Early Post-surgical Temozolomide Therapy in Patients With High-Grade Gliomas Admitted to Acute Rehabilitation: A Feasibility Study
Overview
- Phase
- Early Phase 1
- Intervention
- Temozolomide
- Conditions
- Glioma of Brain
- Sponsor
- University of Rochester
- Locations
- 1
- Primary Endpoint
- The number of patient who fail to complete temozolomide (TMZ)
- Status
- Withdrawn
- Last Updated
- 5 years ago
Overview
Brief Summary
The purpose of this study is to investigate the feasibility of a possible treatment regimen that could be used to delay tumor progression in patients with glioblastoma. The study is being conducted in patients who qualify for inpatient rehabilitation, as this population is particularly vulnerable to delays in initiation of chemoradiation and further tumor growth in the period between surgical resection and the start of treatment.
Detailed Description
This is a pilot study to evaluate the feasibility and safety of early postsurgical temozolomide therapy prior to initiation of standard chemoradiation regimen in patients with glioblastoma who undergo inpatient rehabilitation. The study will be conducted with adult patients who qualify for inpatient rehabilitation following surgical resection of pathologically confirmed Grade IV glioma. Patients will begin a 21-day cycle of temozolomide starting 14 days after surgery at 75mg per square meter of body surface area daily to serve as bridge therapy. Patients will then progress to receive standard therapy following their rehabilitation stay. Patients will be assessed for their ability to complete the chemotherapy protocol without dose-limiting toxicity as well as complete inpatient rehabilitation successfully. Additionally, we will be assessing for tumor progression between the time of surgery and the time of treatment initiation. If this study shows the expected results, the research team plans to proceed to a larger trial assessing the efficacy of early TMZ in patients with glioblastoma (GBM) who are admitted to acute inpatient rehabilitation compared to the current standard of care.
Investigators
Kevin Walter
Professor
University of Rochester
Eligibility Criteria
Inclusion Criteria
- •Adult patients, aged 18+
- •Newly diagnosed World Health Organization (WHO) Grade IV glioma, confirmed on pathology
- •Karnofsky Performance Score ≥ 60
- •Subject has undergone biopsy, subtotal resection, or gross total resection of tumor
- •Subject has been evaluated by physical therapy and thought to be a candidate for acute rehabilitation
- •Subject must be accepted for admission on 5-1200 unit at Strong Memorial Hospital
- •Subject must be able to provide informed consent
- •Subject must meet the following laboratory parameters:
- •Absolute neutrophil count \> 1.5 x103/uL
- •Platelet count \> 140 x103/uL
Exclusion Criteria
- •Subject has received previous treatment for high-grade glioma
- •Subject has other active malignancy
- •Subject is currently pregnant or breastfeeding
- •Subject is a women of childbearing potential who is not using a reliable method of contraception
- •Subject has history of hypersensitivity to temozolomide
Arms & Interventions
Temozolomide Arm
This study will only include one treatment group who will receive oral temozolomide at 75 mg per square meter of body surface area daily for 21 days before progressing to standard chemoradiation treatment.
Intervention: Temozolomide
Outcomes
Primary Outcomes
The number of patient who fail to complete temozolomide (TMZ)
Time Frame: 1 month
The number of subjects who fail to complete early TMZ plus inpatient rehabilitation for any reason, including adverse events or progression or patient withdrawal
Secondary Outcomes
- Response rate to TMZ(1 month)
- Mean functional independence measure (FIM) score(1 month)