E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Newly diagnosed Glioblastoma (Astrocytoma, WHO grade IV) |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 7.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10018336 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this exploratory study is to estimate the percentage of subjects who survived 6 months without disease progression (6-month PFS).
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E.2.2 | Secondary objectives of the trial |
The secondary objectives are to: · Investigate safety and tolerability. · Investigate the PK of cilengitide and TMZ. · Estimate response rate. · Estimate overall survival time. · Estimate rate of 1-year survival. · Estimate median time to disease progression.
Additional goals of the study are: · To increase the safety database in a well defined population of GB subjects (in support of the results from the NABTT-9911 study). · To investigate the relationship between efficacy and alterations in molecular profiles in order to identify molecular markers that correlate with response or resistance. · To measure subject Quality of Life (QoL) by the EORTC- QLQC30 + QLQ BN 20 and the Functional Assessment of Cancer Therapy–Brain (FACT-Br) 1997.
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
- Written informed consent obtained before undergoing any study-related activities - Males or females ≥ 18 to < 70 years of age. - Newly diagnosed, histologically proven supratentorial GB (WHO Grade IV). The histological diagnosis can be obtained either from a brain biopsy or from a neurosurgical resection of the tumor. - Interval of ≥ 3 weeks but ≤ 5 weeks since surgery or biopsy before enrollment. - For subjects who had undergone a tumor biopsy, disease evaluated by Gd-MRI within 1 week prior to the first dose of cilengitide. - For subjects who had undergone tumor resection or debulking, availability of a postoperative Gd-MRI performed within < 48 hours after surgery. (In the exceptional case that it was not possible to obtain a Gd-MRI within 48 hours post surgery, and upon receiving confirmation from the central registration desk, a Gd-MRI is to be performed within 1 week prior to the start of cilengitide treatment.) - Tumor tissue specimens from the GB surgery (paraffin-embedded and fresh-frozen) or biopsy (paraffin-embedded and, if available, fresh frozen) must be available for central pathology review and analysis of molecular markers relevant for this study (avb3 and avb5 integrins and MGMT gene methylation status). - No prior chemotherapy in the last 5 years. - No prior RT of the head. - Stable or decreasing dose of steroids for ≥ 8 days. - Eastern Cooperative Oncology Group performance status (ECOG PS) ≤ 2. - Women of childbearing potential must have a negative pregnancy test at screening. - Subjects with the potential for pregnancy or impregnating their partner must agree to follow acceptable methods of birth control, such as hormonal contraception, intra-uterine pessar (IUP) or sterilization, to avoid conception during the study and for at least 6 months after receiving the last dose of study drug. - Laboratory values (within 1 week prior to the first dose of cilengitide): Absolute neutrophil count ≥1500/mm³. Platelets ≥ 100,000/mm³. Creatinine ≤ 1.5 times upper limit of normal (ULN) or creatine clearance rate ≥ 60 mL/min. PT international normalized ratio (INR) and partial thromboplastin time (PTT) within normal limits. Hemoglobin ≥10 mg/dL. Total bilirubin ≤ 1.5 times the ULN. Aspartate aminotransferase and alanine aminotransferase ≤ 2.5 times above ULN. Alkaline phosphatase ≤ 2.5 times above ULN. - Clinically normal cardiac function without history of ischemic heart disease in the past 6 months and normal 12-lead electrocardiogram (ECG) measured during screening. No history of stroke.
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E.4 | Principal exclusion criteria |
- Planned surgery for other diseases (e. g., dental extraction). - History of recent peptic ulcer disease (endoscopically proven gastric ulcer, duodenal ulcer, or esophageal ulcer) within 6 months of enrollment. - History of prior malignancy. Subjects with curatively treated cervical carcinoma in situ or basal cell carcinoma of the skin, or subjects who have been free of other malignancies for ≥ 5 years are eligible for this study. - History of coagulation disorder associated with bleeding or recurrent thrombotic events. - Concurrent illness, including severe infection, which may jeopardize the ability of the subject to receive the procedures outlined in this protocol with reasonable safety. - Subject is pregnant, anticipates becoming pregnant within 6 months after study participation, or is currently breast-feeding. - Receiving concurrent investigational agents or has received an investigational agent within the past 30 days prior to the first dose of cilengitide. - Prior antiangiogenic therapy. - Placement of Gliadel® wafer at surgery. - Unable to undergo Gd-MRI. - Current alcohol dependence or drug abuse. - Treatment with a prohibited concomitant medication (see Section 6.9.1). - Known hypersensitivity to the study treatment. - Legal incapacity or limited legal capacity. - Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be assessed with the patient before enrollment in the trial.
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E.5 End points |
E.5.1 | Primary end point(s) |
The purpose of the current Phase I/IIa study is to investigate the tolerability and activity of the combination of cilengitide with the newly established treatment regimen (RT and TMZ, followed by maintenance TMZ). The current study is an exploratory, uncontrolled, open-label study, the results of which will be compared to the recently published data of the EORTC Phase III study. The primary endpoint is the rate of subjects alive and progression-free at 6 months (6-month PFS). In the EORTC trial the improvement of PFS correlated with the improvement in overall survival. Therefore this surrogate marker appears to be appropriate for a Phase I/II study. The evaluation of disease progression will be based on radiological and neurological criteria as well as steroid use. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The end of the clinical study will be the last visit of the last subject after the last cilengitide administration (end of the Continuing Treatment Phase). |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |