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VEGF Trap in Treating Patients With Recurrent Malignant Gliomas That Did Not Respond to Temozolomide
This study is ongoing, but not recruiting participants.
First Received: August 24, 2006   Last Updated: July 25, 2009   History of Changes
Sponsored by: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00369590
  Purpose

RATIONALE: VEGF Trap may stop the growth of malignant or anaplastic gliomas by blocking blood flow to the tumor.

PURPOSE: This phase II trial is studying how well VEGF Trap works in treating patients with recurrent malignant or anaplastic gliomas that did not respond to temozolomide.


Condition Intervention Phase
Brain and Central Nervous System Tumors
Biological: aflibercept
Phase II

Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase II Single Arm Trial of VEGF Trap in Patients With Recurrent Temozolomide-Resistant Malignant Gliomas

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Progression-free survival (PFS) at 6 months [ Designated as safety issue: No ]
  • Toxicity [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Efficacy as measured by radiographic response, PFS, time to progression, and overall survival [ Designated as safety issue: No ]
  • Tumor response as assessed by MRI and neurologic exam [ Designated as safety issue: No ]
  • Pharmacokinetics (single-dose and repeated-dose) [ Designated as safety issue: No ]

Estimated Enrollment: 45
Study Start Date: August 2006
Estimated Primary Completion Date: July 2007 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the therapeutic efficacy of VEGF Trap in patients with temozolomide-resistant malignant gliomas at first recurrence as measured by 6-month progression-free survival (PFS).
  • Determine the safety profile of VEGF Trap in these patients.

Secondary

  • Determine the efficacy of this regimen as measured by radiographic response, PFS, time to progression, and overall survival.
  • Characterize the single-dose and repeated-dose pharmacokinetic profiles of VEGF Trap in these patients.

Tertiary

  • Determine the therapeutic efficacy of VEGF Trap in patients with temozolomide-resistant anaplastic glioma at first recurrence as measured by 6-month PFS.

OUTLINE: This is a multicenter study. Patients are stratified according to histology (glioblastoma vs anaplastic glioma).

Patients receive VEGF Trap IV over 1 hour on day 1. Treatment repeats every 14 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed periodically.

PROJECTED ACCRUAL: A total of 45 patients will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed diagnosis of 1 of the following:

    • Intracranial glioblastoma or gliosarcoma*
    • Anaplastic astrocytoma*
    • Anaplastic oligodendroglioma*
    • Anaplastic mixed oligoastrocytoma*
    • Malignant astrocytoma not otherwise specified* NOTE: *If original histology was grade 3 glioma, subsequent histological diagnosis of 1 of these diseases is allowed provided no prior diagnosis of grade 2 glioma
  • At least 20 unstained slides OR 1 tissue block available from original diagnostic biopsy/surgery or from biopsy/surgery at recurrence
  • Patients presenting at the time of first recurrence or relapse, defined as progression after initial therapy (i.e., radiotherapy +/- chemotherapy if that was used as initial therapy) are eligible

    • No more than 1 prior chemotherapy regimen (initial treatment and treatment for 1 relapse)
    • Surgical resection for relapsed disease with no anticancer therapy instituted for up to 12 weeks followed by another surgical resection is considered 1 relapse
    • If prior therapy for a grade 3 glioma was given, surgical diagnosis of a high-grade glioma is considered the first relapse
    • Prior surgical, interstitial brachytherapy, or stereotactic radiosurgery not considered prior therapy

      • If prior therapy included interstitial brachytherapy or stereotactic radiosurgery, must have confirmation of true progressive disease rather than radiation necrosis based upon either positron emission tomography (PET) scan, thallium scanning, MR spectroscopy, or surgical documentation of disease
  • Must show unequivocal radiographic evidence of tumor progression by MRI
  • Recent resection of recurrent or progressive tumor allowed

    • Residual disease not required
  • Must have failed prior radiotherapy
  • Must have failed prior treatment with temozolomide

    • Temozolomide-resistant recurrent glioblastoma is defined as tumor progression or tumor recurrence during or after treatment with temozolomide-based chemotherapy regimens

PATIENT CHARACTERISTICS:

  • Karnofsky performance status 60-100%
  • Life expectancy > 8 weeks
  • WBC ≥ 3,000/mm³
  • Absolute neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 10 g/dL (transfusion allowed)
  • SGOT/SGPT < 2 times upper limit of normal (ULN)
  • Bilirubin < 2 times ULN
  • Creatinine < 1.5 mg/dL OR creatinine clearance ≥ 60 mL/min
  • Urine protein:creatinine ratio < 1 OR 24-hour urine protein < 500 mg/dL
  • INR ≤ 1.5
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception prior to, during, and for ≥ 6 months after completion of study treatment
  • No significant medical illnesses that, in the opinion of the investigator, cannot be adequately controlled with appropriate therapy or would preclude compliance with study treatment
  • No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
  • No history of allergic reactions attributed to compounds of similar chemical or biological composition to other agents used in the study
  • No history of any other cancer (except nonmelanoma skin cancer or carcinoma in situ of the cervix), unless in complete remission and off of all therapy for that disease for ≥ 3 years
  • No uncontrolled intercurrent illness, including, but not limited to, any of the following:

    • Ongoing or active infection
    • Psychiatric illness or social situations that would limit compliance with study requirements
  • No serious or nonhealing wound, ulcer, or bone fracture
  • No history of intracerebral or intratumoral hemorrhage
  • No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days
  • No significant traumatic injury within the past 28 days
  • No clinically significant cardiovascular disease, including any of the following:

    • Cerebrovascular accident within the past 6 months
    • Uncontrolled hypertension, defined as blood pressure (BP) > 140/90 mm Hg or systolic BP > 180 mm Hg if diastolic BP < 90 mm Hg, on ≥ 2 repeated determinations on separate days within the past 3 months
    • Myocardial infarction, coronary artery bypass graft (CABG), or unstable angina pectoris within the past 6 months
    • New York Heart Association class III-IV congestive heart failure
    • No serious cardiac arrhythmia requiring medication
    • Clinically significant peripheral vascular disease within the past 6 months
    • Pulmonary embolism, deep vein thrombosis, or other thromboembolic event within the past 6 months
  • No evidence of bleeding diathesis or coagulopathy
  • No other disease that would obscure toxicity or dangerously alter drug metabolism

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from prior therapy
  • No prior VEGF Trap
  • At least 28 days since prior cytotoxic therapy
  • At least 14 days since prior vincristine
  • At least 42 days since prior nitrosoureas
  • At least 21 days since prior procarbazine
  • At least 7 days since prior noncytotoxic agents (e.g., interferon, tamoxifen, thalidomide, or isotretinoin [radiosensitizer does not count])
  • At least 28 days since prior major surgery or open biopsy
  • At least 7 days since prior core biopsy
  • At least 28 days since prior investigational agents
  • At least 42 days since prior radiotherapy
  • No prior polifeprosan 20 with carmustine implant (Gliadel wafers)
  • No prior bevacizumab or vascular endothelial growth factor receptor inhibitors
  • No concurrent full-dose anticoagulants (e.g., warfarin or low molecular-weight heparin)
  • No other concurrent investigational drugs
  • No concurrent cytotoxic or noncytotoxic therapy, including chemotherapy, radiotherapy, hormonal therapy, or immunotherapy
  • No concurrent major surgery
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • Concurrent anticonvulsant therapy allowed
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00369590

Locations
United States, California
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California, United States, 94115
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
Bethesda, Maryland, United States, 20892-1182
United States, Massachusetts
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
Boston, Massachusetts, United States, 02115
United States, New York
Memorial Sloan-Kettering Cancer Center
New York, New York, United States, 10021
United States, North Carolina
Duke Comprehensive Cancer Center
Durham, North Carolina, United States, 27710
United States, Pennsylvania
UPMC Cancer Centers
Pittsburgh, Pennsylvania, United States, 15232
United States, Texas
M. D. Anderson Cancer Center at University of Texas
Houston, Texas, United States, 77030-4009
University of Texas Health Science Center at San Antonio
San Antonio, Texas, United States, 78284-6220
United States, Wisconsin
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
Madison, Wisconsin, United States, 53792
Sponsors and Collaborators
Investigators
Study Chair: John F. deGroot, MD M.D. Anderson Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: Adult Brain Tumor Consortium ( Michael Prados )
Study ID Numbers: CDR0000495275, ABTC-0601, NABTC-0601
Study First Received: August 24, 2006
Last Updated: July 25, 2009
ClinicalTrials.gov Identifier: NCT00369590     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
adult giant cell glioblastoma
adult gliosarcoma
adult anaplastic oligodendroglioma
recurrent adult brain tumor
adult anaplastic astrocytoma
adult mixed glioma

Study placed in the following topic categories:
Glioblastoma
Astrocytoma
Central Nervous System Neoplasms
Temozolomide
Recurrence
Brain Neoplasms
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neuroepithelioma
Oligodendroglioma
Antineoplastic Agents, Alkylating
Glioma
Gliosarcoma
Alkylating Agents
Nervous System Neoplasms
Neoplasms, Glandular and Epithelial

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

ClinicalTrials.gov processed this record on August 12, 2009