Description:
Part 1 is an open-label, single-arm, dose escalation study of MN-166 (ibudilast) and
temozolomide (TMZ) combination treatment. Evaluate safety and tolerability of ibudilast
(MN-166) and TMZ combination treatment for 1 cycle (28 days); determine dosage in
dose-finding study. Part 2 will evaluate efficacy of fixed-dose MN-166 (ibudilast) and TMZ
combination treatment for 6 cycles (~6 months) until disease progression, unacceptable
tolerability and/or toxicity or loss of life.
Title
- Brief Title: Study to Evaluate Ibudilast and TMZ Combo Treatment in Newly Diagnosed and Recurrent Glioblastoma
- Official Title: Phase 1b/2a Single-center, Open-label, Dose Escalation Study to Evaluate the Safety, Tolerability, and Efficacy of MN-166 (Ibudilast) and Temozolomide Combination Treatment in Patients With Newly Diagnosed or Recurrent Glioblastoma
Clinical Trial IDs
- ORG STUDY ID:
MN-166-GBM-1201
- NCT ID:
NCT03782415
Conditions
- Glioblastoma
- Recurrent Glioblastoma
- GBM
- Newly Diagnosed Glioblastoma
Interventions
Drug | Synonyms | Arms |
---|
MN-166 | ibudilast | MN-166 and temozolomide |
Temozolomide | TMZ, Temodar, Temodal, Temcad | MN-166 and temozolomide |
Purpose
Part 1 is an open-label, single-arm, dose escalation study of MN-166 (ibudilast) and
temozolomide (TMZ) combination treatment. Evaluate safety and tolerability of ibudilast
(MN-166) and TMZ combination treatment for 1 cycle (28 days); determine dosage in
dose-finding study. Part 2 will evaluate efficacy of fixed-dose MN-166 (ibudilast) and TMZ
combination treatment for 6 cycles (~6 months) until disease progression, unacceptable
tolerability and/or toxicity or loss of life.
Detailed Description
This is a single-center open-label, dose-escalation study to evaluate the safety,
tolerability and efficacy of MN-166 (ibudilast) and Temozolomide combination treatment in
patients with newly diagnosed or recurrent glioblastoma. To be eligible, subjects are
histologically confirmed glioblastoma or gliosarcoma, or astrocytomas with molecular features
of glioblastoma, WHO Grade 4. Recurrent glioblastoma patients must have a Karnofsky
Performance Status (KPS) ≥70 or Eastern Cooperative Oncology Group (ECOG) performance status
of 0-2. Patients having newly diagnosed glioblastoma, gliosarcoma, or astrocytomas with
molecular features of glioblastoma must have a KPS ≥60 and ECOG score 0-1. This is divided
into a dose-escalation phase (Part 1) followed by a fixed-dose phase (Part 2).
Part 1 will evaluate the safety and tolerability of MN-166 when given in combination with
temozolomide, and determine the dose of MN-166 to be used in Part 2 of the study. Up to 18
adult subjects are planned to be enrolled in Part 1.
Part 2 will evaluate the efficacy of MN-166 and temozolomide combination treatment as
measured by the proportion of subjects who are progression-free at 6 months. Other outcome
measures include the evaluation of overall survival, response rate, and median six-month
progression-free survival up to 2 years and up to 50 subjects are planned to be enrolled in
Part 2.
Trial Arms
Name | Type | Description | Interventions |
---|
MN-166 and temozolomide | Experimental | Part 1: Combination treatment of MN-166 60 mg/day (30 mg twice a day) for 28 days and temozolomide 150 mg/m² on Days 1-5 of 28-day cycle. Part 2: Open-label, fixed-dose MN-166 and temozolomide combination treatment for 6 cycles until disease progression, unacceptable tolerability and/or toxicity or loss of life. | |
Eligibility Criteria
Major Inclusion Criteria for Recurrent GBM Patients:
1. Age 18 or older;
2. Histologically confirmed GBM (glioblastoma), WHO Grade 4;
3. Patients must have a Karnofsky Performance Status (KPS) ≥70 or Eastern Cooperative
Oncology Group (ECOG) performance status of 0-2 (see Appendix 7);
4. Previously received standard front-line GBM treatment including maximal surgical
resection followed by external beam radiation therapy and TMZ therapy. Prior use of
NovoTTF (Optune) and Gliadel wafers is allowed;
5. Patients must be in first relapse;
1. Relapse is defined as progression following initial therapy (i.e., radiation
and/or chemotherapy). The intent therefore is that patients had no more than 1
prior therapy (i.e., initial treatment). If the patient had a surgical resection
for relapsed disease and no anti-cancer therapy was instituted for up to 12
weeks, and the patient undergoes another surgical resection, this is considered
to constitute one (1) relapse;
2. Documented recurrence or progression by brain MRI imaging ≤14 days before study
registration;
3. Measurable disease by RANO criteria (≥ 10 mm x 10 mm).
Major Inclusion criteria for newly diagnosed patients:
1. Ages 18 or older;
2. Newly diagnosed glioblastoma or gliosarcoma (WHO Grade 4) confirmed by histology or
astrocytomas with molecular features of gliobastoma;
3. Starting maintenance therapy with temozolomide (150 mg/m^2 on Days 1-5 every 28 days)
within 4 weeks prior to screening phase;
4. If patient is receiving corticosteroid, dose must be stable or decreasing for at least
5 days prior to the scan. If steroids are added or the steroid dose is increased
between the date of the pretreatment MRI and the start of study, a new baseline MRI or
CT scan is required;
5. Karnofsky Performance Status ≥60 at time of screening;
6. ECOG score of 0 or 1 at time of screening;
7. Life expectancy of at least 3 months.
Exclusion Criteria (applied to all patients):
1. History of Grade 2 (CTCAE v4.0) or greater intracranial or intratumoral hemorrhage
confirmed by either MRI or CT scan;
2. Current use of anticoagulant treatment with coumadin (low-molecular-weight heparin and
factor Xa inhibitors are permitted);
3. Any systemic illness or unstable medical condition that might pose additional risk,
including: cardiac, unstable metabolic or endocrine disturbances, renal or liver
disease;
4. Patients with a history of a different malignancy except the following circumstances:
1. They have been disease-free for at least 2 years prior to starting study drug and
are deemed by the investigator to be at low risk for recurrence of that
malignancy. Patients with the following cancers are eligible if diagnosed and
treated within the past 2 years: i. Cervical cancer in situ, and basal cell or
squamous cell carcinoma of the skin;
7) Patients who have not recovered to ≤ Grade 1 toxicity by NCI CTCAE v4.0 from the toxic
effects of previous therapy with exception of lymphopenia, alopecia and fatigue; 9) For use
of other investigational drug or other anti-tumor treatment, the following time periods
must have elapsed from the projected start of scheduled study treatment:
1. 4 weeks or 5 half-lives (whichever is shorter) from any investigational agent;
2. 4 weeks from cytotoxic therapy (except 23 days for TMZ; 6 weeks from nitrosoureas);
3. 6 weeks from antibodies treatment (i.e., anti-VEGF antibody);
4. 4 weeks or 5 half-lives (whichever is shorter) from other anti-tumor therapies;
5. 2 days from NOVO-TTF (Optune®).
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Evaluate safety and tolerability of ibudilast and temozolomide combination treatment |
Time Frame: | 1-6 months |
Safety Issue: | |
Description: | Determine the proportion of patients with
Treatment-emergent adverse events (TEAEs) as measured by the CTCAE v4.0 and
Treatment discontinuations due to TEAEs and Dose-Limiting Toxicities (DLTs). |
Secondary Outcome Measures
Measure: | Evaluate Tmax |
Time Frame: | 1-6 months |
Safety Issue: | |
Description: | Time from start of dosing at which the maximum concentration is observed) |
Measure: | Cmax |
Time Frame: | 1-6 months |
Safety Issue: | |
Description: | Maximum observed concentration) |
Measure: | AUC |
Time Frame: | 1-6 months |
Safety Issue: | |
Description: | Area under the concentration versus time curve from the start of dose administration to the last quantifiable point within the dosing interval. |
Measure: | Terminal rate constant |
Time Frame: | 1-6 months |
Safety Issue: | |
Description: | Calculated from the terminal slope of the log-linear regression of concentration with time. |
Measure: | Terminal half-life |
Time Frame: | 1-6 months |
Safety Issue: | |
Description: | Time required for the plasma concentration of a drug to decrease 50% in the final stage of its elimination |
Measure: | Maximum tolerated dose determination |
Time Frame: | 1-6 months |
Safety Issue: | |
Description: | Determine maximum tolerable dose of ibudilast taken in combination with TMZ |
Measure: | Evaluate the safety of fixed-dose ibudilast in combination with TMZ |
Time Frame: | 1-6 months |
Safety Issue: | |
Description: | Reporting of treatment-emergent adverse events
Treatment-emergent adverse events (TEAEs) as measured by the CTCAE v4.0 and
Treatment discontinuations due to TEAEs and Dose-Limiting Toxicities (DLTs). |
Measure: | Evaluate overall survival, response rate, and median 6-month progression-free survival (PFS6) |
Time Frame: | 1-6 months |
Safety Issue: | |
Description: | Overall survival will be measured for each subject with time origin at the date of Study Day 1 until recorded date or death or last follow-up visit. |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | MediciNova |
Trial Keywords
- MN-166
- GBM
- glioblastoma
- recurrent GBM
- temozolomide
- newly diagnosed glioblastoma
Last Updated
August 5, 2021