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| Name | Class |
|---|---|
| Dana-Farber Cancer Institute | OTHER |
| Brigham and Women's Hospital | OTHER |
| Pfizer | INDUSTRY |
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For many brain tumors, one reason that chemotherapy drugs might not be effective is that the drug may not be able to get into the brain tumor and kill the cancer cells. The brain is protected by a layer called the blood brain barrier. This barrier prevents substances from entering. The purpose of this research study is to determine if bosutinib can get past the blood brain barrier and into the brain tumor, and to see how well bosutinib works in killing cancer cells.
- Arm A: Participants will receive daily doses of bosutinib orally for 7-9 days prior to surgery. On the day of the scheduled surgery (either craniotomy or surgical resection as planned by the treating doctor), participants will take the bosutinib within 6-12 hours of the surgery. During the surgery, tissue samples of the tumor will be collected to test the levels of bosutinib in the brain. A contrast-enhanced MRI or CT scan will be done within days after the surgery. Daily dosing of bosutinib will resume after a recovery period of 10 days. From then on, the study will be divided into 28-day cycles.
The following tests/procedures will be performed regularly during cycles of study treatment: medical history; physical exam; blood tests; contrast-enhanced CT or MRI scans (even numbered cycles only).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm A | Experimental | Patients who are surgical candidates. Participants are given oral bosutinib, 400mg daily, for 7-9 days prior to resection. After at least 10 days elapsed post-operatively, bosutinib dosing was resumed. |
|
| Arm B | Experimental | Patients that are not surgical candidates. Participants are given oral bosutinib, 400 mg daily in 28 day cycles until disease progression, intolerability or withdrawal of consent. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| bosutinib | Drug | Taken orally |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Progression-Free Survival | Assess progression-free survival at six months in patients with recurrent glioblastoma at first or second recurrence who are treated with continuous daily dosing of bosutinib (Arm B). Progression-free survival is measured from initiation of study treatment to date of progression. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Intratumoral Concentration | Assess the intratumoral concentration of bosutinib in recurrent glioblastoma patients who are candidates for surgical re-resection (ARM A). | 2 years |
| Safety Profile |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tracy Batchelor, MD | Massachusetts General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States | ||
| Dana=Farber Cancer Institute |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25411098 | Background | Taylor JW, Dietrich J, Gerstner ER, Norden AD, Rinne ML, Cahill DP, Stemmer-Rachamimov A, Wen PY, Betensky RA, Giorgio DH, Snodgrass K, Randall AE, Batchelor TT, Chi AS. Phase 2 study of bosutinib, a Src inhibitor, in adults with recurrent glioblastoma. J Neurooncol. 2015 Feb;121(3):557-63. doi: 10.1007/s11060-014-1667-z. Epub 2014 Nov 20. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Arm A | Patients who are surgical candidates bosutinib: Taken orally |
| FG001 | Arm B | Patients that are not surgical candidates bosutinib: Taken orally |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Arm A | Patients who are surgical candidates bosutinib: Taken orally |
| BG001 | Arm B | Patients that are not surgical candidates bosutinib: Taken orally |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median |
| 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 | Assess progression-free survival at six months in patients with recurrent glioblastoma at first or second recurrence who are treated with continuous daily dosing of bosutinib (Arm B). Progression-free survival is measured from initiation of study treatment to date of progression. | This outcome was only applicable to participants enrolled on Arm B. | Posted | Median | 95% Confidence Interval | weeks | 2 years |
|
Adverse event data were followed for the duration of the participants' time on study; an average of two 28-day cycles (56 total days), with a range of one to six cycles.
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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 | Combined Arms | Adverse Events were measured across all participants, regardless of arm. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| cellulitis | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| lymphocyte count decreased | Investigations | CTCAE (4.0) | Non-systematic Assessment |
This study met pre-specified criteria for early closure, as all 9 patients enrolled on Arm B demonstrated disease progression within 6 months.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Tracy T. Batchelor, MD | Massachusetts General Hospital | 617-643-1938 | tbatchelor@mgh.harvard.edu |
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| ID | Term |
|---|---|
| D005909 | Glioblastoma |
| ID | Term |
|---|---|
| D001254 | Astrocytoma |
| D005910 | Glioma |
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
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| ID | Term |
|---|---|
| C471992 | bosutinib |
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Overall safety profile will be characterized by type, frequency, severity (as graded by NCI CTCAE), timing and relationship of study therapy of adverse events and laboratory abnormalities. Safety and tolerability will be measured by the proportion of patients who experience Grade 3 or higher Adverse Events that are possibly, probably or definitely related to bosutinib and the number of same Adverse Events per patient. Adverse Events will be summarized by treatment for each arm by the frequency of patients experiencing treatment emergent adverse events.
| 2 years |
| Anti-tumor Response | Assess anti-tumor response in patients in Arm B using MacDonald criteria. There are four possible responses: complete response, partial response, stable disease, or progressive disease. Criteria are based on measurements of tumor dimension as visualized with a contrast-enhanced MRI. | 2 years |
| Boston |
| Massachusetts |
| 02115 |
| United States |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Prior Surgery | Surgery done at time of diagnosis with glioblastoma | Number | participants |
|
| Karnofsky Performance Status (KPS) | A standard way of measuring the ability of cancer patients to perform ordinary tasks. The Karnofsky Performance Status scores range from 0 to 100. A higher score means the patient is better able to carry out daily activities. (0 being 'Dead' and 100 being 'Normal, no complaints; no evidence of disease'.) | Median | Full Range | units on a scale |
|
| Prior chemoradiation | Number of patients who previously received standard, initial therapy with temozolomide and radiation at diagnosis | Number | participants |
|
|
|
| Secondary | Intratumoral Concentration | Assess the intratumoral concentration of bosutinib in recurrent glioblastoma patients who are candidates for surgical re-resection (ARM A). | Participants in Arm B were never eligible for this outcome measure. Because only two participants were enrolled to Arm A, this analysis was not done as there were not sufficient tumor samples to generate meaningful results. | Posted | 2 years |
|
|
| Secondary | Safety Profile | Overall safety profile will be characterized by type, frequency, severity (as graded by NCI CTCAE), timing and relationship of study therapy of adverse events and laboratory abnormalities. Safety and tolerability will be measured by the proportion of patients who experience Grade 3 or higher Adverse Events that are possibly, probably or definitely related to bosutinib and the number of same Adverse Events per patient. Adverse Events will be summarized by treatment for each arm by the frequency of patients experiencing treatment emergent adverse events. | Posted | Number | participants | 2 years |
|
|
|
| Secondary | Anti-tumor Response | Assess anti-tumor response in patients in Arm B using MacDonald criteria. There are four possible responses: complete response, partial response, stable disease, or progressive disease. Criteria are based on measurements of tumor dimension as visualized with a contrast-enhanced MRI. | Only Arm B participants were evaluable for this outcome measure | Posted | Number | participants | 2 years |
|
|
|
| 6 |
| 11 |
| 11 |
| 11 |
| seizure | Nervous system disorders | CTCAE (4.0) | Non-systematic Assessment |
|
| fall | Injury, poisoning and procedural complications | CTCAE (4.0) | Non-systematic Assessment |
|
| lymphocyte count decreased | Investigations | CTCAE (4.0) | Non-systematic Assessment |
|
| lung infection | Infections and infestations | CTCAE (4.0) | Non-systematic Assessment |
|
| diarrhea | Gastrointestinal disorders | CTCAE (4.0) | Non-systematic Assessment |
|
| nausea | Gastrointestinal disorders | CTCAE (4.0) | Non-systematic Assessment |
|
| dizziness | Nervous system disorders | CTCAE (4.0) | Non-systematic Assessment |
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| vomiting | Gastrointestinal disorders | CTCAE (4.0) | Non-systematic Assessment |
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| headache | Nervous system disorders | CTCAE (4.0) | Non-systematic Assessment |
|
| fatigue | General disorders | CTCAE (4.0) | Non-systematic Assessment |
|
| nausea | Gastrointestinal disorders | CTCAE (4.0) | Non-systematic Assessment |
|
| seizure | Nervous system disorders | CTCAE (4.0) | Non-systematic Assessment |
|
| elevated alanine aminotransferase | Investigations | CTCAE (4.0) | Non-systematic Assessment |
|
| diarrhea | Gastrointestinal disorders | CTCAE (4.0) | Non-systematic Assessment |
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| hypophosphatemia | Metabolism and nutrition disorders | CTCAE (4.0) | Non-systematic Assessment |
|
| rash | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Non-systematic Assessment |
|
| lung infection | Infections and infestations | CTCAE (4.0) | Non-systematic Assessment |
|
| elevated aspartate aminotransferase | Investigations | CTCAE (4.0) | Non-systematic Assessment |
|
| cerebral edema | Nervous system disorders | CTCAE (4.0) | Non-systematic Assessment |
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| maculo-papular rash | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Non-systematic Assessment |
|
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| D009373 |
| Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |
| Title | Measurements |
|---|---|
|
| Progressive disease |
|