AMG 102 and Avastin for Recurrent Malignant Glioma

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Amgen
Information provided by (Responsible Party):
Katy Peters, Duke University Medical Center
ClinicalTrials.gov Identifier:
NCT01113398
First received: April 28, 2010
Last updated: August 21, 2014
Last verified: August 2014
  Purpose

The primary purpose of the study is to assess the response rate of AMG 102 and Avastin treatment in subjects with advanced malignant glioma. Secondary objectives are to estimate overall survival and 6-month progression-free survival rates in this population and to assess the safety of this combination in this population.

Patients must have recurrent histologically confirmed diagnosis of World Health Organization (WHO) grade IV malignant glioma (glioblastoma multiforme or gliosarcoma) with no more than 3 prior progressions. Subjects will receive Avastin and AMG 102 every two weeks. Avastin will be administered prior to AMG 102. Up to 36 adult subjects will take part in this study at Duke.

In initial Phase I and II clinical trials, four potential Avastin-associated safety issues were identified: hypertension, proteinuria, thromboembolic events, and hemorrhage. The most common side effect for AMG 102 have been nausea and fatigue.


Condition Intervention Phase
Glioblastoma Multiforme
Gliosarcoma
Drug: AMG 102
Drug: Avastin
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase II Study to Evaluate the Efficacy and Safety of AMG 102 and Avastin in Subjects With Recurrent Malignant Glioma

Resource links provided by NLM:


Further study details as provided by Duke University:

Primary Outcome Measures:
  • Radiological response rates [ Time Frame: 6 months ] [ Designated as safety issue: No ]
    Radiological response rates as determined by the Modified McDonald criteria, which incorporates steroid use and clinical status in addition to the tumor response.


Secondary Outcome Measures:
  • Overall Survival and 6-month progression-free survival [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  • Incidence and severity of CNS hemorrhage and systemic hemorrhage; Incidence of grade 4 or greater hematologic and grade 3 or greater non-hematologic toxicities [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]

Enrollment: 36
Study Start Date: August 2010
Estimated Study Completion Date: February 2016
Estimated Primary Completion Date: February 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: AMG 102 with Avastin
Avastin will be administered as a continuous intravenous infusion at 10 mg/kg prior to AMG 102, which will be administered as a continuous intravenous infusion by an infusion pump at 20 mg/kg. Subjects will receive infusions every 2 weeks.
Drug: AMG 102
AMG 102 will be administered as a continuous intravenous infusion by an infusion pump at 20 mg/kg every 2 weeks over 60 or 30 minutes.
Other Name: rilotumumab
Drug: Avastin
Avastin will be administered as a continuous intravenous infusion at 10 mg/kg every 2 weeks (6-week study cycle) over 60 or 30 minutes. Avastin will be given prior to AMG 102.
Other Name: Bevacizumab

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have recurrent histologically confirmed diagnosis of WHO grade IV malignant glioma (glioblastoma multiforme or gliosarcoma) with no more than 3 prior progressions.
  • Age ≥ 18 years.
  • Karnofsky ≥ 60%.
  • An interval of at least 4 weeks between either prior tumor biopsy or prior major surgical procedure and study enrollment.
  • Bi-dimensionally measurable disease as assessed by magnetic resonance imaging.
  • Hemoglobin ≥9.0 g/dl, ANC ≥1500 cells/µl, Platelets ≥125,000 cells/µl (without transfusion within 14 days before enrollment).
  • Serum creatinine < 1.5 mg/dl, bilirubin < 1.5 times upper limit of normal, and serum SGOT (AST) and SGPT (ALT) < 2.5 times upper limit of normal.
  • For patients on corticosteroids, they must be on a stable dose for 1 week prior to entry, and the dose should not be escalated over entry dose level, if clinically possible.
  • Signed informed consent approved by the Institutional Review Board.
  • No evidence of active CNS hemorrhage on the baseline MRI or CT scan.
  • If sexually active, patients will take contraceptive measures for the duration of treatment as stated in the informed consent.

Exclusion Criteria:

  • Pregnancy or breast-feeding.
  • Baseline ECG with QTc > 0.45 second
  • Co-medication that may interfere with study results; e.g. immuno-suppressive agents other than corticosteroids.
  • Thrombosis or vascular ischemic events within the last twelve months, such as deep venous thrombosis, pulmonary embolism, transient ischemic attack, cerebral infarction, or myocardial infarction.
  • Active infection requiring IV antibiotics 7 days before enrollment.
  • History of central nervous system bleeding as defined by stroke or intraocular bleed (including embolic stroke) within 6 months before enrollment.
  • Evidence of acute intracranial hemorrhage; except for subjects with stable grade 1 hemorrhage.
  • Less than 12 weeks from radiation therapy, unless progressive disease outside of the radiation field or 2 consecutive scans or histopathologic confirmation.
  • Treated previously with any c-Met or HGF targeted therapy.
  • Treated previously with VEGF or VEGFR therapies, including antibodies and tyrosine kinase inhibitors.
  • Treated with thalidomide or tamoxifen within 1 week before enrollment unless the patient has recovered from the toxic effects of such therapy.
  • Treated with immunotherapeutic agents, vaccines, or MAb therapy within 4 weeks before enrollment unless the patient has recovered from the toxic effects of such therapy.
  • Treated with alkylating agents within 4 weeks before enrollment or if the patient has been treated with daily or metronomic chemotherapy unless the patient has recovered from the toxic effects of such therapy.
  • Treated with chemotherapy (non-alkylating agents) within 2 weeks before enrollment unless the patient has recovered from the toxic effects of such therapy.
  • Less than 4 weeks after surgical resection of the brain tumor or less than 2 weeks after stereotactic biopsy before enrollment unless the patient has recovered from acute side effects of such procedures except for neurological effects.
  • Plans to receive surgery, radiation therapy or other elective surgeries during the course of the study.
  • Concurrent severe and/or uncontrolled medical disease (e.g. uncontrolled diabetes, congestive cardiac failure, myocardial infarction within 6 months before enrollment) that could compromise participation in the study.
  • Concurrent or prior (within 7 days of enrollment) anticoagulation therapy, except: Use of low dose coumadin-type anticoagulants (≤ 2 mg PO QD) low molecular weight heparins (LMWH), e.g. Enoxaparin sodium (Lovenox) and unfractionated heparin for prophylaxis against central venous catheter thrombosis is allowed.
  • Grade 2 or greater peripheral edema or effusion (pleural, pericardial, or ascites).
  • Inability to comply with study and/or follow-up procedure.
  • Current, recent (within 4 weeks of the first infusion of this study), or planned participation in an experimental drug study.

Avastin-Specific Exclusion Criteria

Subjects meeting any of the following criteria are ineligible for study entry:

  • Inadequately controlled hypertension (defined as systolic blood pressure >150 mmHg and/or diastolic blood pressure > 100 mmHg)
  • Prior history of hypertensive crisis or hypertensive encephalopathy
  • New York Heart Association (NYHA) Grade II or greater congestive heart failure
  • History of myocardial infarction or unstable angina within 6 months prior to Day 1, the day protocol therapy starts.
  • History of stroke or transient ischemic attack within 6 months prior to Day 1
  • Significant vascular disease (e.g. aortic aneurysm, requiring surgical repair or recent peripheral arterial thrombosis) (within 6 months prior to Day 1).
  • History of hemoptysis (≥ 1/2 teaspoon of bright red blood per episode) within 28 days prior to Day 1
  • Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation)
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 1
  • Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to Day 1
  • Serious, non-healing wound, active ulcer or untreated bone fracture
  • Proteinuria as defined by ≥ +1 on urinalysis dipstick
  • Known hypersensitivity to any component of Avastin
  • Pregnant (positive pregnancy test) or lactation.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01113398

Locations
United States, North Carolina
The Preston Robert Tisch Brain Tumor Center
Durham, North Carolina, United States, 27710
Sponsors and Collaborators
Katy Peters
Amgen
Investigators
Principal Investigator: Katherine B Peters, MD, PhD Duke University
Principal Investigator: Mary Lou Affronti, DNP, RN, MSN, ANP, MHSc Duke University
  More Information

Additional Information:
No publications provided

Responsible Party: Katy Peters, Assistant Professor of Medicine, Duke University Medical Center
ClinicalTrials.gov Identifier: NCT01113398     History of Changes
Other Study ID Numbers: Pro00022491
Study First Received: April 28, 2010
Last Updated: August 21, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by Duke University:
glioblastoma multiforme
gliosarcoma
malignant glioma
glioma
Avastin
bevacizumab
AMG 102
rilotumumab
recurrent
Duke
Pro00022491

Additional relevant MeSH terms:
Gliosarcoma
Glioblastoma
Glioma
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Astrocytoma
Bevacizumab
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Pharmacologic Actions
Growth Inhibitors
Antineoplastic Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on September 16, 2014