Adult Glioblastoma Clinical Trial
Official title:
A Phase II Study of the Efficacy of Hypofractionated Radiation Therapy With Bevacizumab and Temozolomide Followed by Maintenance Temozolomide and Bevacizumab for Recurrent High-Grade Gliomas
This phase II trial studies how well giving hypofractionated radiation therapy together with temozolomide and bevacizumab works in treating patients with high-grade glioblastoma multiforme or anaplastic glioma. Specialized radiation therapy, such as hypofractionated radiation therapy, that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. 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. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Giving hypofractionated radiation therapy together with temozolomide and bevacizumab may kill more tumor cells.
PRIMARY OBJECTIVES:
I. To determine the overall survival (OS) for patients with recurrent high grade malignant
gliomas treated with concurrent radiation, temozolomide, and bevacizumab followed by adjuvant
temozolomide and bevacizumab.
SECONDARY OBJECTIVES:
I. Determine the impact of this regimen on neurologic symptoms via Functional Assessment of
Cancer Therapy-Brain (FACT-Br) and FACT-Fatigue scales and Eastern Cooperative Oncology Group
(ECOG) performance status.
II. Determine the safety profile of this regimen. III. Determine the progression free
survival (PFS) at 6 and 12 months (all patients) as well as at 3 months (bevacizumab-exposed
patients only).
OUTLINE:
CONCURRENT THERAPY: Patients undergo hypofractionated radiation therapy 5 days a week
beginning on day 0. Patients also receive temozolomide orally (PO) once daily (QD) and
bevacizumab intravenously (IV) over 30-90 minutes once every 2 weeks beginning on days -3 to
0. Treatment continues for 5 weeks in the absence of disease progression or unacceptable
toxicity.
ADJUVANT THERAPY: Beginning 2 weeks after completion of radiation therapy, patients receive
temozolomide PO QD for 6 weeks and bevacizumab IV over 30-90 minutes once every 2 weeks.
Courses repeat every 8 weeks in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 2-3 months.
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