A Randomized Phase I/II Study of ABT-888 in Combination With Temozolomide in Recurrent (Temozolomide Resistant) Glioblastoma

Phase 1: Maximum Tolerated Dose (MTD)

时间窗: Start of treatment to 8 weeks.

Dose limiting toxicity (DLT) = any of the following events within 1st 8 weeks of treatment attributable to study drugs: Any grade (gr) 3/4 thrombocytopenia, gr 4 anemia, gr 3 neutropenia with fever (\>100.4). gr 4 neutropenia lasting \> 7 days; Any non-hematologic (NH) gr 3+ toxicity (TOX), excluding alopecia, despite maximal medical therapy (MLT); NH TOX such as rash, nausea, vomiting, diarrhea, mucositis, hypophosphatemia, and hypertension will only be considered DLTs if they remain gr 3+ despite MLT; 2nd occurrence of thromboembolism; Failure to recover from TOX (\<= gr 1) to be eligible for re-treatment with study drugs \<= 14 days of last dose of either drug; Any episode of non-infectious radiologically observed pneumonitis gr 2-4 any duration. Dose level will be considered acceptable if \<= 1 of the 1st 6 eligible patients experiences a DLT. If current level is considered acceptable, dose escalation occurs. Otherwise preceding acceptable dose level will be declared the MTD.

Phase II: 6-month Progression-free Survival (PFS) Rate for Patients With Measurable Disease After Surgery

时间窗: Randomization to 6 months.

For patients with measureable disease after surgery: Progression defined as ≥ 25% increase in size of enhancing tumor or any new tumor; or neurologically worse, and steroids stable/increased. Bevacizumab (BEV)-naïve group: p0= 15% as estimate of 6-mo. PFS \[null hypothesis (NH)\], p1= 30%, with a 15% absolute increase \[alternative hypothesis (AH)\]. Error rates of 10% alpha and 10% beta. If \<= 11 patients experience 6-month PFS of the first 53 analyzable patients, then do not reject the null hypothesis that the 6-month PFS rate of experimental arm is less than 15%; BEV-failure group: p0 = 2% as a conservative estimate of 6-month PFS \[NH\], p1 = 15%, with a 13% absolute increase \[AH\]. Using first 26 analyzable subjects for each experimental arm, there is \>= 90% power to detect \>= 15% increase at a significance level of 0.10, using a 1-sided binomial test. If \>= 2 patients (8%) are progression free at 6 mo., then claim this regimen to be promising in the patient group.