Combination of Sorafenib and Radiation for Brain Metastases and Primary Brain Tumors
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Purpose
Sorafenib™ has the potential to inhibit tumor growth, tumor angiogenesis , and enhance radiation response. This study will test the combination of Sorafenib™ and radiation therapy with or without temozolomide to determine tolerance of the combined treatments. Defining safe dosing of Sorafenib™ in this combination therapy will be achieved.
| Condition | Intervention | Phase |
|---|---|---|
|
Brain Metastases Primary Brain Tumors |
Drug: Sorafenib Drug: Temozolomide Radiation: Radiotherapy |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase I Study of the Combination of Sorafenib and Radiation Therapy -/+ Temozolomide for the Treatment of Patients With Brain Metastases and Primary Brain Tumors |
- Maximum Tolerated Dose of Sorafenib [ Time Frame: 30 days post-treatment ] [ Designated as safety issue: Yes ]To determine the maximum tolerated dose (MTD) and a recommended phase II dose (RP2D) of Sorafenib and radiotherapy -/+ temozolomide patients with malignancies of the brain.
- Response Rate [ Time Frame: 30 days post-treatment ] [ Designated as safety issue: No ]Response rate (in those patients with measurable disease)
- Prediction of 1-year Recurrence [ Time Frame: 1 year post-treatment ] [ Designated as safety issue: No ]Determine if an increase in urinary VEGF and MMP levels, from the end of treatment to a patient's 1-month follow-up examination, is predictive of 1-year recurrence
- Safety and Toxicity of Sorafenib [ Time Frame: 30 days post-treatment ] [ Designated as safety issue: Yes ]To evaluate the safety and toxicity profile of Sorafenib in combination with radiation therapy -/+ temozolomide
| Enrollment: | 35 |
| Study Start Date: | March 2008 |
| Estimated Study Completion Date: | March 2013 |
| Primary Completion Date: | June 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Cohort 1 - Brain Metastasis
Sorafenib and Radiotherapy
|
Drug: Sorafenib
Sorafenib 200mg twice daily during XRT and 30 days after. (Sorafenib will be escalated for both cohorts to determine maximum tolerated dose)
Other Name: Nexavar
Radiation: Radiotherapy
Radiation Therapy (XRT)
Other Names:
|
|
Experimental: Cohort 2 - Gliomas
Sorafenib and Radiotherapy, plus Temozolomide
|
Drug: Sorafenib
Sorafenib 200mg twice daily during XRT and 30 days after. (Sorafenib will be escalated for both cohorts to determine maximum tolerated dose)
Other Name: Nexavar
Drug: Temozolomide
For Cohort 2 - Gliomas only.
Other Names:
Radiation: Radiotherapy
Radiation Therapy (XRT)
Other Names:
|
Detailed Description:
The current standard of care for patients with brain metastatic malignancies is to receive radiation therapy alone, while the standard of care for patients with high grade primary brain malignancies, astrocytomas, is to receive to receive concurrent temozolomide with radiation therapy. In this phase I study, based on the range of efficacy of kinase inhibitors and its ability to cross the blood-brain barrier we will conduct two parallel studies. The first is to combine sorafenib and radiation therapy for the treatment of patients with brain metastases and the second is to combine sorafenib with temozolomide for primary brain tumors.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients requiring a minimum 2-week course of radiation therapy
- Age > or = 18
- All tumors of the central nervous system, or metastasis to the central nervous system.
- Measurable disease preferred but not required for eligibility
- Histologically or cytologically documented evidence of malignancy (for infratentorial and supratentorial glioma patients only).
- Radiographic evidence of brain metastasis
- ECOG performance status of 0 or 1
- Life expectancy of > or = 3 months
Exclusion Criteria:
- Patients receiving chemotherapy or other investigational drugs must be discontinued 14 days prior to enrollment.
- Cardiac disease: Congestive heart failure > class II NYHA. Patients must not have unstable angina (anginal symptoms at rest) or new onset angina (began within the last 3 months) or myocardial infarction within the past 6 months.
- Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy.
- Uncontrolled hypertension defined as systolic blood pressure > 150 mmHg or diastolic pressure > 90 mmHg, despite optimal medical management.
- Known human immunodeficiency virus (HIV) infection or chronic Hepatitis B or C.
- Active clinically serious infection > CTCAE Grade 2
Contacts and Locations| United States, Pennsylvania | |
| Thomas Jefferson University | |
| Philadelphia, Pennsylvania, United States, 19107 | |
| Principal Investigator: | Adam Dicker, MD, PhD | Thomas Jefferson University |
More Information
Additional Information:
No publications provided
| Responsible Party: | Thomas Jefferson University |
| ClinicalTrials.gov Identifier: | NCT00639262 History of Changes |
| Other Study ID Numbers: | 07P.381, 2006-58 |
| Study First Received: | March 13, 2008 |
| Last Updated: | March 22, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Thomas Jefferson University:
|
Sorafenib Radiation Therapy Radiotherapy |
Temozolomide Brain Metastases Brain Tumors |
Additional relevant MeSH terms:
|
Brain Neoplasms Neoplasm Metastasis Neoplasms, Second Primary Central Nervous System Neoplasms Nervous System Neoplasms Neoplasms by Site Neoplasms Brain Diseases Central Nervous System Diseases Nervous System Diseases Neoplastic Processes Pathologic Processes |
Temozolomide Dacarbazine Sorafenib Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Antineoplastic Agents Therapeutic Uses Protein Kinase Inhibitors Enzyme Inhibitors |
ClinicalTrials.gov processed this record on May 23, 2013