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Sorafenib in Newly Diagnosed High Grade 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: NCT00884416
Recruitment Status : Completed
First Posted : April 20, 2009
Last Update Posted : November 4, 2014
Information provided by (Responsible Party):
Andreas F. Hottinger, University Hospital, Geneva

Brief Summary:
This is a phase I study to evaluate the safety and tolerability of Sorafenib in combination with Temodar and radiation therapy in patients with newly diagnosed high grade glioma (glioblastoma, gliosarcoma, anaplastic astrocytoma and anaplastic oligodendroglioma or oligoastrocytoma). The mechanism of action of sorafenib, an oral multikinase inhibitor, makes it an interesting drug to investigate in the treatment of patients with high grade glioma as this agent has anti-angiogenic activity and inhibits other pathways such as Ras, Platelet-derived growth factor (PDGF) and fms-like tyrosine kinase receptor-3 (Flt-3), which are potential targets against gliomas.

Condition or disease Intervention/treatment Phase
Glioblastoma Gliosarcoma Anaplastic Astrocytoma Anaplastic Oligoastrocytoma Anaplastic Oligodendroglioma Drug: Sorafenib dose escalation Phase 1

Detailed Description:
Up to 18 patients will be included in this phase I study. The primary goal of this study will be to establish the maximum tolerated dose of sorafenib when used in combination with temozolomide and radiation therapy. Secondary goals of this study include: response rate, time to treatment failure, 6 month progression-free survival, event free survival and overall survival. A correlative study will investigate the pharmacokinetics of sorafenib used in combination with radiation therapy and temozolomide.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 17 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase I Dose Finding Study of Sorafenib in Combination With Radiation Therapy and Temozolomide as a First Line Treatment of Patients With High Grade Glioma
Study Start Date : March 2009
Actual Primary Completion Date : December 2011
Actual Study Completion Date : March 2012

Arm Intervention/treatment
Experimental: Sorafenib dose titration Drug: Sorafenib dose escalation
Sorafenib dose escalation scheme: 3 first patients: 200 mg/d, if dose limiting toxicities (DLT) not reached: 3 patients at 200 mg BID, if no DLT reached: 3 patients at 400 mg bid

Primary Outcome Measures :
  1. Safety and tolerability of sorafenib in combination with radiation and temozolomide chemotherapy [ Time Frame: 35 weeks ]
    Safety and tolerability of sorafenib in combination with radiation and temozolomide chemotherapy in patients with newly diagnosed high grade glioma

Secondary Outcome Measures :
  1. Maximum Observed Plasma Concentration (Cmax) and Area under the curve (AUC) of sorafenib and temozolomide [ Time Frame: 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 hours post dose ]
  2. Response rate [ Time Frame: 35 weeks ]
  3. Time to treatment failure [ Time Frame: 20 months ]
  4. 6 month progression-free survival [ Time Frame: 6 months ]
  5. Event free survival [ Time Frame: 20 months ]
  6. Overall survival [ Time Frame: 20 months ]

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:

  • Histological documentation of newly diagnosed malignant glioma
  • ECOG performance status of 0 or 1
  • Age ≥18
  • Life expectancy of at least 12 weeks
  • Hemoglobin ≥ 9.0 g/dl
  • Granulocyte count ≥1.5 X 10^9/L
  • Platelet count ≥100 X 10^9/L
  • SGOT ≤ 2.5X upper limit of normal (ULN)
  • SGPT ≤ 2.5X upper limit of normal (ULN)
  • Alkaline phosphatase ≤4x ULN
  • Serum creatinine ≤1.5X ULN
  • Bilirubin ≤1.5X ULN
  • Spontaneous PT-INR/PTT < 1.5x upper limit of normal (patients on therapeutic anticoagulation will be allowed to participate.
  • Patients must be on a stable or decreasing dose of corticosteroids for at least 2 weeks
  • Patient for whom a first line treatment with temozolomide and radiotherapy is adequate
  • Prophylactic anti-emetic, pentamidine inhalation / co-trimoxazole and anticonvulsants are allowed
  • All patients must sign written informed consent.

Exclusion Criteria:

  • Prior treatment for high grade glioma
  • Previous exposure to Ras pathway inhibitors
  • Other concurrent active malignancy (with the exception of cervical carcinoma in situ or non melanoma carcinoma of the skin, superficial bladder tumor [Ta, Tis & T1] or any cancer curatively treated > 3 years prior to study entry).
  • Serious medical or psychiatric illness that would, in the opinion of the investigator, interfere with the prescribed treatment, including but not limited to: Congestive heart failure > NYHA class 2, active CAD, cardiac arrythmias requiring anti-arrythmic therapy or uncontrolled hypertension within the last 12 months
  • Any condition limiting the patient's judgment capacity
  • History of HIV infection, chronic hepatitis C or B as well as clinically active infections (> grade 2 NCI-CTC version 3.0)
  • History of organ allograft
  • Renal dialysis
  • Evidence or history of bleeding diathesis
  • Major surgery within 4 weeks of start of study treatment, except for neurosurgical resection
  • Autologous bone marrow transplant or stem cell rescue within 4 months of study
  • Substance abuse, medical, psychological or social conditions that may interfere with the patient's participation in the study or evaluation of study results.
  • Medical condition that prevents the patient from swallowing pills
  • Use of biologic response modifiers, such as G-CSF within 3 week of study entry.
  • Pregnant or breast-feeding women.
  • Refusal to use effective contraception. Women of childbearing potential must have a negative pregnancy test performed within 7 days of the start of treatment. Both men and women enrolled in this trial must use adequate barrier birth control measures during the course of the trial and for at least 3 months after administration of study medication.
  • Known or suspected allergy to the investigational agent or any agent given in association with this trial.

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): NCT00884416

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Geneva University Hospital (Hopitaux Universitaires de Geneve), Department of Oncology
Geneva, GE, Switzerland, 1211
Sponsors and Collaborators
University Hospital, Geneva
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Principal Investigator: Pierre-Yves Dietrich, MD Department of oncology, Geneva University hospital
Publications of Results:
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Responsible Party: Andreas F. Hottinger, Principal Investigator, University Hospital, Geneva Identifier: NCT00884416    
Other Study ID Numbers: 08-122
First Posted: April 20, 2009    Key Record Dates
Last Update Posted: November 4, 2014
Last Verified: October 2014
Keywords provided by Andreas F. Hottinger, University Hospital, Geneva:
high grade glioma
anaplastic astrocytoma
anaplastic oligoastrocytoma
anaplastic oligodendroglioma
phase I
first line treatment
radiation therapy
protein kinase inhibitors
Additional relevant MeSH terms:
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Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action