Expired Study
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Durham, North Carolina 27710


Purpose:

Primary objective: To determine the 6-month progression free survival of patients with recurrent GBM treated with Erlotinib plus Sirolimus. Secondary objectives: To further define the safety and tolerability of Erlotinib plus Sirolimus when administered to patients with recurrent GBM; and to evaluate progression free survival, radiographic response and overall survival of patients with recurrent GBM treated with Erlotinib plus Sirolimus.


Study summary:

The primary objective of this study will be to determine the 6-month progression free survival of patients with recurrent GBM treated with Erlotinib plus Sirolimus. This is an exploratory, single-arm, phase II study designed to assess the anti-tumor activity of a combinatorial regimen consisting of Erlotinib plus Sirolimus among patients with recurrent GBM. The combinatorial regimen of Erlotinib plus Sirolimus is rationally designed to simultaneously inhibit upstream (EGFR) and downstream (mTOR) mediators of PI3/AKT signaling. In a recently completed phase I study, we determined that an EGFR inhibitor (Gefitinib) can be safely combined with Sirolimus at dose levels that are routinely used in the monotherapy setting. Therefore, the primary endpoint of this study is the probability of progression-free survival at 6 months among recurrent GBM patients treated with standard doses of Erlotinib plus Sirolimus. An important secondary objective is to further assess the safety of Erlotinib and Sirolimus for patients with recurrent GBM.


Criteria:

Inclusion Criteria: - Pts have confirmed diagnosis of recurrent primary WHO grade IV MG. Pts w recurrent disease whose diagnostic pathology confirmed GBM will not need re-biopsy. Pts w prior low-gr glioma / anaplastic glioma are eligible if histologic assessment demonstrates transformation to GBM - Age >18 yrs - Interval of >2 wk between prior surgical resection - Interval of >12 wks between prior XRT unless there is either: histopathologic confirmation of recurrent tumor; new enhancement on MRI outside of XRT treatment field; / progressive radiographic changes after XRT/temo as well as after adjuvant, post-XRT temo - Interval of >4 wks between chemo & enrollment on protocol unless: unequivocal evidence of tumor progression; & pt has recovered fully from all toxicity associated w prior surgery, XRT/chemo. Pts treated w chemo agents such as VP-16 who would normally be retreated after shorter intervals may be treated at usual starting time even if <4 wks from last prior dose chemo - Karnofsky performance score >70 percent - Hematocrit >29 percent, ANC >1,500 cells/microliter, platelets >100,000 cells/microliter - Serum creatinine <1.5 mg/dl, serum SGOT & bilirubin <1.5 x ULN; fasting plasma triglyceride & cholesterol < gr1 - For pts on corticosteroids, dose should not be increasing for >7 days prior to baseline Gd-MRI of brain if medically appropriate - Pts in enzyme inducing antiepileptic drug cohort must be on stable dose of p450-inducing EIAED for >2 wks. Pts in non-EIAED cohort must not receive any p450-EIAED for >2 wks prior to & during participation in trial - Signed informed consent approved by IRB prior to pt entry - If sexually active, pts will take contraceptive measures for duration of treatments & for 3 months following discontinuation of Erlotinib - Pts who have had prior bevacizumab are eligible however interval of >6 weeks must have elapsed since their last dose Exclusion Criteria: - Prior mTOR directed therapy - Prior EGFR-directed therapy - Female pts are pregnant/breast feeding, or adults of reproductive potential not employing effective method of birth control. Women of childbearing potential must have negative serum pregnancy test <72 hours prior to administration of Erlotinib - Co-medication that may interfere w study results - Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection requiring IV antibiotics, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, hyperlipidemia not controlled w medication, psychiatric illness/social situations that would limit compliance w study requirements,/disorders associated w significant immunocompromise - Acute/chronic liver disease - Impairment of GI function/GI disease that may significantly alter absorption of Erlotinib - Pts who have received investigational drugs <4 wks prior to entry on study or who have not recovered from toxic effects of such therapy - Pts who have received biologic, immunotherapeutic/cytostatic agents <1 wk prior to entry on study/have not recovered from toxic effects of such therapy - Pt is <5 yrs free of another primary malignancy except: if other primary malignancy is not currently clinically significant/requiring active intervention,/if other primary malignancy is basal cell skin cancer/cervical carcinoma in situ. Existence of any other malignant disease is not allowed - Pts have had any surgery other than resection of brain tumor <2 wks prior to entry on study/have not recovered from side effects of such therapy - Pts unwilling to/unable to comply w protocol - Pts w acute/chronic renal insufficiency/those w acute renal insufficiency of any severity due to hepato-renal syndrome/in peri-operative liver transplantation period


Study is Available At:


Original ID:

00000345


NCT ID:

NCT00672243


Secondary ID:


Study Acronym:


Brief Title:

Ph II Erlotinib + Sirolimus for Pts w Recurrent Malignant Glioma Multiforme


Official Title:

Phase II Trial of Erlotinib Plus Sirolimus for Patients With Recurrent Malignant Glioma Multiforme


Overall Status:

Completed


Study Phase:

Phase 2


Genders:

Both


Minimum Age:

18 Years


Maximum Age:

N/A


Quick Facts

Healthy Volunteers
Oversight Has DMC
Study Is FDA Regulated
Study Is Section 801
Has Expanded Access

Study Source:

Duke University


Oversight Authority:

United States: Institutional Review Board


Reasons Why Stopped:


Study Type:

Interventional


Study Design:

Allocation: Non-Randomized, Endpoint Classificati


Number of Arms:

2


Number of Groups:

0


Total Enrollment:

20


Enrollment Type:

Anticipated


Overall Contact Information

Official Name:David Reardon, MD
Principal Investigator
Duke University Health System

Study Dates

Start Date:April 2007
Completion Date:December 2009
Completion Type:Actual
Primary Completion Date:April 2009
Primary Completion Type:Actual
Verification Date:January 2011
Last Changed Date:January 9, 2011
First Received Date:January 29, 2008

Study Outcomes

Outcome Type:Secondary Outcome
Measure:Gr 3 or greater, treatment related, non-hematologic toxicities
Time Frame:6 months
Safety Issues:True
Outcome Type:Secondary Outcome
Measure:a.Median PFS, radiographic response & overall survival b.Correlation of clinical response & pathological findings of EGFR expression, amplification, PTEN gene copy number & EGFR-vIII expression
Time Frame:6 months
Safety Issues:False
Outcome Type:Primary Outcome
Measure:6 month progression-free survival.
Time Frame:6 months
Safety Issues:False

Study Interventions

Intervention Type:Drug
Name:Erlotinib, Sirolimus
Description:Estimated date of study completion is 6-9 mths from study initiation. Pts will take both Erlotinib & Sirolimus on daily dosing schedule. Each cycle will last 28 days. Erlotinib administered orally, continuously once daily in fasting state for each 28-day cycle. Dose of Erlotinib represents standardized dosing previously established in prior ph I studies among pts w RMG. Erlotinib when administered as single agent were well tolerated up to daily doses of 200 mg & 650 mg for pts not on &am
Arm Name:A
Other Name:Erlotinib - Tarceva

Study Arms

Study Arm Type:Experimental
Arm Name:B
Description:Pts receiving EIAEDs
Study Arm Type:Experimental
Arm Name:A
Description:Pts not receiving EIAEDs

Study Agencies

Agency Class:Other
Agency Type:Lead Sponsor
Agency Name:Duke University
Agency Class:Industry
Agency Type:Collaborator
Agency Name:Genentech

Sample and Retention Information

There are no available Sample and Retention Information

Study References

There are no available Study References

Data Source: ClinicalTrials.gov

Date Processed: January 21, 2020

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