Radiation Injuries Clinical Trial
Official title:
Effect and Safety of Apatinib on Radiation-Induced Brain Injury: an Open-label, Single-arm, Phase 2 Study.
Purpose: This early phase 2 clinical trial aims to evaluate the therapeutic effects and
safety of apatinib in radiation-induced brain injury.
Further study details as provided by Sun Yet-sen Memorial Hospital, Sun Yat-sen University /
Yamei Tang.
Primary outcome measure: The proportion of patients with an objective response defined as ≥
25% reduction in brain edema volume on MR fluid attenuated inversion recovery (FLAIR) images.
The incidence of nasopharyngeal carcinoma (NPC) is high in China especially in southern
China. Radiotherapy is the mainstay of therapy for NPC and greatly improves patient survival.
Along with promising therapeutic effects, complications such as radiation dermatitis,
temporal lobe necrosis, cognitive impairment, and cranial nerve injury are also associated
with radiotherapy. Previously, corticosteroids were considered conventional treatment for
radiation-induced brain injury (RI). Unfortunately, only 20% patients with early phase RI
seem to benefit from corticosteroid treatment. Moreover, the long-term use of steroids is
associated with substantial adverse effects. Recently, bevacizumab, an anti-vascular
endothelial growth factor (VEGF) recombinant monoclonal antibody, has been introduced as an
efficient treatment for RI. However, the risk of severe adverse effects to bevacizumab, e.g.
severe hypertension, proteinuria, nasopharyngeal necrosis and bleeding, limits its usage in
certain patients with RI. Apatinib mesylate tablet is an oral small molecule tyrosine kinase
inhibitor (TKI), which can specifically bind to vascular endothelial growth factor receptor 2
(VEGFR-2) and strongly inhibit neovascularization. Apatinib is currently used as a third-line
treatment for advanced gastric cancer. Previous studies and clinical observation showed that
apatinib could significantly improve brain injury after radiation, reduce brain tissue
exudation and reduce edema. In this study, investigators will discuss the therapeutic effect
of apatinib on RI and evaluate its safety through a prospective phase II clinical trial. It
is hopeful to explore a new and effective method for the treatment of RI.
Primary objectives: The primary objective of this phase II, open-label, single-arm designed
clinical trial is to evaluate the efficacy and safety of apatinib in patients with RI.
OUTLINE: This is a phase II, open-label, single-arm designed clinical trial. Participants are
enrolled and administrated with oral apatinib mesylate tablet for 4 weeks.
Arm 1: Participants receive oral apatinib with a dosage of 250mg once daily for 4 weeks, in
the absence of unacceptable toxicity or severe deterioration.
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