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Trial Title:
Neuradiab® Combined With Bevacizumab (Avastin) Therapy in Patients With Recurrent Glioblastoma Multiforme
NCT ID:
NCT00906516
Condition:
Brain Tumors
Conditions: Official terms:
Glioblastoma
Brain Neoplasms
Bevacizumab
Conditions: Keywords:
Recurrent Glioblastoma multiforme (GBM)
Recurrent Brain Tumor
Recurrent Brain Disease
Neuradiab
Avastin
Bevacizumab
Study type:
Interventional
Study phase:
Phase 2
Overall status:
Unknown status
Study design:
Allocation:
N/A
Intervention model:
Single Group Assignment
Primary purpose:
Treatment
Masking:
None (Open Label)
Intervention:
Intervention type:
Drug
Intervention name:
Neuradiab in combination with Bevacizumab (Avastin)
Description:
Patients will be treated following surgical removal of recurrent glioblastoma with a single intracavitary dose of Neuradiab® delivering 44 Gy±10% to the ridge of the surgically created resection cavity followed by therapy with Bevacizumab (Avastin) at a minimum of 30 days after Neuradiab administration.
Treatment with Bevacizumab will consist of 10mg/kg iv on days 1 and 15 every 28 days. Other chemotherapies (in addition to Avastin) will be permitted based on most current clinical practice and clinical evaluation of the patient.
Arm group label:
Neuradiab in combination with Avastin
Other name:
131I-labeled anti-tenascin murine monoclonal antibody;
Other name:
Bevacizumab
Summary:
Bradmer Pharmaceuticals, Inc. (Bradmer) is requesting approval to study the safety of
Neuradiab® when combined with Bevacizumab (Avastin) therapy given at a minimum of 30 days
after Neuradiab administration in patients with a first or second recurrence of glioblastoma
multiforme (GBM), in an attempt to manage life threatening recurrence of Grade IV malignant
glioma.
Detailed description:
At present there are no satisfactory therapies for these patients with recurrent GBM and the
practitioner is left with best effort combination therapy for this disease. At present a
number of chemotherapeutic agents, including nitrosoureas, carboplatin, bevacizumab,
etoposide, irinotecan, and imatinib, have been used as salvage therapy either alone or in
combination. Additional trials with a variety of agents are underway, but preliminary results
from single-agent studies have been disappointing. Currently, only nitrosoureas (lomustine
and carmustine), including Gliadel® Wafer (carmustine) as adjunct to surgery, are approved
for use in previously treated GBM. At present the treatment of recurrent disease with any
available agent results in median survival in the ranges of 22-44 weeks. The historical data
from previous human exposure with Neuradiab is highly suggestive of a benefit to patient
survival.
Since Neuradiab® has shown promising efficacy in patients with recurrent disease with
acceptable risk-benefit ratio, and since there is no substantial survival benefit from
currently available agents used to treat this patient population, Neuradiab® is being
proposed as an experimental alternative to recurrent GBM patients under a Single-Center Phase
II Trial. Recurrent GBM is a serious and immediately life-threatening disease, for which
there is no comparable or satisfactory alternative drug or other therapy available to treat
that stage of the disease. Overall, survival data indicate a need for more effective
treatments for recurrent GBM.
Criteria for eligibility:
Criteria:
Inclusion Criteria:
- Previous histopathology confirmed diagnosis of (World Health Organization [WHO] grade
IV astrocytoma; (http://rad.usuhs.mil/rad/who/who2b.html)
- Patients with recurrent disease presenting as a supratentorial unifocal lesion seen on
magnetic resonance imaging (MRI) suspicious for glioblastoma multiforme will be
considered as long as:
1. Patient is eligible for or has undergone a gross total surgical resection of the
tumor mass with a residual ridge ≤ 1cm
2. A post-operative MRI will be obtained within 72 hours of resection and must show
an adequate resection defined by ≤ 1 cm enhancement.
- No evidence of hemorrhage on the baseline MRI or CT scan other than those that are
postoperative grade 1.
- Age ≥ 18 years of age at the time of study entry.
- Karnofsky Performance Status ≥ 70%.
- Adequate bone marrow function
- Adequate hepatic function
- Adequate renal function
- Patient must be HAMA negative prior to study entry
- Able to tolerate standard post operative management for GBM debulking including
corticosteroid therapy
- An interval of at least 30 days from prior chemotherapy (6 weeks for nitrosoureas) or
investigational agent unless the patient has recovered from all anticipated toxicities
associated with that therapy
- Women of childbearing potential must have a negative pregnancy test (serum or urine).
- The patient must agree to use an effective contraceptive method
- Patient must give written informed consent prior to any study-specific procedures
being implemented
Exclusion Criteria:
- Infratentorial tumor, tumor with subependymal spread, multifocal tumor, tumor with
ventricular communication, intraventricular tumor or tumor which is within one gyrus
(approximately 1cm) of the motor/sensory strip, either of the speech centers, or
exceeds beyond the cranial vault.
- Severe, active comorbidity, including any of the following:
1. Unstable angina and/or congestive heart failure requiring hospitalization
2. Transmural myocardial infarction within the last 6 months
3. Acute bacterial or fungal infection requiring intravenous antibiotics at the time
of study entry
4. Chronic obstructive pulmonary disease exacerbation or other respiratory illness
requiring hospitalization or precluding study therapy at the time of study entry
5. Known hepatic insufficiency resulting in clinical jaundice (excluding Gilbert's
syndrome) and/or coagulation defects
6. Known AIDS based upon current CDC definition
7. Major medical illnesses or psychiatric impairments that, in the investigator's
opinion, will prevent administration or completion of protocol therapy
8. Active connective tissue disorders, such as lupus or scleroderma that, in the
opinion of the treating physician, may put the patient at high risk for radiation
toxicity.
- History of severe allergic reaction to contrast media.
- Any serious medical condition or psychiatric illness unresponsive to medical
intervention.
- Prior malignancy if active treatment was required during the previous 3 years (except
for adequately treated basal cell or squamous cell skin cancer and prior GBM)
- Known hypersensitivity to murine proteins.
- Inability to undergo an MRI.
- Patient has been treated with any anti-angiogenic therapy within 30 days prior to
study entry
- Co-medication that may interfere with study results; e.g. immuno-suppressive agents
other than corticosteroids
Gender:
All
Minimum age:
18 Years
Maximum age:
N/A
Healthy volunteers:
No
Locations:
Facility:
Name:
The Preston Robert Tisch Brain Tumor Center
Address:
City:
Durham
Zip:
27710
Country:
United States
Contact:
Last name:
David A. Reardon, MD
Phone:
919-668-1409
Email:
reard003@mc.duke.edu
Contact backup:
Last name:
Susan T. Boulton, RN, BSN
Phone:
(919) 668-0896
Email:
boult001@mc.duke.edu
Investigator:
Last name:
David A. Reardon, MD
Email:
Principal Investigator
Start date:
May 2009
Completion date:
December 2010
Lead sponsor:
Agency:
Bradmer Pharmaceuticals Inc.
Agency class:
Industry
Source:
Bradmer Pharmaceuticals Inc.
Record processing date:
ClinicalTrials.gov processed this data on April 10, 2024
Source: ClinicalTrials.gov page:
https://clinicaltrials.gov/ct2/show/NCT00906516
http://www.bradmerpharma.com