Brain and Central Nervous System Tumors Clinical Trial
Official title:
A Phase I Open Label Safety Study to Evaluate the Pharmacokinetic Profile and Tolerance of Mibefradil Dose Finding in Subjects With Recurrent High-Grade Glioma Undergoing Standard, Repeated Temozolomide Treatment
RATIONALE: Mibefradil dihydrochloride may stop the growth of tumor cells by blocking some of
the enzymes needed for cell growth. Drugs used in chemotherapy, such as temozolomide, 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 trial is studying the best dose of mibefradil dihydrochloride when
given together with temozolomide in treating patients with glioma.
OBJECTIVES:
Primary
- Determine the maximum-tolerated dose (MTD) of mibefradil dihydrochloride administered
prior to five days of temozolomide (TMZ) at 150-200 mg/m² in subjects with progressive
or recurrent high-grade glioma.
Secondary
- Assess the safety of mibefradil dihydrochloride administered prior to five days of TMZ
at 150-200 mg/m² when the mibefradil dihydrochloride dose is escalated from a starting
dose of 100 mg/day, given four times a day for seven consecutive days.
- Determine the pharmacokinetic profile of mibefradil.
- Determine the steady state levels of mibefradil dihydrochloride on the last day of
dosing.
- Assess the severity and frequency of adverse events for tested mibefradil
dihydrochloride dose levels including cumulative toxicity and/or tolerance to adverse
effects.
- Estimate the number and type of radiographic responses to treatment with mibefradil
dihydrochloride and temozolomide.
- Assess the potential effect of mibefradil dihydrochloride on tumor metabolism as
determined by Fluorothymidine Positron Emission Tomography (FLT PET) scans with the
radiotracer [18F]-3'-fluoro-3'-deoxy-L-thymidine (dose-expansion cohort only).
OUTLINE: This is a dose-escalation study of mibefradil dihydrochloride followed by a
dose-expansion study.
Patients receive mibefradil dihydrochloride orally (PO) 4 times a day on days 1-7 (days 1-8
on first course) and temozolomide PO on days 8-12 (days 9-13 on first course). Treatment
repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Blood samples are collected during the first course for pharmacokinetic studies.
Patients in the dose-expansion cohort undergo [18F]-3'-fluoro-3'-deoxy-L-thymidine
(FLT)-positron emission tomography (PET) at baseline and on day 7 of the first course of
therapy.
After completion of study therapy, patients are followed up every 2 months.
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