Glioblastoma Clinical Trial
Official title:
89Zr-RO5323441 PET Imaging in Patients With Recurrent Glioblastoma Treated With Bevacizumab
The research the investigators propose is a molecular imaging study of RO5323441, an antibody against placental growth factor (PlGF) in patients with recurrent GBM treated with bevacizumab, a drug against vascular endothelial growth factor (VEGF). Both VEGF and PlGF are molecules involved in tumor growth since they enable the development of tumor vasculature, thus delivery of oxygen and nutrients to the tumor. The treatment will consist of bevacizumab (i.v.) given every 2 weeks, until the patient has clinical benefit (no disease progression) or unacceptable toxicity. Meanwhile, patients will receive and injection of low protein-dose radiolabeled RO5323441 (89Zr-RO5323441) on day -3 and 11 of the first bevacizumab treatment cycle. Brain-only 89Zr-RO5323441 positron emission tomography (PET) will be performed at 2 hours after each injection of 89Zr-RO5323441 on day -3 and 11. Whole body 89Zr-RO5323441 PET will be performed on day 1 and 15, before and after the first treatment with bevacizumab. The main purpose of this trial is to determine how much of RO5323441 actually gets into the recurrent GBM lesions, since for a drug to be active, it has to be able to reach cancer cells. As second aims, RO5323441 accumulation in normal, non-tumor organs, will be assessed, as well as how bevacizumab influences RO5323441 penetration into tumor lesions (to answer the question of combined bevacizumab + RO5323441 treatment in GBM) or RO5323441 biodistribution in non-tumor organs.
Status | Withdrawn |
Enrollment | 0 |
Est. completion date | September 2016 |
Est. primary completion date | September 2015 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Age more or at least equal to 18 years - WHO Performance Status between 0 and 2 - Histologically proven glioblastoma multiforme at recurrence, including patients with anaplastic oligoastrocytomas with necrosis - Patients treated with one line of systemic treatment (combined treatment with temozolomide and RT followed by 6 cycles of temozolomide is considered as one line of systemic treatment) - No prior treatment with bevacizumab or other PlGF,VEGF,VEGF-R targeted agents, cilengitide or enzastaurin - No radiotherapy within 4 weeks prior to the diagnosis of progression - No chemotherapy within 4 weeks prior to study enrollment - Adequate bone marrow function - Adequate liver function - Adequate renal function - Women of reproductive potential, female patients within one year of entering the menopause as well as males must agree to use an effective non-hormonal method of contraception during the treatment period and for at least 6 months after the last dose of bevacizumab - Written informed consent Exclusion Criteria: - Invasive procedures (major surgical procedure, open biopsy or significant traumatic injury) within 28 days prior to start study treatment, or anticipation of the need for major surgery during the course of the study treatment. Placement of a vascular access device is not considered as a major surgical procedure if performed more than 24 hours prior to bevacizumab administration. - Arterial or venous thrombosis less or equal than 6 months prior to study registration - Prior history of hypertensive crisis or hypertensive encephalopathy - History of myocardial infarction (less or equal than 6 months prior to inclusion), unstable angina, New York Heart Association (NYHA) grade II or greater congestive heart failure, or serious cardiac arrhythmia requiring digoxin treatment - Uncontrolled hypertension defined by a systolic blood pressure (BP) more than 140 mm Hg and or diastolic pressure more than 100 mm Hg, with or without anti-hypertensive medication. Patients with initial blood pressure elevation are eligible if initiation or adjustment of anti-hypertensive medication lowers pressure to meet the entry criteria - History or evidence of inherited bleeding diathesis or coagulopathy with risk of bleeding - Current or recent (within 10 days of first dose of bevacizumab) use of aspirin more than 325 mg per day) or other NSAID with anti-platelet activity or treatment with dipyramidole, ticlopidine, clopidogrel and cilostazol - Use of therapeutic-dose oral or parenteral anticoagulants or thrombolytic agent for therapeutic (as opposed to prophylactic) purposes - Clinically serious (as judged by the investigator) non-healing wounds, active skin ulcers or incompletely healed bone fracture - Evidence of any active infection requiring hospitalization or antibiotics, within 2 weeks prior to day 1 of cycle 1 - Current or recent (within 4 weeks of enrollment) treatment with another investigational drug or participation in another investigational study - Known hypersensitivity to any part of the bevacizumab formulation - Hypersensitivity to Chinese hamster ovary cell products or other recombinant human or humanized antibody - Other diseases, interfering with the follow-up - Geographical, psychological or other non-medical conditions interfering with follow-up - Pregnant or lactating females (serum pregnancy test to be assessed before entry in the trial) |
Intervention Model: Single Group Assignment, Masking: Open Label
Country | Name | City | State |
---|---|---|---|
Netherlands | University Medical Center Groningen | Groningen |
Lead Sponsor | Collaborator |
---|---|
University Medical Center Groningen |
Netherlands,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Assess the penetration of RO5323441 into recurrent GBM by 89Zr-RO5323441 PET imaging and to quantify its uptake | Calculations of specific 89Zr-RO5323441 uptake in recurrent GBM lesions will be determined for all patients who underwent tracer injection(s) and 89Zr-RO5323441 PET. 89Zr-RO5323441 tumor uptake will be scored visually and quantitatively. The visual analysis of the PET scans will be performed by a qualified nuclear medicine physician. Quantification of 89Zr-RO5323441 uptake will be performed using AMIDE software (Stanford University, Palo Alto, CA). Standardized uptake value (SUV) and relative uptake value (RUV)of 89Zr-RO5323441 will be determined. | Patients will be assessed up to 19 days after the first 89Zr-RO5323441 tracer injection (D-3) | No |
Secondary | Visualize and quantify 89Zr-RO5323441 non-tumor organ distribution | 89Zr-RO5323441 non-tumor organs biodistribution will be determined for all patients who underwent tracer injection(s)and 89Zr-RO5323441 PET. 89Zr-RO5323441 non-tumor organs biodistribution will be scored visually and quantitatively. The visual analysis of the PET scans will be performed by a qualified nuclear medicine physician. Quantification of 89Zr-RO5323441 biodistribution in non-tumor organs will be performed using AMIDE software (Stanford University, Palo Alto, CA). | Patients will be assessed up to 19 days after the first 89Zr-RO5323441 tracer injection (D-3) | No |
Secondary | Assess the effect of bevacizumab treatment on 89Zr-RO5323441 uptake in recurrent GBM lesions | 89Zr-RO5323441 uptake values in recurrent GBM lesions at baseline and day 15 will be compared to assess bevacizumab effect on tracer tumor uptake. | Patients will be assessed up to 19 days after the first 89Zr-RO5323441 tracer injection, which also corresponds to the second bevacizumab dose administered | No |
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