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Adult Study: ABT-414 Alone or ABT-414 Plus Temozolomide vs. Lomustine or Temozolomide for Recurrent Glioblastoma Pediatric Study: Evaluation of ABT-414 in Children With High Grade Gliomas

NCT02343406

Description:

This study was conducted to evaluate the efficacy and safety of depatuxizumab mafodotin (ABT-414) alone or with temozolomide versus temozolomide or lomustine alone in adult participants with recurrent glioblastoma. The study also included a substudy to evaluate safety, tolerability and pharmacokinetics of ABT-414 in a pediatric population.

Related Conditions:
  • Glioblastoma
Recruiting Status:

Completed

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Adult Study: ABT-414 Alone or ABT-414 Plus Temozolomide vs. Lomustine or Temozolomide for Recurrent Glioblastoma Pediatric Study: Evaluation of ABT-414 in Children With High Grade Gliomas
  • Official Title: INTELLANCE-2: ABT-414 Alone or ABT-414 Plus Temozolomide Versus Lomustine or Temozolomide for Recurrent Glioblastoma: A Randomized Phase 2 Study of the EORTC Brain Tumor Group

Clinical Trial IDs

  • ORG STUDY ID: M14-483
  • SECONDARY ID: 2014-004438-24
  • SECONDARY ID: EORTC 1410-BTG
  • NCT ID: NCT02343406

Conditions

  • Glioblastoma

Interventions

DrugSynonymsArms
Depatuxizumab mafodotinABT-414ABT-414/temozolomide
TemozolomideTMZABT-414/temozolomide
LomustineGleostineControl_lomustine

Purpose

This study was conducted to evaluate the efficacy and safety of depatuxizumab mafodotin (ABT-414) alone or with temozolomide versus temozolomide or lomustine alone in adult participants with recurrent glioblastoma. The study also included a substudy to evaluate safety, tolerability and pharmacokinetics of ABT-414 in a pediatric population.

Detailed Description

      The study objectives were to assess whether depatuxizumab mafodotin (ABT-414) alone or in
      combination with temozolomide (TMZ) improved overall survival (OS), progression-free survival
      (PFS), tumor response, quality of life, neurological deterioration-free survival (NDFS), and
      steroid use compared to standard treatment with lomustine single agent or TMZ re-challenge in
      adult subjects ≥ 18 years of age with centrally-confirmed recurrent epidermal growth factor
      receptor (EGFR)-amplified glioblastoma. The safety, pharmacokinetics, and efficacy of
      depatuxizumab mafodotin in children <18 years of age was evaluated in a pediatric substudy.
      The EMEA-001732-PIP02-15 pediatric investigation plan was withdrawn on 07 July 2019 due to
      the discontinuation of the depatuxizumab mafodotin research program.
    

Trial Arms

NameTypeDescriptionInterventions
ABT-414/temozolomideExperimentalDepatuxizumab mafodotin (ABT-414) administered once every 2 weeks in combination with temozolomide (TMZ) to adult participants
  • Depatuxizumab mafodotin
  • Temozolomide
ABT-414_adultExperimentalDepatuxizumab mafodotin (ABT-414) administered once every 2 weeks to adult participants
  • Depatuxizumab mafodotin
Control_lomustineActive ComparatorAdult participants relapsing during temozolomide (TMZ) treatment or within the first 16 weeks after the first day of the last TMZ cycle received lomustine on Day 1 of every 42-day treatment period until one of the treatment withdrawal criteria was met, up to a maximum of 1 year.
  • Lomustine
Control_ temozolomideActive ComparatorAdult participants relapsing 16 weeks or more after the first day of the last temozolomide (TMZ) cycle received TMZ on Day 1 to Day 5 for the first 28-day cycle, with dose escalation in subsequent cycles in case of adequate tolerance and treatment continuing until one of the treatment withdrawal criteria was met.
  • Temozolomide
ABT-414_ pediatricExperimentalDepatuxizumab mafodotin (ABT-414) administered once every 2 weeks to pediatric participants. Temozolomide (TMZ) was only allowed for pediatric participants if its use was in accordance with local clinical practice, and was not considered an investigational product for the study (unless this was a local requirement).
  • Depatuxizumab mafodotin

Eligibility Criteria

        Inclusion Criteria:

        Adult participants (greater than or equal to 18 years old):

          -  Histologically confirmed de novo (primary) glioblastoma with unequivocal tumor
             progression or recurrence.

          -  In case of testing at the time of first progression: either at least 3 months after
             the end of radiotherapy or have tumor progression that is clearly outside the
             radiation field or have tumor progression unequivocally proven by surgery/biopsy

          -  Absence of any psychological, familial, sociological or geographical factors
             potentially hampering compliance with the study protocol and follow-up schedule; such
             conditions should be assessed with the patient before registration in the trial.

          -  Availability of adequate biological material (formalin-fixed paraffin embedded [FFPE]
             tumor) for central testing of Epithelial Growth Factor Receptor (EGFR) amplification

          -  Presence of EGFR amplification confirmed by central assessment; participants with
             undetermined EGFR status are excluded

          -  World Health Organization (WHO) Performance status 0 - 2

          -  No more than one line of chemotherapy (concurrent and adjuvant Temozolomide based
             chemotherapy including in combination with another investigational agent is considered
             one line of chemotherapy). Chemotherapy must have been completed at least 4 weeks
             prior to randomization.

          -  Post surgery MRI within 48 hours following surgery, however an MRI scan has to be done
             within 2 weeks prior to randomization.

          -  Surgery completed at least 2 weeks before randomization and patients should have fully
             recovered as assessed by investigators.

          -  Renal function: calculated creatinine clearance ≥ 30 mL/min by the Cockcroft-Gault
             formula.

          -  Liver function: bilirubin < 1.5× upper limit of the normal range (ULN), alkaline
             phosphatase and transaminases (ASAT) < 2.5× ULN

        Pediatric sub-study participants (less than 18 years old):

          -  Histologically proven high grade glioma (HGG: WHO grade III glioma [e.g anaplastic
             astrocytoma, anaplastic oligodendroglioma, anaplastic oligoastrocytoma], grade IV
             glioma [e.g. glioblastoma, gliosarcoma] or diffuse intrinsic pontine glioma [DIPG]).

          -  Must either have recurrent/progressive tumor or, if newly diagnosed, have completed
             any planned radiation therapy at least 4 weeks prior to first dose of ABT-414.

          -  The tumor tissue must have been determined to have EGFR amplification, (by local or
             other testing service).

          -  Availability of adequate biological material for retrospective confirmatory central
             testing of EGFR amplification

          -  Participant has sufficiently recovered from previous therapy. The investigator
             believes that benefit of treating the pediatric subject with ABT-414 outweighs the
             expected risks and that this treatment is in the best interests of the pediatric
             subject.

          -  Renal function: calculated creatinine clearance ≥ 30 mL/min by the Cockcroft-Gault
             formula for pediatric patients ≥12 years of age and estimated glomerular filtration
             rate ≥ 30 mL/min/1.73 m^2 by modified Schwartz equation for pediatric patients < 12
             years of age.

          -  Liver function: Total bilirubin ≤ 1.5× upper limit of the normal range (ULN),
             Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) <= 3× ULN.
             Participants with Gilbert's syndrome documented in medical history may be enrolled if
             total bilirubin is < 3 times ULN. Not allowed are participants with known chronic
             liver disease and/or cirrhosis.

        Exclusion Criteria:

        Adult population (greater than or equal to 18 years old):

          -  Prior treatment with nitrosoureas

          -  Prior treatment with bevacizumab

          -  Previous exposure to Epithelial Growth Factor Receptor (EGFR) targeted agents,
             including EGFRvIII targeting agents

          -  Prior discontinuation of temozolomide chemotherapy for toxicity reasons

          -  Prior Radiation Therapy (RT) with a dose over 65 Gy to the brain, stereotactic
             radiosurgery or brachytherapy unless the recurrence is histologically proven

          -  Previous other malignancies, except for any previous malignancy which was treated with
             curative intent more than 5 years prior to randomization, and except for adequately
             controlled limited basal cell carcinoma of the skin, squamous carcinoma of the skin or
             carcinoma in situ of the cervix

          -  Women of childbearing potential must have a negative serum or urine pregnancy test
             (minimum sensitivity 25 IU/L or equivalent units of HCG) within 72 hours prior to
             randomization.

          -  No history of wheat allergies and Coeliac disease.

          -  No EIAED, patients who require anti-convulsant therapy must be taking non-enzyme
             inducing antiepileptic drugs (non-EIAED). Patients previously on EIAED must be fully
             switched to non-EIAED at least 2 weeks prior to randomization.

        Pediatric sub-study (less than 18 years old):

          -  (For recurrent disease) No prior RT with a dose over 65 Gy to the brain, stereotactic
             radiosurgery or brachytherapy unless the recurrence is histologically proven

          -  No current or recent (within 4 weeks or 5 half-lives [whichever is shorter] before
             enrollment) treatment with another investigational drug

          -  Female participants of childbearing potential must have a negative serum or urine
             pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 72
             hours prior to randomization.
      
Maximum Eligible Age:99 Years
Minimum Eligible Age:N/A
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Adult Study: Overall Survival (OS)
Time Frame:From the date of randomization up to the date of participant's death; participants who completed treatment were to be assessed every 12 weeks, up to 28 months.
Safety Issue:
Description:Overall Survival (OS) was defined as time from randomization to death due to any cause, regardless of whether the event occurred on or off study drug (depatuxizumab mafodotin/temozolomide/lomustine).

Secondary Outcome Measures

Measure:Adult Study: Objective Response Rate (ORR)
Time Frame:Every 8 weeks at each assessment of disease, up to 28 months
Safety Issue:
Description:The objective response rate (ORR) included best overall responses - complete response (CR) and partial response (PR) - assessed by the independent review committee per response assessment in neurooncology criteria (RANO) criteria from the date of randomization until disease progression or death, whichever came first. All objective responses (CR and PR) must be have been confirmed by repeat MRI 4 weeks after the first time when CR or PR is identified. Any subject who did not meet CR or PR including those who did not have post-baseline radiological assessments was considered a nonresponder.
Measure:Adult Study: Overall Survival in the Subgroup With Epidermal Growth Factor Receptor (EGFRvIII) Mutation
Time Frame:From the date of randomization up to the date of participant's death; participants who completed treatment were to be assessed every 12 weeks, up to 28 months
Safety Issue:
Description:Overall Survival (OS) was defined as time from randomization to death due to any cause, regardless of whether the event occurred on or off study drug (depatuxizumab mafodotin/temozolomide/lomustine) for all randomized participants that had the Epidermal Growth Factor Receptor (EGFRvIII) mutation.
Measure:Pediatric Study: Objective Response Rate (ORR)
Time Frame:Evaluated every 8 weeks (+/- 7 days) at each assessment of disease according to response assessment in neuro-oncology criteria (RANO), until progression or withdrawal up to approximately 52 weeks
Safety Issue:
Description:The pediatric data collection for this study was still ongoing when INTELLANCE-1 (NCT02573324; EudraCT number 2015-001166-26) interim efficacy results overall indicated no survival benefit to adding depatuxizumab mafodotin to standard radiotherapy/temozolomide therapy in newly diagnosed glioblastoma patients. Based on the INTELLANCE-1 results, AbbVie decided to stop further enrollment of pediatric participants into the pediatric substudy and to stop the collection of efficacy data. Because of this decision not to summarize except for safety data, the pediatric substudy ORR analysis was not summarized due to the small number of pediatric participants enrolled in the study.
Measure:Pediatric Study: Best Tumor Response Rate
Time Frame:Evaluated every 8 weeks (+/- 7 days) at each assessment of disease according to response assessment in neuro-oncology criteria (RANO), until progression or withdrawal up to approximately 52 weeks
Safety Issue:
Description:The pediatric data collection for this study was still ongoing when INTELLANCE-1 (NCT02573324; EudraCT number 2015-001166-26) interim efficacy results overall indicated no survival benefit to adding depatuxizumab mafodotin to standard radiotherapy/temozolomide therapy in newly diagnosed glioblastoma patients. Based on the INTELLANCE-1 results, AbbVie decided to stop further enrollment of pediatric participants into the pediatric substudy and to stop the collection of efficacy data. Because of this decision not to summarize except for safety data, the pediatric substudy ORR analysis was not summarized due to the small number of pediatric participants enrolled in the study.
Measure:Pediatric Study: Duration of Response
Time Frame:Evaluated every 8 weeks (+/- 7 days) at each assessment of disease according to response assessment in neuro-oncology criteria (RANO), until progression or withdrawal up to approximately 52 weeks
Safety Issue:
Description:The pediatric data collection for this study was still ongoing when INTELLANCE-1 (NCT02573324; EudraCT number 2015-001166-26) interim efficacy results overall indicated no survival benefit to adding depatuxizumab mafodotin to standard radiotherapy/temozolomide therapy in newly diagnosed glioblastoma patients. Based on the INTELLANCE-1 results, AbbVie decided to stop further enrollment of pediatric participants into the pediatric substudy and to stop the collection of efficacy data. Because of this decision not to summarize except for safety data, the pediatric substudy ORR analysis was not summarized due to the small number of pediatric participants enrolled in the study.
Measure:Pediatric Study: Overall Survival
Time Frame:From the date of enrollment to the date of death; participants who completed treatment were to be assessed every 12 weeks, up to 28 months
Safety Issue:
Description:The pediatric data collection for this study was still ongoing when INTELLANCE-1 (NCT02573324; EudraCT number 2015-001166-26) interim efficacy results overall indicated no survival benefit to adding depatuxizumab mafodotin to standard radiotherapy/temozolomide therapy in newly diagnosed glioblastoma patients. Based on the INTELLANCE-1 results, AbbVie decided to stop further enrollment of pediatric participants into the pediatric substudy and to stop the collection of efficacy data. Because of this decision not to summarize except for safety data, the pediatric substudy ORR analysis was not summarized due to the small number of pediatric participants enrolled in the study.
Measure:Pediatric Study: Time to Progression
Time Frame:Evaluated every 8 weeks (+/- 7 days) from the date of enrollment until the date of first objective progression or participant's death, whichever occurs first, up to approximately 52 weeks
Safety Issue:
Description:The pediatric data collection for this study was still ongoing when INTELLANCE-1 (NCT02573324; EudraCT number 2015-001166-26) interim efficacy results overall indicated no survival benefit to adding depatuxizumab mafodotin to standard radiotherapy/ temozolomide therapy in newly diagnosed glioblastoma patients. Based on the INTELLANCE-1 results, AbbVie decided to stop further enrollment of pediatric participants into the pediatric substudy and to stop the collection of efficacy data. Because of this decision not to summarize except for safety data, pediatric time to progression data analysis was not summarized due to the small number of pediatric participants enrolled in the study.
Measure:Pediatric Study: Progression-Free Survival
Time Frame:Evaluated every 8 weeks (+/- 7 days) from the date of enrollment until the date of first objective progression or participant's death, whichever occurs first, up to approximately 52 weeks
Safety Issue:
Description:The pediatric data collection for this study was still ongoing when INTELLANCE-1 (NCT02573324; EudraCT number 2015-001166-26) interim efficacy results overall indicated no survival benefit to adding depatuxizumab mafodotin to standard radiotherapy/temozolomide therapy in newly diagnosed glioblastoma patients. Based on the INTELLANCE-1 results, AbbVie decided to stop further enrollment of pediatric participants into the pediatric substudy and to stop the collection of efficacy data. Because of this decision not to summarize except for safety data, the pediatric substudy ORR analysis was not summarized due to the small number of pediatric participants enrolled in the study.
Measure:Pediatric Study: Percentage of Participants With Changes in Neurological Status and Functioning
Time Frame:Baseline, Day 1 and 15 of each cycle, every 6 months for 5 years thereafter, and then annually
Safety Issue:
Description:The pediatric data collection for this study was still ongoing when INTELLANCE-1 (NCT02573324; EudraCT number 2015-001166-26) interim efficacy results overall indicated no survival benefit to adding depatuxizumab mafodotin to standard radiotherapy/temozolomide therapy in newly diagnosed glioblastoma patients. Based on the INTELLANCE-1 results, AbbVie decided to stop further enrollment of pediatric participants into the pediatric substudy and to stop the collection of efficacy data. Because of this decision not to summarize except for safety data, the pediatric substudy ORR analysis was not summarized due to the small number of pediatric participants enrolled in the study.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:AbbVie

Trial Keywords

  • Glioblastoma
  • Epithelial Growth Factor vIII mutation
  • Temozolomide
  • Lomustine
  • ABT-414
  • European Organization for Research and Treatment of Cancer
  • Recurrent glioblastoma
  • Epithelial Growth Factor
  • Brain Tumor
  • Brain Tumor Group
  • Antibody Drug Conjugate
  • EORTC
  • Pediatric High Grade Gliomas
  • Pediatric Diffuse Intrinsic Pontine Glioma
  • Pediatric WHO grade III glioma
  • Pediatric WHO grade IV glioma
  • EGFR amplification
  • Children

Last Updated

May 22, 2020