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Treatment of Relapsed/Refractory Intracranial Glioma in Patients Under 22 Years of Age

Phase 1
Recruiting
Conditions
Glioblastoma Multiforme
Anaplastic Astrocytoma
Fibrillary Astrocytomas
Diffuse Intrinsic Pontine Glioma
Oligodendroglioma
Diffuse Intrinsic Brainstem Glioma
DIPG Brain Tumor
H3 K27M
Interventions
Drug: SIACI of cetuximab and bevacizumab
Registration Number
NCT05956821
Lead Sponsor
University of Miami
Brief Summary

This study assesses the safety and efficacy of repeat monthly dosing of super-selective intra-arterial cerebral infusion (SIACI) of cetuximab and bevacizumab in patients \< 22 years of age.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Documented histologic diagnosis of relapsed or refractory glioblastoma multiforme (GBM), anaplastic astrocytoma (AA), fibrillary astrocytomas (FA), pilomyxoid astrocytoma (PXA), oligodendroglioma, or anaplastic mixed oligoastrocytoma (AOA), or radiologically diagnosed diffuse intrinsic brainstem glioma (DIPG)
  • Must have at least one confirmed and evaluable tumor site
  • Must have a Karnofsky or Lansky performance status ≥60%.
  • No chemotherapy for three weeks prior to treatment
  • Patients must have adequate hematologic reserve with absolute neutrophils≥1000/mm3 and platelets ≥100,000/ mm3
  • Pre-enrollment chemistry parameters must show: bilirubin<1.5x the institutional upper limit of normal (IUNL); Aspartate Aminotransferase( AST) or Alanine transaminase (ALT)<2.5x IUNL and creatinine<1.5x IUNL
  • Pre-enrollment coagulation parameters (PT and PTT) must be ≤1.5x the IUNL
  • Growth factor(s): Must not have received within 1 week of entry onto this study
  • Steroids: Systemic corticosteroid therapy is permissible in patients with Central Nervous System (CNS) tumors for treatment of increased intracranial pressure or symptomatic tumor edema. Patients with CNS tumors who are receiving dexamethasone must be on a stable or decreasing dose for at least 1 week prior to study entry.
  • Patients of reproductive age must agree to use a medically effective method of contraception during and for a period of three months after the treatment period. A pregnancy test will be performed on each premenopausal female of childbearing potential immediately prior to entry into the research study
  • Patients or their parents/guardians must be able to understand and give written informed consent. Informed consent must be obtained at the time of patient screening
  • Because of known concerns with Avastin and wound healing, craniotomy patients are eligible for the treatment if they have had a craniotomy greater than two weeks prior to Intra-Arterial (IA) therapy. Craniotomy or major procedure after SIACI Avastin therapy should wait 4 weeks. Minor surgeries may be performed after two weeks
Exclusion Criteria
  • Females who are pregnant or lactating
  • Females of childbearing potential and fertile men will be informed as to the potential risk of procreation while participating in this research trial and will be advised that they must use effective contraception during and for a period of three months after the treatment period. If they do not agree, they will be ineligible for the study
  • Patients with significant concurrent medical or psychiatric conditions that would place them at increased risk or affect their ability to receive or comply with treatment or post-treatment clinical monitoring

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
SIACI of cetuximab and bevacizumabSIACI of cetuximab and bevacizumabParticipants in this group will receive Cetuximab and Bevacizumab infusion into an artery each month for up to approximately one year.
Primary Outcome Measures
NameTimeMethod
Number of Treatment Related Adverse Events1 month post injection

The number of treatment-related adverse events will be assessed and graded according to the NCI Common Toxicity Criteria, version 5.0.

Progression-free survival (PFS)1 year

PFS will be measured from the date of the first dose of SIACI Cetuximab/Avastin to the date of progression.

Composite Overall Response Rate (CORR)6 months

The overall response proportion along with a 95% confidence interval will be estimated via binomial proportions. We will define "evaluable" patients as patients who met eligibility requirements and have initiated therapy.

Overall Survival (OS)1 year

OS will be measured from the date of diagnosis to the date of death

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Jackson Memorial Hospital

🇺🇸

Miami, Florida, United States

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