ClinicalTrials.gg
TerminatedNCT03363659Updated Oct 3, 2024Results posted

Disulfiram and Copper Gluconate With Temozolomide in Unmethylated Glioblastoma Multiforme

A Phase 2 interventional study of Disulfiram and Copper gluconate in Glioblastoma and Glioblastoma Multiforme, sponsored by Wake Forest University Health Sciences. Terminated at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-10-03.

Sponsored by Wake Forest University Health Sciences · Phase 2, Interventional, and Treatment

Why this study was terminated
Investigator decision
Phase
Phase 2
Study type
Interventional
Enrollment
15
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

One of Disulfiram antitumor effects suggested in preclinical studies is MGMT (methyl-guanine-methyl-transferase) inhibition. Disulfiram MGMT inhibitory effect is enhanced by addition of Copper. This study evaluates the impact of Disulfiram (DSF) + Copper (Cu) combination when added to standard Temozolomide in the treatment of unmethylated Glioblastoma Multiforme (GBM) patients.

Read the detailed description

Glioblastoma is the most common malignant primary brain tumor and one of the most devastating cancers. The current standard of care for glioblastoma includes maximal safe resection followed by radiotherapy and temozolomide, which results in a median progression-free survival of less than 7 months, and median overall survival (OS) of less than 15 months. Moreover, patients with unmethylated glioblastoma respond poorly to this current standard treatment. This clinical trial evaluates the potential role of continuous, upfront use of Disulfiram in combination with Copper gluconate in enhancing temozolomide effect in the treatment of unmethylated Glioblastoma multiforme (GBM) patients.

02

Conditions studied

  • Glioblastoma
  • Glioblastoma Multiforme

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Keywords

  • Glioblastoma
  • Glioblastoma Multiforme
  • Anaplastic Glioma
  • Unmethylated
03

In context

Glioblastoma

2,132 studies on the registry are indexed under Glioblastoma; 464 are open to participants now.

This study's enrollment of 15 is below the median of 36 across 1,753 interventional studies indexed under Glioblastoma.

Browse Glioblastoma studies →

Lead sponsor

Wake Forest University Health Sciences is the lead sponsor of 1,351 studies on the registry; 201 are open to participants now.

Of its 332 completed or terminated interventional studies of FDA-regulated products, 251 (76%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age 18 or older
  • Diagnosis of confirmed glioblastoma (WHO grade IV). Subjects with an original histologic diagnosis of low grade glioma or anaplastic glioma (WHO grade II or III) are eligible if a subsequent histological diagnosis of glioblastoma is made
  • Patients whose tumor is determined to be unmethylated
  • Patients with incomplete resection as determined by residual, measurable gadolinium or contrast-enhancing lesion or lesions
  • Recent resection of glioblastoma within 4 weeks of study entry. Patients who have only had a tumor and who are considered unresectable are eligible (but based on the study accrual this subset of patients with unresectable tumor may be considered for separate analysis)
  • Performance Status (ECOG PS) of ≤ 2 (see appendix A)
  • Willing to remain abstinent from consuming alcohol while on DSF
  • No prior radiation or chemotherapy
  • Meets the following laboratory criteria:

    • ≥ 1,500/mcL (microliter)
    • ≥ 100,000/mcL
    • > 10.0 g/dL (grams/deciliter) (transfusion and/or ESA (erythropoiesis-stimulating agent) allowed)
    • Total and alkaline phosphatase ≤ 2x institutional (ULN)
    • (AST) and alanine aminotransferase (ALT) \< 3 x ULN
    • Blood urea nitrogen (BUN) and creatinine \< 1.5 x ULN
  • Able to take oral medication
  • Able to understand and willing to sign an institutional review board (IRB)-approved written document (legally authorized representative permitted)

Exclusion criteria

Exclusion Criteria:

  • Radiographic evidence of dissemination, extensive intraparenchymal dissemination, infratentorial tumor, or disease to sites remote from the supratentorial brain
  • Enrolled in another clinical trial testing a novel therapy or drug
  • Received prior radiation therapy or chemotherapy for glioblastoma
  • History of allergic reaction/ to DSF (without alcohol) or copper.
  • Treatment with the following medications that may interfere with metabolism of DSF: warfarin (unless otherwise chosen by the study PI who will actively adjust Coumadin dose to consistently maintain a safe, therapeutic (INR) \< 3, theophylline, amitriptyline, isoniazid, metronidazole, phenytoin, phenobarbital, chlorzoxazone, halothane, imipramine, chlordiazepoxide, diazepam. (Note: lorazepam and oxazepam are not affected by the P450 system and are not with DSF).
  • Active severe hepatic or renal disease
  • Grade 2 or higher peripheral neuropathy or ataxia per version 4.0 (2009)
  • History of idiopathic seizure disorder schizophrenia, or psychosis unrelated to glioblastoma, , or anti-epileptic medications
  • History of Wilson's or Gilbert's disease
  • Current excessive use of alcohol
Terms in these criteria, in plain language(17)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
15 participants (actual)

Study arms

  • Experimental
    DSF-Cu with temozolomide and radiation

    Disulfiram (DSF; oral) / copper gluconate (Cu; oral) dosed at 125 mg / 2 mg, twice daily. Temozolomide will be administered following the standard Stupp protocol at a dose of 75 mg/m2 for 42 days with concurrent radiation therapy. Temozolomide maintenance dose will be 150 mg/m2 once daily on Days 1-5 of every 28-day cycle while DSF-Cu is continued twice daily, as tolerated, for the duration of the Temozolomide adjuvant treatment. Patients demonstrating continued benefit from the adjuvant temozolomide after 6 cycles can continue treatment to a maximum of 12 cycles

    Drug: Disulfiram · Dietary Supplement: Copper gluconate · Drug: Temozolomide

Interventions

  • Disulfiram is taken orally, twice daily.

    Also known as: Antabuse

  • Dietary supplementCopper gluconate

    Copper gluconate is taken orally, twice daily

  • Temozolomide is taken once daily

    Also known as: Temodar, Temodal, Temcad

06

What researchers measure

Primary outcomes

  1. 6 Months Progression Free Survival (PFS)

    To determine 6 month PFS of patients with unmethylated glioblastoma treated with DSF-Cu in combination with concurrent radiation and temozolomide. This was assessed by the number of participants who did not have disease progression and were alive at 6 months.

    Time frame: 6 months

  2. Overall Survival

    Overall Survival will be assessed as a number of participants alive at 1 and 2 years.

    Time frame: 1 and 2 years

Secondary outcomes

  1. Quality of Life (QOL)

    Edmonton Symptom Assessment System - Revised (ESAS-r) questionnaire

    Time frame: 1 year

07

Results

Posted Sep 8, 2023

Participant flow

First subject enrollment 28th March 2018. Subjects screened at neuro-oncology MDCC (Multi-disciplinary cancer clinic) and enrolled at neuro-oncology clinic. Study closed 13th January 2022.

Participant flow — Overall Study
MilestoneOpen Label
Started15
Completed12
Not completed3
Withdrew: Adverse event1
Withdrew: Screen fail1
Withdrew: Withdrawal by subject1

Outcome measures

Primary6 Months Progression Free Survival (PFS)

To determine 6 month PFS of patients with unmethylated glioblastoma treated with DSF-Cu in combination with concurrent radiation and temozolomide. This was assessed by the number of participants who did not have disease progression and were alive at 6 months.

Time frame:
6 months
Reported as:
Count of participants · Participants
6 Months Progression Free Survival (PFS)
ParticipantsOpen Label
6 Months Progression Free Survival (PFS)1
PrimaryOverall Survival

Overall Survival will be assessed as a number of participants alive at 1 and 2 years.

Time frame:
1 and 2 years
Reported as:
Count of participants · Participants
Overall Survival
ParticipantsOpen Label
1 Year9
2 Years2
SecondaryQuality of Life (QOL)

Edmonton Symptom Assessment System - Revised (ESAS-r) questionnaire

Time frame:
1 year

No measurements were reported for this outcome.

Adverse events

Collected over Reportable adverse events will be tracked for 30 days after the last dose of DSF-Cu. Survival for participants was followed for up to 2 years.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Open Label11/15 (73.3%)1/13 (7.7%)0/13 (0%)
Most frequent serious events
Most frequent serious events
EventOpen Label
Hepatic FailureHepatobiliary disorders1/13

Baseline characteristics

15 subjects consented, 1 subject was a screen fail and 1 subject withdrew before any planned intervention.

Age, Categorical
Age, Categorical(Participants)Open Label
<=18 years0
Between 18 and 65 years12
>=65 years1
Sex: Female, Male
Sex: Female, Male(Participants)Open Label
Female3
Male12
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Open Label
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American1
White14
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(Participants)Open Label
United States15
08

Study locations

1 site
  • Aurora Health Care, Aurora St. Luke's Medical Center
    Milwaukee, Wisconsin 53215, United States
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 3, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03363659
Responsible party
Sponsor
First posted
Dec 6, 2017
Start date
Mar 28, 2018
Primary completion
Jan 13, 2022
Completion
Jan 13, 2022
Results posted
Sep 8, 2023
Last update
Oct 3, 2024

Study contacts

Asadullah Khan, MD
principal investigator · Wake Forest University Health Sciences

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Jan 2023. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Disulfiram · Gluconates · Temozolomide

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