A Phase 2 interventional study of bortezomib + temozolomide+ radiation therapy in Brain and Central Nervous System Tumors, sponsored by Jonsson Comprehensive Cancer Center. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-08-28.
Sponsored by Jonsson Comprehensive Cancer Center · Phase 2, Interventional, and Treatment
RATIONALE: Bortezomib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving bortezomib together with temozolomide and radiation therapy may kill more tumor cells and allow doctors to save the part of the body where the cancer started.
PURPOSE: This phase II trial is studying the side effects and how well bortezomib works when given together with temozolomide and regional radiation therapy in treating patients with newly diagnosed glioblastoma multiforme or gliosarcoma.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a multicenter study.
Tumor tissue samples are collected at baseline (from surgery) and periodically during study for further analysis.
After completion of study therapy, patients are followed up periodically.
1,920 studies on the registry are indexed under Glioblastoma; 450 are open to participants now.
This study's enrollment of 24 is below the median of 36 across 1,618 interventional studies indexed under Glioblastoma.
Browse Glioblastoma studies →Jonsson Comprehensive Cancer Center is the lead sponsor of 396 studies on the registry; 67 are open to participants now.
Of its 37 completed or terminated interventional studies of FDA-regulated products, 2 (5%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Patients receive bortezomib IV on days 1, 4, 8, 11, 29, 32, 36, and 39 and oral temozolomide on days 1-42.Patients undergo external-beam fractionated regional radiotherapy 5 days a week for 6 weeks in the absence of disease progression or unacceptable toxicity.2-6 weeks after radiotherapy, patients receive bortezomib IV on days 1, 4, 8, and 11 and oral temozolomide on days 1-5.Treatment repeats every 28 days for up to 24 courses in the absence of disease progression or unacceptable toxicity.
Drug: bortezomib + temozolomide+ radiation therapy
Patients will be treated with Bortezomib at 1.3 mg/m2 IV on days1,4,8,11,29,32,36 and 39 and Temozolomide on 75mg/m2 daily during radiation. External beam fractionated regional radiation will be given on consecutive week days at 200 centigray (cGy) daily doses to a total dose of 6000 cGy.
Overall Survival
Estimate the overall survival in subjects with newly-diagnosed glioblastoma (GBM) treated with bortezomib/temozolomide/radiation followed by bortezomib/temozolomide for 24 cycles until progression is detected or for up to 24 cycles (\~2 years).
Time frame: 2 years
Toxicity Assessed According to the NCI Common Terminology Criteria for Adverse Events (CTCAE) Version 3.
Time frame: 2 years
Time to Progression
Median time to tumor progression. Because many newly-diagnosed patients are likely not to have evaluable disease due to gross total resections. A 7-point scale was used to guide Magnetic resonance imaging (MRI) assessment to determine progression in this study. A -2 or -3 assessment will be taken as progression. The 7-point scale is listed below. complete resolution of tumor: 3 tumor definitely smaller: 2 tumor probably smaller: 1 tumor unchanged: 0 tumor probably worse: -1 tumor definitely worse: -2 new lesion: -3
Time frame: From the completion of radiation treatment to tumor progression
Survival at 1 Year
Overall Survival at 12 months from completion of radiation treatment
Time frame: 1 year
Tumor Progression as Assessed by Magnetic Resonance Imaging (MRI) and Neurologic Exam
MRI will be done 2 weeks after completion of radiation and then every 8 weeks. Neurologic exam to be performed every 2 weeks during radiation therapy, then every every 4 weeks after radiation is completed.
Time frame: at 6, 12, 18 and 24 months from completion of radiation treatment.
Recruitment period: 10/03/2011 - 4/17/2015 Location: University of California at Los Angeles, Columbia University, New York.
| Milestone | Experimental |
|---|---|
| Started | 24 |
| Completed | 24 |
| Not completed | 0 |
Estimate the overall survival in subjects with newly-diagnosed glioblastoma (GBM) treated with bortezomib/temozolomide/radiation followed by bortezomib/temozolomide for 24 cycles until progression is detected or for up to 24 cycles (\~2 years).
| months | Experimental |
|---|---|
| Overall Survival | 19.1 (6.7 to 31.4) |
| Participants | Experimental |
|---|---|
| Radiotherapy phase — Grade 3 toxicity | 6 |
| Radiotherapy phase — Grade 4 Toxicity | 1 |
| Radiotherapy phase — < Grade 3 Toxicity | 17 |
| Post Radiotherapy phase — Grade 3 toxicity | 7 |
| Post Radiotherapy phase — Grade 4 Toxicity | 0 |
| Post Radiotherapy phase — < Grade 3 Toxicity | 17 |
| Follow-up phase — Grade 3 toxicity | 0 |
| Follow-up phase — Grade 4 Toxicity | 0 |
| Follow-up phase — < Grade 3 Toxicity | 24 |
Median time to tumor progression. Because many newly-diagnosed patients are likely not to have evaluable disease due to gross total resections. A 7-point scale was used to guide Magnetic resonance imaging (MRI) assessment to determine progression in this study. A -2 or -3 assessment will be taken as progression. The 7-point scale is listed below. complete resolution of tumor: 3 tumor definitely smaller: 2 tumor probably smaller: 1 tumor unchanged: 0 tumor probably worse: -1 tumor definitely worse: -2 new lesion: -3
| months | Experimental |
|---|---|
| Time to Progression | 6.2 (3.7 to 8.8) |
Overall Survival at 12 months from completion of radiation treatment
| percentage of participants | Experimental |
|---|---|
| Survival at 1 Year | 87.5 (66.1 to 95.8) |
MRI will be done 2 weeks after completion of radiation and then every 8 weeks. Neurologic exam to be performed every 2 weeks during radiation therapy, then every every 4 weeks after radiation is completed.
| percentage of participants | Experimental |
|---|---|
| Progression Free Survival rate at 6 months | 54.2 (32.7 to 71.4) |
| Progression Free Survival rate at 12 months | 29.2 (13.0 to 47.6) |
| Progression Free Survival rate at 18 months | 25.0 (10.2 to 43.1) |
| Progression Free Survival rate at 24 moths | 25 (10.2 to 43.1) |
Collected over Adverse Events data was collected up to 2 years from the completion of radiation treatment. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Experimental | 15/24 (62.5%) | 5/24 (20.8%) | 24/24 (100%) |
| Event | Experimental |
|---|---|
| RashSkin and subcutaneous tissue disorders | 1/24 |
| ShinglesInfections and infestations | 1/24 |
| HydrocephalusNervous system disorders | 1/24 |
| CraniotomyNervous system disorders | 1/24 |
| Pullmonary embolismRespiratory, thoracic and mediastinal disorders | 1/24 |
| Event | Experimental |
|---|---|
| FatigueGeneral disorders | 17/24 |
| lymphopeniaBlood and lymphatic system disorders | 14/24 |
| HeadacheNervous system disorders | 14/24 |
| Injection site reactionSkin and subcutaneous tissue disorders | 13/24 |
| NauseaGastrointestinal disorders | 11/24 |
| AnemiaBlood and lymphatic system disorders | 9/24 |
| LeukocytopeniaBlood and lymphatic system disorders | 9/24 |
| ConstipationGastrointestinal disorders | 8/24 |
| ThrombocytopeniaBlood and lymphatic system disorders | 7/24 |
| NeutropeniaBlood and lymphatic system disorders | 6/24 |
Twenty-four patients with newly diagnosed Glioblastoma Multiforme were enrolled in this study
| Age, Continuous(years) | Experimental |
|---|---|
| Age Range | 57 (27 to 75) |
| Sex: Female, Male(Participants) | Experimental |
|---|---|
| Female | 11 |
| Male | 13 |
| Race (NIH/OMB)(Participants) | Experimental |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 2 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 1 |
| White | 18 |
| More than one race | 0 |
| Unknown or Not Reported | 3 |
| Region of Enrollment(participants) | Experimental |
|---|---|
| United States | 24 |
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Jonsson Comprehensive Cancer Center