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Using Proton MRS to Predict Response of Vorinostat Treatment in Glioblastoma

18 Years
Not Enrolling
Adult Glioblastoma, Depression, Recurrent Adult Brain Tumor

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Trial Information

Using Proton MRS to Predict Response of Vorinostat Treatment in Glioblastoma


I. To evaluate the strength of the association between magnetic resonance spectroscopy (MRS)
imaging measurable biomarkers and response to vorinostat plus temozolomide.


I. To evaluate MRS-detected inositol and N-acetylaspartate (NAA) levels (at 3 tesla) as
indicators of mood alterations as measured by a self-report depression survey (IDS-SR).


Patients receive vorinostat orally (PO) once daily (QD) on days -7 to -1 (course 1 only)
and days 8-14 and 22-28 and temozolomide PO QD on days 1-5. Courses repeat every 28 days in
the absence of disease progression or unacceptable toxicity. Patients previously treated
with standard radiotherapy and temozolomide receive maintenance temozolomide PO on days 1-5.

Treatment repeats every 28 days in the absence of disease progression or unacceptable
toxicities. Patients undergo magnetic resonance spectroscopy imaging at baseline and at
approximately 1 and 8 weeks on treatment. Patients also undergo an Inventory of Depression
Symptomatology Self-Reported (IDS-SR) assessment at baseline and periodically during study.

Inclusion Criteria:

- Patients must have 1 of the following:

- Diagnosis of recurrent or progressive glioblastoma

- Patients with recurrent disease may have had treatment for any number of
prior relapses

- Newly diagnosed glioblastoma and have completed radiation therapy and are
receiving standard follow-up temozolomide

- Must be able to have an MRI, and have a measurable contrast-enhancing supratentorial
tumor of at least 1 cm by shortest diameter

- Residual disease following resection measuring 1 cm in diameter or greater is
mandated for eligibility into the study

- Patients must have a stable or progressive disease as determined by serial brain MRI
using the McDonald Criteria on a scan 14 days or fewer before registration and on a
stable steroid dose for 5 days

- Patients with prior therapy that included interstitial brachytherapy or stereotactic
radiosurgery must have confirmation of true progressive disease rather than radiation
necrosis based upon either PET or thallium scanning, MR spectroscopy, or surgical
documentation of disease

- WBC > 3,000/μL

- ANC > 1,500/μL

- Platelet count > 100,000/μL

- Hemoglobin > 10 g/dL (transfusion allowed)

- SGOT < 2 times upper limit of normal (ULN)

- Bilirubin < 2 times ULN

- Creatinine < 1.5 mg/dL

- Negative pregnancy test

- Women of childbearing potential and men must agree to use adequate barrier
contraception for the duration of study participation

- Able to swallow capsules

- No patients with pacemakers, non-titanium aneurysm clips, neurostimulators, cochlear
implants, non-titanium metal in ocular structures, history of being a steel worker,
or other incompatible implants

- No significant medical illnesses that, in the investigator's opinion, cannot be
adequately controlled with appropriate therapy or would compromise the patient's
ability to tolerate this therapy

- No history of any other cancer except non-melanoma skin cancer or carcinoma in-situ
of the cervix, or cancer in complete remission and off all therapy for ≥ 3 years

- No active infection or serious intercurrent medical illness

- No disease that would obscure toxicity or dangerously alter drug metabolism

- No history of allergic reactions attributed to compounds of similar chemical or
biologic composition to vorinostat (SAHA) or other agents used in this study

- No prolonged QTc waves on baseline EKG

- No other anticancer therapy (including chemotherapy, radiation, hormonal treatment,
or immunotherapy) of any kind is permitted during the study period

- At least 3 weeks since prior radiotherapy

- Patients must have recovered from the toxic effects of prior therapy, including

- At least 28 days since any prior investigational agent or prior cytotoxic therapy

- At least 23 days since prior temozolomide

- At least 14 days since prior vincristine (42 days for nitrosourea)

- At least 21 days since prior procarbazine

- At least 7 days since prior non-cytotoxic agents (e.g., interferon, tamoxifen,
thalidomide, cis-retinoic acid, etc.)

- At least 2 weeks since prior valproic acid (or another histone deacetylase inhibitor)

- No other concurrent investigational agents

Type of Study:


Study Design:

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic

Outcome Measure:

Proportion of patients with MRS response to initial vorinostat by MRI and MRS scans

Outcome Time Frame:

8 weeks

Safety Issue:


Principal Investigator

Jeffrey Olson

Investigator Role:

Principal Investigator

Investigator Affiliation:

Emory University


United States: Food and Drug Administration

Study ID:




Start Date:

December 2010

Completion Date:

Related Keywords:

  • Adult Glioblastoma
  • Depression
  • Recurrent Adult Brain Tumor
  • Brain Neoplasms
  • Depression
  • Depressive Disorder
  • Glioblastoma



Emory UniversityAtlanta, Georgia  30322