Trial of Dichloroacetate (DCA) in Glioblastoma Multiforme (GBM)

NCT05120284 | Active Not Recruiting Phase 2 DMC FDA Drug

• 3 other identifiers: IRB202101509FD-R-007271-01PRO00034631
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 2

Brief Summary

Conduct a multicenter, open label Phase IIA trial of oral DCA in 40 surgical patients with recurrent GBM who have clinically indicated debulking surgery planned. No patients will be recruited at UF. Patients will be genotyped to establish safe dosing regimens and will be randomized to receive DCA (N=20) or no DCA (N=20) for one week prior to surgery. Deidentified blood and tumor tissue obtained at surgery will be assessed at UF for biochemical markers of DCA dynamics.

Conditions

Glioblastoma Multiforme

Outcome Measures

Primary Outcomes (1)

• Level of phosphorylated PDC protein expressed in surgical tissue

  The efficacy of dichloroacetate will be determined by the level of phosphorylated PDC protein expressed in surgical tissue.

  Within 4 weeks post surgery

Study Arms (2)

Pre-Surgical Dichloroacetate (DCA)

ACTIVE COMPARATOR

Study medication begins in subjects randomized to preoperative DCA. All subjects will be given the 12.5 mg/kg/12 hour DCA for pre-surgical dosing. Post-surgery the GSTZ1 haplotype will be utilized to dose all patients.

Drug: Dichloroacetate (DCA); Genetic: Genotype

No Pre-Surgical Dichloroacetate (DCA)

ACTIVE COMPARATOR

Subject randomized to start DCA after surgery will do so 12-24 hours postoperatively, depending on their ability to safely receive medication.

Drug: Dichloroacetate (DCA); Genetic: Genotype

Interventions

Dichloroacetate (DCA) DRUG

Study medication DCA is a liquid formulation mixed with an artificial sweetener containing aspartame and strawberry extract (50mg/mL) Participants will be genotyped to determine GSTZ1 (glutathione S-transferase Zeta-1) haplotype status, which will stratify this group into 1 of 2 dose regimens: EGT carriers will receive 12-14 mg/kg/12hr DCA. EGT non-carriers will receive 6-7 mg/kg/12 hr.

Also known as: Sodium Dichloroacetate

No Pre-Surgical Dichloroacetate (DCA); Pre-Surgical Dichloroacetate (DCA)

Genotype GENETIC

Participants will be genotyped to determine GSTZ1 haplotype status.

No Pre-Surgical Dichloroacetate (DCA); Pre-Surgical Dichloroacetate (DCA)

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Study subjects will be male and female adults, aged 18 through 80 years, previously diagnosed with a GBM who have experienced tumor recurrence as determined by neuroimaging and some degree of symptomatology (e.g., headache, mental status change, seizure) and have clinically indicated tumor debulking surgery planned.
• All subjects will have completed initial, standard- therapy with surgical debulking, followed by radiation and temozolomide (TMZ) and will, therefore, be considered treatment failures. Patients with truly unmethylated GBM do not require prior treatment with temozolomide (TMZ).
• Patients will be recruited and studied at Johns Hopkins University, Johns Hopkins affiliated Sibley Memorial Hospital, and Wake Forest University. The DCA liquid formulation is on file with the FDA, is identical to that administered in our Phase I trial of brain tumor patients and can be given by mouth or feeding tube. Patients may retain whatever medications they are receiving for other conditions (e.g., hypertension, seizures), except patients requiring insulin or sulfonylurea therapy (see below).
• The probability of adverse drug-drug interactions is extremely low, for the following reasons. First, DCA is the only pharmaceutical in clinical use that is metabolized by GSTZ1. Second, DCA is not known to be metabolized by any other drug metabolizing enzyme system, thus precluding competition with other agents for biotransformation. Third, the results of both open label and randomized controlled trials of orally or parenterally administered DCA in the treatment of children and/or adults have never shown evidence of adverse drug-drug interactions (34). Thus, from decades of clinical investigations of use of DCA in various acutely or chronically ill populations, there is nothing to suggest adverse drug-drug interactions should be anticipated in this trial.
• Patients who are diabetic must have a screening hemoglobin A1c (Hgb A1c) level of at least 6.0.

You may not qualify if:

• Patients considered pre-terminal (life expectancy ≤ 2 months)
• Those who are pregnant will be excluded.
• DCA inhibits gluconeogenesis and lowers blood glucose levels in patients with type 2 diabetes. Therefore, in subjects who are receiving either insulin or a sulfonylurea, coadministration of DCA could lead to symptomatic hypoglycemia and those patients will be excluded from the trial.
• DCA is dialyzable and its clearance diminishes in patients with end stage renal failure (GFR ≤ 30 ml/min); such patients will be excluded from participating.
• DCA is metabolized by hepatic GSTZ1, so patients with severe liver insufficiency (total bilirubin \> 2.0 mg/dl or ALT or AST \> 3 x ULN) will be excluded.
• Patients with Hgb A1c level less than 6.0 at screening

Sponsors & Collaborators

• University of Florida: lead

Study Sites (2)

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Baltimore, Maryland, 21231, United States

Location

Wake Forest University

Winston-Salem, North Carolina, 27587, United States

Location

Related Publications (42)

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MeSH Terms

Conditions

Glioblastoma

Interventions

Dichloroacetic Acid; Genotype

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)

Chloroacetates; Acetates; Acids, Acyclic; Carboxylic Acids; Organic Chemicals; Hydrocarbons, Chlorinated; Hydrocarbons, Halogenated; Hydrocarbons; Genetic Phenomena

Study Officials

• Peter Stacpoole, PhD, MD

  University of Florida

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: subsequent ordered and alternating patients

Study Record Dates

• First Submitted: November 2, 2021
• First Posted: November 15, 2021
• Study Start: July 1, 2022
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): August 31, 2026
• Last Updated: August 29, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (2)