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Phase II Study of Irinotecan HCI for Recurrent Anaplastic Astrocytomas, Mixed Malignant Gliomas, and Oligodendrogliomas

Information source: H. Lee Moffitt Cancer Center and Research Institute
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Astrocytoma; Glioma; Oligodendroglioma

Intervention: Irinotecan Hydrochloride (HCI) Treatment (Drug); Continued Irinotecan Hydrochloride (HCI) Treatment (Drug)

Phase: Phase 2

Status: Terminated

Sponsored by: H. Lee Moffitt Cancer Center and Research Institute

Official(s) and/or principal investigator(s):
Edward Pan, MD, Principal Investigator, Affiliation: H. Lee Moffitt Cancer Center and Research Institute

Summary

Phase 2 trial to explore the efficacy and safety of irinotecan (CPT-11). Also administered at each cycle was zofran/Kytril/Anzemet, decadron, and IV atropine. At each cycle, patient exams and interviews as well as lab results were to help the research team to determine the symptomatic side effects of the treatment. Recorded past toxicities were to be compared with current side effects.

Clinical Details

Official title: A Phase II Study of Irinotecan HCI in Patients With Recurrent Anaplastic Astrocytomas, Mixed Malignant Gliomas, and Oligodendrogliomas

Study design: Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic

Primary outcome: Number of Participants With Objective Response After 3 Cycles of Treatment

Secondary outcome:

Overall Survival at 6 Months

Progression Free Survival

Frequency and Severity of Toxicity

Overall Survival at 12 Months

Detailed description: Phase 2 trial to explore the efficacy and safety of irinotecan (CPT-11) in patients with recurrent anaplastic astrocytomas (AA), mixed malignant glioma, and oligodendrogliomas (OA). Patients were to be stratified by tumor histology and treated with CPT-11 every 21 days (treatment cycle). Baseline data (collected <14 days) was to consist of a neurological/oncological history, neurological examination, height, weight, performance status, Quality Of Life FACT-L questionnaire, laboratory studies to include complete blood count (CBC), differential, platelets, prothrombin time (PT), complete metabolic panel (CMP), Lactose dehydrogenase (LDH), and a pregnancy test, as well as a cranial Computerized Tomography/Magnetic Resonance Imaging (CT/MRI) with and without contrast (to measure or evaluate the size and location of the tumor before treatment). Administered every 21 days was a dose of irinotecan (CPT-11), zofran/Kytril/Anzemet, decadron, and intravenous (IV) atropine. At each cycle, patient exams and interviews as well as lab results were to help the research team to determine the symptomatic side effects of the treatment. Recorded past toxicities were to be compared with current side effects. Between days 15-21 (within 7 days of next scheduled CPT-11 treatment) the following tests

were to be repeated - a neurological/oncological history and neurological examination,

weight, blood drawn (CMP, LDH), performance status, and Quality Of Life FACT-L questionnaire. Also, a MRI (Cranial CT/MRI with and without contrast) was to be performed for tumor assessments at week 9, 18, 27, 36, and after every nine weeks thereafter until progression. Response was to be measured by a reduction in tumor size. These supportive therapies were provided as necessary:

- Antiemetic Therapy

- Anticholinergics

- Loperamide (ImodiumĀ®)

- Growth Factors

- Other Concomitant Medications

Eligibility

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Patients must have histological or neuroradiographic documented recurrent glioma

defined as an anaplastic astrocytoma, mixed malignant glioma or oligodendroglioma. All patients must have had prior pathologic confirmation of primary tumor histology.

- Patients must be > than or equal to 18 years old.

- Patients must have a Karnofsky performance score (KPS) of > or equal to 50

- Measurable disease per MacDonald criteria is required

- Patients must have a predicted life expectancy of at least 12 weeks

- Required initial laboratory data:

1. Absolute Neutrophil Count (ANC) > 1,500 2. Platelets > 100,000 3. Serum Creatinine < 2. 0 4. Serum Bilirubin < 2. 0 5. Aspartamine transaminase/ Alanine transaminase (AST/ALT) < 3x normal 6. Pregnancy test for females with child-bearing potential negative

- Patients must sign and date an IRB approved informed consent form stating he or she

is aware of the neoplastic nature of the disease. Patient must willingly provide written consent after being informed of the procedure to be followed, the experimental nature of the therapy, alternatives, potential benefits, side effects, risks, and discomforts. (Human protection committee approval of this protocol and consent form is required).

- Patients must be willing and able to comply with scheduled visits, treatment plan,

and laboratory tests and accessible for follow-up.

- Patients must have been previously treated with both surgery and radiotherapy.

- Prior adjuvant and one salvage chemotherapy regimen is permitted.

- Prior stereotactic radiotherapy is permitted.

Exclusion Criteria:

- Patients have evidence of leptomeningeal spread of disease.

- Patients having been treated with 2 or more salvage regimens.

- Pregnant or breast-feeding women. With the exception of post-menopausal or infertile

women, a negative blood test for pregnancy is mandatory before entry on study. Fertile persons refusing to use adequate contraceptives may not participate.

- Patients with a history of irritable bowel disease, irritable bowel syndrome, chronic

diarrhea or presence of a bowel obstruction.

- Patients with a second active malignancy or diagnosis of other cancer within 3 years

of enrollment, except for surgically cured basal cell carcinoma, or in situ carcinoma of the cervix.

- Mentally incapacitated patients or psychiatric illness that would prevent the patient

from giving informed consent.

- Patients with poorly controlled diabetes, hepatitis infection, uncontrolled high

blood pressure, unstable angina, symptomatic congestive heart failure, and myocardial infarction within the previous six months, or serious uncontrolled cardiac arrhythmia.

- Known to be human immunodeficiency virus (HIV) positive or to have an acquired

immunodeficiency syndrome (AIDS) related illness.

- Patients with an active infection that is not adequately controlled with antibiotics.

- Patients with other severe concurrent disease, which, in the judgment of the

investigator, would make the patient inappropriate for entry into this study.

- Patients with a known sensitivity to any of the products to be administered during

treatment.

- Patients currently enrolled in another clinical trial or patients who have

participated in a trial of an investigational device or drug within the last 30 days.

- Patients previously treated with CPT-11.

- Concurrent stereotactic radiotherapy.

Locations and Contacts

H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, United States
Additional Information

Moffitt Cancer Center Clinical Trials Website

Starting date: February 2006
Last updated: November 7, 2011

Page last updated: August 23, 2015

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