A Phase II, Multicenter, Open-Label Trial of the Safety and Efficacy of Tarceva (Erlotinib Hydrochloride) in Patients With First Relapse of Grade IV Glioma (Glioblastoma Multiforme)
Inclusion Criteria:
- Signed informed consent
- Age >= 18 years
- Histologically confirmed GBM in first relapse
- Disease progression in those patients following prior implantation with Gliadel(R)
wafer(s) (polifeprosan 20 with carmustine implant) must be confirmed by biopsy.
Prior therapy with Gliadel(R) is allowed only as a component of primary surgery.
Patients with Gliadel(R) implants after a secondary resection are not eligible.
- Radiographic evidence of disease progression, as assessed by the investigator, on
magnetic resonance imaging (MRI) or CT scan
- Bi-dimensionally measurable disease with a minimum measurement of 1 cm on MRI or CT
scan performed within 14 days prior to study entry
- Prior radiotherapy
- Availability of tissue to allow central confirmation of GBM diagnosis (all original
slides are preferred)
- Availability of paraffin blocks or slides to allow determination of EGFR
amplification status
- Recovery from the toxic effects of a prior therapy, including 4 weeks from prior
cytotoxic agents (except 6 weeks from prior nitrosoureas, 3 weeks from prior
procarbazine administration, 2 weeks from prior vincristine, or 3 weeks from
irinotecan [CPT-11] when given on a weekly schedule), 4 weeks from any prior
investigational agent, and 1 week from prior non-cytotoxic agents (e.g., interferon,
tamoxifen, thalidomide, 13-cis-retinoic acid, etc.)
- If receiving corticosteroids, patients must be on a stable, non-increasing dose of
corticosteroids for >= 2 weeks prior to baseline MRI scan
- ECOG performance status of 0 or 1
- Life expectancy > 12 weeks
- Use of an effective means of contraception in males and in females of childbearing
potential
- Ability to comply with study and follow-up procedures If the decision is made at the
end of Stage 1 to enroll patients with tumors known to be positive for EGFR
amplification, the following additional inclusion criteria will be applied:
Confirmation of diagnosis; Confirmation of positive EGFR amplification status
Exclusion Criteria:
- Prior treatment with Gleevec (e.g., imatinib mesylate) or agents directed at EGFR
(e.g., Iressa)
- Prior treatment with Gliadel(R) following second (salvage or debulking) therapy
- History of any other malignancy within 5 years (except non-melanoma skin cancer or
carcinoma in situ of the cervix)
- More than one prior chemotherapy regimen
- ANC < 1500/uL
- Platelets < 100,000/uL
- Total bilirubin > 1.6 mg/dL
- AST/ALT >= 2.5 x upper limit of normal (ULN)
- Creatinine > 1.5 x ULN
- Pregnant or nursing females
- Unstable systemic disease, including active infection, uncontrolled hypertension,
unstable angina, congestive heart failure, or myocardial infarction within 6 months
prior to study entry, or serious cardiac arrhythmia requiring medication
- Major surgical procedure 2 weeks prior to study entry or anticipation of need for
major surgical procedure during the course of the study
- Inability to take oral medication