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A Randomized Phase III Study of Temozolomide and Short-Course Radiation Versus Short-Course Radiation Alone In The Treatment of Newly Diagnosed Glioblastoma Multiforme in Elderly Patients


Phase 3
65 Years
N/A
Open (Enrolling)
Both
Brain and Central Nervous System Tumors

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Trial Information

A Randomized Phase III Study of Temozolomide and Short-Course Radiation Versus Short-Course Radiation Alone In The Treatment of Newly Diagnosed Glioblastoma Multiforme in Elderly Patients


OBJECTIVES:

Primary

- Compare overall survival rates in older patients with newly diagnosed glioblastoma
multiforme treated with short-course radiotherapy with or without temozolomide.

Secondary

- Compare progression-free survival of patients treated with these regimens.

- Compare the nature, severity, and frequency of adverse events in patients treated with
these regimens.

- Compare the quality of life of patient treated with these regimens.

- Determine the methylation status of the O6-methylguanine-DNA methyltransferase
promoter.

OUTLINE: This is a multicenter, randomized study. Patients are stratified according to
center, age (65-70 years vs 71-75 years vs ≥ 76 years), ECOG performance status (0-1 vs 2),
and extent of resection at surgery (biopsy only vs complete or incomplete resection).
Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients undergo radiotherapy once daily on days 1-5, 8-12, and 15-19 in the
absence of disease progression or unacceptable toxicity.

- Arm II: Patients undergo radiotherapy as in arm I and receive oral temozolomide once
daily on days 1-21.

Beginning 4 weeks after completion of radiotherapy and temozolomide, patients receive
adjuvant oral temozolomide once daily on days 1-5. Treatment with temozolomide alone repeats
every 28 days for up to 12 months in the absence of disease progression or unacceptable
toxicity.

Patients complete quality of life questionnaires at baseline and periodically during study
treatment.

Tissue samples are collected at baseline and analyzed for methylation status of the
O6-methylguanine-DNA methyltransferase promoter.

After completion of study treatment, patients are followed every 3 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histopathologically confirmed glioblastoma multiforme

- Grade IV disease by WHO classification

- Newly diagnosed disease

- Initial diagnostic surgery or biopsy performed within the past 4 weeks

- Not a candidate for standard radiotherapy (60Gy/30 fractions over 6 weeks) in
combination with temozolomide

PATIENT CHARACTERISTICS:

- ECOG performance status 0-2

- Absolute granulocyte count ≥ 1,500/mm³

- Platelet count ≥ 100,000/mm³

- Creatinine ≤ 1.5 times upper limit of normal (ULN)

- Bilirubin ≤ 1.5 times ULN

- ALT and AST < 2.5 times ULN

- No known hypersensitivity to temozolomide or compounds with similar chemical
composition to temozolomide

- No history of other malignancies except adequately treated nonmelanoma skin cancer,
curatively treated in situ cancer of the cervix, or other curatively treated solid
tumors with no evidence of disease for at least 5 years

- No serious active infection (e.g., wound infection requiring parenteral antibiotics)
or other serious underlying medical conditions that would preclude study treatment

- No other condition (e.g., psychological or geographical) that would preclude study
compliance

PRIOR CONCURRENT THERAPY:

- No prior chemotherapy

- No prior radiotherapy

- No prior or concurrent investigational therapy

- No concurrent surgical procedures for tumor debulking

- No concurrent stereotactic boost radiotherapy

- No other concurrent chemotherapy, immunotherapy, or biological therapy

- No concurrent epoetin alfa

- Concurrent corticosteroids allowed provided the patient has been on a stable or
decreasing dose for at least 14 days

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Overall survival

Outcome Time Frame:

7 years

Safety Issue:

No

Principal Investigator

Normand Laperriere, MD, FRCPC

Investigator Role:

Study Chair

Investigator Affiliation:

Princess Margaret Hospital, Canada

Authority:

Canada: Ethics Review Committee

Study ID:

CE6

NCT ID:

NCT00482677

Start Date:

May 2007

Completion Date:

July 2015

Related Keywords:

  • Brain and Central Nervous System Tumors
  • adult glioblastoma
  • adult giant cell glioblastoma
  • adult gliosarcoma
  • Glioblastoma
  • Nervous System Neoplasms
  • Central Nervous System Neoplasms

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