Glioblastoma Clinical Trial
Official title:
A Phase II Study of BKM 120 for Patients With Recurrent Glioblastoma and Activated PI3K Pathway
BKM120 is a newly discovered drug that has been used in other research studies. Information from those other research studies suggests that BKM120 may help to slow or stop the growth of malignant gliomas. The purpose of this study is to see how well BKM120 works in patients with malignant gliomas. Patients on this study will be treated in two groups: patients who are going to receive surgery and those who will not receive surgery. This study is trying to determine how effective BKM120 is in stopping cancer cells from growing. For patients receiving surgery the research will also try to determine if an effective level of BKM120 can penetrate the brain before surgery.
OBJECTIVES:
Cohort 1
Primary Objectives
- Evaluate PI3K pathway modulation due to BKM120 in tumor tissue
- Evaluate BKM120 concentration in tumor tissue, plasma, and cerebrospinal fluid
Secondary Objectives
- Evaluate effects of BKM120 on tumor cell proliferation and tumor cell death
- Investigate the safety profile of BKM120 in this population
- Investigate pharmacokinetics of BKM120 in this population
Exploratory Objectives
- Correlate FDG-PET and FLT-PET with pharmacodynamic effects and 6-month progressive-free
survival (PFS6)
- Determine the effects of BKM120 on primary GBM cell lines derived from participants and
correlate with participant benefit from BKM120 treatment
Cohort 2
Primary Objective
- Investigate the treatment efficacy as measured by 6-month progressive-free survival
(PFS6)
Secondary Objectives
- Investigate the radiographic response, progression free survival, overall survival
- Investigate the safety profile efficacy of BKM120 in this population
Exploratory Objectives
- Correlate benefit from BKM120 treatment with molecular genotype of tumor (using
immunohistochemistry, mutation analysis and RNA expression profiling), and whole blood
proteomics
- Correlate benefit from BKM120 treatment with circulating angiogenic biomarkers
- Utilize advance MRI (perfusion, permeability, diffusion imaging) to determine the
effects of BKM120 on tumor vasculature and to correlate with benefit from BKM120
treatment
STATISTICAL DESIGN:
Cohort 1
The primary endpoint for Cohort 1 is modulation of PI3 kinase pathway based on change in
immunohistochemistry (IHC) scoring for pAKT. Modulation in scoring as measured by reduction
of staining intensity score of one degree or more was reported as a positive response to
drug. This portion of the trial would be considered a success if 9 or more participants of 15
participants showed a response. There was a 94% chance of this occurring if the true response
rate was 75% and only a 10% chance of this occurring if the true response rate was 40%.
Cohort 2
The primary endpoint for Cohort 2 is the proportion of participants progression free at 6
months (PFS6). Historical comparison data suggest that ineffective therapies in recurrent GBM
have a PFS6 rate of approximately 9-16% (Wong 1999; Lamborn 2008). This trial was sized to
differentiate between a 15% versus a 32% PFS6. With a total sample size of 50 participants,
this design yields at least 90% power with a one sided alpha < 0.1 to detect a true PFS6 rate
of at least 32%. If the number of successes was ≥ 12, the therapy would be considered worthy
of further study.
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