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| Name | Class |
|---|---|
| Genentech, Inc. | INDUSTRY |
| Novartis | INDUSTRY |
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In this phase II trial the investigators plan to incorporate two targeted agents, bevacizumab and everolimus, into the first-line multimodality therapy of glioblastoma. In the first portion of the treatment, bevacizumab will be added to standard concurrent radiation therapy plus temozolomide. After completing radiation therapy, patients will continue treatment with the combination of bevacizumab and everolimus.
Although this maintenance regimen departs from the standard treatment with single agent temozolomide, we feel this approach may add to the overall efficacy of treatment for the following reasons: 1) results with bevacizumab/everolimus in renal cell carcinoma suggest there is at least an additive efficacy when these drugs are used in combination; 2) the efficacy of single agent temozolomide following standard concurrent radiation therapy/temozolomide has not been proven, 3) the use of the three-drug maintenance program (i.e., bevacizumab/everolimus/temozolomide) would probably not be tolerated well on a chronic basis in this patient population; and 4) the bevacizumab/everolimus combination has potential advantages as a maintenance therapy, since it has been well tolerated for many months in patients with other malignancies.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | Combined Modality Treatment and Systemic Therapy Combined Modality Therapy - Radiation Therapy: 2 Gy/fraction, single daily fractions Monday-Friday, to total of 60 Gy Temozolomide: 75 mg/m2 by mouth daily Bevacizumab: 10 mg/kg IV every 2 weeks (Weeks 1, 3, 5, and 7) After the last dose of radiation, patients exhibiting an objective response, stable disease on MRI scan, or have stable/improved tumor-related symptoms will begin systemic therapy Systemic Therapy - Bevacizumab: 10 mg/kg IV every 2 weeks Everolimus: 10 mg by mouth daily |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Radiation therapy | Radiation | Radiation therapy, 2.0 Gy daily, 5 days per week by single daily dose, to a total of 60 Gy over 6 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Progression-free Survival (PFS) | Progression-free survival is defined as the duration of time from start of treatment to time of progression or death, whichever comes first. | 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Experiencing Toxicity After This Novel Multimodality Regimen | The toxicity assessments were made according to the common terminology criteria for adverse events (CTCAE version 3.0) of the National Cancer Institute. Number of participants with Grade 1 to 5 adverse events are reported here. | 18 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| John D Hainsworth, M.D. | SCRI Development Innovations, LLC | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clearview Cancer Institute | Huntsville | Alabama | 35805 | United States | ||
| Florida Cancer Specialists |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22706484 | Background | Hainsworth JD, Shih KC, Shepard GC, Tillinghast GW, Brinker BT, Spigel DR. Phase II study of concurrent radiation therapy, temozolomide, and bevacizumab followed by bevacizumab/everolimus as first-line treatment for patients with glioblastoma. Clin Adv Hematol Oncol. 2012 Apr;10(4):240-6. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Overall Study | Radiotherapy administered in 2.0 Gy single daily fractions, Monday through Friday, to a total of at least 60 Gy. Temozolomide 75 mg/m2 orally daily and bevacizumab 10 mg/kg IV every 2 weeks, both beginning on day 1 of radiation therapy |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Modality Therapy |
|
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| Temozolomide | Drug | Temozolomide 75mg/m2 by mouth daily, beginning day 1 of radiation therapy and continuing through the last day of radiation therapy |
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| Bevacizumab | Drug | Bevacizumab 10mg/kg IV, every 2 weeks, beginning day 1 of radiation therapy |
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| Bevacizumab | Drug | Bevacizumab 10mg/kg IV, every 2 weeks, beginning Week 11 |
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| Everolimus | Drug | Everolimus 10mg by mouth daily, beginning Week 11 |
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| Overall Survival of Patients With Glioblastoma Multiforme Following Treatment With This Novel Multimodality Regimen |
Overall survival was defined as the interval from the first day of study treatment until the date of death. |
| 18 months |
| Objective Response Rate of Patients With Glioblastoma Multiforme Following Treatment With This Novel Multimodality Regimen | Response to treatment was assessed by MRI using the MacDonald criteria based on the assessment of the MRI scan for measurable, evaluable, and new lesions. The objective response rate is defined as the proportion of patients with improvement and or decreased extent of lesions compared to baseline. | 18 months |
| Fort Myers |
| Florida |
| 33901 |
| United States |
| Northeast Georgia Medical Center | Gainesville | Georgia | 30501 | United States |
| Consultants in Blood Disorders and Cancer | Louisville | Kentucky | 40207 | United States |
| Center for Cancer and Blood Disorders | Bethesda | Maryland | 20817 | United States |
| Grand Rapids Clinical Oncology Program | Grand Rapids | Michigan | 49503 | United States |
| St. Louis Cancer Care | Chesterfield | Missouri | 63017 | United States |
| Research Medical Center | Kansas City | Missouri | 64132 | United States |
| Methodist Cancer Center | Omaha | Nebraska | 68114 | United States |
| South Carolina Oncology Associates, PA | Columbia | South Carolina | 29210 | United States |
| Tennessee Oncology, PLLC | Nashville | Tennessee | 37023 | United States |
| Peninsula Cancer Institute | Newport News | Virginia | 23601 | United States |
| Virginia Cancer Institute | Richmond | Virginia | 23235 | United States |
| COMPLETED |
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| NOT COMPLETED |
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| Treatment-Free Interval |
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| Maintenance Treatment |
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| ID | Title | Description |
|---|---|---|
| BG000 | Overall Study | Radiotherapy administered in 2.0 Gy single daily fractions, Monday through Friday, to a total of at least 60 Gy. Temozolomide 75 mg/m2 orally daily and bevacizumab 10 mg/kg IV every 2 weeks, both beginning on day 1 of radiation therapy |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Full Range | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Progression-free Survival (PFS) | Progression-free survival is defined as the duration of time from start of treatment to time of progression or death, whichever comes first. | Posted | Median | 95% Confidence Interval | Months | 18 months |
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| Secondary | Number of Participants Experiencing Toxicity After This Novel Multimodality Regimen | The toxicity assessments were made according to the common terminology criteria for adverse events (CTCAE version 3.0) of the National Cancer Institute. Number of participants with Grade 1 to 5 adverse events are reported here. | Posted | Count of Participants | Participants | 18 months |
|
| ||||||||||||||||||||||||||||
| Secondary | Overall Survival of Patients With Glioblastoma Multiforme Following Treatment With This Novel Multimodality Regimen | Overall survival was defined as the interval from the first day of study treatment until the date of death. | Posted | Number | 95% Confidence Interval | Months | 18 months |
|
| |||||||||||||||||||||||||||
| Secondary | Objective Response Rate of Patients With Glioblastoma Multiforme Following Treatment With This Novel Multimodality Regimen | Response to treatment was assessed by MRI using the MacDonald criteria based on the assessment of the MRI scan for measurable, evaluable, and new lesions. The objective response rate is defined as the proportion of patients with improvement and or decreased extent of lesions compared to baseline. | Only 51 patients had measurable tumor and were evaluable for response assessment. | Posted | Count of Participants | Participants | 18 months |
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Overall Study | Radiotherapy administered in 2.0 Gy single daily fractions, Monday through Friday, to a total of at least 60 Gy. Temozolomide 75 mg/m2 orally daily and bevacizumab 10 mg/kg IV every 2 weeks, both beginning on day 1 of radiation therapy | 32 | 68 | 53 | 68 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fatigue | General disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Myocardial Infarction | Cardiac disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Thrombotic Microangiopathy | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment | Thrombotic Thrombocytopenic Purpura (TTP) |
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| CNS Hemorrhage | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Severe Epistaxis with Hematesis | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Dehydration | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Fever in absence of neutropenia | General disorders | CTCAE (3.0) | Systematic Assessment |
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| Death | General disorders | CTCAE (3.0) | Systematic Assessment |
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| Pain | General disorders | CTCAE (3.0) | Systematic Assessment |
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| Cholecystitis | Hepatobiliary disorders | CTCAE (3.0) | Systematic Assessment |
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| Pneumonia | Infections and infestations | CTCAE (3.0) | Systematic Assessment |
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| Infection with Unknown ANC | Infections and infestations | CTCAE (3.0) | Systematic Assessment |
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| Infection with Normal ANC | Infections and infestations | CTCAE (3.0) | Systematic Assessment |
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| Febrile Neutropenia | Infections and infestations | CTCAE (3.0) | Systematic Assessment |
| |
| Infection - Cellulitis | Infections and infestations | CTCAE (3.0) | Systematic Assessment | Herpes Orbital Cellulitis |
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| Infection - Urinary Tract Infection | Infections and infestations | CTCAE (3.0) | Systematic Assessment |
| |
| Hyperglycemia | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Necrotizing Fasciitis | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Rhabdomyolysis | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Seizure | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Cognitive Disturbance | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Neuropathy - Motor | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Somnolence | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| CNS Ischemia | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Syncope | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
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| Dizziness | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Mental Status | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Confusion | Nervous system disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Neurology - Other | Nervous system disorders | CTCAE (3.0) | Systematic Assessment | Progressive Glioblastoma Multiforme |
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| Renal Failure | Renal and urinary disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Dyspnea | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Pneumonitis | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Systematic Assessment |
| |
| Pneumothorax | Surgical and medical procedures | CTCAE (3.0) | Systematic Assessment |
| |
| Thrombosis/Thrombus/Embolism | Vascular disorders | CTCAE (3.0) | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Neutropenia | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
|
| Thrombocytopenia | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment | Modality Treatment |
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| Fatigue | General disorders | CTCAE (3.0) | Systematic Assessment | Modality Treatment |
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| Hypertension | Cardiac disorders | CTCAE (3.0) | Systematic Assessment | Modality Treatment |
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| Nausea/Vomiting | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment | Modality Treatment |
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| Stomatitis/Mucositis | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment | Modality Treatment |
|
| Rash | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Systematic Assessment | Modality Treatment |
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| Thrombocytopenia | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
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| Fatigue | General disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
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| Thrombosis/Embolism | Vascular disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
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| Hypertension | Cardiac disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
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| Pneumonitis | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
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| Proteinuria | Renal and urinary disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
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| Stomatitis/Mucositis | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
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| Hyperlipidemia | General disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
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| Diarrhea | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
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| Rash | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
|
| Nausea/Vomiting | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment | Maintenance Treatment |
|
The sponsor can review/embargo results communications prior to public release for a period that is >60 days but ≤180 days from date submitted to sponsor, who may require changes to the communication in order to remove specifically identified confidential information (other than study data) and/or delay the proposed publication to enable the sponsor to seek patent protection for inventions. The PI may not publish its results until 18 mos. after the trial has been completed at all sites.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| John D. Hainsworth, MD. | Sarah Cannon Research Institute | 877-691-7274 | ASKSARAH@scresearch.net |
| ID | Term |
|---|---|
| D005909 | Glioblastoma |
| ID | Term |
|---|---|
| D001254 | Astrocytoma |
| D005910 | Glioma |
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |
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| ID | Term |
|---|---|
| D011878 | Radiotherapy |
| D003131 | Combined Modality Therapy |
| D000077204 | Temozolomide |
| D000068258 | Bevacizumab |
| D000068338 | Everolimus |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D003606 | Dacarbazine |
| D014226 | Triazenes |
| D009930 | Organic Chemicals |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D020123 | Sirolimus |
| D018942 | Macrolides |
| D007783 | Lactones |
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| Lack of Efficacy |
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| Withdrawal by Subject |
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| Symptomatic Deterioration |
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| Withdrawn Consent |
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