Tipifarnib in Treating Young Patients With Recurrent or Progressive High-Grade Glioma, Medulloblastoma, Primitive Neuroectodermal Tumor, or Brain Stem Glioma

This study has been completed.
Information provided by (Responsible Party):
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
First received: October 3, 2003
Last updated: October 7, 2013
Last verified: October 2013
This phase II trial is studying how well tipifarnib works in treating young patients with recurrent or progressive high-grade glioma, medulloblastoma, primitive neuroectodermal tumor, or brain stem glioma. Tipifarnib may stop the growth of tumor cells by blocking the enzymes necessary for their growth.

Condition Intervention Phase
Childhood High-grade Cerebral Astrocytoma
Childhood Oligodendroglioma
Recurrent Childhood Brain Stem Glioma
Recurrent Childhood Cerebellar Astrocytoma
Recurrent Childhood Cerebral Astrocytoma
Recurrent Childhood Medulloblastoma
Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor
Recurrent Childhood Visual Pathway and Hypothalamic Glioma
Drug: tipifarnib
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Study of R115777 (Zarnestra) (NSC # 702818, IND# 58,359) in Children With Recurrent or Progressive: High Grade Glioma, Medulloblastoma/PNET or Brainstem Glioma

Resource links provided by NLM:

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Best objective tumor response rates (complete and partial response), based on MRIs [ Time Frame: Up to 2 years ] [ Designated as safety issue: No ]
    Estimated ultimately as a simple binomial proportion. Estimated actuarially, using the product-limit (PL) estimate.

  • Time to tumor progression (TTP) [ Time Frame: Time from study enrollment to radiographically determined tumor progression or recurrence, assessed up to 2 years ] [ Designated as safety issue: No ]
    The distribution of TTP will be analyzed using PL estimate.

  • Time to treatment failure (TTF) [ Time Frame: Time from study enrollment to tumor progression, tumor recurrence, death from any cause, or occurrence of a second malignant neoplasm, assessed up to 2 years ] [ Designated as safety issue: No ]
    The distribution of TTF will be analyzed using PL estimate.

  • Time to death (TTD) [ Time Frame: Time from study enrollment to death from any cause, assessed up to 2 years ] [ Designated as safety issue: No ]
    The distribution of TTD will be analyzed using PL estimate.

  • Incidence of adverse events graded according to NCI CTCAE version 3.0 [ Time Frame: Up to 2 years ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 90
Study Start Date: November 2003
Primary Completion Date: September 2006 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm I
Patients receive oral tipifarnib twice daily on days 1-21. Courses repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity.
Drug: tipifarnib
Given orally

Detailed Description:


I. Determine the response rate in pediatric patients with recurrent or progressive high-grade glioma, medulloblastoma/primitive neuroectodermal tumor (PNET), or brain stem glioma treated with tipifarnib.

II. Determine the distribution of time to progression, time to treatment failure, and time to death in patients treated with this drug.

OUTLINE: This is an open-label, multicenter study. Patients are stratified according to disease (high-grade glioma vs recurrent or progressive medulloblastoma/primitive neuroectodermal tumor [PNET] vs progressive diffuse, intrinsic brain stem glioma).

Patients receive oral tipifarnib twice daily on days 1-21. Courses repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity.


Ages Eligible for Study:   up to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Histologically confirmed brain tumor, including the following:

    • Anaplastic astrocytoma
    • Glioblastoma multiforme
    • Gliosarcoma
    • Anaplastic oligodendroglioma
    • Medulloblastoma/primitive neuroectodermal tumor (PNET)
    • Diffuse intrinsic brain stem glioma*
  • Progressive or relapsed disease after prior conventional therapy
  • Radiographic evidence of measurable disease
  • Performance status - Karnofsky 60-100% (over 16 years of age)
  • Performance status - Lansky 60-100% (16 years of age and under)
  • Performance status - ECOG 0-2
  • At least 8 weeks
  • Absolute neutrophil count at least 1,000/mm^3
  • Platelet count at least 100,000/mm^3 (transfusion independent)
  • Hemoglobin at least 8.0 g/dL (red blood cell transfusions allowed)
  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)
  • SGPT and SGOT less than 2.5 times ULN
  • Creatinine clearance OR radioisotope glomerular filtration rate at least 70 mL/min
  • Maximum creatinine based on age as follows:

    • 0.8 mg/dL (5 years and under)
    • 1.0 mg/dL (6 to 10 years)
    • 1.2 mg/dL (11 to 15 years)
    • 1.5 mg/dL (over 15 years)
  • Shortening fraction at least 27% by echocardiogram
  • Ejection fraction at least 50% by MUGA
  • No dyspnea at rest
  • No exercise intolerance
  • Pulse oximetry greater than 94%*
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Seizure disorder is allowed provided it is well-controlled on non-enzyme-inducing anticonvulsants
  • No active graft-versus-host disease
  • No uncontrolled infection
  • No allergy to azoles (e.g., ketoconazole, itraconazole, or fluconazole)
  • Recovered from prior immunotherapy
  • At least 7 days since prior antineoplastic biologic agents
  • At least 1 month since prior autologous stem cell transplantation (SCT)
  • At least 6 months since prior allogeneic SCT
  • More than 1 week since prior growth factors
  • No concurrent immunomodulating agents
  • More than 2 weeks since prior myelosuppressive chemotherapy (4-6 weeks for nitrosoureas or temozolomide) and recovered
  • No concurrent anticancer chemotherapy
  • Concurrent dexamethasone allowed provided patient is on a stable or decreasing dose for at least 1 week prior to study entry
  • Concurrent corticosteroids allowed only for treatment of increased intracranial pressure
  • Recovered from prior radiotherapy
  • At least 2 weeks since prior local palliative radiotherapy (small port)
  • At least 3 months since prior craniospinal radiotherapy
  • At least 6 weeks since other prior substantial bone marrow radiotherapy
  • No concurrent palliative radiotherapy
  • No prior initiation of therapy on another phase II study
  • No concurrent participation in another therapeutic COG study
  • No concurrent enzyme-inducing anticonvulsants
  • No other concurrent anticancer or experimental drugs
  • No concurrent foods or medications that interfere with CYP3A4, including any of the following:

    • Carbamazepine
    • Phenytoin
    • Phenobarbital
    • Grapefruit juice
    • Erythromycin
    • Azithromycin
    • Clarithromycin
    • Rifampin and its analogues
    • Fluconazole
    • Ketoconazole
    • Itraconazole
    • Cimetidine
    • Cannabinoids (i.e., marijuana or dronabinol)
    • Omeprazole
    • Hypericum perforatum (St. John's wort)
    • Ethosuximide
    • Glucocorticoids
    • Griseofulvin
    • Nafcillin
    • Nelfinavir
    • Norfloxacin
    • Norfluoxetine
    • Nevirapine
    • Oxcarbazepine
    • Phenylbutazone
    • Primidone
    • Progesterone (all progestins)
    • Rifabutin
    • Rofecoxib
    • Sulfadimidine
    • Sulfinpyrazone
    • Troglitazone
    • Rifapentine
    • Modafinil
    • Amiodarone
    • Anastrozole
    • Clotrimazole
    • Cyclosporine
    • Danazol
    • Delavirdine
    • Diethyldithiocarbamate
    • Diltiazem
    • Dirithromycin
    • Disulfiram
    • Entacapone (high dose)
    • Ethinyl estradiol
    • Fluoxetine
    • Fluvoxamine
    • Gestodene
    • Indinavir
    • Isoniazid
    • Metronidazole
    • Mibefradil
    • Miconazole
    • Nefazodone
    • Oxiconazole
    • Paroxetine
    • Propoxyphene
    • Roxithromycin
    • Quinidine
    • Quinine
    • Quinupristin and dalfopristin
    • Ranitidine
    • Ritonavir
    • Saquinavir
    • Sertindole
    • Sertraline
    • Troleandomycin
    • Valproic acid
    • Verapamil
    • Voriconazole
    • Zafirlukast
    • Zileuton
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00070525

United States, California
Children's Oncology Group
Arcadia, California, United States, 91006-3776
Sponsors and Collaborators
National Cancer Institute (NCI)
Principal Investigator: Maryam Fouladi Children's Oncology Group
  More Information

Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00070525     History of Changes
Other Study ID Numbers: NCI-2012-01806  NCI-2012-01806  CDR0000334862  COG-ACNS0226  ACNS0226  ACNS0226  U10CA098543 
Study First Received: October 3, 2003
Last Updated: October 7, 2013
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Neuroectodermal Tumors
Neuroectodermal Tumors, Primitive
Neuroectodermal Tumors, Primitive, Peripheral
Optic Nerve Glioma
Cranial Nerve Diseases
Cranial Nerve Neoplasms
Eye Diseases
Neoplasms by Histologic Type
Neoplasms by Site
Neoplasms, Germ Cell and Embryonal
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Neoplasms, Neuroepithelial
Nervous System Diseases
Nervous System Neoplasms
Optic Nerve Diseases
Optic Nerve Neoplasms
Peripheral Nervous System Neoplasms
Antineoplastic Agents

ClinicalTrials.gov processed this record on May 25, 2016