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Bevacizumab, Temozolomide and Hypofractionated Radiotherapy for Patients With Newly Diagnosed Malignant Glioma
This study is currently recruiting participants.
Verified by Memorial Sloan-Kettering Cancer Center, April 2009
First Received: October 29, 2008   Last Updated: April 2, 2009   History of Changes
Sponsors and Collaborators: Memorial Sloan-Kettering Cancer Center
Genentech
Information provided by: Memorial Sloan-Kettering Cancer Center
ClinicalTrials.gov Identifier: NCT00782756
  Purpose

The purpose of this study is to test the safety of a new plan for treating glioblastoma. The usual first treatment for glioblastoma is to give focused radiation over 6 weeks in combination with a chemotherapy called temozolomide. In this study the radiation will be given over 2 weeks in combination with temozolomide and another drug, bevacizumab, will also be given. Our idea is that this treatment plan may attack both the tumor and the blood vessels feeding the tumor more effectively. This study will look at what effects, good or bad, this approach has on the patient and the tumor.


Condition Intervention Phase
Brain Cancer
Malignant Glioma
Other: radiotherapy (RT) in combination with temozolomide and bevacizumab
Phase II

MedlinePlus related topics: Brain Cancer Cancer Radiation Therapy
Drug Information available for: Temozolomide Bevacizumab
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label, Single Group Assignment, Safety/Efficacy Study
Official Title: A Phase II Study of Bevacizumab, Temozolomide and Hypofractionated Radiotherapy for Patients With Newly Diagnosed Malignant Glioma

Further study details as provided by Memorial Sloan-Kettering Cancer Center:

Primary Outcome Measures:
  • To test the safety and feasibility of delivering bevacizumab and temozolomide in combination with hypo-fractionated radiotherapy to patients with newly diagnosed glioblastoma [ Time Frame: conclusion of the study ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Progression free survival [ Time Frame: conclusion of the study ] [ Designated as safety issue: No ]
  • Overall survival [ Time Frame: conclusion of the study ] [ Designated as safety issue: No ]
  • Neurocognitive outcome [ Time Frame: conclusion of the study ] [ Designated as safety issue: No ]

Estimated Enrollment: 25
Study Start Date: October 2008
Estimated Study Completion Date: October 2011
Estimated Primary Completion Date: October 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
RT, with temozolomide and bevacizumab: Experimental
This treatment regimen is novel in that it delivers the initial course of RT over 2 weeks instead of 6 weeks; also, the addition of bevacizumab during and after RT is a new approach.
Other: radiotherapy (RT) in combination with temozolomide and bevacizumab

Bevacizumab10 mg/kg IV once every two weeks on days 1 and 14 of every cycle (Cycle defined as 28 days). Temozolomide 75mg/m2 daily beginning on day 1 through completion of radiotherapy. Hypofractionated dose painting IMRT will start on day 1 and will be delivered on a Monday, Wednesday, Friday schedule for a total of 6 fractions. Post RT therapy: Bevacizumab 10mg/kg IV every two weeks. Temozolomide 150-200mg/m2 daily for 5 consecutive days will be given on 28 day cycles.

Follow up: CBC weekly, comprehensive metabolic panel, urinalysis and blood pressure every other week. Neurological/physical examination monthly.

Gd-enhanced MRI with perfusion every 2 cycles. Neurocognitive assessment at approximately 4-5 months post-surgery and then every 6 months.


  Eligibility

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

Inclusion Criteria:

  • Pathologic diagnosis of glioblastoma or grade IV glioma.
  • Tumor volume should be less than 60 cc (approximately 5cm maximum diameter).
  • Age > or = to 18
  • KPS > 60
  • Granulocyte count >1.5 X 10 9/L
  • Platelet count >99 X 10 9/L
  • SGOT < 2.5X upper limit of normal (ULN)
  • Serum creatinine < 2X ULN
  • Bilirubin < 2X ULN
  • All patients must sign written informed consent

Exclusion Criteria:

  • Any prior chemotherapy, radiotherapy and biologic therapy for glioma.
  • Any prior experimental therapy for glioma.
  • Tumor invasion of the corpus callosum.
  • Multicentric glioma
  • Other concurrent active malignancy (with the exception of cervical carcinoma in situ or basal cell ca of the skin).
  • Serious medical or psychiatric illness that would in the opinion of the investigator interfere with the prescribed treatment.
  • Pregnant or breast feeding women.
  • Refusal to use effective contraception
  • Inadequately controlled hypertension (defined as systolic blood pressure >150 mmHg and/or diastolic blood pressure > 100 mmHg)
  • Prior history of hypertensive crisis or hypertensive encephalopathy
  • New York Heart Association (NYHA) Grade II or greater congestive heart failure
  • History of myocardial infarction or unstable angina within 12 months prior to Day 1
  • History of stroke or transient ischemic attack
  • Significant vascular disease (e.g., aortic aneurysm, requiring surgical repair or recent peripheral arterial thrombosis) within 6 months prior to Day 1
  • History of hemoptysis (≥ 1/2 teaspoon of bright red blood per episode) within 1 month prior to Day 1
  • Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation)
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 1 of treatment or anticipation of need for major surgical procedure during the course of the study
  • Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to Day 1
  • History of abdominal fistula or gastrointestinal perforation within 6 months prior to Day 1
  • Serious, non-healing wound, active ulcer, or untreated bone fracture
  • Proteinuria as demonstrated by a UPC ratio ≥ 1.0 at screening
  • Known hypersensitivity to any component of bevacizumab
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00782756

Contacts
Contact: Lauren Abrey, MD abreyl@mskcc.org
Contact: Kathryn Beal, MD bealk@mskcc.org

Locations
United States, New Jersey
Memoral Sloan Kettering Cancer Center Recruiting
Basking Ridge, New Jersey, United States
Contact: Lauren Abrey, MD         abreyl@mskcc.org    
United States, New York
Memorial Sloan-Kettering Cancer Center Recruiting
New York, New York, United States, 10065
Contact: Lauren Abrey, MD         abreyl@mskcc.org    
Contact: Kathryn Beal, MD         bealk@mskcc.org    
Principal Investigator: Lauren Abrey, MD            
Memorial Sloan-Kettering Cancer Center at Commack Recruiting
Commack, New York, United States, 11725
Contact: Lauren Abrey, MD         abreyl@mskcc.org    
Sponsors and Collaborators
Memorial Sloan-Kettering Cancer Center
Genentech
Investigators
Principal Investigator: Lauren Abrey, MD Memorial Sloan-Kettering Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: Memorial Sloan-Kettering Cancer Center ( Lauren Abrey, MD )
Study ID Numbers: 08-126
Study First Received: October 29, 2008
Last Updated: April 2, 2009
ClinicalTrials.gov Identifier: NCT00782756     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by Memorial Sloan-Kettering Cancer Center:
Radiation
BEVACIZUMAB (AVASTIN)
TEMOZOLOMIDE

Study placed in the following topic categories:
Central Nervous System Diseases
Central Nervous System Neoplasms
Bevacizumab
Brain Diseases
Angiogenesis Inhibitors
Temozolomide
Brain Neoplasms
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neuroepithelioma
Glioma
Antineoplastic Agents, Alkylating
Alkylating Agents
Nervous System Neoplasms
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Neoplasms, Nerve Tissue
Central Nervous System Neoplasms
Bevacizumab
Brain Diseases
Neoplasms by Site
Neoplasms, Germ Cell and Embryonal
Therapeutic Uses
Growth Inhibitors
Glioma
Angiogenesis Modulating Agents
Alkylating Agents
Nervous System Neoplasms
Neoplasms by Histologic Type
Growth Substances
Nervous System Diseases
Central Nervous System Diseases
Temozolomide
Angiogenesis Inhibitors
Pharmacologic Actions
Neuroectodermal Tumors
Brain Neoplasms
Neoplasms
Antineoplastic Agents, Alkylating
Neoplasms, Neuroepithelial
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on May 07, 2009