Mibefradil Dihydrochloride and Temozolomide in Treating Patients With Recurrent Glioma
RATIONALE: Mibefradil dihydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.
PURPOSE: This phase I trial is studying the best dose of mibefradil dihydrochloride when given together with temozolomide in treating patients with glioma.
|Brain and Central Nervous System Tumors||Drug: temozolomide Other: 3'-deoxy-3'-[18F]fluorothymidine Other: pharmacological study Drug: Mibefradil||Phase 1|
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||A Phase I Open Label Safety Study to Evaluate the Pharmacokinetic Profile and Tolerance of Mibefradil Dose Finding in Subjects With Recurrent High-Grade Glioma Undergoing Standard, Repeated Temozolomide Treatment|
- Maximum-tolerated dose of mibefradil dihydrochloride [ Time Frame: 2 years ]
- Dose-limiting toxicity [ Time Frame: 2 years ]
- Toxicity and adverse events according to CTCAE v. 4.0 [ Time Frame: 2 years ]
- Biological activity of treatment determined by radiographic response [ Time Frame: 3 years ]
- Pharmacokinetics of mibefradil dihydrochloride [ Time Frame: 2 years ]
- Potential effect of mibefradil dihydrochloride on tumor metabolism as determined by [F-18]FLT PET scans in the dose-expansion cohort [ Time Frame: 6 months ]
|Study Start Date:||April 2012|
|Primary Completion Date:||August 2015 (Final data collection date for primary outcome measure)|
Experimental: Dose Finding
Dose Escalation of Mibefradil for 7 days followed by TMZ (150-200mg/m2) every 28 days. At MTD 10 additional pts treated with an addition FLT PET-CT scan.
Mibefradil Temozolmide FLT PET CT '3'-deoxy-3'-[18F]fluorothymidine' Pharmacology Studies
tracer used for FLT PET CTOther: pharmacological study Drug: Mibefradil
- Determine the maximum-tolerated dose (MTD) of mibefradil dihydrochloride administered prior to five days of temozolomide (TMZ) at 150-200 mg/m² in subjects with progressive or recurrent high-grade glioma.
- Assess the safety of mibefradil dihydrochloride administered prior to five days of TMZ at 150-200 mg/m² when the mibefradil dihydrochloride dose is escalated from a starting dose of 100 mg/day, given four times a day for seven consecutive days.
- Determine the pharmacokinetic profile of mibefradil.
- Determine the steady state levels of mibefradil dihydrochloride on the last day of dosing.
- Assess the severity and frequency of adverse events for tested mibefradil dihydrochloride dose levels including cumulative toxicity and/or tolerance to adverse effects.
- Estimate the number and type of radiographic responses to treatment with mibefradil dihydrochloride and temozolomide.
- Assess the potential effect of mibefradil dihydrochloride on tumor metabolism as determined by Fluorothymidine Positron Emission Tomography (FLT PET) scans with the radiotracer [18F]-3'-fluoro-3'-deoxy-L-thymidine (dose-expansion cohort only).
OUTLINE: This is a dose-escalation study of mibefradil dihydrochloride followed by a dose-expansion study.
Patients receive mibefradil dihydrochloride orally (PO) 4 times a day on days 1-7 (days 1-8 on first course) and temozolomide PO on days 8-12 (days 9-13 on first course). Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Blood samples are collected during the first course for pharmacokinetic studies.
Patients in the dose-expansion cohort undergo [18F]-3'-fluoro-3'-deoxy-L-thymidine (FLT)-positron emission tomography (PET) at baseline and on day 7 of the first course of therapy.
After completion of study therapy, patients are followed up every 2 months.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01480050
|United States, Alabama|
|UAB Comprehensive Cancer Center|
|Birmingham, Alabama, United States, 35294-3410|
|United States, Georgia|
|Winship Cancer Institute of Emory University|
|Atlanta, Georgia, United States, 30322|
|United States, Maryland|
|Johns Hopkins University|
|Baltimore, Maryland, United States, 21205|
|United States, Michigan|
|Henry Ford Hospital|
|Detroit, Michigan, United States, 48202|
|United States, North Carolina|
|Wake Forest University Comprehensive Cancer Center|
|Winston-Salem, North Carolina, United States, 27157-1096|
|United States, Pennsylvania|
|Abramson Cancer Center of the University of Pennsylvania|
|Philadelphia, Pennsylvania, United States, 19104-4283|
|Hillman Cancer Center at University of Pittsburgh Cancer Institute|
|Pittsburgh, Pennsylvania, United States, 15232|
|Principal Investigator:||Matthias Holdhoff, MD||Sidney Kimmel Comprehensive Cancer Center|