Glioblastoma Clinical Trial
Official title:
Phase I/II Study of the Tolerability, Safety, and Efficacy of Liposomal Curcumin in Combination With Radiation and Temozolomide in Patients With Newly Diagnosed High-Grade Gliomas
The objective of this study is to assess the tolerability, safety, and efficacy of Liposomal Curcumin (LC) in combination with radiotherapy (RT) and Temozolomide (TMZ) in patients with newly diagnosed High-Grade Gliomas (HGG).
Status | Recruiting |
Enrollment | 30 |
Est. completion date | May 2027 |
Est. primary completion date | February 2026 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: 1. =18 years of age 2. Histologically confirmed HGG (WHO grade III or IV, including GBM, astrocytoma, gliosarcoma, H3K27M mutant diffuse midline glioma). Patients with methylated or unmethylated O(6)-methylguanine-DNA methyltransferase (MGMT) promoter are eligible, as are IDH WT and mutant patients as long as the treatment plan is for combined RT/TMZ. The neuropathologic diagnosis of HGG will be made at the respective institution. If any question arises regarding the accuracy of the neuropathologic diagnosis, slides (and pathological blocks, if necessary) will be centrally reviewed 3. Planning standard therapy with TMZ and RT for 6 weeks 4. Karnofsky Performance Scale (KPS) = 60% Adequate organ and marrow function defined as: - Hgb > 9 g/dL - ANC = 1500/µL - Platelet count = 100,000/µL - Total bilirubin = 1.5 * institutional ULN - AST and ALT = 3 * institutional ULN - Creatinine = 1.5 * institutional ULN OR - Estimated glomerular filtration rate (eGFR) = 60 mL/min/1.73 m2 unless data exist supporting safe use at lower values of renal function, but eGFR must be = 30 mL/min/1.73 m2 5. Patients with human immunodeficiency virus (HIV) who are on effective antiretroviral therapy are eligible if the viral load was assessed as undetectable within 6 months prior to baseline 6. Women: WOCBP must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for the duration of study participation 7. Men: must agree to use adequate contraception prior to study entry, for the duration of study participation, and for 4 months after completion of LC administration Exclusion Criteria: 1. Any concurrent cancer diagnosis that is untreated, actively treated, or has undergone any therapy (RT, cytotoxic, targeted, immunotherapeutic, etc) within 2 years of study enrollment, with the exception of squamous or basal cell skin cancer 2. Patient has not recovered from AEs due to prior anticancer therapy (ie, residual toxicities > Grade 1), with the exception of alopecia 3. Receiving any other investigational agent 4. Active infection requiring systemic antibiotics 5. History of allergic reaction to compounds that are chemically or biologically similar to LC (see Protocol Section 5.5.1.2 and Section 5.5.1.3 of protocol) 6. Patient is taking a medication that may potentiate hemolysis 7. Unstable angina or myocardial infarction within the past 6 months 8. Prolonged QTc interval, Bazett formula (QTcB) (> 450 msec for males or > 460 msec for females) 9. Psychiatric illness or social situation that could limit compliance with study r requirements 10. Pregnant or breastfeeding |
Country | Name | City | State |
---|---|---|---|
United States | Johns Hopkins University/Johns Hopkins Hospital | Baltimore | Maryland |
Lead Sponsor | Collaborator |
---|---|
SignPath Pharma, Inc. | Avance Clinical |
United States,
Glioblastoma cell-induced immunosuppression causing chemoresistance. Chapter in: Glioblastoma Resistance to Chemotherapy: Molecular Mechanisms and Innovative Reversal Strategies. Elsevier/Academic Press. 2021
Sordillo PP, Sordillo LA, Helson L. The Kynurenine Pathway: A Primary Resistance Mechanism in Patients with Glioblastoma. Anticancer Res. 2017 May;37(5):2159-2171. doi: 10.21873/anticanres.11551. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The number of observed Dose Limiting Toxicity (DLTs) | The MTD/RP2D of LC in combination with RT and TMZ and adjuvant TMZ in newly diagnosed HGG will be determined by recording the number of observed dose limiting toxicities (DLTs). DLTs, as defined in this study occur if in the first three patients entered at a dose-level, more than one of these 3 experiences a serious adverse event, as defined by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5. If one of the first three patients entered at the level experiences an SAE (as defined by NCI CTCAE Version 5), then three additional patients are entered at that same dose level. If one of the additional three patients experiences an SAE (as defined by NCI CTCAE Version 5), the dose is not advanced beyond that level. | 10 weeks | |
Primary | The number of observed Dose Limiting Toxicity (DLTs) | The safety and tolerability of LC infused IV over 3 hours will be assessed by recording the number of observed DLTs. DLTs, as defined in this study occur if in the first three patients entered at a dose-level, more than one of these 3 experiences a serious adverse event, as defined by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5. If one of the first three patients entered at the level experiences an SAE (as defined by NCI CTCAE Version 5), then three additional patients are entered at that same dose level. If one of the additional three patients experiences an SAE (as defined by NCI CTCAE Version 5), the dose is not advanced beyond that level. | The duration of treatment for each patient up to 34 weeks | |
Secondary | The incidence of Adverse Events | The safety and tolerability of LC in combination with standard RT/TMZ and adjuvant TMZ will be assessed by recording the incidence of Adverse Events (AEs) using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.
Subjects will undergo medical history evaluations, physical and neurological examinations, brain MRI, functional assessment using the Karnofsky Performance Scale (KPS) Index, vital sign measurements, weight, adverse event assessments, concomitant medication assessments, and laboratory testing including but not limited to blood sample collection for hematology and chemistry, urinalysis, coagulation, lipid panel, electrocardiogram, and pregnancy test for females of childbearing potential. |
The duration of treatment for each patient, up to 34 weeks | |
Secondary | The proportion of patients at each dose level who receive at least 80% of the planned infusions of LC, 80% of RT, and 60% of TMZ during the first 10 weeks of treatment | The feasibility of weekly LC infusion will be assessed by recording the proportion of patients at each dose level who are able to complete at least 80% of the planned infusions of LC, 80% of RT, and 60% of TMZ during the first 10 weeks of treatment. | 10 weeks | |
Secondary | Overall Survival (OS) | The efficacy of weekly LC infusion will be assessed by recording overall survival (OS) at each dose level, defined as the duration of time from the start of treatment with LC to time of death. | The duration of treatment for each patient up to 34 weeks; OS is time from beginning of therapy to time of death. | |
Secondary | Progression free survival (PFS) | The efficacy of weekly LC infusion will be assessed by recording progression free survival (PFS) based on Response Assessment in Neuro-Oncology (RANO) criteria at each dose level, defined as defined as the duration of time from the start of treatment with LC to time of progression or death. | The duration of treatment for each patient up to 34 weeks; PFS is time from the start of therapy until the date when tumor progression is documented |
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