Phase I Trial of Arsenic Trioxide and Stereotactic Radiotherapy for Recurrent Malignant Glioma

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: NCT00185861
Recruitment Status : Completed
First Posted : September 16, 2005
Last Update Posted : April 9, 2009
CTI BioPharma
Information provided by:
Stanford University

Brief Summary:
To investigate the safety of delivering arsenic trioxide (ATO) in combination with stereotactic radiotherapy in recurrent malignant glioma by performing an open label, Phase I dose escalation trial. Results from this study will provide a basis for further study of ATO combined with radiation therapy as a radiosensitizer for malignant brain tumors in future Phase II studies.

Condition or disease Intervention/treatment Phase
Brain Cancer Drug: Arsenic Trioxide Procedure: Stereotactic radiosurgery Phase 1

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 12 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase I Trial of Arsenic Trioxide and Stereotactic Radiotherapy for Recurrent Malignant Glioma
Study Start Date : December 2003
Actual Primary Completion Date : January 2008
Actual Study Completion Date : April 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Arsenic

Primary Outcome Measures :
  1. Describe and define toxicities of ATO combined with radiotherapy in patients with recurrent malignant glioma.
  2. Define the maximum tolerated dose (MTD) of ATO combined with stereotactic radiotherapy for recurrent malignant glioma.

Secondary Outcome Measures :
  1. Evaluate time to progression and survival
  2. Evaluate radiographic tumor response rate
  3. Determine the recommended dose for investigation in a Phase II study

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

Inclusion Criteria:

  • Evidence of recurrent disease.
  • All patients will have received previous conventional radiotherapy at least 3 weeks prior to enrollment. Histologic verification of malignant glioma is required. If the initial primary brain tumor was histologically malignant glioma and subsequent contrast enhanced MRI imaging shows tumor consistent with recurrence, additional biopsy or surgery is not required. However, if a low-grade neoplasm was the initial histologic diagnosis, tissue confirmation of malignant glioma is required at the time of recurrence.
  • Age: Patients must be >18 years of age
  • Patients must have a Karnofsky >60%, and/or ECOG performance status <2
  • Patients must have an estimated life expectancy of greater than 8 weeks.
  • Patients must have normal organ and marrow functions as defined below:

    • Leukocytes >3,000/¼l
    • Absolute neutrophil count >1,500/¼l
    • Hemoglobin > 10 gm/dl
    • Platelets >100,000/¼l (transfusion independent)
    • Total bilirubin within normal institutional limits
    • AST (SGOT)/ALT (SGPT) <1.5 X institutional upper limit of normal
    • Creatinine within normal institutional limits OR
    • Creatinine clearance >60mL/min/1.73 m2 for patients with creatinine levels above institutional normal
    • Serum potassium* e 4.0mEq/L
    • Serum magnesium* e 1.8mEq/L
    • Serum calcium* within the institutional normal range (should be corrected if low normal)
    • Electrocardiogram Normal
    • electrocardiogram with a rate corrected QT interval (QTc) <500 msec

      *Oral or intravenous supplementation may be used to normalize serum electrolytes

    • Phase I ATO Stereotactic Radiotherapy for Recurrent Malignant Glioma 16 of 44
  • Informed consent All patients or their legal guardians must sign a document of informed consent indicating their understanding of the investigational nature of this study and the risks involved prior to any protocol related are performed (which does not include imaging and laboratory studies that help to establish eligibility).

Exclusion Criteria:- Patients who have had chemotherapy or conventional radiotherapy within 3 weeks of enrollment.

  • Patients who have received prior radiosurgery or stereotactic radiotherapy within 10mm of the current target tumor.
  • Patients may not be receiving any other investigational agents.
  • Patients who cannot undergo MRI or CT are not eligible as MRI will be used to confirm the diagnosis and CT will be used for treatment planning.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to arsenic trioxide or other agents used in study.
  • Patients who are taking substances known to prolong the QT interval, see Appendix B. If the QT prolonging drug is discontinued and switched to an alternative agent, the patients will be allowed to enroll into this protocol as long the agent has been discontinued for a period of at least 2 weeks.
  • Patients currently taking Amphotericin B or related antifungal agents will be excluded due to potential for increased renal electrolyte wasting during arsenic trioxide therapy.
  • Patients with known second-degree heart block or other cardiac dysfunction. New York Heart Association Class II or greater (see Appendix E)
  • Uncontrolled intercurrent illnesses including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or psychiatric illness/social situations that would limit compliance with study requirements. Phase I ATO Stereotactic Radiotherapy for Recurrent Malignant Glioma 17 of 44
  • Patients must not be pregnant or breast-feeding. All patients with the potential for pregnancy should be counseled and requested to follow acceptable birth control methods (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Patients who are pregnant or breast-feeding will be excluded because no information on this agent exists with regard to safety of arsenic trioxide for a fetus or breast-feeding infant. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.

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): NCT00185861

United States, California
Stanford University School of Medicine
Stanford, California, United States, 94305
Sponsors and Collaborators
Stanford University
CTI BioPharma
Principal Investigator: Iris Catrice Gibbs Stanford University

Responsible Party: Iris Catrice Gibbs, Principal Investigator, Stanford Univesity School of Medicine Identifier: NCT00185861     History of Changes
Other Study ID Numbers: BRNCNS0001
First Posted: September 16, 2005    Key Record Dates
Last Update Posted: April 9, 2009
Last Verified: April 2009

Additional relevant MeSH terms:
Brain Neoplasms
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Central Nervous System Neoplasms
Nervous System Neoplasms
Neoplasms by Site
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Arsenic trioxide
Antineoplastic Agents