Brain and Central Nervous System Tumors Clinical Trial
Official title:
A Phase II Trial of Intensive Chemotherapy and Autotransplantation for Patients With Newly Diagnosed Anaplastic Oligodendroglioma
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Combining more than one drug and combining chemotherapy with
autologous bone marrow transplantation or peripheral stem cell transplantation may allow
doctors to give higher doses of chemotherapy drugs and kill more tumor cells.
PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy plus bone
marrow transplantation or peripheral stem cell transplantation in treating patients who have
oligodendroglioma.
OBJECTIVES:
- Determine the duration of response in patients with newly diagnosed pure and mixed
anaplastic oligodendrogliomas treated with intensive chemotherapy supported by
autologous transplantation.
- Determine the neurological and systemic toxic effects of this regimen in these
patients.
- Determine the relationship of 1p loss of heterozygosity on radiographic response,
progression-free survival, and overall survival of patients treated with this regimen.
OUTLINE: This is a multicenter study.
- Mobilization and stem cell harvest: Patients receive filgrastim (G-CSF) subcutaneously
daily for up to 7 days followed by peripheral blood stem cell (PBSC) or bone marrow
(BM) harvest.
- Induction therapy: All patients then receive induction therapy (PCV) comprising of oral
lomustine on day 1, vincristine IV on days 8 and 29, and oral procarbazine on days
8-21. Treatment repeats every 42 days in the absence of progressive disease or
unacceptable toxicity. Patients with prior complete resections receive 3 courses of PCV
then proceed to high-dose chemotherapy and transplantation as described below, provided
tumor has not recurred. Patients with prior partial resections or biopsies receive 2
courses of PCV and are assessed for response; those who achieve complete response (CR)
or major partial response (PR) receive 1 more course of PCV. Patients who achieve
partial response or have stable disease receive 2 more courses of PCV and are
reassessed.
- High-dose chemotherapy and transplantation: Patients who achieve CR or PR receive
thiotepa IV on days -8 to -6 and busulfan IV over 2 hours on day -5 to -3. Patients
undergo autologous BM or PBSC transplantation on day 0.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then
annually thereafter.
PROJECTED ACCRUAL: A total of 60 patients will be accrued for this study within 3-5 years.
;
Primary Purpose: Treatment
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