Phase 2
Completed N=266
Adult Study: ABT-414 Alone or ABT-414 Plus Temozolomide vs. Lomustine or Temozolomide for Recurrent Glioblastoma Pediatric Study: Evaluation of ABT-414 in Children With High Grade Gliomas
Source: ClinicalTrials.gov NCT02343406 ↗Enrolled (actual)
266
Serious AEs
37.7%
Results posted
May 2020
Primary outcomePrimary: Adult Study: Overall Survival (OS) — 5.7; 4.6; 4.9; 9.6 months — p== 0.062
Summary
This study was conducted to evaluate the efficacy and safety of depatuxizumab mafodotin (ABT-414) alone or with temozolomide versus temozolomide or lomustine alone in adult participants with recurrent glioblastoma. The study also included a substudy to evaluate safety, tolerability and pharmacokinetics of ABT-414 in a pediatric population.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Adult Study: Overall Survival (OS) |
5.7; 4.6; 4.9; 9.6; 7.9; 8.2 | = 0.062 |
| PRIMARY Adult Study: Progression-Free Survival (PFS) |
1.8; 1.5; 1.6; 2.7; 1.9; 1.9 | = 0.123 |
| PRIMARY Pediatric Study: Percentage of Participants With Adverse Events From the First Visit Until 49 Days After the Last Dose of Study Drug |
100 | — |
| PRIMARY Pediatric Study: Maximum Observed Serum Concentration (Cmax) of ABT-414 |
31.4 | — |
| PRIMARY Pediatric Study: Maximum Observed Plasma Concentration (Cmax) of Cys-mcMMAF |
0.272 | — |
| PRIMARY Pediatric Study: Half-life (t1/2) Observed for ABT-414 |
9.0 | — |
| PRIMARY Pediatric Study: Half-life (t1/2) Observed for Cys-mcMMAF |
11.2 | — |
| PRIMARY Pediatric Study: Area Under the Concentration-time Curve (AUC) Observed for ABT-414 |
3170 | — |
| PRIMARY Pediatric Study: Area Under the Concentration-time-curve (AUC) Observed for Unconjugated Cys-mcMMAF |
14.1 | — |
| SECONDARY Adult Study: Objective Response Rate (ORR) |
14.3; 7.7; 4.4 | = 0.06 |
| SECONDARY Adult Study: Overall Survival in the Subgroup With Epidermal Growth Factor Receptor (EGFRvIII) Mutation |
6.3; 5.0; 4.7; 9.4; 8.4; 7.5 | = 0.127 |
| SECONDARY Pediatric Study: Objective Response Rate (ORR) |
— | — |
| SECONDARY Pediatric Study: Best Tumor Response Rate |
— | — |
| SECONDARY Pediatric Study: Duration of Response |
— | — |
| SECONDARY Pediatric Study: Overall Survival |
— | — |
| SECONDARY Pediatric Study: Time to Progression |
— | — |
| SECONDARY Pediatric Study: Progression-Free Survival |
— | — |
| SECONDARY Pediatric Study: Percentage of Participants With Changes in Neurological Status and Functioning |
— | — |
Eligibility Criteria
Inclusion Criteria
Adult participants (greater than or equal to 18 years old):
- Histologically confirmed de novo (primary) glioblastoma with unequivocal tumor progression or recurrence.
- In case of testing at the time of first progression: either at least 3 months after the end of radiotherapy or have tumor progression that is clearly outside the radiation field or have tumor progression unequivocally proven by surgery/biopsy
- Absence of any psychological, familial, sociological or geographical factors potentially hampering compliance with the study protocol and follow-up schedule; such conditions should be assessed with the patient before registration in the trial.
- Availability of adequate biological material (formalin-fixed paraffin embedded [FFPE] tumor) for central testing of Epithelial Growth Factor Receptor (EGFR) amplification
- Presence of EGFR amplification confirmed by central assessment; participants with undetermined EGFR status are excluded
- World Health Organization (WHO) Performance status 0 - 2
- No more than one line of chemotherapy (concurrent and adjuvant Temozolomide based chemotherapy including in combination with another investigational agent is considered one line of chemotherapy). Chemotherapy must have been completed at least 4 weeks prior to randomization.
- Post surgery MRI within 48 hours following surgery, however an MRI scan has to be done within 2 weeks prior to randomization.
- Surgery completed at least 2 weeks before randomization and patients should have fully recovered as assessed by investigators.
- Renal function: calculated creatinine clearance ≥ 30 mL/min by the Cockcroft-Gault formula.
- Liver function: bilirubin < 1.5× upper limit of the normal range (ULN), alkaline phosphatase and transaminases (ASAT) < 2.5× ULN
Pediatric sub-study participants (less than 18 years old):
- Histologically proven high grade glioma (HGG: WHO grade III glioma [e.g anaplastic astrocytoma, anaplastic oligodendroglioma, anaplastic oligoastrocytoma], grade IV glioma [e.g. glioblastoma, gliosarcoma] or diffuse intrinsic pontine glioma [DIPG]).
- Must either have recurrent/progressive tumor or, if newly diagnosed, have completed any planned radiation therapy at least 4 weeks prior to first dose of ABT-414.
- The tumor tissue must have been determined to have EGFR amplification, (by local or other testing service).
- Availability of adequate biological material for retrospective confirmatory central testing of EGFR amplification
- Participant has sufficiently recovered from previous therapy. The investigator believes that benefit of treating the pediatric subject with ABT-414 outweighs the expected risks and that this treatment is in the best interests of the pediatric subject.
- Renal function: calculated creatinine clearance ≥ 30 mL/min by the Cockcroft-Gault formula for pediatric patients ≥12 years of age and estimated glomerular filtration rate ≥ 30 mL/min/1.73 m^2 by modified Schwartz equation for pediatric patients < 12 years of age.
- Liver function: Total bilirubin ≤ 1.5× upper limit of the normal range (ULN), Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) <= 3× ULN. Participants with Gilbert's syndrome documented in medical history may be enrolled if total bilirubin is < 3 times ULN. Not allowed are participants with known chronic liver disease and/or cirrhosis.
Exclusion Criteria
Adult population (greater than or equal to 18 years old):
- Prior treatment with nitrosoureas
- Prior treatment with bevacizumab
- Previous exposure to Epithelial Growth Factor Receptor (EGFR) targeted agents, including EGFRvIII targeting agents
- Prior discontinuation of temozolomide chemotherapy for toxicity reasons
- Prior Radiation Therapy (RT) with a dose over 65 Gy to the brain, stereotactic radiosurgery or brachytherapy unless the recurrence is histologically proven
- Previous other malignancies, except for any previous malignancy which was treated with curative intent more than 5 yea
Data sourced from ClinicalTrials.gov (NCT02343406). 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. Informational only — not medical advice.