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A Randomized, Phase III, Double-Blind, Placebo-Controlled Trial of Memantine for Prevention of Cognitive Dysfunction in Patients Receiving Whole-Brain Radiotherapy


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Cognitive/Functional Effects, Metastatic Cancer, Neurotoxicity, Unspecified Adult Solid Tumor, Protocol Specific

Thank you

Trial Information

A Randomized, Phase III, Double-Blind, Placebo-Controlled Trial of Memantine for Prevention of Cognitive Dysfunction in Patients Receiving Whole-Brain Radiotherapy


OBJECTIVES:

Primary

- Determine whether the addition of memantine hydrochloride to whole-brain radiotherapy
(WBRT) preserves cognitive function, specifically memory, as measured by the Hopkins
Verbal Learning Test for delayed recall (HVLT-delayed recall), over that of placebo and
WBRT in patients with brain metastases at 24 weeks from the start of drug treatment.

Secondary

- Determine whether the addition of memantine hydrochloride preserves cognitive function,
specifically memory, as measured by the HVLT-delayed recall at 8 weeks, 16 weeks, and
12 months from the start of drug treatment.

- Determine whether the addition of memantine hydrochloride increases time to
neurocognitive failure as measured by cognitive decline on a battery of tests including
the HVLT for free recall, delayed recall, and delayed recognition; the Controlled Word
Association Test (COWAT); the Trail Making Test Parts A and B (TMT); the Medical
Outcomes Scale-Cognitive Functioning Subscale (MOS); and the Mini-Mental Status
Examination (MMSE).

- Evaluate the potential benefit of memantine hydrochloride in change and overall quality
of life, as measured by the Functional Assessment of Cancer Therapy-Brain (FACT-Br)
subscale.

- Determine whether the addition of memantine hydrochloride increases progression-free
survival.

- Determine whether the addition of memantine hydrochloride increases overall survival.

- Compare adverse events between the treatment arms according to the CTCAE v3.0 criteria.

- Collect serum, plasma, buffy coat cells, urine, and CSF for future translational
research analyses.

OUTLINE: This is a multicenter study. Patients are stratified according to recursive
partitioning analysis (RPA) prognostic class (class I vs class II with controlled systemic
disease) and prior surgical therapy (none vs radiosurgery or surgical resection). Patients
are randomized to 1 of 2 treatment arms.

- Arm I: Patients undergo whole-brain radiotherapy (WBRT) 5 days a week for 3 weeks (15
fractions). Patients also receive oral memantine hydrochloride once daily beginning on
day 1 of WBRT and continuing for 24 weeks.

- Arm II: Patients undergo WBRT as in arm I. Patients also receive oral placebo once
daily beginning on day 1 of WBRT and continuing for 24 weeks.

After completion of study treatment, patients are followed at 6 months, every 4 months for 1
year, every 6 months for 2 years, and then annually thereafter.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed diagnosis of a solid tumor malignancy
within the past 5 years

- If the original histologic proof of malignancy is > 5 years, then pathological
(i.e., more recent) confirmation is required (e.g., from a systemic metastasis
or brain metastasis)

- Brain metastases must be visible on contrast-enhanced MRI or a contrast enhanced CT
scan (for patients unable to undergo MRI within the past 28 days)

- Patients unable to undergo MRI imaging because of non-compatible devices are
eligible, provided the contrast-enhanced CT scans are obtained and are of
sufficient quality

- Patients who had undergone radiosurgery or surgical resection and are planning
adjuvant whole-brain radiotherapy do not have to have visible disease but do
need a baseline MRI

- Must have stable systemic disease (i.e. no evidence of systemic disease progression
within the past 3 months)

- Patients with brain metastases at initial presentation are eligible and do not need
to demonstrate 3 months of stable scans

PATIENT CHARACTERISTICS:

Inclusion

- Karnofsky performance status 70-100%

- Serum creatinine ≤ 3 mg/dL and creatinine clearance ≥ 30 mL/min

- Total bilirubin ≤ 2.5 mg/dL

- BUN < 20 mg/dL

- Mini-mental status exam score ≥ 18

- Negative serum pregnancy test

- Fertile patients must practice adequate contraception

Exclusion

- Severe, active co-morbidity, defined as follows:

- Unstable angina and/or congestive heart failure requiring hospitalization within
the last 6 months

- Transmural myocardial infarction within the last 6 months

- Acute bacterial or fungal infection requiring intravenous antibiotics at the
time of registration

- Chronic obstructive pulmonary disease exacerbation or other respiratory illness
requiring hospitalization or precluding study therapy at the time of
registration

- Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects

- Pregnant or lactating women

- Prior allergic reaction to memantine hydrochloride

- Current alcohol or drug abuse

- Intractable seizures while on adequate anticonvulsant therapy (i.e., more than one
seizure per month for the past 2 months)

PRIOR CONCURRENT THERAPY:

Inclusion

- At least 14 days but no more than 56 days since prior therapy for brain metastasis,
including radiosurgery and surgical resection

- No systemic chemotherapy for 14 days prior, during, or for 14 days after completion
of whole-brain radiotherapy (WBRT)

Exclusion

- Prior cranial radiotherapy

- Patients may have received up to 3 prior WBRT treatments and still be registered
and randomized on the protocol provided WBRT parameters meet protocol
requirements

- Chronic short-acting benzodiazepine use

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Masking: Double-Blind, Primary Purpose: Supportive Care

Outcome Measure:

Cognitive function, specifically memory, 24 weeks from the start of drug treatment as measured by the Hopkins Verbal Learning Test-Revised for delayed recall (HVLT-R-delayed recall)

Safety Issue:

No

Principal Investigator

Paul D. Brown, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Mayo Clinic

Authority:

United States: Federal Government

Study ID:

CDR0000577872

NCT ID:

NCT00566852

Start Date:

March 2008

Completion Date:

Related Keywords:

  • Cognitive/Functional Effects
  • Metastatic Cancer
  • Neurotoxicity
  • Unspecified Adult Solid Tumor, Protocol Specific
  • cognitive/functional effects
  • neurotoxicity
  • tumors metastatic to brain
  • unspecified adult solid tumor, protocol specific
  • Neoplasm Metastasis
  • Neoplasms
  • Neoplasms, Second Primary
  • Neurotoxicity Syndromes

Name

Location

Roswell Park Cancer Institute Buffalo, New York  14263
Mayo Clinic Scottsdale Scottsdale, Arizona  85259
Mayo Clinic Cancer Center Rochester, Minnesota  55905
Barbara Ann Karmanos Cancer Institute Detroit, Michigan  48201
Cleveland Clinic Cancer Center Cleveland, Ohio  44195
CCOP - Upstate Carolina Spartanburg, South Carolina  29303
Medical City Dallas Hospital Dallas, Texas  75230
University of Texas Health Science Center at San Antonio San Antonio, Texas  78284-7811
CCOP - Christiana Care Health Services Wilmington, Delaware  19899
CCOP - North Shore University Hospital Manhasset, New York  11030
Veterans Affairs Medical Center - Atlanta (Decatur) Decatur, Georgia  30033
CCOP - Carle Cancer Center Urbana, Illinois  61801
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Methodist Cancer Center at Methodist Hospital Indianapolis, Indiana  46202
Fairview Ridges Hospital Burnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy Hospital Coon Rapids, Minnesota  55433
Fairview Southdale Hospital Edina, Minnesota  55435
Mercy and Unity Cancer Center at Unity Hospital Fridley, Minnesota  55432
Minnesota Oncology Hematology, PA - Maplewood Maplewood, Minnesota  55109
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital Minneapolis, Minnesota  55407
Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Penn State Cancer Institute at Milton S. Hershey Medical Center Hershey, Pennsylvania  17033-0850
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center Madison, Wisconsin  53792-6164
Medical College of Wisconsin Cancer Center Milwaukee, Wisconsin  53226
Rapid City Regional Hospital Rapid City, South Dakota  57709
Providence Saint Joseph Medical Center - Burbank Burbank, California  91505
Northwest Community Hospital Arlington Heights, Illinois  60005
CCOP - Montana Cancer Consortium Billings, Montana  59101
Veterans Affairs Medical Center - Albany Albany, New York  12208
New York Methodist Hospital Brooklyn, New York  11215-3609
Albert Einstein Cancer Center Philadelphia, Pennsylvania  19141
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Holden Comprehensive Cancer Center at University of Iowa Iowa City, Iowa  52242-1002
CCOP - Grand Rapids Grand Rapids, Michigan  49503
Charles M. Barrett Cancer Center at University Hospital Cincinnati, Ohio  45267-0526
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia Philadelphia, Pennsylvania  19107
UPMC Cancer Center at Magee-Womens Hospital Pittsburgh, Pennsylvania  15213-3180
Cleveland Clinic Taussig Cancer Center Cleveland, Ohio  44195
MBCCOP - Gulf Coast Mobile, Alabama  36688
USC/Norris Comprehensive Cancer Center and Hospital Los Angeles, California  90033-0804
CCOP - St. Louis-Cape Girardeau Saint Louis, Missouri  63141
CCOP - Virginia Mason Research Center Seattle, Washington  98101
Vince Lombardi Cancer Clinic at Aurora St. Luke's Medical Center Milwaukee, Wisconsin  53201-2901
Rebecca and John Moores UCSD Cancer Center La Jolla, California  92093-0658
University of California Davis Cancer Center Sacramento, California  95817
City of Hope Comprehensive Cancer Center Duarte, California  91010
Fletcher Allen Health Care - University Health Center Campus Burlington, Vermont  05401
Arizona Cancer Center at University of Arizona Health Sciences Center Tucson, Arizona  85724
Josephine Ford Cancer Center at Henry Ford Hospital Detroit, Michigan  48202
Washington Cancer Institute at Washington Hospital Center Washington, District of Columbia  20010
Harry and Jeanette Weinberg Cancer Institute at Franklin Square Hospital Center Baltimore, Maryland  21237
Hulston Cancer Center at Cox Medical Center South Springfield, Missouri  65807
McDowell Cancer Center at Akron General Medical Center Akron, Ohio  44307
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
Long Island Jewish Medical Center New Hyde Park, New York  11040
Yale Cancer Center New Haven, Connecticut  06520-8028
University of Florida Shands Cancer Center Gainesville, Florida  32610-0232
Winship Cancer Institute of Emory University Atlanta, Georgia  30322
Mission Hospitals - Memorial Campus Asheville, North Carolina  28801
Medical University of Ohio Cancer Center Toledo, Ohio  43614
Hollings Cancer Center at Medical University of South Carolina Charleston, South Carolina  29425
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas Dallas, Texas  75390
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
Saint Peter's University Hospital New Brunswick, New Jersey  08901-1780
James P. Wilmot Cancer Center at University of Rochester Medical Center Rochester, New York  14642
Bay Area Cancer Care Center at Bay Area Medical Center Marinette, Wisconsin  54143
Baptist Cancer Institute - Jacksonville Jacksonville, Florida  32207
William Beaumont Hospital - Royal Oak Campus Royal Oak, Michigan  48073
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Utah Cancer Specialists at UCS Cancer Center Salt Lake City, Utah  84106
Cancer Care Northwest - Spokane South Spokane, Washington  99202
Greenebaum Cancer Center at University of Maryland Medical Center Baltimore, Maryland  21201
Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center Los Angeles, California  90048-1865
Indiana University Melvin and Bren Simon Cancer Center Indianapolis, Indiana  46202-5289
Lucille P. Markey Cancer Center at University of Kentucky Lexington, Kentucky  40536-0093
CCOP - Nevada Cancer Research Foundation Las Vegas, Nevada  89109-2306
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Oklahoma University Cancer Institute Oklahoma City, Oklahoma  73104
Geisinger Cancer Institute at Geisinger Health Danville, Pennsylvania  17822-0001
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
Huntsman Cancer Institute at University of Utah Salt Lake City, Utah  84112
University of Virginia Cancer Center Charlottesville, Virginia  22908
Cleveland Clinic Cancer Center at Fairview Hospital Cleveland, Ohio  44111
Hillcrest Cancer Center at Hillcrest Hospital Mayfield Heights, Ohio  44124
Rosenfeld Cancer Center at Abington Memorial Hospital Abington, Pennsylvania  19001
Fox Chase Cancer Center - Philadelphia Philadelphia, Pennsylvania  19111-2497
All Saints Cancer Center at Wheaton Franciscan Healthcare Racine, Wisconsin  53405
John Muir/Mt. Diablo Comprehensive Cancer Center Walnut Creek, California  94598
CentraCare Clinic - River Campus St. Cloud, Minnesota  56303
Cancer Institute of New Jersey at Cooper - Voorhees Voorhees, New Jersey  08043
Highland Hospital of Rochester Rochester, New York  14620
Northwest Ohio Oncology Center Maumee, Ohio  43537
St. Charles Mercy Hospital Oregon, Ohio  43616
North Coast Cancer Care, Incorporated Sandusky, Ohio  44870
Cleveland Clinic - Wooster Wooster, Ohio  44691
Bryn Mawr Hospital Bryn Mawr, Pennsylvania  19010
Delaware County Regional Cancer Center at Delaware County Memorial Hospital Drexel Hill, Pennsylvania  19026
Lankenau Cancer Center at Lankenau Hospital Wynnewood, Pennsylvania  19096
Dixie Regional Medical Center - East Campus Saint George, Utah  84770
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital Yakima, Washington  98902
Poudre Valley Radiation Oncology Fort Collins, Colorado  80528
Northeast Georgia Medical Center Gainesville, Georgia  30501
Cancer Center at Ball Memorial Hospital Muncie, Indiana  47303
Great Lakes Cancer Institute at McLaren Regional Medical Center Flint, Michigan  48532
Regional Cancer Center at Singing River Hospital Pascagoula, Mississippi  39581
Cancer Treatment Center Wooster, Ohio  44691
West Allis Memorial Hospital West Allis, Wisconsin  53227
Stanford Cancer Center Stanford, California  94305-5824
John B. Amos Cancer Center Columbus, Georgia  31904
St. Mary Mercy Hospital Livonia, Michigan  48154
Billings Clinic - Downtown Billings, Montana  59107-7000
Summa Center for Cancer Care at Akron City Hospital Akron, Ohio  44309-2090
Barberton Citizens Hospital Barberton, Ohio  44203
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center Columbus, Ohio  43210-1240
Flower Hospital Cancer Center Sylvania, Ohio  43560
St. Anne Mercy Hospital Toledo, Ohio  43623
St. Luke's Cancer Network at St. Luke's Hospital Bethlehem, Pennsylvania  18015
York Cancer Center at Apple Hill Medical Center York, Pennsylvania  17405
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center Murray, Utah  84157
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center Ogden, Utah  84403
Schiffler Cancer Center at Wheeling Hospital Wheeling, West Virginia  26003
John H. Stroger, Jr. Hospital of Cook County Chicago, Illinois  60612-9985
St. Joseph Hospital Regional Cancer Center - Orange Orange, California  92868-3849
Arizona Oncology Services Foundation Phoenix, Arizona  85013
Enloe Cancer Center at Enloe Medical Center Chico, California  95926
Radiological Associates of Sacramento Medical Group, Incorporated Sacramento, California  95815
Parkview Regional Cancer Center at Parkview Health Fort Wayne, Indiana  46805
Elliot Regional Cancer Center at Elliot Hospital Manchester, New Hampshire  03103
Three Rivers Community Hospital Grants Pass, Oregon  97527
Dubs Cancer Center at Rogue Valley Medical Center Medford, Oregon  97504
Theda Care Cancer Institute Appleton, Wisconsin  54911
Community Memorial Hospital Cancer Care Center Menomonee Falls, Wisconsin  53051
Cancer Institute at St. John's Hospital Springfield, Illinois  62701
Sentara Cancer Institute at Sentara Norfolk General Hospital Norfolk, Virginia  23507
University of Wisconcin Cancer Center at Aspirus Wausau Hospital Wausau, Wisconsin  54401
Solano Radiation Oncology Center Vacaville, California  95687
Integrated Community Oncology Network Jacksonville Beach, Florida  32250
Baptist Medical Center South Jascksonville, Florida  32258
Florida Cancer Center - Palatka Palatka, Florida  32177
Flagler Cancer Center Saint Augustine, Florida  32086
Lipson Cancer and Blood Center at Rochester General Hospital Rochester, New York  14621
Tyler Cancer Center Tyler, Texas  75702
Boston University Cancer Research Center Boston, Massachusetts  02118
Good Samaritan Hospital of Maryland Baltimore, Maryland  21239
Mercy General Hospital Sacramento, California  95819
Providence Cancer Center at Providence Hospital Mobile, Alabama  36608
Trinity CancerCare Center Minot, North Dakota  58701
Franciscan Skemp Healthcare - La Crosse Campus La Crosse, Wisconsin  54601
Cancer Care Center, Incorporated Salem, Ohio  44460
Center for Cancer Care at Goshen General Hospital Goshen, Indiana  46526
Ocean Medical Center at Meridian Health Brick, New Jersey  08724
J. Phillip Citta Regional Cancer Center at Community Medical Center Toms River, New Jersey  08755
Providence Cancer Center at PMCC Medford, Oregon  97504
Albert Lea Cancer Center at Albert Lea Medical Center Albert Lea, Minnesota  56007
Central Maryland Oncology Center Columbia, Maryland  21044
Cancer Institute of New Jersey at Cooper University Hospital - Camden Camden, New Jersey  08103
Lovelace Medical Center - Downtown Albuquerque, New Mexico  87102
Precision Radiotherapy at University Pointe West Chester, Ohio  45069
Integrated Community Oncology Network - Orange Park Orange Park, Florida  32073
Immanuel St. Joseph's Mankato, Minnesota  56002
Cancer Care Center at John Muir Health - Concord Campus Concord, California  94524-4110
West Texas Cancer Center Odessa, Texas  79761
UPMC Cancer Center at Beaver Medical Center Beaver, Pennsylvania  15009
UPMC Cancer Center at Jefferson Regional Medical Center Clairton, Pennsylvania  15025
UPMC Cancer Center - Arnold Palmer Pavilion Greensburg, Pennsylvania  15601
UPMC Cancer Center at the John P. Murtha Pavilion Johnstown, Pennsylvania  15901
UPMC - Moon Moon Township, Pennsylvania  15108
UPMC Cancer Center - Natrona Heights Natrona Heights, Pennsylvania  15065
Jameson Memorial Hospital - North Campus New Castle, Pennsylvania  16105
UPMC - Shadyside Pittsburgh, Pennsylvania  15213-2582
UPMC Cancer Center at UPMC St. Margaret Pittsburgh, Pennsylvania  15215
UPMC Cancer Center at UPMC Passavant Pittsburgh, Pennsylvania  15237
UPMC Cancer Center at UPMC Northwest Seneca, Pennsylvania  16346
Washington Hospital Cancer Center Washington, Pennsylvania  15301
University Medical Center at Princeton Princeton, New Jersey  08540
Radiation Oncology Associates, PA Albuquerque, New Mexico  87109
Cancer Institute at St. Joseph Medical Center Towson, Maryland  21204
New York Oncology Hematology, PC at Albany Regional Cancer Care Albany, New York  12208
Glendale Adventist Medical Center Glendale, California  91206
Auburn Radiation Oncology Auburn, California  95603
Radiation Oncology Centers - Cameron Park Cameron Park, California  95682
Radiation Oncology Center - Roseville Roseville, California  95661
Saint John's Cancer Center at Saint John's Medical Center Anderson, Indiana  46016
Mercy Cancer Center at Mercy San Juan Medical Center Carmichael, California  95608
St. Agnes Hospital Cancer Center Baltimore, Maryland  21229
Renown Institute for Cancer at Renown Regional Medical Center Reno, Nevada  89502
Sands Cancer Center Canandiaqua, New York  14424
University Radiation Oncology at Parkridge Hospital Rochester, New York  14626
Community Regional Cancer Care at Community Hospital North Indianapolis, Indiana  46256
Community Regional Cancer Care at Community Hospital East Indianapolis, Indiana  46219
Integrated Community Oncology Network at Southside Cancer Center Jacksonville, Florida  32207
Kansas City Cancer Centers - Southwest Overland Park, Kansas  66210
Longview Cancer Center Longview, Texas  75601
Rocky Mountain Cancer Centers - Colorado Springs Colorado Springs, Colorado  80933-1181
Northeast Radiation Oncology Center Dunmore, Pennsylvania  18512
Radiation Oncology Associates Southwest Fort Wayne, Indiana  46804
Central Indiana Cancer Centers - East Indianapolis, Indiana  46219
Kansas City Cancer Centers - North Kansas City, Missouri  64154
Payson Center for Cancer Care at Concord Hospital Concord, New Hampshire  03301
Trinitas Comprehensive Cancer Center at Trinitas Hospital Elizabeth, New Jersey  07207
Willamette Valley Cancer Center - Eugene Eugene, Oregon  97401
Texas Oncology, PA at Harris Center HEB Bedford, Texas  76022
Texas Oncology, PA at Texas Cancer Center - Denton South Denton, Texas  76210
Klabzuba Cancer Center at Harris Methodist Fort Worth Hospital Fort Worth, Texas  76104
Cancer Care Centers of South Texas - Northeast San Antonio, Texas  78217
Texas Oncology, PA at Texas Cancer Center - Sherman Sherman, Texas  75090
Texas Oncology, PA at Texas Oncology Cancer Center Sugar Land Sugar Land, Texas  77479
Bloomington Hospital Regional Cancer Institute Bloomington, Indiana  47403
Nebraska Medical Center Omaha, Nebraska  68198
Emanuel Regional Cancer Services at Emanuel Medical Center Turlock, California  95382
Princeton Radiation Oncology Center Jamesburg, New Jersey  08831
Arizona Oncology - Tucson Tucson, Arizona  85704
Rocky Mountain Cancer Centers - Aurora Aurora, Colorado  80012
Norton Suburban Hospital Louisville, Kentucky  40207
Kansas City Cancer Centers - South Kansas City, Missouri  64131
New Hanover Radiation Oncology, PA Wilmington, North Carolina  28401
Cancer Center at Clarion Hospital Clarion, Pennsylvania  16214
UPMC Cancer Center at UPMC McKeesport McKeesport, Pennsylvania  15132
UPMC Cancer Center - Upper St. Clair Pittsburgh, Pennsylvania  15243
UPMC Cancer Center - Uniontown Uniontown, Pennsylvania  15401
Texas Oncology, PA at Texas Cancer Center Dallas Southwest Dallas, Texas  75237
Adams Cancer Center Gettysburg, Pennsylvania  17325
Cherry Tree Cancer Center Hanover, Pennsylvania  17331
Tate Cancer Center at Baltimore Washington Medical Center Glen Burnie, Maryland  21061
Texas Oncology, PA at Texas Cancer Center - Arlington South Arlington, Texas  76014
Florida Institute of Research, Medicine and Surgery Cancer Center Orlando, Florida  32806
Charach Cancer Center at Huron Valley - Sinai Hospital Commerce, Michigan  48382