Phase II Trial of Super Selective Intra-arterial Repeated Infusion of Cetuximab (Erbitux) With Reirradiation for Treatment of Relapsed/Refractory Glioblastoma Multiforme, Anaplastic Astrocytoma, and Anaplastic Oligoastrocytoma

  • STATUS
    Recruiting
  • End date
    May 28, 2025
  • participants needed
    37
  • sponsor
    Northwell Health
Updated on 28 October 2022
platelet count
cancer
tyrosine
monoclonal antibodies
coumadin
growth factor
karnofsky performance status
EGFR
cetuximab
aptt
glioblastoma multiforme
astrocytoma
brain tumor
anaplastic astrocytoma
tumor progression
astrocytoma, anaplastic
oligoastrocytoma
anaplastic oligoastrocytoma
beam radiation
malignant brain tumor
primary brain neoplasm
primary brain tumors

Summary

Primary brain tumors are typically treated by surgery, radiation therapy and chemotherapy, either individually or in combination. Present therapies are inadequate, as evidenced by the low 5-year survival rate for brain cancer patients, with median survival at approximately 12 months. Glioma is the most common form of primary brain cancer, afflicting approximately 7,000 patients in the United States each year. These highly malignant cancers remain a significant unmet clinical need in oncology. GBM often has a high expression of EFGR (Epidermal Growth Factor Receptor), which is associated with poor prognosis. Several methods of inhibiting this receptor have been tested, including monoclonal antibodies, vaccines, and tyrosine kinase inhibitors. The investigators hypothesize that in patients with recurring GBM, intracranial superselective intra-arterial infusion of Cetuximab (CTX), at a dose of 250mg/m2 in conjunction with hypofractionated radiation, will be safe and efficacious and prevent tumor progression in patients with recurrent, residual GBM.

Details
Condition Glioblastoma, Anaplastic Astrocytoma, Anaplastic Oligoastrocytoma, Glioma, Brain Neoplasm, Brain Cancer, Brain Tumor, Brain Tumor, Recurrent, Brain Neoplasm, Malignant
Treatment Intra-arterial Cetuximab, Intra-arterial Mannitol, Hypofractionated re-irradiation
Clinical Study IdentifierNCT02800486
SponsorNorthwell Health
Last Modified on28 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Male or female patients of ≥18 years of age
Patients with a documented histologic diagnosis of relapsed or refractory glioblastoma multiforme (GBM), anaplastic astrocytoma (AA) or anaplastic oligoastrocytoma (AOA)
Patients with pathology confirmed histologic EGFR overexpression
Patients must have at least one confirmed and evaluable tumor site.∗
A confirmed tumor site is one in which is biopsy-proven
Patients must have a Karnofsky performance status ≥60% and an expected survival of ≥ three months
No chemotherapy for two weeks prior to treatment under this research protocol and no external beam radiation for eight weeks prior to treatment under this research protocol
Patients must have adequate hematologic reserve with WBC≥3000/mm3, absolute neutrophils ≥1500/mm3 and platelets ≥100,000/ mm3. Patients who are on Coumadin must have a platelet count of ≥150,000/ mm3
Pre-enrollment chemistry parameters must show: bilirubin<1.5X the institutional upper limit of normal (IUNL); AST or ALT<2.5X IUNL and creatinine<1.5X IUNL
Pre-enrollment coagulation parameters (PT and PTT) must be ≤1.5X the IUNL
Patients must agree to use a medically effective method of contraception during and for a period of three months after the treatment period. A pregnancy test will be performed on each premenopausal female of childbearing potential immediately prior to entry into the research study
Patients must be able to understand and give written informed consent. Informed consent must be obtained at the time of patient screening

Exclusion Criteria

Women who are pregnant or lactating
Women of childbearing potential and fertile men will be informed of the potential unknown risk of conception while participating in this research trial and will be advised that they must use effective contraception during and for a period of three months after the treatment period
Patients with significant intercurrent medical or psychiatric conditions that would place them at increased risk or affect their ability to receive or comply with treatment or post-treatment clinical monitoring
Patients with radiological evidence of leptomeningeal disease
Patients with history of allergic reaction to CTX
Patients who completed chemo/RT less than 6 months prior to enrollment
Patients who have not failed standard Stupp protocol
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