Brain and Central Nervous System Tumors Clinical Trial
Official title:
Phase I GLIADEL and Continuous Infusion of Intravenous O6-Benzylguanine Trial in Patients With Recurrent Malignant Glioma
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 giving drugs in different ways
may kill more tumor cells.
PURPOSE: Phase I trial to study the effectiveness of O6-benzylguanine and implanted
carmustine wafers in treating patients who have recurrent malignant glioma.
OBJECTIVES: I. Determine the dose of O6-benzylguanine that completely suppresses AGT levels
in patients with recurrent malignant glioma. II. Evaluate the safety and tolerance of
increasing duration for up to 2 weeks of continuously infused O6-benzylguanine at a dose
that will completely suppress tumor AGT activity combined with intracranially implanted
polifeprosan 20 with carmustine implants (Gliadel wafers) in this patient population.
OUTLINE: This is a dose escalation study of O6-benzylguanine (O6-BG). Patients in the first
cohort receive O6-BG IV over 1 hour followed by continuous infusion of O6-BG for 2 days
prior to surgery. Patients undergo surgical resection and receive up to 8 polifeprosan 20
with carmustine implants (Gliadel wafers) in the resected tumor cavity. Cohorts of 14
patients receive escalating doses of O6-BG until 11 out of 14 patients in a cohort have
complete suppression of AGT levels. Once the dose of O6-BG that completely suppresses AGT
has been established, subsequent patients receive O6-BG IV beginning at least 1 hour prior
to surgery followed by the established continuous infusion dose beginning on the day of
surgery. The infusion continues for up to 14 days postoperatively. Cohorts of 6-12 patients
receive lengthened durations of continuous infusion O6-BG until the maximum tolerated dose
(MTD) is determined or the length of the infusion reaches 14 days. The MTD is defined as the
dose preceding that at which 3 of 6 or 5 of 12 patients experience dose limiting toxicities.
Patients are followed at 3, 6, 9, and 12 months, and then until death.
PROJECTED ACCRUAL: A minimum of 38 patients will be accrued for this study over 9.5 months.
;
Primary Purpose: Treatment
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