Glioblastoma Multiforme Clinical Trial
Official title:
Phase 2 Dose-Escalation Study of TPI 287 in Combination With Bevacizumab in Adults With Recurrent or Progressive Glioblastoma Following a Bevacizumab-Containing Regimen
The purpose of this study is to evaluate the safety, maximum tolerated dose (MTD), and efficacy of TPI 287 in combination with Avastin (bevacizumab) in subjects who have glioblastoma multiforme (GBM) that has progressed following prior radiation and temozolomide (TMZ) therapy and that has progressed following prior bevacizumab therapy.
This multi-center trial is a phase 2, dose-escalation study of the safety, tolerability
(MTD), and efficacy of TPI 287 in combination with bevacizumab in subjects who have GBM that
has progressed following prior radiation and TMZ therapy and that has progressed following
prior bevacizumab therapy.
All subjects will be administered TPI 287 as an intravenous (IV) infusion (target duration of
1 hour) once every 3 weeks (Days 1 and 22 of a 42-day cycle) and bevacizumab as a 30 to 90
minute IV infusion once every 2 weeks (Days 1, 15, and 29 of the 42-day cycle). The
subsequent cycle will start 3 weeks after the last TPI 287 infusion and 2 weeks after the
last bevacizumab infusion, maintaining the once every 3 week and once every 2 week schedule,
respectively.
The dose of TPI 287 will be escalated in sequential dose cohorts of 3 to 6 subjects, while
the dose of bevacizumab remains constant (10 mg/kg). The initial cohort of 3 subjects will be
treated at a TPI 287 dose of 140 mg/m2 (dose level 0). The next dose level will be 160 mg/m2
(dose level 1). Subsequent dose levels will be increased in increments of 10 mg/m2 (i.e.,
dose level 2 = 170 mg/m2, dose level 3 = 180 mg/m2, etc.). If dose de-escalation below the
starting dose level is required, dose levels of 130 and 120 mg/m2 will be used. Twelve (12)
to 18 subjects are planned for enrollment during the dose escalation phase, depending on the
number of subjects that experience dose limiting toxicities (DLTs).
Once the MTD is identified, 6 additional subjects will be enrolled at the MTD (for a total of
12) to better characterize the toxicity profile at this level.
Dose modifications and delays will be required as described in the protocol. Subjects may
continue on treatment unless they meet one or more of the discontinuation criteria outlined
in the protocol. Subjects who are discontinued prior to completing Cycle 1 for any reason
other than toxicity will be replaced.
Adverse events (AEs) and concomitant medications will be monitored throughout the study.
Subjects will be given a diary to record any AEs or concomitant medications taken between
visits. Additional safety evaluations will include physical examination (including neurologic
examination), Karnofsky performance status (KPS), weight (body surface area, BSA), vital
signs, hematology, serum chemistry, and urinalysis.
Efficacy evaluations will include magnetic resonance imaging [MRI, including both pre and
post-gadolinium T1-weighted scans and T2/fluid attenuated inversion recovery (FLAIR) images],
corticosteroid usage, and neurologic status (as measured by neurologic exam and KPS).
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