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Brain and Central Nervous System TumorsPhase 2NCT01013285

Bevacizumab, Temozolomide, and External Beam Radiation Therapy as First-Line Therapy in Treating Patients With Newly Diagnosed Glioblastoma Multiforme or Gliosarcoma

A Phase 2 study testing bevacizumab, temozolomide and external beam radiation therapy in people with Brain and Central Nervous System Tumors, run by Jonsson Comprehensive Cancer Center at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

RATIONALE: Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Brain and Central Nervous System Tumors
What is being tested?
bevacizumab, temozolomide and external beam radiation therapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
70 participants
Where
1 siteUnited States
Study dates
Jun 2006to Aug 2015
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically confirmed intracranial glioblastoma multiforme (GBM) or gliosarcoma.
  • Prior histologic diagnosis of low-grade glioma allowed provided it has been upgraded to GBM after repeat resection
  • Has undergone surgery to collect tumor tissue 3-6 weeks ago
  • Measurable or assessable disease is not required
  • Karnofsky performance status 60-100%
  • Life expectancy > 8 weeks
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  • White Blood Cell (WBC) ≥ 3,000/mm³
  • Absolute Neutrophil Count (ANC) ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 10 g/dL (transfusion allowed)
  • Serum Glutamate Oxaloacetate Transaminase (SGOT) < 2.5 times upper limit of normal (ULN)
  • Bilirubin < 2.5 times ULN
  • INR (international normalized ratio) ≤ 1.5 times ULN (except if on therapeutic anticoagulation therapy)
  • aPTT (activated partial thromboplastin time) ≤ 1.5 times ULN (except if on therapeutic anticoagulation therapy)
  • Creatinine < 1.5 mg/dL
  • Urine protein:creatinine ratio < 1.0
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • More than 28 days since prior major surgical procedures or open biopsy (other than craniotomy)
  • More than 7 days since prior minor surgical procedures (e.g., placement of PortoCath (port-a-cath - a port placed under the subjects skin), stereotactic biopsy, fine-needle aspirations, or core biopsies)
  • More than 4 weeks since prior and no concurrent participation in another experimental drug study.
  • Prior or concurrent corticosteroids, anti-epileptic drugs, analgesics, or other drugs to treat symptoms or prevent complications are allowed
  • Concurrent full-dose warfarin or its equivalent (i.e., unfractionated and/or low molecular weight heparin) allowed

Who cannot join

  • unstable angina
  • BP > 150/100 mm Hg
  • New York Heart Association (NYHA) class II-IV congestive heart failure
  • myocardial infarction within the past 6 months
  • stroke within the past 6 months
  • clinically significant peripheral vascular disease
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  • evidence of bleeding diathesis or coagulopathy
  • intracerebral abscess within past 6 months
  • abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
  • serious, non-healing wound, ulcer, or bone fracture
  • Any wound requiring surgical intervention (including scalp wounds requiring cranioplasty) allowed provided the wound is clean and without further infection post-surgical intervention
  • significant traumatic injury within the past 28 days
  • concurrent serious uncontrolled medical illness including, but not limited to, the following:
  • Ongoing or active infection requiring IV antibiotics
  • Psychiatric illness/social situation that would limit compliance with study requirements
  • Disorders associated with significant immunocompromised state (e.g., HIV, systemic lupus erythematosus)
  • other cancer within the past 3 years, except nonmelanoma skin cancer or carcinoma in situ of the cervix
  • disease that would obscure toxicity or dangerously alter drug metabolism
  • significant medical illness that, in the investigator's opinion, cannot be adequately controlled with appropriate therapy or would compromise the patient's ability to tolerate study therapy
  • prior radiotherapy to the brain
  • prior cytotoxic or non-cytotoxic drug therapy or experimental drug therapy for the brain tumor
  • prior Gliadel wafers
  • concurrent participation in any other clinical trial
  • concurrent GM-CSF (granulocyte-macrophage colony-stimulating factor)
  • concurrent stereotactic radiosurgery or brachytherapy
  • concurrent major surgical procedure
  • other concurrent anticancer therapy, including chemotherapy, hormonal therapy, radiotherapy, or immunotherapy

Trial locations and contacts

1 site in 1 country.

United States1 site

  • Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA)

    Los Angeles, California, 90095-1781

Other trials in United States

About this study

Official title: Phase II Trial of Bevacizumab in Combination With Temozolomide and Regional Radiation Therapy for Upfront Treatment of Patients With Newly-diagnosed Glioblastoma Multiforme

RATIONALE: Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high energy x-rays to kill tumor cells. Giving bevacizumab together with temozolomide and radiation therapy may kill more tumor cells.

PURPOSE: This phase II trial is studying the side effects and how well giving bevacizumab together with temozolomide and external beam radiation therapy works when given as first-line therapy in treating patients with newly diagnosed glioblastoma multiforme or gliosarcoma.

Read the detailed description

OBJECTIVES:

Primary

  • To investigate the safety and tolerability of bevacizumab in combination with temozolomide and external beam fractionated regional radiotherapy as first-line treatment in patients with newly diagnosed glioblastoma multiforme or gliosarcoma. (Pilot phase)
  • To estimate the overall survival of patients treated with this regimen. (Expansion phase)

Secondary

  • To further investigate the safety and tolerability of this regimen in these patients. (Expansion phase)
  • To isolate DNA, RNA, and protein from frozen and paraffin-embedded archival tumor samples for evaluations, such as immunohistochemical pathway profiling of vascular endothelial growth factor (VEGF)-dependent angiogenic pathways, gene expression microarray, and O-6 methylguanine DNA methyltransferase (MGMT) promoter methylation status to define important molecular features of treatment response.

OUTLINE: This is a multicenter study.

Patients undergo external beam fractionated regional radiotherapy once daily 5 days a week for 6 weeks and receive concurrent oral temozolomide once daily for 6 weeks. Patients also receive bevacizumab IV over 30-90 minutes every 2 weeks beginning on the first day of radiotherapy and continuing in the absence of disease progression or unacceptable toxicity. Beginning 2-5 weeks after completion of radiotherapy, patients receive oral temozolomide on days 1-5. Treatment with temozolomide repeats every 28 days for up to 24 courses in the absence of disease progression or unacceptable toxicity.

Blood and frozen and paraffin-embedded tumor tissue samples are collected for biomarker and genetic analysis.

After completion of study treatment, patients are followed up periodically.

Being tested
bevacizumab, temozolomide, external beam radiation therapy
Keywords
adult giant cell glioblastoma, adult gliosarcoma, adult glioblastoma
Medical subject headings
Central Nervous System Neoplasms, Glioblastoma, Gliosarcoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT01013285
Study groupRoleWhat they receive
bevacizumab, temozolomide, external beam radiationExperimentalNot described
Receives: Biological: bevacizumab; Drug: temozolomide; Radiation: external beam radiation therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Survival

    Measured: 2 years

Secondary outcomes (4)

  1. Time to Disease Progression

    Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

    Measured: 2 years

  2. Progression-free Survival at 6 Months

    participants who were alive and disease progression free at 6 months

    Measured: 6 months

  3. Radiographic Response (When Evaluable)

    Radiation therapy (RT) median from diagnosis to RT. Patients will have brain MRI evaluation of response and progression every 8 weeks starting from the day 56 scan obtained 2 weeks after completion of radiation and daily temozolomide and assessment will be conducted on a 7-point scale. This scale is expected to be more useful in this study because many newly-diagnosed patients are likely not to have evaluable disease due to gross total resections. Determination of whether progression occurs based on the day 56 scan will take into account the untreated window between baseline MRI and day of 1 of study.

    7 Point Likert Scale: 3 to -3, 3 means complete resolution of tumor, and -3 means new lesion. A -2 or -3 assessment will be taken as tumor progression.

    complete resolution of tumor: 3

    tumor resolved 3 tumor definitely smaller: 2 tumor probably smaller: 1 tumor unchanged: 0 tumor probably worse: -1 tumor definitely worse: -2 New Lesion: -3

    Measured: 2 years

  4. Median Overall Survival (OS) Based on the MGMT Promoter Methylation Status

    IDH1 and MGMT methylation are important independent prognostic biomarkers that have to be included in a Cox regression model. In addition, subgroup analysis could reveal differential sensitivities to the treatment arm. The MGMT promoter methylation status, IDH1 mutation status were not available for all of the control samples. Therefore, only the samples with both info available were included in the analysis. Baseline analysis results are included in the Baseline Characteristics module.

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Nov 2009 (estimated)
  2. Study startJun 2006
  3. Primary completionOct 2013
  4. Study completionAug 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
70 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01013285
Sponsor's protocol ID
11-000558
Other IDs
UCLA-0604016, AVF3770s, CDR0000628787, GENENTECH-UCLA-0604016
Status last verified
Apr 2016
First submitted
11 Nov 2009
Last updated
21 Sep 2020
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing bevacizumab, temozolomide and external beam radiation therapy in people with Brain and Central Nervous System Tumors, run by Jonsson Comprehensive Cancer Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 23 inclusion and 27 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Sep 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Survival (time frame: 2 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01013285.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Sep 2020.

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