Brain and Central Nervous System Tumors Clinical Trial
Official title:
Phase I/II Study of Intravenous Infusion of Tetra-o-Methyl Nordihydroguaiaretic Acid (EM-1421) in Subjects With Recurrent High Grade Glioma
RATIONALE: Drugs used in chemotherapy, such as tetra-O-methyl nordihydroguaiaretic acid
(EM-1421), work in different ways to stop the growth of tumor cells, either by killing the
cells or by stopping them from dividing.
PURPOSE: This phase I/II trial is studying the side effects and best dose of EM-1421 and to
see how well it works in treating patients with recurrent high-grade glioma.
OBJECTIVES:
Primary
- Determine the maximum tolerated dose (MTD) of tetra-O-methyl nordihydroguaiaretic acid
(EM-1421) in patients with recurrent high-grade glioma. (Phase I)
- Determine the response rate in patients treated with EM-1421 administered at the MTD.
(Phase II)
Secondary
- Describe the pharmacokinetics of EM-1421 in these patients. (Phase I)
- Determine the effects of hepatic enzyme-inducing anticonvulsants on the pharmacokinetic
profile of EM-1421 in these patients. (Phase I)
- Determine the toxicity of this drug in these patients. (Phase I)
- Assess the tolerability of this drug in these patients. (Phase I)
- Assess the antitumor activity of this drug, in terms of overall survival. (Phase I)
- Assess the overall survival of these patients. (Phase II)
- Assess the safety and tolerability of EM-1421 given at the MTD in these patients. (Phase
II)
OUTLINE: This is a multicenter, phase I, dose-escalation study followed by a phase II,
open-label study. Patients are stratified according to the use of cytochrome P450-inducing
anticonvulsants (use of anticonvulsant drugs that induce hepatic metabolic enzymes vs use of
anticonvulsant drugs that cause modest or no induction of hepatic metabolic enzymes or no use
of anticonvulsant drugs).
- Phase I: Patients receive tetra-O-methyl nordihydroguaiaretic acid (EM-1421) IV on days
1-5. Treatment repeats every 28 days in the absence of disease progression or
unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of EM-1421 until the maximum tolerated dose
(MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 3 of 6
patients experience dose-limiting toxicity.
- Phase II: Patients receive EM-1421 as in phase I at the MTD. Blood is collected on days
1 and 5 of courses 1 and 2 of treatment for pharmacokinetic studies.
After completion of study therapy, patients are followed every 2 months.
PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.
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