Phase I Trial of Arsenic Trioxide and Stereotactic Radiotherapy for Recurrent Malignant Glioma

NCT00185861 | Completed Phase 1

• 3 other identifiers: BRNCNS000179756NCT00185861
• Study Type: interventional
• Target: 12
• Locations: 1 country
• Sites: 1

Brief Summary

To investigate the safety of delivering arsenic trioxide (ATO) in combination with stereotactic radiotherapy in recurrent malignant glioma by performing an open label, Phase I dose escalation trial. Results from this study will provide a basis for further study of ATO combined with radiation therapy as a radiosensitizer for malignant brain tumors in future Phase II studies.

Conditions

Brain Cancer

Outcome Measures

Primary Outcomes (2)

• Describe and define toxicities of ATO combined with radiotherapy in patients with recurrent malignant glioma.

• Define the maximum tolerated dose (MTD) of ATO combined with stereotactic radiotherapy for recurrent malignant glioma.

Secondary Outcomes (3)

• Evaluate time to progression and survival

• Evaluate radiographic tumor response rate

• Determine the recommended dose for investigation in a Phase II study

Interventions

Arsenic Trioxide DRUG

Stereotactic radiosurgery PROCEDURE

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Evidence of recurrent disease.
• All patients will have received previous conventional radiotherapy at least 3 weeks prior to enrollment. Histologic verification of malignant glioma is required. If the initial primary brain tumor was histologically malignant glioma and subsequent contrast enhanced MRI imaging shows tumor consistent with recurrence, additional biopsy or surgery is not required. However, if a low-grade neoplasm was the initial histologic diagnosis, tissue confirmation of malignant glioma is required at the time of recurrence.
• Age: Patients must be \>18 years of age
• Patients must have a Karnofsky \>60%, and/or ECOG performance status \<2
• Patients must have an estimated life expectancy of greater than 8 weeks.
• Patients must have normal organ and marrow functions as defined below:
• Leukocytes \>3,000/¼l
• Absolute neutrophil count \>1,500/¼l
• Hemoglobin \> 10 gm/dl
• Platelets \>100,000/¼l (transfusion independent)
• Total bilirubin within normal institutional limits
• AST (SGOT)/ALT (SGPT) \<1.5 X institutional upper limit of normal
• Creatinine within normal institutional limits OR
• Creatinine clearance \>60mL/min/1.73 m2 for patients with creatinine levels above institutional normal
• Serum potassium\* e 4.0mEq/L

You may not qualify if:

• Patients who have received prior radiosurgery or stereotactic radiotherapy within 10mm of the current target tumor.
• Patients may not be receiving any other investigational agents.
• Patients who cannot undergo MRI or CT are not eligible as MRI will be used to confirm the diagnosis and CT will be used for treatment planning.
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to arsenic trioxide or other agents used in study.
• Patients who are taking substances known to prolong the QT interval, see Appendix B. If the QT prolonging drug is discontinued and switched to an alternative agent, the patients will be allowed to enroll into this protocol as long the agent has been discontinued for a period of at least 2 weeks.
• Patients currently taking Amphotericin B or related antifungal agents will be excluded due to potential for increased renal electrolyte wasting during arsenic trioxide therapy.
• Patients with known second-degree heart block or other cardiac dysfunction. New York Heart Association Class II or greater (see Appendix E)
• Uncontrolled intercurrent illnesses including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or psychiatric illness/social situations that would limit compliance with study requirements. Phase I ATO Stereotactic Radiotherapy for Recurrent Malignant Glioma 17 of 44
• Patients must not be pregnant or breast-feeding. All patients with the potential for pregnancy should be counseled and requested to follow acceptable birth control methods (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Patients who are pregnant or breast-feeding will be excluded because no information on this agent exists with regard to safety of arsenic trioxide for a fetus or breast-feeding infant. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.

Sponsors & Collaborators

• Stanford University: lead
• Cephalon: collaborator
• CTI BioPharma: collaborator

Study Sites (1)

Stanford University School of Medicine

Stanford, California, 94305, United States

Location

MeSH Terms

Conditions

Brain Neoplasms

Interventions

Arsenic Trioxide; Radiosurgery

Condition Hierarchy (Ancestors)

Central Nervous System Neoplasms; Nervous System Neoplasms; Neoplasms by Site; Neoplasms; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Intervention Hierarchy (Ancestors)

Arsenicals; Inorganic Chemicals; Oxides; Oxygen Compounds; Radiotherapy; Therapeutics; Stereotaxic Techniques; Neurosurgical Procedures; Surgical Procedures, Operative; Investigative Techniques

Study Officials

• Iris Catrice Gibbs

  Stanford University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: September 12, 2005
• First Posted: September 16, 2005
• Study Start: December 1, 2003
• Primary Completion: January 1, 2008
• Study Completion: April 1, 2009
• Last Updated: April 9, 2009

Record last verified: 2009-04

Locations

US (1)