Study of Letrozole in Recurrent Gliomas

Brain Tumor Clinical Trial

Official title:

A Phase 0/1 Pharmacokinetic and Pharmacodynamics and Safety and Tolerability Study of Letrozole in Combination With Standard Therapy in Recurrent High Grade Gliomas

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03122197
• Other study ID #: UCCI-BN-16-01
• Status: Recruiting
• Phase: Early Phase 1
• Start date: May 16, 2017
• Est. completion date: December 2024

Study information

• Verified date: December 2023
• Source: University of Cincinnati
• Contact: UC Cancer Center Clinical Trials Office
• Phone: 513-584-7698
• Email: cancer[@]uchealth.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine the ability of letrozole to penetrate the blood brain barrier and concentrate in gliomas.

Description:

Nine to forty-two (42 patients only if every cohort required expansion) total patients were planned for the main BN-16-01 phase 0/1 study to explore the ability of letrozole to penetrate the blood brain barrier and gliomas. As of November 2023 The BN-16-01 main study has completed active recruitment (20 subjects were accrued) and all safety and pharmacokinetics data have been analyzed with subsequent publications pending. Characterization of the safety and pharmacokinetics of letrozole in combination with standard of care treatments, such as TMZ has been completed for the main study and provides the rationale for initiation of a sub-study.

A new sub-study "Letrozole and Temozolomide" expansion cohort has been opened to accrual. This Phase 1 expansion cohort of letrozole 15mg administered in combination with 50 mg/m2 metronomic temozolomide (TMZ) in patients with high grade gliomas. 19 subjects total (2 historical subjects from the main study and 17 new accruals) will be enrolled into this expansion cohort.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 39
• Est. completion date: December 2024
• Est. primary completion date: September 1, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria

1. Radiographically, histologically or cytologically confirmed recurrent brain high grade glioma with plan for resection or biopsy.

• Inclusion #1 for Sub-study Only: Radiographically, histologically or cytologically confirmed recurrent brain high grade glioma.

2. Age >18 years.

3. ECOG performance status 0 -2 (Karnofsky >60%, see Appendix A).

4. CBC/differential obtained within 28 days prior to registration on study, with adequate bone marrow function defined as follows:

• Absolute neutrophil count (ANC) = 1,000 cells/mm3;

• Platelets = 100,000 cells/mm3;

• Hemoglobin = 8.0 g/dl (Note: The use of transfusion or other intervention to achieve Hgb = 8.0 g/dl is acceptable).

5. Adequate hepatic function, defined as follows:

• Total bilirubin < 2 x institutional ULN within 14 days prior to registration;

• AST or ALT < 3 x institutional ULN within 14 days prior to registration.

6. Adequate renal function, defined as GFR > 30 ml/min or Cr < 1.5.

7. Negative serum pregnancy test within 2 weeks prior to registration for women of childbearing potential.

8. Imaging prior to treatment including MRI of brain (with contrast preferred but not required).

9. Ability to understand and the willingness to sign a written informed consent document.

10. Inclusion #10 for Sub-study Only: Measurable disease per RANO criteria within 28 days of starting treatment on this study.

Exclusion Criteria

1. Patients may not be receiving any other investigational agents.

2. History of allergic reactions attributed to letrozole or other agents used in study.

Exclusion #2 for Sub-study Only: History of allergic reactions attributed to letrozole or TMZ.

3. Uncontrolled intercurrent illness including, but not limited to, ongoing significant or serious active cardiovascular disease (CHF exacerbation, unstable angina or MI in last 6 months), or infection including the diagnosis of AIDS or active hepatitis B or C infection, or psychiatric illness or medical or personal conditions that in the opinion of the investigator would limit the patient's ability to participate.

4. Patients attempting to conceive, and pregnant or nursing women are excluded from this study.

Related Conditions & MeSH terms

• Brain Neoplasms
• Brain Tumor

Intervention

Drug:
• Letrozole Oral Tablet
Administration: Letrozole will be given orally once daily.
• Temozolomide
50 mg/m2 TMZ administered orally once daily

Locations

Country	Name	City	State
United States	University of Cincinnati	Cincinnati	Ohio

Sponsors (1)

Lead Sponsor	Collaborator
University of Cincinnati

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Overall Letrozole AUC in tumor tissue.	Pharmacokinetic modeling will be used to determine the overall AUC in the tumor tissue to assess for letrozole penetration through blood brain barrier.	5 days
Primary	Progression free survival in letrozole and temozolomide combination	Sub-study expansion cohort only: Progression free survival using RANO criteria at 6 months from the start of the combination of 15 mg letrozole and 50 mg/m2 temozolomide.	6 months
Secondary	Adverse Events	The number of patients with treatment related toxicity will be assessed using CTCAE v4.0	The time patients remain on treatment until 30 days after treatment completed
Secondary	Progression free Survival	Patients will be followed for response using RANO criteria to determine time from start of treatment to progression.	From start of treatment until time of progression assessed up to 1 year
Secondary	Overall Survival	Patients will be followed from start of treatment until time of death	From start of treatment until time of death assessed up to 1 year