An Open Label, Prospective, Pilot Study to Evaluate the Efficacy and Safety of Best Physician's Choice of Standard of Care Combined With NaviFUS System in Patients With Recurrent Glioblastoma Multiforme

NaviFUS Corporation1 site in 1 country6 target enrollmentJuly 21, 2020

ConditionsGlioblastoma Multiforme Glioblastoma Glioma Brain Tumor Neoplasms Neoplasms, Nerve Tissue

InterventionsBevacizumab NaviFUS System

DrugsBevacizumab

Overview

Phase: N/A
Intervention: Bevacizumab
Conditions: Glioblastoma Multiforme
Sponsor: NaviFUS Corporation
Enrollment: 6
Locations: 1
Primary Endpoint: Adverse Event
Status: Completed
Last Updated: 23 days ago

Overview Investigators Eligibility Criteria Arms & Interventions Outcomes Sites Similar Trials

Overview

Brief Summary

This is a prospective, single-arm, two stages, open-label, pilot study to investigate the efficacy and safety of FUS add-on bevacizumab (BEV) in rGBM patients. The BEV is the best physician's choice of standard of care for rGBM after prior radiotherapy and temozolomide chemotherapy in the LinKou Chang Gung Memorial Hospital. Eligible patients will be enrolled through the process of informed consent.

Detailed Description

This trial will be divided into two stages. The study design and procedures will be as follows: Stage 1: Eligible patients will first be administered with BEV 10 mg/kg intravenous (IV) infusion. After 30-60 minutes, patients will receive microbubbles (MB) (SonoVue®) 0.1 mL/kg and optimal ultrasound exposure doses (based on the acoustic emission feedback FUS power control algorithm) generated from the NaviFUS System single exposure unit for up to two minutes every 2 weeks to transiently open the BBB. After 4 weeks of treatment with BEV and single unit FUS-MB treatment, if the patient experienced BBB opening using FUS treatment and BEV IV infusion without any serious adverse effects (such as brain significant bleeding), then the patient may proceed to stage 2. Stage 2: Patients who complete stage 1 will enter stage 2 to receive the BEV with MB-mediated multiple units of FUS treatment for up to five minutes (but the maximum exposure time per single unit is two minutes) every 2 weeks for up to 30 weeks or until evidence of progressive disease, unacceptable toxicity, non-compliance with study follow-up, or withdrawal of consent. After completion of study treatment, patients will be followed up for 28 days.

Registry

clinicaltrials.gov

Start Date

July 21, 2020

End Date

August 4, 2023

Last Updated

23 days ago

Study Type

Interventional

Study Design

Single Group

Sex

All

Investigators

Sponsor

NaviFUS Corporation

Responsible Party

Sponsor

Eligibility Criteria

Inclusion Criteria

•Adult male/female patients ≥ 20 years of age
•Patients with histologically confirmed glioblastoma, recurrent after prior radiotherapy and temozolomide chemotherapy.
•Patient may have been operated for recurrence. If operated: with measurable residual tumor
•Minimum interval since completion of radiation treatment is 12 weeks
•Patients if already on the steroids then should be on a stable dose of steroids for at least 7 days prior to study treatment
•Body mass index (BMI) ≥17 kg / m2
•Minimum interval since last drug therapy:
•1 week for non-cytotoxic agents (e.g., interferon, tamoxifen), daily chemotherapy (e.g., metronomic temozolomide, cytoxan) or targeted therapies administered daily (e.g., gleevec, tarceva)
•4 weeks since last cytotoxic therapy
•6 weeks since the completion of a nitrosourea-containing chemotherapy regimen (e.g., carmustine (BCNU))

Exclusion Criteria

•Patients who have had previous treatment with an inhibitor of vascular endothelial growth factor (VEGF) or VEGFR (including bevacizumab)
•New York Heart Association (NYHA) Grade II or greater congestive heart failure requiring hospitalization within 12 months prior to screening
•Severe hypertension at screening (diastolic blood pressure \> 100 mmHg on medication)
•Uncontrolled intercurrent illness including, but not limited to symptomatic congestive heart failure, unstable angina pectoris, severe cerebral or myocardial infarction, cardiac shunt, heart attack within the previous 12 months, stroke (except for transient ischemic attack; TIA) within the previous 6 months, or psychiatric illness/social situations that would limit compliance with study requirements
•Unstable pulmonary disease or Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of screening
•Implanted pacemaker, defibrillator or deep brain stimulator, other implanted electronic devices in the brain or documented clinically significant arrhythmias
•Major surgery such as intra-thoracic, intra-abdominal or intra-pelvic (with the exception of craniotomy), open biopsy or significant traumatic injury ≤ 4 weeks prior to screening, or patients who have had minor procedures, percutaneous biopsies or placement of vascular access device ≤ 1 week prior to screening, or who have not recovered from side effects of such procedure or injury
•Known HIV positive patients, however, that HIV testing is not required for entry into this study
•Acute bacterial or fungal infection requiring intravenous antibiotics at the time of screening
•Receiving anticoagulant (e.g. warfarin) or antiplatelet (e.g. aspirin) therapy within one week prior to beginning treatment

Arms & Interventions

Bevacizumab plus NaviFUS System

Device: NaviFUS System BBB Disruption by FUS in recurrent GBM Microbubbles (MB) (SonoVue®) 0.1 mL/kg and optimal ultrasound exposure doses (based on the acoustic emission feedback FUS power control algorithm) generated from the NaviFUS System every 2 weeks to transiently open the BBB. Drug: Bevacizumab 10 mg/kg every 2 weeks for up to 36 weeks or until evidence of progressive disease, unacceptable toxicity, non-compliance with study follow-up, or withdrawal of consent.

Intervention: Bevacizumab