Brain and Central Nervous System Tumors Clinical Trial
Official title:
A Phase I/II Trial of Arsenic Trioxide and Temozolomide in Combination With Radiation Therapy for Patients With Malignant Gliomas
RATIONALE: Drugs used in chemotherapy, such as arsenic trioxide and temozolomide, work in
different ways to stop the growth of tumor cells, either by killing the cells or by stopping
them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving
arsenic trioxide and temozolomide together with radiation therapy after surgery may kill any
remaining tumor cells.
PURPOSE: This phase I/II trial is studying the side effects and best dose of arsenic trioxide
and temozolomide when given together with radiation therapy and to see how well they work in
treating patients with malignant glioma that has been removed by surgery.
OBJECTIVES:
Primary
- Determine the maximum tolerated dose (MTD) of arsenic trioxide and temozolomide when
combined with radiotherapy in patients with resected supratentorial malignant glioma.
(Phase I)
- Determine the toxicity of this regimen in these patients. (Phase I)
Secondary
- Determine the 6- and 12-month progression-free survival of patients treated with this
regimen once an MTD is reached. (Phase II)
- Determine the radiographic response for patients treated with the above regimen. (Phase
II)
- Determine the safety of this regimen in these patients. (Phase II)
OUTLINE: This is a phase I, dose-escalation study of arsenic trioxide and temozolomide
followed by a phase II study.
- Phase I: Patients undergo radiotherapy once daily 5 days a week and receive oral
temozolomide once daily for approximately 6½ weeks. Patients also receive arsenic
trioxide IV over 1-4 hours once daily, 5 days a week in week 1 and then twice a week in
weeks 2-7. Beginning within 3-5 weeks after completion of radiotherapy, patients receive
oral temozolomide once daily on days 1-5. Treatment with temozolomide repeats every 28
days for up to 1 year in the absence of disease progression and unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of arsenic trioxide and temozolomide until
the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that
at which 1 of 3 or 2 of 6 patients experience dose-limiting toxicity.
- Phase II: Patients undergo radiotherapy and receive arsenic trioxide and temozolomide as
in phase I at the MTD. Patients then receive temozolomide as in phase I for up to 1 year
in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed periodically for 1 year.
PROJECTED ACCRUAL: A total of 12-18 patients will be accrued for the phase I portion of this
study. A total of 25 patients will be accrued for the phase II portion of this study.
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