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Phase 2 N=121 Treatment

Stage 1: Marizomib + Bevacizumab in WHO Gr IV GBM; Stage 2: Marizomib Alone; Stage 3: Combination of Marizomib and Bevacizumab

Malignant Glioma · Glioblastoma

Enrolled (actual)
121
Serious AEs
38.8%
Results posted
Jun 2022
Primary outcome: Primary: Radiographic Objective Response Rate (ORR) - Part 2 Cohort — 3.3 Percent of participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
MRZ (Drug); BEV (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Celgene
Primary completion
Jun 2021

Outcome Measures

OutcomeResultp-value
PRIMARY
Radiographic Objective Response Rate (ORR) - Part 2 Cohort
3.3
PRIMARY
Overall Survival (OS) - Part 3 Cohorts
8.3; 7.5
SECONDARY
Number of Participants Experiencing Adverse Events
6; 3; 27; 30; 31; 10
SECONDARY
Number of Participants Experiencing Serious Adverse Events (SAEs)
1; 0; 12; 10; 14; 5
SECONDARY
Number of Participants Experiencing Dose-Limiting Toxicity (DLT)
1; 0; 0; 0; 0; 0
SECONDARY
Number of Participants Experiencing Dose-Limiting Adverse Events (DLAEs)
31; 10
SECONDARY
Radiographic Objective Response Rate (ORR)
50.0; 33.3; 48.0; 24.1; 20.0
SECONDARY
Progression Free Survival (PFS)
7.3; 3.7; 3.9; 1.8; 3.5; 2.1
SECONDARY
Overall Survival (OS)
10.4; 6.3; 10.4; 11.4; 8.3; NA

Summary

This is a Phase 1/2 clinical trial to evaluate a new combination of drugs, marizomib (MRZ) and bevacizumab (BEV; Avastin®), for the treatment of WHO Grade IV malignant glioma. The study population includes subjects who are in first or second relapse and who have not previously received any bevacizumab or other anti-angiogenic agent or proteasome inhibitor for treatment of malignant glioma. Part 1 Phase 1 evaluates the combination of MRZ and BEV, while Part 2 Phase 2 evaluates single-agent MRZ. Part 3 (Phase 2) includes a combination MRZ using intra-patient dose escalation, and BEV at a fixed dose. Part 4 Phase 1 evaluates MRZ through enteral administration, and BEV at a fixed dose. Part 5 Phase 1 evaluates the repeat-dose pharmacokinetics of MRZ administered IV with ECG.

Eligibility Criteria

Inclusion Criteria

  • Understand and voluntarily sign and date an informed consent document prior to any study related assessments/procedures are conducted.
  • Males and females at least 18 years of age at the time of signing of the informed consent document.
  • All subjects must have histologic evidence of G4 MG (including glioblastoma and gliosarcoma) and radiographic evidence of recurrence or disease progression (defined as either a greater than 25% increase in the largest bidimensional product of enhancement, a new enhancing lesion, or significant increase in T2 FLAIR).
  • Subjects must have previously completed standard radiation therapy and been exposed to temozolomide. Patients must be in first or second relapse.
  • No prior treatment with MRZ or any other proteasome inhibitors or any other anti-angiogenic agents.
  • No investigational agent within 4 weeks prior to first dose of study drug.
  • At least 4 weeks from surgical resection and 12 weeks from end of radiotherapy prior to enrollment in this study, unless relapse is confirmed by tumor biopsy or new lesion outside of radiation field, or if there are two MRIs confirming progressive disease that are 8 weeks apart.
  • Subjects with a history of seizures must be on a stable dose of anti-epileptic drugs (AEDs) and without seizures for 14 days prior to enrollment in patients enrolled prior to Amendment 2. Subjects enrolled after Amendment 2 is approved with a history of seizures must be on a stable dose of anti-epileptic drugs (AEDs) for 7 days prior to enrollment.
  • All AEs resulting from prior chemotherapy, surgery, or radiotherapy, must have resolved to at least NCI-CTCAE (v. 4.03) Grade 1 (except for laboratory parameters outlined below).
  • Laboratory results within 7 days prior to MRZ administration (transfusions and/or growth factor support may not be used to meet this criteria):
  • Platelet count at least 100,000/mm3
  • Hemoglobin at least 9 g/dL
  • Absolute neutrophil count (ANC) at least 1,500/mm3
  • Serum bilirubin at least 1.5 × upper limit of normal (ULN) or at least 3 × ULN if Gilbert's disease is documented
  • Aspartate transaminase (AST) at least 2.5 ULN
  • Alanine transaminase (ALT) at least 2.5 ULN
  • Serum creatinine at least 1.5 × ULN
  • Urine protein: creatinine ratio ≤ 1.0 at screening
  • Karnofsky Performance Status (KPS) score at least 70%.
  • For women of child-bearing potential and for men with partners of child-bearing potential, subject must agree to take contraceptive measures for duration of treatments and 6 months after the last dose of BEV. A female subject of childbearing potential (FCBP) is a female who: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (ie, has had menses at any time in the preceding 24 consecutive months).
  • Willing and able to adhere to the study visit schedule and other protocol requirements.

Exclusion Criteria

  • Co-medication that may interfere with study results, eg, immuno-suppressive agents other than corticosteroids. (Steroid therapy for control of cerebral edema is allowed at the discretion of the Investigator. Subjects should be on a stable dose of steroids for at least 1 week prior to first dose of MRZ. Co-medications must not be taken for 2 hours prior to and up to 2 hours after enteral administration of MRZ (Part 4 Phase 1).
  • Evidence of CNS hemorrhage on baseline MRI or CT scan (except for post-surgical, asymptomatic Grade 1 hemorrhage that has been stable for at least 3 months for subjects enrolled prior to Amendment 2 and for at least 4 weeks in subjects enrolled after Amendment 2 is approved).
  • History of thrombotic or hemorrhagic stroke or myocardial infarction within 6 months.
  • Chemotherapy administered within 4 weeks (except 6 weeks for nitrosoureas, 12 weeks for an implanted nitros
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02330562). 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.

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