Tinostamustine With or Without Radiation Therapy in Treating Patients With Newly Diagnosed MGMT-Unmethylated Glioblastoma

NCT03452930 | Completed Phase 1 FDA Drug

• 2 other identifiers: 2017-0555NCI-2018-00872
• Study Type: interventional
• Target: 5
• Locations: 1 country
• Sites: 1

Brief Summary

This phase I trial studies the side effects and best dose of tinostamustine (EDO-S101) given with or without radiation therapy in treating patients with newly diagnosed MGMT-unmethylated glioblastoma. Tinostamustine may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth in patients with glioblastoma.

Conditions

Glioblastoma; Gliosarcoma; MGMT-Unmethylated Glioblastoma

Outcome Measures

Primary Outcomes (1)

• Maximum tolerated dose (MTD) (Stages 1 & 2)

  Defined by dose limiting toxicity (DLT). Toxicity will be evaluated according to the most current version of the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) toxicity criteria. The MTD is confirmed when six (6) patients are treated at a dose level with less than two (2) DLTs.

  Up to 4 weeks

Secondary Outcomes (4)

• Incidence of adverse events (Stage 1)

  Up to 2 years

• Objective response rate (ORR) (Stage 2)

  Up to 2 years

• Overall survival (OS) (Stage 2)

  Up to 2 years

• Progression-free survival (PFS) (Stage 2)

  Up to 2 years

Study Arms (2)

Stage 1 (tinostamustine)

EXPERIMENTAL

Patients who have completed TMZ and RT receive tinostamustine IV over 60 minutes on day 1. Treatment repeats every 21 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity.

Drug: Tinostamustine

Stage 2 (RT, tinostamustine)

EXPERIMENTAL

Patients who have received no treatment other than surgery undergo RT 5 days a week for up to 6 weeks in the absence of disease progression or unacceptable toxicity. Patients also receive tinostamustine over 60 minutes IV on day 1. Treatment repeats every 21 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity.

Radiation: Radiation Therapy; Drug: Tinostamustine

Interventions

Radiation Therapy RADIATION

Undergo RT

Also known as: Cancer Radiotherapy, ENERGY_TYPE, Irradiate, Irradiated, Irradiation, Radiation, Radiation Therapy, NOS, Radiotherapeutics, Radiotherapy, RT, Therapy, Radiation

Stage 2 (RT, tinostamustine)

Tinostamustine DRUG

Given IV

Also known as: 1H-Benzimidazole-2-heptanamide, 5-(Bis(2-chloroethyl)amino)-N-hydroxy-1-methyl-, EDO-S 101, EDO-S-101, EDO-S101

Stage 1 (tinostamustine); Stage 2 (RT, tinostamustine)

Eligibility Criteria

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

You may qualify if:

• Be willing and able to provide written informed consent for the trial.
• Have histologically confirmed World Health Organization grade IV glioma (glioblastoma \[GB\] or gliosarcoma).
• Have a performance status of \>= 60 on the Karnofsky performance scale (KPS).
• If patient is on steroids, patient must be on a stable or decreasing dose of steroids for at least 5 days at the time of baseline brain magnetic resonance imaging (MRI).
• Absolute neutrophil count (ANC) \>= 1,500 /mcL (within 14 days \[+3 working days\] of treatment initiation).
• Platelets \>= 100,000 /mcL (within 14 days \[+3 working days\] of treatment initiation).
• Hemoglobin \>= 9 g/dL or \>= 5.6 mmol/L (within 14 days \[+3 working days\] of treatment initiation).
• Serum creatinine OR measured or calculated creatinine clearance (glomerular filtration rate \[GFR\] can also be used in place of creatinine or creatinine clearance \[CrCl\]) =\< 1.5 x upper limit of normal (ULN) OR \>= 60 mL/min for subject with creatinine levels \> 1.5 x institutional ULN (within 14 days \[+3 working days\] of treatment initiation).
• Serum total bilirubin =\< 1.5 x ULN OR direct bilirubin =\< ULN for subjects with total bilirubin levels \> 1.5 ULN (within 14 days \[+3 working days\] of treatment initiation).
• Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 2.5 x ULN (within 14 days \[+3 working days\] of treatment initiation).
• International normalized ratio (INR) or prothrombin time (PT), activated partial thromboplastin time (aPTT) =\< 1.5 x ULN (within 14 days \[+3 working days\] of treatment initiation).
• Female subjects of childbearing potential should have a negative serum pregnancy test within 72 hours of starting first dose of study drug.
• Female subjects of childbearing potential should be willing to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the duration of the study. Subjects of childbearing potential are those who have not been surgically sterilized or have not been free from menses for \> 1 year.
• Male subjects should agree to use an adequate method of contraception during the course of the study.
• Patients must have completed standard radiation therapy with concurrent TMZ and must not have evidence of progressive disease on post treatment imaging. Progression can only be defined using diagnostic imaging if there is new enhancement outside of the radiation field (beyond the high-dose region or 80% isodose line) or if there is unequivocal evidence of viable tumor on histopathologic sampling (e.g., solid tumor areas \[i.e, \> 70% tumor cell nuclei in areas\], high or progressive increase in MIB-1 proliferation index compared with prior biopsy, or evidence for histologic progression or increased anaplasia in tumor). Note: Given the difficulty of differentiating true progression from pseudoprogression, clinical decline alone, in the absence of radiographic or histologic confirmation of progression, will not be sufficient for definition of progressive disease in the first 12 weeks after completion of concurrent chemoradiotherapy. (For Stage 1: post-chemoradiation group only)

You may not qualify if:

• Has received prior interstitial brachytherapy, implanted chemotherapy, or therapeutics delivered by local injection or convection enhanced delivery. Prior treatment with Gliadel wafers will be excluded. Concomitant use of the Optune device will also be excluded.
• Is currently participating or has participated in any other any other investigational or therapeutic trial before or after chemoradiation.
• Any serious medical condition that interferes with adherence to study procedures.
• Has had prior chemotherapy, targeted small molecule therapy, within 2 weeks prior to study day 1 or who has not recovered (i.e., =\< grade 1 or at baseline) from adverse events due to a previously administered agent. Note: subjects with =\< grade 2 neuropathy are an exception to this criterion and may qualify for the study. Note: if subject received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy. (For Stage 1: post-chemoradiation group only)
• Patients with a history of a second malignancy diagnosed within three (3) years of study enrollment or have a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy.
• New York Heart Association (NYHA) stage III/IV congestive heart failure, arrhythmias not adequately controlled.
• Patients with prolonged corrected QT (QT) interval defined as male \> 450 msec and female \> 470 msec.
• Patients who are on treatment with drugs known to prolong the QT/QTc interval. Case of the selective serotonin reuptake inhibitors (SSRIs): Patients treated with a SSRI AND displaying a QTc prolongation are NOT eligible in the trial. Nevertheless, there is no need to stop or change a SSRI if a patient is on a stable dose AND with no impact on QT/QTc interval, since it is not expected that plasma concentration of the SSRI will be affected by the administration of EDO-S101
• Serum potassium and magnesium within normal range, at baseline (supplementation is permissible)
• Has known gliomatous meningitis, extracranial disease, or multifocal disease. Subject has multifocal GBM, defined as discrete sites of contrast enhancing disease without contiguous T2/fluid-attenuated inversion recovery (FLAIR) abnormality that require distinct radiotherapy ports. Satellite lesions that are associated with a contiguous area of T2/FLAIR abnormality as the main lesion(s) and that are encompassed within the same radiotherapy port as the main lesion(s) are permitted.
• Has an active infection requiring systemic therapy.
• Has an ongoing or previous history of spontaneous intratumoral hemorrhage.
• Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
• Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
• Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit.

Sponsors & Collaborators

• M.D. Anderson Cancer Center: lead
• National Cancer Institute (NCI): collaborator

Study Sites (1)

M D Anderson Cancer Center

Houston, Texas, 77030, United States

Location

Related Links

• MD Anderson Cancer Center

MeSH Terms

Conditions

Glioblastoma; Gliosarcoma

Interventions

Radiotherapy; Radiation; tinostamustine

Condition Hierarchy (Ancestors)

Astrocytoma; Glioma; Neoplasms, Neuroepithelial; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Glandular and Epithelial; Neoplasms, Nerve Tissue

Intervention Hierarchy (Ancestors)

Therapeutics; Physical Phenomena

Study Officials

• Shiao-Pei S Weathers

  M.D. Anderson Cancer Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 16, 2018
• First Posted: March 2, 2018
• Study Start: August 13, 2018
• Primary Completion: June 5, 2024
• Study Completion: June 5, 2024
• Last Updated: June 4, 2025

Record last verified: 2024-06

Locations

US (1)