Nuvigil or Placebo in Newly Diagnosed Malignant Glioma

NCT01400958 | Terminated Phase 2 Results DMC

• 2 other identifiers: MCC-16233C10953/6253
• Study Type: interventional
• Target: 6
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine if Nuvigil® improves fatigue experienced by people receiving external beam radiation therapy for the treatment of malignant gliomas. It is also being done to determine if Nuvigil® improves cognitive function (perception, thinking, reasoning, and remembering) and overall quality of life in people receiving external beam radiation therapy for the treatment of malignant gliomas. Another purpose of this study is to see if people who receive Nuvigil® have more or less side effects than people who receive placebo. Placebo is a substance that looks like an active drug but has no active ingredient.

Conditions

Malignant Glioma

Keywords

fatigue; external beam radiation; EBRT; radiation therapy; placebo; cognitive function; TMZ; Temozolomide

Outcome Measures

Primary Outcomes (1)

• Occurrence of Improved Fatigue Experience After Treatment

  Determine if Nuvigil® improves fatigue experienced by patients receiving external beam radiation therapy for the treatment of malignant gliomas. Participants who maintained minimal, or experienced improved fatigue experience on a scale of 0 (No fatigue) - 10 (As bad as you can imagine).

  5 months

Secondary Outcomes (1)

• Occurrence of Improved Cognitive Performance

  5 months

Study Arms (2)

A: Nuvigil®

ACTIVE COMPARATOR

Study evaluation times correspond to standard follow-up evaluations for newly diagnosed malignant glioma patients. After 6 weeks of concurrent External Beam Radiation Therapy (EBRT) and Temozolomide (TMZ), there is typically a 4 week treatment break prior to the start of the 6 monthly cycles of TMZ. No further placebo or Nuvigil® will be given after the 6 week treatment regimen. Thus, study evaluations will occur at baseline (Week 0), immediately after completion of EBRT, TMZ, and Nuvigil® or placebo (Week 7), at the end of the 4 week washout period (Week 10), after the first 2 cycles of TMZ (Week 18), and after the 6th cycle of TMZ (Week 34).

Drug: Nuvigil®

B: Placebo

PLACEBO COMPARATOR

Study evaluation times correspond to standard follow-up evaluations for newly diagnosed malignant glioma patients. After 6 weeks of concurrent EBRT and TMZ, there is typically a 4 week treatment break prior to the start of the 6 monthly cycles of TMZ. No further placebo or Nuvigil® will be given after the 6 week treatment regimen. Thus, study evaluations will occur at baseline (Week 0), immediately after completion of EBRT, TMZ, and Nuvigil® or placebo (Week 7), at the end of the 4 week washout period (Week 10), after the first 2 cycles of TMZ (Week 18), and after the 6th cycle of TMZ (Week 34).

Drug: Placebo

Interventions

Nuvigil® DRUG

Nuvigil® 150 mg/day x 42 days THEN, No More Drug

Also known as: Armodafinil

A: Nuvigil®

Placebo DRUG

Placebo x 42 days; THEN, No More Placebo

B: Placebo

Eligibility Criteria

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

You may qualify if:

• Ages 18 years or greater at study entry
• Histologic diagnosis of a supratentorial World Health Organization (WHO) grade 3 anaplastic glioma (including astrocytoma, oligodendroglioma, and mixed oligoastrocytoma) or WHO grade 4 glioblastoma which requires external beam radiation therapy (EBRT) and concurrent temozolomide (TMZ)
• Have adequate renal and liver function as evidenced by the following screening lab values: Creatinine ≤ 1.7mg/dl; Total Bilirubin ≤ 1.5mg/dl; Transaminases ≤ 4 times above the upper normal limit; Prothrombin time/international normalized ratio (PT/INR) \< 1.4 for patients not on warfarin
• Adequate bone marrow functions as defined by the following lab values: Absolute neutrophil count (ANC) ≥ 1,500/mm³; Platelets ≥ 100,000 cells/mm³; Hemoglobin ≥ 10.0 gm/dL; White blood cell count (WBC) ≥ 3,000/mcL
• Karnofsky Performance Status ≥ 60%
• Recovered from the immediate neurosurgical post-operative period (e.g. for craniotomy, at least a 2 week period of time to allow for wound healing)
• Agrees to use acceptable birth control method(s). Females using steroidal contraception (oral, depot, or implantable) must agree to use an alternative or concomitant method of contraception throughout therapy as well as for one month after discontinuation of therapy.
• Agrees to avoid alcohol consumption while on therapy

You may not qualify if:

• Pre-existing documented traumatic brain injury
• Pre-existing dementing illness due to degenerative, cerebrovascular, or other static or progressive neurologic process
• Neurological deficit such as hemineglect or homonymous hemianopsia on baseline neurologic examination that would preclude effective participation in cognitive testing
• Intracranial space occupying lesion other than malignant glioma or benign asymptomatic meningioma
• Prior treatment with EBRT or stereotactic radiosurgery (SRS) to the brain
• Prior treatment with Nuvigil® or Provigil® within 4 weeks prior to study entry
• Leptomeningeal disease suggested clinically or by radiographic criteria
• History of left ventricular cardiac hypertrophy
• Ischemic ECG changes, chest pain, arrhythmia, or other clinically significant manifestations of mitral valve prolapse in association with central nervous system (CNS) stimulant use within the past 6 months
• Unstable angina or myocardial infarction within the past 6 months
• Premorbid or ongoing psychosis
• Currently receiving Ritalin or Tricyclic Antidepressants. Nuvigil has been demonstrated to affect the serum levels of Triazolam and Cyclosporine. Patients taking these medications will be monitored for potential dose adjustments. Other medications that are metabolized by the cytochrome P450 pathway may be potentially affected, but have not been demonstrated to do so in clinical testing. Such medications will be monitored throughout the study for possible dose adjustments.
• Patients who are experiencing significant fatigue secondary to medical or physiologic causes other than primarily from their malignant gliomas
• Pregnant, breast-feeding, or lack of willingness to use recommended birth control methods
• Patients with known hypersensitivity to modafinil, armodafinil, or its inactive ingredients

Sponsors & Collaborators

• H. Lee Moffitt Cancer Center and Research Institute: lead
• Cephalon: collaborator

Study Sites (1)

H. Lee Moffitt Cancer Center and Research Institute

Tampa, Florida, 33612, United States

Location

MeSH Terms

Conditions

Glioma; Fatigue

Interventions

Modafinil

Condition Hierarchy (Ancestors)

Neoplasms, Neuroepithelial; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Glandular and Epithelial; Neoplasms, Nerve Tissue; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Benzhydryl Compounds; Benzene Derivatives; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Hydrocarbons; Organic Chemicals

Limitations and Caveats

Planned accrual of 60 participants for analysis was not met. Recruitment was closed early due to slow accrual and initiating Principal Investigator (PI) leaving Moffitt.

Results Point of Contact

• Title: Peter A. Forsyth, M.D.
• Organization: H. Lee Moffitt Cancer Center and Research Institute

peter.forsyth@moffitt.org

813-745-3063

Study Officials

• Peter Forsyth, M.D.

  H. Lee Moffitt Cancer Center and Research Institute

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 21, 2011
• First Posted: July 25, 2011
• Study Start: December 1, 2010
• Primary Completion: December 1, 2012
• Study Completion: September 1, 2013
• Last Updated: December 16, 2013
• Results First Posted: December 16, 2013

Record last verified: 2013-10

Locations

US (1)