Motexafin Gadolinium in Treating Patients With Glioblastoma Multiforme Who Are Undergoing Radiation Therapy to the Brain

A Phase I Trial To Evaluate Repetitive Intravenous Doses Of Gadolinium-Texaphyrin As A Radiosensitizer In Patients With Glioblastoma Multi Forme

RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs such as motexafin gadolinium may make the tumor cells more sensitive to radiation therapy.

PURPOSE: Phase I trial to study the effectiveness motexafin gadolinium in treating patients with glioblastoma multiforme who are undergoing radiation therapy to the brain.

OBJECTIVES:

• Determine the toxicity of 2 different schedules of motexafin gadolinium as a radiosensitizer in patients with glioblastoma multiforme receiving cranial radiotherapy.
• Determine the maximum tolerated doses of this drug on these 2 schedules in these patients.
• Determine the pharmacokinetic profile of this drug in these patients.
• Determine the biodistribution of this drug in both neoplastic tissue and normal brain parenchyma in these patients.
• Determine the effect and accumulation of this drug in both normal brain parenchyma and neoplastic tissue in these patients.
• Correlate the effect and accumulation of this drug in both normal brain parenchyma and neoplastic tissue with the pharmacokinetics of this drug in these patients.

OUTLINE: This is a multicenter, dose-escalation study of motexafin gadolinium (PCI-0120). Patients are sequentially assigned to 1 of 2 treatment groups.

• Group I: Patients receive PCI-0120 IV over 30-60 minutes once every other day for 6 weeks. Patients concurrently undergo cranial radiotherapy once daily 5 days a week for 6 weeks.
• Group II: Patients receive PCI-0120 IV over 30-60 minutes once daily concurrently during radiotherapy. Patients undergo cranial radiotherapy as in group I.

Cohorts of 3-6 patients in each group receive escalating doses of PCI-0120 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity.

Patients are followed at 1 month and then every 2 months thereafter.

PROJECTED ACCRUAL: Approximately 18-30 patients will be accrued for this study.

DISEASE CHARACTERISTICS:

• Histologically confirmed supratentorial grade IV astrocytoma

  • Glioblastoma multiforme
  • Previously untreated disease

• Measurable and contrast-enhancing tumor by MRI after incomplete resection/biopsy

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Performance status:

• Karnofsky 60-100%

Life expectancy:

• Not specified

Hematopoietic:

• WBC at least 3,000/mm^3
• Absolute granulocyte count at least 1,500/mm^3
• Platelet count at least 100,000/mm^3
• Hemoglobin at least 10 g/dL

Hepatic:

• Bilirubin no greater than 2.0 mg/dL
• SGOT/SGPT no greater than 4 times upper limit of normal (ULN)
• Alkaline phosphatase no greater than 4 times ULN
• PT/APTT normal

Renal:

• Creatinine no greater than 1.5 mg/dL

Cardiovascular:

• No uncontrolled hypertension

Other:

• Mini mental state exam score at least 15
• No history of glucose-6-phosphate dehydrogenase deficiency or porphyria
• No other malignancy within the past 5 years except curatively treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or carcinoma in situ of the breast
• No serious infection
• No other medical illness that would preclude study participation
• No allergy to MRI contrast (e.g., motexafin gadolinium)
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for up to 2 months after study

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• No prior biologic therapy or immunotherapy for this disease, including any of the following:

  • Immunotoxins
  • Immunoconjugates
  • Antisense therapy
  • Peptide receptor antagonists
  • Interferons
  • Interleukins
  • Tumor-infiltrating lymphocytes
  • Lymphokine-activated killer cell therapy
  • Gene therapy

Chemotherapy:

• No prior chemotherapy for this disease

Endocrine therapy:

• Must be on a stable corticosteroid regimen (i.e., no increase within 5 days prior to treatment on this protocol)
• No other prior hormonal therapy for this disease

Radiotherapy:

• No prior radiotherapy for this disease

Surgery:

• See Disease Characteristics
• Recovered from prior surgery

Other:

• No other concurrent investigational agents