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Bosutinib in Adult Patients With Recurrent Glioblastoma

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ClinicalTrials.gov Identifier: NCT01331291
Recruitment Status : Completed
First Posted : April 8, 2011
Results First Posted : June 20, 2016
Last Update Posted : July 25, 2016
Sponsor:
Collaborators:
Dana-Farber Cancer Institute
Brigham and Women's Hospital
Pfizer
Information provided by (Responsible Party):
Tracy T. Batchelor, MD, Massachusetts General Hospital

Tracking Information
First Submitted Date  ICMJE March 28, 2011
First Posted Date  ICMJE April 8, 2011
Results First Submitted Date  ICMJE June 9, 2016
Results First Posted Date  ICMJE June 20, 2016
Last Update Posted Date July 25, 2016
Study Start Date  ICMJE April 2011
Actual Primary Completion Date December 2014   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 9, 2016)
Progression-Free Survival [ Time Frame: 2 years ]
Assess progression-free survival at six months in patients with recurrent glioblastoma at first or second recurrence who are treated with continuous daily dosing of bosutinib (Arm B). Progression-free survival is measured from initiation of study treatment to date of progression.
Original Primary Outcome Measures  ICMJE
 (submitted: April 6, 2011)
Progression-Free Survival [ Time Frame: 2 years ]
Assess progression-free survival at six months in patients with recurrent GBM at first or second recurrence who are treated with continuous daily dosing of bosutinib (Arm B)
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: June 9, 2016)
  • Intratumoral Concentration [ Time Frame: 2 years ]
    Assess the intratumoral concentration of bosutinib in recurrent glioblastoma patients who are candidates for surgical re-resection (ARM A).
  • Safety Profile [ Time Frame: 2 years ]
    Overall safety profile will be characterized by type, frequency, severity (as graded by NCI CTCAE), timing and relationship of study therapy of adverse events and laboratory abnormalities. Safety and tolerability will be measured by the proportion of patients who experience Grade 3 or higher Adverse Events that are possibly, probably or definitely related to bosutinib and the number of same Adverse Events per patient. Adverse Events will be summarized by treatment for each arm by the frequency of patients experiencing treatment emergent adverse events.
  • Anti-tumor Response [ Time Frame: 2 years ]
    Assess anti-tumor response in patients in Arm B using MacDonald criteria. There are four possible responses: complete response, partial response, stable disease, or progressive disease. Criteria are based on measurements of tumor dimension as visualized with a contrast-enhanced MRI.
Original Secondary Outcome Measures  ICMJE
 (submitted: April 6, 2011)
  • Intratumoral Concentration [ Time Frame: 2 years ]
    Assess the intratumoral concentration of bosutinib in recurrent GBM patients who are candidates for surgical re-resection (ARM A).
  • Safety Profile [ Time Frame: 2 years ]
    Overall safety profile will be characterized by type, frequency, severity (as graded by NCI CTCAE), timing and relationship of study therapy of adverse events and laboratory abnormalities. Adverse Events will be summarized by treatment for each arm by the frequency of patients experiencing treatment emergent adverse events.
  • Anti-tumor Response [ Time Frame: 2 years ]
    Assess anti-tumor response in patients in Arm B using MacDonald criteria.
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Bosutinib in Adult Patients With Recurrent Glioblastoma
Official Title  ICMJE An Open Label, Phase 2 Trial of Orally Administered Bosutinib (SKI-606) in Adult Patients With Recurrent Glioblastoma (GBM)
Brief Summary For many brain tumors, one reason that chemotherapy drugs might not be effective is that the drug may not be able to get into the brain tumor and kill the cancer cells. The brain is protected by a layer called the blood brain barrier. This barrier prevents substances from entering. The purpose of this research study is to determine if bosutinib can get past the blood brain barrier and into the brain tumor, and to see how well bosutinib works in killing cancer cells.
Detailed Description

- Arm A: Participants will receive daily doses of bosutinib orally for 7-9 days prior to surgery. On the day of the scheduled surgery (either craniotomy or surgical resection as planned by the treating doctor), participants will take the bosutinib within 6-12 hours of the surgery. During the surgery, tissue samples of the tumor will be collected to test the levels of bosutinib in the brain. A contrast-enhanced MRI or CT scan will be done within days after the surgery. Daily dosing of bosutinib will resume after a recovery period of 10 days. From then on, the study will be divided into 28-day cycles.

The following tests/procedures will be performed regularly during cycles of study treatment: medical history; physical exam; blood tests; contrast-enhanced CT or MRI scans (even numbered cycles only).

  • Arm B: Participants will receive daily doses of bosutinib. The study is divided int 28-day cycles. There are no breaks from taking bosutinib between treatment cycles. The following tests/procedures will be performed regularly during cycles of study treatment: medical history; physical exam; blood tests; contrast-enhanced CT or MRI scans (even numbered cycles only).
  • Participants may continue to receive daily bosutinib until their disease worsens, they experience unmanageable side-effects, or they decide to stop treatment.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Glioblastoma
Intervention  ICMJE Drug: bosutinib
Taken orally
Other Name: SKI-606
Study Arms  ICMJE
  • Experimental: Arm A
    Patients who are surgical candidates. Participants are given oral bosutinib, 400mg daily, for 7-9 days prior to resection. After at least 10 days elapsed post-operatively, bosutinib dosing was resumed.
    Intervention: Drug: bosutinib
  • Experimental: Arm B
    Patients that are not surgical candidates. Participants are given oral bosutinib, 400 mg daily in 28 day cycles until disease progression, intolerability or withdrawal of consent.
    Intervention: Drug: bosutinib
Publications * Taylor JW, Dietrich J, Gerstner ER, Norden AD, Rinne ML, Cahill DP, Stemmer-Rachamimov A, Wen PY, Betensky RA, Giorgio DH, Snodgrass K, Randall AE, Batchelor TT, Chi AS. Phase 2 study of bosutinib, a Src inhibitor, in adults with recurrent glioblastoma. J Neurooncol. 2015 Feb;121(3):557-63. doi: 10.1007/s11060-014-1667-z. Epub 2014 Nov 20.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: April 6, 2011)
36
Original Estimated Enrollment  ICMJE Same as current
Actual Study Completion Date  ICMJE December 2014
Actual Primary Completion Date December 2014   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • 18 years of age or older
  • Histologically confirmed WHO (World Health Organization) grade IV astrocytoma (glioblastoma). Patients with recurrent disease whose original pathology confirmed glioblastoma will not need re-biopsy. Patients with prior low-grade glioma or anaplastic glioma are eligible if histological assessment demonstrates transformation to GBM.
  • The first-line regimen must have included, at a minimum, temozolomide and radiation.
  • First or second episode of progressive disease.
  • No more than two prior treatment regimens for progressive disease. Concurrent temozolomide and radiation followed by monthly cycles of temozolomide is counted as one regimen.
  • For all study arms, patients must have at least 15 unstained slides or 1 tissue block available from a prior biopsy or surgery.
  • All patients must have progressive disease on contrast-enhanced brain CT or MRI as defined by MacDonald Criteria, or have documented recurrent glioblastoma on diagnostic biopsy. Arm A patients may continue treatment in the post-operative period even if there is no residual contrast-enhancing tumor after surgery.
  • For Arm A, patients must be candidates for surgical partial or gross-total resection.
  • Interval of at least 2 weeks between prior surgical resection and adequate wound healing.
  • Interval of at least 12 weeks from prior radiotherapy unless there is either a) histopathologic confirmation of recurrent tumor; b) new enhancement on MRI outside of the XRT (external beam radiation therapy) treatment field.
  • Patients must have sufficient time for recovery from prior therapy
  • Karnofsky Performance Status of 60% or greater
  • Laboratory levels as outlined in the protocol
  • Women of child-bearing potential and men must agree to use adequate contraception prior to study entry, for the duration of study participation and for 3 months thereafter.

Exclusion Criteria:

  • Participants may not be receiving any other investigational agents
  • Previously treated with an anti-VEGF (anti-vascular endothelial growth factor) agent
  • For subjects in Arm A: if the diagnostic pathology of the biopsy specimen is not consistent with recurrent glioblastoma then the subject will be taken off study and be replaced with another subject that meets the inclusion criteria and is eligible for surgical resection
  • Any surgery within 2 weeks of baseline disease assessments, or not fully recovered from any side effects of previous procedures
  • Any clinically significant gastrointestinal abnormalities, which may impair intake, transit or absorption of the study drug, such as the inability to take oral medications in tablet form.
  • Any psychiatric or cognitive disorder that would limit the understanding or rendering of informed consent and/or compromise compliance with the requirements of this protocol
  • Concomitant use of CYP3A4/5 inhibitors during the treatment phase of the study and within 72 hours prior to starting study drug administration
  • Concomitant use of CYP3A4/5 inducers, which include enzyme inducing antiepileptic drugs during treatment phase of the study and within 2 weeks prior to starting treatment.
  • Uncontrolled or significant cardiovascular disease
  • Prior stereotactic radiotherapy, convection enhanced delivery or brachytherapy as gliosis/scarring from these modalities may limit delivery
  • Pregnant or breast feeding women
  • HIV-positive individuals on combination antiretroviral therapy
  • Other severe acute or chronic medical condition or laboratory abnormality
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT01331291
Other Study ID Numbers  ICMJE 10-190
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Tracy T. Batchelor, MD, Massachusetts General Hospital
Study Sponsor  ICMJE Massachusetts General Hospital
Collaborators  ICMJE
  • Dana-Farber Cancer Institute
  • Brigham and Women's Hospital
  • Pfizer
Investigators  ICMJE
Principal Investigator: Tracy Batchelor, MD Massachusetts General Hospital
PRS Account Massachusetts General Hospital
Verification Date June 2016

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP