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High-Dose Methotrexate and Leucovorin in Treating Patients With Newly Diagnosed Glioblastoma Multiforme

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00082797
Recruitment Status : Completed
First Posted : May 19, 2004
Last Update Posted : January 29, 2010
National Cancer Institute (NCI)
Information provided by:
Eastern Cooperative Oncology Group

Brief Summary:

RATIONALE: Drugs used in chemotherapy, such as methotrexate, work in different ways to stop tumor cells from dividing so they stop growing or die. Leucovorin may decrease side effects caused by high-dose methotrexate.

PURPOSE: This phase II trial is studying how well giving high-dose methotrexate together with leucovorin works in treating patients with newly diagnosed glioblastoma multiforme.

Condition or disease Intervention/treatment Phase
Brain and Central Nervous System Tumors Drug: leucovorin calcium Drug: methotrexate Phase 2

Detailed Description:



  • Determine the response in patients with newly diagnosed glioblastoma multiforme treated with high-dose methotrexate and leucovorin calcium.


  • Determine the acute toxicity of this regimen in these patients.
  • Determine the duration of survival of patients treated with this regimen.

OUTLINE: This is a multicenter study.

Patients receive high-dose methotrexate IV over 4 hours on day 1 and oral or IV leucovorin calcium every 6 hours beginning on day 2 and continuing until blood methotrexate levels are acceptable. Treatment repeats every 14 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Patients then receive standard radiotherapy with or without chemotherapy. Patients with disease progression proceed to standard radiotherapy with or without chemotherapy upon stopping methotrexate therapy.

Patients are followed at 30 days and then every 2 months for up to 2 years.

PROJECTED ACCRUAL: A total of 19-36 patients will be accrued for this study.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 36 participants
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Study Of Systemic High-Dose Methotrexate For The Treatment Of Glioblastoma Multiforme In Newly Diagnosed Patients With Measurable Disease
Study Start Date : February 2005
Actual Primary Completion Date : May 2007

Primary Outcome Measures :
  1. Response rate (complete and partial)

Secondary Outcome Measures :
  1. Frequency of toxicity

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically confirmed glioblastoma multiforme (GBM)

    • Supratentorial grade IV disease
  • Measurable and contrast-enhancing disease ≥ 1 cm by CT scan or MRI
  • No radiographic evidence of ascites or pleural effusion



  • 18 and over

Performance status

  • ECOG 0-2

Life expectancy

  • Not specified


  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3


  • SGOT ≤ 4.0 times upper limit of normal
  • Bilirubin ≤ 2.0 mg/dL


  • Creatinine ≤ 2.0 mg/dL
  • Creatinine clearance ≥ 50 mL/min


  • No uncontrolled hypertension
  • No unstable angina
  • No symptomatic congestive heart failure
  • No uncontrolled cardiac arrhythmia
  • No myocardial infarction within the past 6 months


  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able to achieve hydration
  • No diabetes insipidus
  • No known hypersensitivity to methotrexate or leucovorin calcium
  • No concurrent serious infection or medical illness that would preclude study participation
  • No other malignancy within the past 2 years except basal cell or squamous cell skin cancer or carcinoma in situ of the cervix


Biologic therapy

  • No prior immunotherapy for GBM
  • No prior administration of any of the following biologic agents for GBM:

    • Immunotoxins
    • Immunoconjugates
    • Antisense therapy
    • Peptide receptor antagonists
    • Interferons
    • Interleukins
    • Tumor-infiltrating lymphocytes
    • Lymphokine-activated killer cells
    • Gene therapy
  • No concurrent prophylactic growth factors (e.g., filgrastim [G-CSF] or sargramostim [GM-CSF])


  • No prior chemotherapy for GBM
  • No other concurrent chemotherapy

Endocrine therapy

  • Prior glucocorticoid therapy allowed
  • No prior hormonal therapy for GBM
  • Patients must be maintained on a stable corticosteroid regimen for at least 1 week


  • No prior cranial irradiation
  • No prior radiotherapy for GBM


  • Recovered from prior surgery


  • At least 1 week since prior treatment with any of the following:

    • Salicylates
    • Non-steroidal anti-inflammatory drugs
    • Sulfonamide medications
    • Vitamin C
  • No other concurrent investigational agents

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00082797

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Sponsors and Collaborators
Eastern Cooperative Oncology Group
National Cancer Institute (NCI)
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Study Chair: Stuart A. Grossman, MD Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Study Chair: Jana Portnow, MD City of Hope Comprehensive Cancer Center
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Responsible Party: Group Chair, Eastern Cooperative Oncology Group Identifier: NCT00082797    
Other Study ID Numbers: CDR0000360834
First Posted: May 19, 2004    Key Record Dates
Last Update Posted: January 29, 2010
Last Verified: January 2010
Keywords provided by Eastern Cooperative Oncology Group:
adult glioblastoma
adult giant cell glioblastoma
adult gliosarcoma
Additional relevant MeSH terms:
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Nervous System Neoplasms
Central Nervous System Neoplasms
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Neoplasms by Site
Nervous System Diseases
Calcium-Regulating Hormones and Agents
Physiological Effects of Drugs
Abortifacient Agents, Nonsteroidal
Abortifacient Agents
Reproductive Control Agents
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Dermatologic Agents
Enzyme Inhibitors
Folic Acid Antagonists