A Phase II Trial of Sutent (Sunitinib; SU011248) for Recurrent Anaplastic Astrocytoma and Glioblastoma

NCT00606008

Last updated date
Study Location
H. Lee Moffitt Cancer Center and Research Institute
Tampa, Florida, 33612, United States
Contact
1-800-718-1021

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Eligibility Criteria
condition
The disease, disorder, syndrome, illness, or injury that is being studied.
Anaplastic Astrocytoma, Glioblastoma
Sex
Females and Males
Age
Pediatric Trials: 0-17 Years
Adult Trials: 18+ Years
18 + years
Inclusion Criteria
The factors, or reasons, that allow a person to participate in a clinical study.
Show details

- Resolution of all acute toxic effects of prior chemotherapy or radiotherapy or surgical procedures to NCI CTCAE Version 3.0 grade ≤1.

- Adequate organ function as defined by the following criteria:

- Serum aspartate transaminase (AST; serum glutamic oxaloacetic transaminase [SGOT]) and serum alanine transaminase (ALT; serum glutamic pyruvic transaminase [SGPT]) ≤3 x local laboratory upper limit of normal (ULN), or AST and ALT ≤3 x ULN if liver function abnormalities are due to underlying malignancy

- Total serum bilirubin ≤1.5 x ULN

- Absolute neutrophil count (ANC) ≥1500/µL

- Platelets ≥100,000/µL

- Hemoglobin ≥9.0 g/dL

- Serum calcium ≤12.0 mg/dL

- Serum creatinine ≤1.5 x ULN

- Patients must have histologically or neuroradiographically recurrent anaplastic astrocytoma (AA) or glioblastoma (GBM). Must have had prior pathologic confirmation of primary tumor histology.

- Must be ≥ 18 years old.

- Must have a Karnofsky performance status (KPS) ≥ 60%

- Measurable disease per MacDonald criteria required using contrast enhanced cranial MRI.

- Life expectancy ≥ 12 weeks.

- Must sign and date an Institutional Review Board (IRB) approved informed consent stating that he or she is aware of the neoplastic nature of the disease. Must willingly provide written consent after being informed of procedure to be followed, the experimental nature of the therapy, alternatives, potential benefits, side effects, risks, and discomforts.

- Willing and able to comply with scheduled visits, treatment plan, laboratory tests and accessible for follow-up.

- Have undergone surgery documenting tumor histology though repeat surgery at time of tumor recurrence is not mandatory.

- Have received prior external beam radiotherapy.

- Patients may have received one or two prior salvage chemotherapy and may have received adjuvant chemotherapy following initial surgery.

- May not have received prior stereotactic radiotherapy.

- May have been treated with Gliadel at initial surgery only.

Exclusion Criteria
The factors, or reasons, that prevent a person from participating in a clinical study.
Show details


- Major surgery or radiation therapy within 4 weeks of starting study treatment.


- NCI CTCAE grade 3 hemorrhage within 4 weeks of starting study treatment.


- History of or known spinal cord compression or carcinomatous meningitis, or evidence
of leptomeningeal disease on screening CT or MRI scan.


- Any of the following within 6 months prior to study drug administration: myocardial
infarction, severe/unstable angina, coronary/peripheral artery bypass graft,
symptomatic congestive heart failure, cerebrovascular accident or transient ischemic
attack, or pulmonary embolism.


- Ongoing cardiac dysrhythmias of NCI CTCAE grade ≥2.


- Prolonged QTc interval on baseline EKG.


- Hypertension that cannot be controlled by medications (>150/100 mm Hg despite optimal
medical therapy).


- Pre-existing thyroid abnormality with thyroid function that cannot be maintained in
normal range with medication.


- Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome
(AIDS)-related illness or other active infection.


- Concurrent treatment on another clinical trial. Supportive care trials or
non-treatment trials, e.g. QOL, are allowed.


- Concomitant use of ketoconazole and other agents known to inhibit Cytochrome P450 3A4
(CYP3A4).


- Concomitant use of theophylline and phenobarbital and/or other agents metabolized by
the cytochrome P450 system.


- Ongoing treatment with therapeutic doses of Coumadin (low dose up to 2 mg po daily for
thrombo-prophylaxis is allowed).


- Pregnancy or breastfeeding. Female subjects must be surgically sterile,
postmenopausal, or must agree to use effective contraception during the period of
therapy. Female subjects with reproductive potential must have a negative pregnancy
test (serum or urine) prior to enrollment. Male subjects must be surgically sterile or
must agree to use effective contraception during the period of therapy.


- Other severe acute or chronic medical or psychiatric condition or laboratory
abnormality that may increase the risk associated with study participation or study
drug administration, or may interfere with interpretation of study results, and in the
judgment of investigator would make patient inappropriate for entry into this study.


- Patients having been treated with 3 or more salvage regimens.


- Patients with a second active malignancy or diagnosis of other cancer within 3 years
of enrollment, except for surgically cured basal cell carcinoma, or in situ carcinoma
of the cervix.


- Mentally incapacitated patients or psychiatric illness that would prevent them from
giving informed consent.


- Poorly controlled diabetes, hepatitis infection, uncontrolled high blood pressure,
unstable angina, symptomatic congestive heart failure, and myocardial infarction
within previous 6 months, or serious uncontrolled cardiac arrhythmia.


- Known to be HIV positive or to have an AIDS-related illness.


- Patients with an active infection that is not adequately controlled with antibiotics.


- Patients with other severe concurrent disease, which, in the judgment of the
investigator, would make the patient inappropriate for entry into this study.


- Known sensitivity to any of the products to be administered during treatment.


- Currently enrolled in another clinical trial or patients who have participated in a
trial of an investigational device or drug within the last 30 days.

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Anaplastic Astrocytoma, GlioblastomaA Phase II Trial of Sutent (Sunitinib; SU011248) for Recurrent Anaplastic Astrocytoma and Glioblastoma
NCT00606008
  1. Tampa, Florida
ALL GENDERS
18 Years+
years
MULTIPLE SITES
Advanced Information
Descriptive Information
Brief Title  ICMJE A Phase II Trial of Sutent (Sunitinib; SU011248) for Recurrent Anaplastic Astrocytoma and Glioblastoma
Official Title  ICMJE A Phase II Trial of Sutent (Sunitinib; SU011248) for Recurrent Anaplastic Astrocytoma and Glioblastoma Multiforme
Brief Summary

We are asked patients to take part in this study because they had recurrent (returned) (1st or 2nd) anaplastic astrocytoma (AA) or glioblastoma multiforme (GBM).

The purposes of this study are:

  • To see if Sutent has any change on the patient and their cancer.
  • To see if Sutent will slow or stop the growth of their tumor.
  • To measure the safety of Sutent. Sutent is Food and Drug Administration (FDA) approved to treat patients with a gastrointestinal stromal tumor after the disease worsened while taking another medicine called imatinib mesylate or when imatinib mesylate cannot be taken. Sutent is also FDA approved to treat patients with advanced renal cell carcinoma. At this time, it is not known whether Sutent will improve symptoms, or help patients with this disease live longer.
Detailed Description

Trial patients received sunitinib 50 mg daily for 4 weeks without regard to meals, followed by a 2-week rest period. This 6-week regimen constituted 1 cycle. Patients were treated for up to 9 cycles [~ year) or until disease progression or death or if persistent toxicities occurred. Complete blood count with differential, complete metabolic profile, neurologic exam, and brain magnetic resonance imaging (MRI) with contrast were obtained after each cycle. Toxicity assessments were obtained after each cycle. Toxicity was graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 3.0.

SCHEDULE OF EVENTS - PROTOCOL ACTIVITIES

<14 Days Prior to Initial Study Treatment:

  • Neurological/Oncological History
  • Neurological Examination
  • Height/Weight/Body Surface Area
  • Performance Status
  • Quality of Life (QOL) FACT-L
  • Laboratory Studies; complete blood count (CBC), Differential, Platelets, prothrombin time/partial thromboplastin time (PT/PTT), international normalized ratio (INR), Serum Creatinine, blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), Total Bilirubin, alkaline phosphatase (AlkPHs), Pregnancy Test, electrocardiogram (EKG)
  • Cranial MRI or CT with and without contrast
  • Multiple uptake gated acquisition (MUGA) Scan

Day 1, At the Beginning of Each Treatment Cycle:

  • Adverse Event Assessment
  • Laboratory Studies; CBC, Differential, Platelets

Every Cycle, Days 42-45 (within 3 days of next scheduled Sutent treatment):

  • Neurological/Oncological History
  • Neurological Examination
  • Height/Weight/Body Surface Area
  • Performance Status
  • QOL FACT-L
  • Laboratory Studies; Serum Creatinine, BUN, ALT, AST, LDH, Total Bilirubin, AlkPHs
  • Cranial MRI or CT with and without contrast
  • Survival

At Off Study:

  • Performance Status
  • Cranial MRI or CT with and without contrast
  • Survival
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Anaplastic Astrocytoma
  • Glioblastoma
Intervention  ICMJE Drug: Sunitinib Malate
Initially, patients were started on sunitinib at a dose of 50 mg daily. If 50 mg daily resulted in unacceptable toxicity, 2 dose modifications were allowed (to 37.5 and to 25 mg daily, if necessary). Study patients who could not tolerate 25 mg daily of sunitinib were taken off study.
Other Names:
  • Sutent
  • SU011248
Study Arms  ICMJE Experimental: Sutent Treatment
Sutent was administered daily for 4 weeks at a dose of 50 mg followed by a 2 week study drug free break.
Intervention: Drug: Sunitinib Malate
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: April 12, 2012)
30
Original Estimated Enrollment  ICMJE
 (submitted: January 31, 2008)
55
Actual Study Completion Date  ICMJE August 2012
Actual Primary Completion Date August 2012   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Resolution of all acute toxic effects of prior chemotherapy or radiotherapy or surgical procedures to NCI CTCAE Version 3.0 grade ?1.
  • Adequate organ function as defined by the following criteria:

    • Serum aspartate transaminase (AST; serum glutamic oxaloacetic transaminase [SGOT]) and serum alanine transaminase (ALT; serum glutamic pyruvic transaminase [SGPT]) ?3 x local laboratory upper limit of normal (ULN), or AST and ALT ?3 x ULN if liver function abnormalities are due to underlying malignancy
    • Total serum bilirubin ?1.5 x ULN
    • Absolute neutrophil count (ANC) ?1500/µL
    • Platelets ?100,000/µL
    • Hemoglobin ?9.0 g/dL
    • Serum calcium ?12.0 mg/dL
    • Serum creatinine ?1.5 x ULN
  • Patients must have histologically or neuroradiographically recurrent anaplastic astrocytoma (AA) or glioblastoma (GBM). Must have had prior pathologic confirmation of primary tumor histology.
  • Must be ? 18 years old.
  • Must have a Karnofsky performance status (KPS) ? 60%
  • Measurable disease per MacDonald criteria required using contrast enhanced cranial MRI.
  • Life expectancy ? 12 weeks.
  • Must sign and date an Institutional Review Board (IRB) approved informed consent stating that he or she is aware of the neoplastic nature of the disease. Must willingly provide written consent after being informed of procedure to be followed, the experimental nature of the therapy, alternatives, potential benefits, side effects, risks, and discomforts.
  • Willing and able to comply with scheduled visits, treatment plan, laboratory tests and accessible for follow-up.
  • Have undergone surgery documenting tumor histology though repeat surgery at time of tumor recurrence is not mandatory.
  • Have received prior external beam radiotherapy.
  • Patients may have received one or two prior salvage chemotherapy and may have received adjuvant chemotherapy following initial surgery.
  • May not have received prior stereotactic radiotherapy.
  • May have been treated with Gliadel at initial surgery only.

Exclusion Criteria:

  • Major surgery or radiation therapy within 4 weeks of starting study treatment.
  • NCI CTCAE grade 3 hemorrhage within 4 weeks of starting study treatment.
  • History of or known spinal cord compression or carcinomatous meningitis, or evidence of leptomeningeal disease on screening CT or MRI scan.
  • Any of the following within 6 months prior to study drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism.
  • Ongoing cardiac dysrhythmias of NCI CTCAE grade ?2.
  • Prolonged QTc interval on baseline EKG.
  • Hypertension that cannot be controlled by medications (>150/100 mm Hg despite optimal medical therapy).
  • Pre-existing thyroid abnormality with thyroid function that cannot be maintained in normal range with medication.
  • Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS)-related illness or other active infection.
  • Concurrent treatment on another clinical trial. Supportive care trials or non-treatment trials, e.g. QOL, are allowed.
  • Concomitant use of ketoconazole and other agents known to inhibit Cytochrome P450 3A4 (CYP3A4).
  • Concomitant use of theophylline and phenobarbital and/or other agents metabolized by the cytochrome P450 system.
  • Ongoing treatment with therapeutic doses of Coumadin (low dose up to 2 mg po daily for thrombo-prophylaxis is allowed).
  • Pregnancy or breastfeeding. Female subjects must be surgically sterile, postmenopausal, or must agree to use effective contraception during the period of therapy. Female subjects with reproductive potential must have a negative pregnancy test (serum or urine) prior to enrollment. Male subjects must be surgically sterile or must agree to use effective contraception during the period of therapy.
  • Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with interpretation of study results, and in the judgment of investigator would make patient inappropriate for entry into this study.
  • Patients having been treated with 3 or more salvage regimens.
  • Patients with a second active malignancy or diagnosis of other cancer within 3 years of enrollment, except for surgically cured basal cell carcinoma, or in situ carcinoma of the cervix.
  • Mentally incapacitated patients or psychiatric illness that would prevent them from giving informed consent.
  • Poorly controlled diabetes, hepatitis infection, uncontrolled high blood pressure, unstable angina, symptomatic congestive heart failure, and myocardial infarction within previous 6 months, or serious uncontrolled cardiac arrhythmia.
  • Known to be HIV positive or to have an AIDS-related illness.
  • Patients with an active infection that is not adequately controlled with antibiotics.
  • Patients with other severe concurrent disease, which, in the judgment of the investigator, would make the patient inappropriate for entry into this study.
  • Known sensitivity to any of the products to be administered during treatment.
  • Currently enrolled in another clinical trial or patients who have participated in a trial of an investigational device or drug within the last 30 days.
Sex/Gender  ICMJE
Sexes Eligible for Study:All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT00606008
Other Study ID Numbers  ICMJE MCC-14916
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE Not Provided
Responsible Party H. Lee Moffitt Cancer Center and Research Institute
Study Sponsor  ICMJE H. Lee Moffitt Cancer Center and Research Institute
Collaborators  ICMJE Pfizer
Investigators  ICMJE
Principal Investigator:Edward Pan, M.D.H. Lee Moffitt Cancer Center and Research Institute
PRS Account H. Lee Moffitt Cancer Center and Research Institute
Verification Date September 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP