Phase I Study of Polifeprosan 20 With Carmustine Implant (Gliadel) and O(6)-Benzylguanine in Pediatric Patients With Recurrent Malignant Glioma
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outline Trial Contact Information Registry Information
Alternate Title
Carmustine Implants and O(6)-Benzylguanine in Treating Children With
Recurrent Malignant Glioma
Basic Trial Information
Phase | Type | Status | Age | Protocol IDs |
---|
Phase I | Treatment | Completed | 3 to 21 | PBTC-009 NCT00045721 |
Objectives - Determine the dose of O(6)-benzylguanine that reliably inhibits alkylguanine-DNA alkyltransferase activity in pediatric patients with recurrent malignant glioma.
- Determine the toxic effects of O(6)-benzylguanine and polifeprosan 20 with carmustine implant (Gliadel) in these patients.
- Determine antitumor response in patients treated with this regimen.
Entry Criteria Disease Characteristics:
- Histologically confirmed progressive supratentorial anaplastic astrocytoma or
glioblastoma multiforme
- No multifocal disease or leptomeningeal dissemination of tumor
- No evidence of tumor crossing midline
- Limited intraventricular involvement
- Measurable unilateral mass at least 10 mm by contrast-enhanced MRI
- Received prior involved-field radiotherapy as a component of prior therapy
- Amenable to and in need of significant debulking
Prior/Concurrent Therapy:
Biologic therapy - At least 6 months since prior bone marrow transplantation
- More than 2 weeks since prior colony-stimulating growth factors (e.g.,
filgrastim (G-CSF), sargramostim (GM-CSF), or epoetin alfa)
Chemotherapy - No more than 2 prior cytotoxic chemotherapy regimens
- No more than 3 prior chemotherapy regimens total
- More than 3 weeks since prior myelosuppressive chemotherapy (6 weeks for
nitrosoureas) and recovered
- Prior systemic carmustine (or other nitrosourea) allowed provided patient did
not experience non-hematopoietic grade III/IV toxicity
Endocrine therapy - Concurrent dexamethasone allowed if on a stable dose for at least the past
week
Radiotherapy - See Disease Characteristics
- At least 3 months since prior radiotherapy
- No prior craniospinal irradiation for metastatic disease
Surgery - See Disease Characteristics
- Prior biopsy or cytoreductive surgery allowed
Other - Concurrent anticonvulsants allowed
- No other concurrent anticancer or investigational drugs
Patient Characteristics:
Age Performance status - Karnofsky 60-100% OR
-
Lansky 60-100%
Life expectancy Hematopoietic - Absolute neutrophil count greater than 1,000/mm3*
- Platelet count greater than 100,000/mm3*
- Hemoglobin greater than 8 g/dL (transfusions allowed)
[Note: * Transfusion independent
] Hepatic - Bilirubin no greater than 1.5 times normal
- AST and ALT less than 3 times normal
- Albumin at least 2 g/dL
-
No overt hepatic disease
Renal - Creatinine clearance no greater than 1.5 times normal OR
-
Glomerular filtration rate greater than 70 mL/min
- No overt renal disease
Cardiovascular Pulmonary - No overt pulmonary disease
Other - Neurological deficits must be stable for at least the past week
- No uncontrolled infection
- No known hypersensitivity to nitrosoureas or polyethylene glycol
- Not pregnant or nursing
-
Negative pregnancy test
- Fertile patients must use effective contraception
Expected Enrollment Approximately 20 patients will be accrued for this study within 2 years. Outline This is a multicenter, dose-escalation study of O(6)-benzylguanine. Patients receive O(6)-benzylguanine (O6-BG) IV over 1 hour immediately followed by O6-BG IV continuously for 9 days. Two days after initiation of continuous infusion of O6-BG, patients undergo maximal tumor debulking. At the time of surgery, patients receive up to 8 polifeprosan 20 wafers with carmustine (Gliadel) implanted into the resection cavity. Cohorts of up to 14 patients receive escalating doses of continuous infusion O6-BG until the optimally biologically effective dose (BED) is determined. The BED is defined as the dose at which at least 11 of 14 patients meet the target of complete suppression of alkylguanine-DNA alkyltransferase levels. Patients are followed at day 11, at weeks 2, 4, 6, 8, and 12, at months 6, 9, and 12, every 6 months for 4 years, and then annually for 5 years.
Trial Contact Information
Trial Lead Organizations Pediatric Brain Tumor Consortium ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) | Ian Pollack, MD, Protocol chair | ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) | | ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) |
Registry Information | ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) | Official Title | | Phase I Trial of GLIADEL and O(6)-Benzylguanine in Pediatric Patients with Recurrent Malignant Gliomas | ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) | Trial Start Date | | 2003-03-03 | ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) | Registered in ClinicalTrials.gov | | NCT00045721 | ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) | Date Submitted to PDQ | | 2002-07-11 | ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) | Information Last Verified | | 2004-07-19 | ![](https://webarchive.library.unt.edu/eot2008/20090513051619im_/http://www.cancer.gov/images/spacer.gif) | NCI Grant/Contract Number | | U01-CA81457 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |