Clinical trial

Phase 0/I Dose Escalation Study of Mycophenolate Mofetil Combined With Radiation Therapy in Glioblastoma

Name
UMCC 2019.192
Description
This is a phase 0/1 dose-escalation trial to determine the maximum tolerated dose of Mycophenolate Mofetil (MMF) when administered with radiation, in patients with glioblastoma or gliosarcoma.
Trial arms
Trial start
2020-08-05
Estimated PCD
2024-10-01
Trial end
2027-10-01
Status
Recruiting
Phase
Early phase I
Treatment
Mycophenolate Mofetil
500-2000mg orally twice daily, one week prior to re-resection (2 participants at each of 4 dose levels: 500mg, 1000mg, 1500mg and 2000mg)
Arms:
Phase 0 - Recurrent glioblastoma (GBM) / gliosarcoma (GS)
Other names:
MMF
Radiation Therapy
40.5 Gy in 15 fractions
Arms:
Phase 1 - Recurrent GBM / GS
Other names:
RT
Re-resection (as part of standard of care)
Re-resection or biopsy of tumor as part of standard of care
Arms:
Phase 0 - Recurrent glioblastoma (GBM) / gliosarcoma (GS)
Temozolomide
Temozolomide capsules are an approved oral chemotherapeutic drug for the treatment of adult patients with newly diagnosed GBM/GS concomitantly with radiotherapy and then as adjuvant treatment. The dosing and timing of temozolomide therapy will be determined as per standard-of-care for the individual patient by the treating oncologist.
Arms:
Phase 1 - Newly Diagnosed GBM / GS
Other names:
TMZ
Mycophenolate Mofetil
250-2000mg orally twice daily, one week prior to and concurrent with RT.
Arms:
Phase 1 - Recurrent GBM / GS
Other names:
MMF
Mycophenolate Mofetil
250-2000mg orally twice daily, one week prior to and concurrent with RT and cyclic chemotherapy with temozolomide.
Arms:
Phase 1 - Newly Diagnosed GBM / GS
Other names:
MMF
Radiation Therapy
60 Gy in 30 fractions
Arms:
Phase 1 - Newly Diagnosed GBM / GS
Other names:
RT
Size
68
Primary endpoint
Concentration of mycophenolic acid (MPA) in tumor tissue in Phase 0 participants
At 1 week
Number of recurrent phase 1 participants who experience dose-limiting toxicities (DLTs) at each dose level
Up to 28 days following completion of MMF + RT (up to ~9 weeks)
Number of newly diagnosed phase 1 participants who experience dose-limiting toxicities (DLTs) at each dose level -- DLT1 period
Up to 28 days following completion of MMF + RT + TMZ (up to ~11 weeks)
Number of newly diagnosed phase 1 participants who experience dose-limiting toxicities (DLTs) at each dose level -- DLT2 period
During the first 2 cycles (8 weeks) of MMF with adjuvant TMZ (up to ~19 weeks)
Eligibility criteria
Inclusion Criteria: * Glioblastoma or gliosarcoma (recurrent or newly diagnosed). * Karnofsky Performance Status 60 or greater. * Phase 0: Candidate for clinically indicated re-resection or biopsy of glioblastoma or gliosarcoma per treating physician(s). * Phase 1, Recurrent: Candidate for clinically indicated re-irradiation of glioblastoma or gliosarcoma per treating physician(s) (No more than one prior course of radiation for GBM). * Phase 1, Newly Diagnosed: Candidate for upfront standard of care chemoradiation for glioblastoma or gliosarcoma per treating physician(s), to start no earlier than 14 days post- operatively from last definitive surgery for glioblastoma or gliosarcoma (if more than one surgery done. Ex. biopsy prior to resection). * ANC \>=1,500 cells/mm\^3 within 14 days prior to enrollment. * Patient (men and childbearing age women) agrees to the use of highly effective contraception during study participation and for at least 6 weeks for female patients and 90 days for male patients after final MMF administration. * Ability to understand and the willingness to sign a written informed consent. Exclusion Criteria: * Lack of histopathological diagnosis of the tumor. * Gliomatosis cerebri pattern (tumor involving 3 or more lobes) of disease. * Leptomeningeal disease. * Use of bevacizumab within 8 weeks of study enrollment. * Known history of HIV. * Active hepatitis B or C infection. * Active systemic or central nervous system (CNS) infection. * Grade 4 lymphopenia (if ALC \<0.5, patient must be on Pneumocystis jirovecii prophylaxis). * Estimated CrCl \< 25 ml/min. * History of organ transplantation. * Patients with known hypoxanthine-guanine phosphoribosyl-transferase deficiency. * Serious intercurrent disease. * History of allergic reaction or hypersensitivity to mycophenolate mofetil or mycophenolic acid or any component of the drug product; or medical contraindication for MMF per treating physician(s). * Known immunosuppressive condition from autoimmune disease, immune deficiency syndrome, or chronic immunosuppressive therapy. * Inability to undergo MRI brain with and without contrast. * Pregnant or lactating women. * Patients with known phenylketonuria. * Phase 0: Patients undergoing biopsy who are deemed unlikely to have sufficient tissue to spare for research purposes (e.g., those whose tumors are in an eloquent brain location where all tissue taken must be used for diagnostic purposes). * Phase I: Increase in steroid requirement within 7 days of study enrollment (stable or decreasing dose allowed). * Phase I, Recurrent: Radiation within 6 months prior to study enrollment. * Phase I, Recurrent: Surgery within 4 weeks of re-irradiation. * Phase I, Newly Diagnosed: History of hypersensitivity reactions to temozolomide or any other ingredients in temozolomide and dacarbazine. * Phase I, Newly Diagnosed: Prior chemotherapy or radiation therapy for glioblastoma or gliosarcoma.
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE1'], 'designInfo': {'allocation': 'NON_RANDOMIZED', 'interventionModel': 'SEQUENTIAL', 'interventionModelDescription': 'Phase 0 will include 8 participants; eligible participants from phase 0 may continue on to phase 1.', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 68, 'type': 'ESTIMATED'}}
Updated at
2023-06-22

1 organization

1 product

1 drug

5 indications

Indication
Glioblastoma
Indication
Gliosarcoma
Indication
Grade IV
Indication
Astrocytoma
Product
TMZ