Glioma
Neoplasms, Neuroepithelial
Nervous System Neoplasms
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on May 07, 2009