Central Nervous System Tumors Clinical Trial
Official title:
Randomized Trial Assessing the Significance of Bevacizumab in Recurrent Grade II and Grade III Gliomas - The TAVAREC Trial
RATIONALE: 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.
Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some
block the ability of tumor cells to grow and spread. Others find tumor cells and help kill
them or carry tumor-killing substances to them. It is not yet known whether temozolomide is
more effective when given with or without bevacizumab in treating patients with recurrent
glioma.
PURPOSE: This randomized clinical trial is studying how well temozolomide works with or
without bevacizumab in treating patients with recurrent glioma.
OBJECTIVES:
Primary
- To document the activity of both combination temozolomide plus bevacizumab and
temozolomide alone in patients with recurrent grade II or grade III glioma without
1p/19q co-deletion.
Secondary
- To characterize the safety of treatment in these patients.
- To document the quality of life and cognitive functioning, as a measure of clinical
benefit, of these patients.
- To explore qualification or occurrence of prognostic and/or predictive biomarkers of
activity or efficacy in these patients. (exploratory)
- To document the discordances between RANO and Macdonald's criteria for the evaluation of
response and progression. (exploratory)
OUTLINE: This is a multicenter study. Patients are stratified according to institution,
initial histology (grade II vs grade III), WHO performance status (0-1 vs 2), and prior
treatment (radiotherapy [RT] alone, temozolomide [TMZ] or procarbazine, lomustine and
vincristine [PCV] alone vs TMZ/RT). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral temozolomide once daily on days 1-5. Treatment repeats
every 28 days for 12 courses in the absence of disease progression or unacceptable
toxicity.
- Arm II: Patients receive oral temozolomide as in arm I and bevacizumab IV over 90
minutes on days 1 and 15. Treatment repeats every 28 days for 12 courses in the absence
of disease progression or unacceptable toxicity.
Patients complete neurocognitive questionnaires (i.e., the Hopkins Verbal Learning test, the
Controlled Oral Word Association test, and the Trail Making tests A and B). Quality-of-life
assessment questionnaires, including EORTC QLQ-C30 and EORTC-BN20, are completed by both
patients and caregivers/relatives at baseline and then periodically.
Frozen tumor biopsies or paraffin blocks and blood specimens are collected for bio-banking
and translational research.
After completion of study therapy, patients are followed up every 3 months.
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