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NovoTTF-100A With Bevacizumab (Avastin) in Patients With Recurrent Glioblastoma

Information source: Case Comprehensive Cancer Center
ClinicalTrials.gov processed this data on August 20, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Adult Giant Cell Glioblastoma; Adult Glioblastoma; Adult Gliosarcoma; Recurrent Adult Brain Tumor

Intervention: Bevacizumab (Biological); NovoTTF-l00A (Device); Quality of Life Assessment (Other)

Phase: Phase 2

Status: Recruiting

Sponsored by: Case Comprehensive Cancer Center

Official(s) and/or principal investigator(s):
Manmeet Ahluwalia, MD, Study Chair, Affiliation: Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center

Summary

NovoTTF-100A is a device and Bevacizumab is a study drug that have both been approved by the FDA (Food and Drug Administration) for use as monotherapy in treating glioblastoma multiforme. The NovoTTF-l00A is a portable battery operated device which produces TTFields within the human body using surface electrodes (transducer arrays). Intermediate frequency electric fields (TTFields) stunt the growth of tumor cells. The purpose of this study is to determine the efficacy of the combination of Bevacizumab and NovoTTF-100A in Bevacizumab naive (meaning have never received bevacizumab before) patients with recurrent glioblastoma (GBM) as measured by 6-month progression free survival.

Clinical Details

Official title: A Prospective Phase II Trial of NovoTTF-100A With Bevacizumab (Avastin) in Patients With Recurrent Glioblastoma

Study design: Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome: Progression Free Survival (PFS)

Secondary outcome:

Objective response rate based on RANO Criteria

Number of patients that experience toxicities with this combination of therapies

Median overall survival

To assess time-to-progression

Neurocognitive function (NCF)

Quality of Life (QOL)

Detailed description: This will be an open label Phase II trial in adults with recurrent glioblastoma (GBM). The NovoTTF-100A treatment and Bevacizumab will be administered on an outpatient basis; NovoTTF-100A treatment will be initiated in the outpatient clinic. PRIMARY OBJECTIVES: I. To determine the efficacy of the combination of bevacizumab and NovoTTF-100A in bevacizumab-naive patients with recurrent glioblastoma (GBM) as measured by 6-month progression-free survival (PFS6). SECONDARY OBJECTIVES: I. To assess safety and tolerability of the combination of bevacizumab and Novo-TTF-100A in this patient population. II. To evaluate overall survival in this population. III. To determine objective response rate (ORR) by modified Revised Assessment in Neuro-Oncology (RANO) criteria in this population. IV. To assess time-to-progression in this population. V. To assess neurocognitive function (NCF) and quality of life (QOL) in this population. OUTLINE: Patients receive bevacizumab intravenously (IV) on days 1 and 15. Patients also undergo electric field therapy with NovoTTF-100A for at least 18 hours daily. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for at least 28 days.

Eligibility

Minimum age: 22 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Patients with histologically confirmed glioblastoma or other grade IV malignant

glioma (i. e. gliosarcoma, small cell glioblastoma, etc.), recurrent after prior external-beam fractionated radiotherapy and temozolomide chemotherapy.

- Patients with up to two prior recurrences are allowed.

- Karnofsky performance status >/=70.

- Patients must have the following laboratory values:

- Absolute neutrophil count (ANC) >/= 1. 5 x 109/L

- Platelets >/= 100 x 109/L

- Hemoglobin (Hgb) > 9 g/dL

- Serum total bilirubin:

- ALT and AST

- Serum creatinine

- Blood coagulation parameters: INR

- Minimum interval since completion of radiation treatment is 12 weeks

- Minimum interval since last drug therapy:

- 3 weeks since last non-cytotoxic therapy

- 3 weeks must have elapsed since the completion of a non-nitrosourea-containing

chemotherapy regimen

- 6 weeks since the completion of a nitrosourea-containing chemotherapy regimen.

- Patients must have signed an approved informed consent and authorization permitting

release of personal health information.

- Patients with the potential for pregnancy or impregnating their partner must agree to

follow acceptable birth control methods to avoid conception. The effects of bevacizumab on developing fetus or nursing infant are not known. Female patients of child-bearing potential must have a negative pregnancy test.

- Patients must have no concurrent malignancy except curatively treated basal or

squamous cell carcinoma of the skin or carcinoma in situ of the cervix and breast, adequately treated stage I or II cancer from which the patient is in complete remission. Patients with other prior malignancies must be disease-free for 2: three years.

- Patients must be maintained on a stable corticosteroid regimen from the time of their

baseline scan until the start of treatment and/or for at least 5 days before starting treatment. Exclusion Criteria:

- Patients who have had previous treatment with bevacizumab.

- Patients who have undergone major surgery (e. g. intra-thoracic, intra-abdominal or

intra-pelvic), open biopsy or significant traumatic injury - Patients with impaired cardiac function or clinically significant cardiac diseases,

including any of the following:

- History or presence of serious uncontrolled ventricular arrhythmias

- Any of the following within 6 months prior to starting study drug: myocardial

infarction (MI), severe/unstable angina, Coronary Artery Bypass Graft (CABG), Congestive Heart Failure (CHF), Cerebrovascular Accident (CV A), Transient Ischemic Attack (TIA), Pulmonary Embolism (PE)

- Uncontrolled hypertension (defined by a systolic blood pressure (SBP) >/= 160 mm

Hg or diastolic blood pressure (DBP) >/= 100 mm Hg while on anti-hypertensive medications)

- Patients with cirrhosis, or active viral or nonviral hepatitis.

- Implanted pacemaker, defibrillator or deep brain stimulator, other implanted

electronic devices in the brain or documented clinically significant arrhythmias.

- Infra-tentorial tumor

- Evidence of increased intracranial pressure (clinically significant papilledema,

vomiting and nausea or reduced level of consciousness)

- Known sensitivity to conductive hydrogels

- Known diagnosis of human immunodeficiency virus (HIV) infection (HIV testing is not

mandatory)

- Other concurrent severe and/or uncontrolled concomitant medical conditions (e. g.

active or uncontrolled infection, uncontrolled diabetes) that could cause unacceptable safety risks or compromise compliance with the protocol

- Pregnant or breast-feeding women

- Patients unwilling or unable to comply with the protocol

Locations and Contacts

Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Cleveland, Ohio 44106, United States; Recruiting
Andrew Sloan, MD, Phone: 216-844-6054, Email: andrew.sloan@uhhospitals.org
Andrew Sloan, MD, Principal Investigator

Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center, Cleveland, Ohio 44195, United States; Recruiting
Manmeet Ahluwalia, MD, Phone: 216-444-6145, Email: ahluwam@ccf.org
Manmeet Ahluwalia, MD, Principal Investigator

Additional Information

Starting date: June 2013
Last updated: May 6, 2015

Page last updated: August 20, 2015

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