Phase 2
N=47
Radiation Therapy and Temozolomide Followed by Temozolomide Plus Sorafenib for Glioblastoma Multiforme
Glioblastoma Multiforme
Bottom Line
View on ClinicalTrials.gov: NCT00544817 ↗Enrolled (actual)
47
Serious AEs
40.4%
Results posted
Dec 2012
Primary outcome: Primary: Progression-free Survival — 6 Months
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Radiation Therapy (Radiation); Temozolomide (Drug); Sorafenib (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- SCRI Development Innovations, LLC
- Primary completion
- Jun 2008
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Progression-free Survival |
6 | — |
| SECONDARY Overall Survival |
12 | — |
| SECONDARY Objective Response |
13 | — |
Summary
The mechanism of action of sorafenib makes it an interesting drug to investigate in the treatment of patients with glioblastoma multiforme. Efficacy of agents with anti-angiogenic activity has already been demonstrated and the PDGF receptor target may also be pertinent in glioblastoma. The combination of temozolomide plus sorafenib has been investigated previously in the treatment of patients with advanced melanoma. The combination was generally well tolerated; in previously untreated patients, a standard dose of sorafenib (400mg PO bid) was administered with temozolomide 150mg/m2 PO daily for 5 days, repeated every 28 days (23).
In this multicenter phase II study, patients with newly diagnosed glioblastoma will receive standard treatment, including initial debulking surgical resection (if feasible) followed by high-dose radiation therapy with concurrent temozolomide. After completion of radiation therapy, patients will continue treatment with temozolomide (150mg/m2 days 1-5) and sorafenib (400mg PO bid daily), repeated at 28-day intervals for 6 cycles.
Eligibility Criteria
Inclusion Criteria
- Histologically confirmed intracranial glioblastoma multiforme (WHO grade 4).
- Patients who have had partial or complete surgical debulking are eligible, as are those with inoperable glioblastoma.
- No previous treatment for glioblastoma except for previous surgical debulking (i.e. no previous radiotherapy, local chemotherapy, or systemic therapy).
- ECOG performance status 0 or 1 (See Appendix C)
- Age ≥ 18 years
- Adequate bone marrow function: hemoglobin ≥ 9.0g/dL; ANC ≥ 1500/μL; platelet count ≥ 100,000/μL.
- Adequate liver function
- Total bilirubin ≤ 1.5 x ULN
- ALT and AST ≤ 2.5 x ULN
- Serum creatinine class 2 NYHA (Appendix D); unstable angina or new onset angina within the last 3 months; myocardial infarction within the last 6 months.
- Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
- Uncontrolled hypertension defined as systolic blood pressure > 150mm Hg or diastolic pressure > 90mm Hg, despite optimal medical management
- Known human immunodeficiency virus (HIV) infection or chronic hepatitis B or C infection
- Active clinically serious infection > grade 2
- Thrombotic or embolic events including cerebral vascular accident or TIAs within the past 6 months
- Pulmonary hemorrhage/bleeding event ≥ grade 2 within 4 weeks of the first dose of sorafenib
- Any other hemorrhage/bleeding event ≥ grade 3 within 4 weeks of the first dose of sorafenib
- Serious non-healing wound, ulcer, or bone fracture
- Evidence or history of bleeding diathesis or coagulopathy
- Major surgery, open biopsy, or significant traumatic injury within 4 weeks of beginning treatment with sorafenib
- Use of St. John's Wort or rifampicin
- Known or suspected allergy to sorafenib or temozolomide
- Any malabsorption problem
- Other active malignancies, or treatment for invasive cancer within the last 2 years
Data sourced from ClinicalTrials.gov (NCT00544817). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.