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Trial of Newly Diagnosed High Grade Glioma Treated With Concurrent Radiation Therapy, Temozolomide and BMX-001
Trial Status: complete
This is a Phase 2 study of newly diagnosed patients with high grade glioma (HGG)
undergoing standard radiation therapy and temozolomide treatment. BMX-001 added to
radiation therapy and temozolomide has the potential not only to benefit the survival of
high grade glioma patients but also to protect against deterioration of cognition and
impairment of quality of life. BMX-001 will be given subcutaneously first with a loading
dose zero to four days prior to the start of chemoradiation and followed by twice a week
doses at one-half of the loading dose for the duration of radiation therapy plus two
weeks. Both safety and efficacy of BMX-001 will be evaluated. Impact on cognition will
also be assessed. Eighty patients will be randomized to the treatment arm that will
receive BMX-001 while undergoing chemoradiation and 80 patients randomized to receive
chemoradiation alone. The sponsor hypothesizes that BMX-001 when added to standard
radiation therapy and temozolomide will be safe at pharmacologically relevant doses in
patients with newly diagnosed high grade glioma. The sponsor also hypothesizes that the
addition of BMX-001 will positively impact the overall survival and improve objective
measures of cognition in newly diagnosed high grade glioma patients.
Inclusion Criteria
Subjects must have histologically confirmed diagnosis of World Health Organization (WHO) grade III or IV malignant glioma
Subjects must be planning to start standard of care radiation therapy and chemotherapy
Subjects must be within 12 weeks of last major neurosurgical procedure for the high-grade glioma (craniotomy, open biopsy, or stereotactic biopsy)
Subjects must have had a definitive resection with residual radiographic contrast enhancement on post-resection CT or MRI of less than or equal to 3 cm in any two perpendicular planes on any images
Serum creatinine ≤ 1.5 mg/dl, serum glutamate oxaloacetate transaminase (SGOT) and bilirubin ≤ 1.5 times upper limit of normal
Signed informed consent approved by the Institutional Review Board
If sexually active, patients must agree to use appropriate contraceptive measures for the duration of the study and for 12 months afterwards as stated in the informed consent
Stable and/or decreasing dose of corticosteroids for greater than or equal to 7 days.
Exclusion Criteria
Pregnancy or breast-feeding
Active infection requiring IV antibiotics 7 days before enrollment
Signs of wound-healing problems or infection at the craniotomy/biopsy site.
Prior, unrelated malignancy requiring current active treatment with the exception of cervical carcinoma in situ and adequately treated basal cell or squamous cell carcinoma of the skin
Co-medication that may interfere with study results; e.g. immuno-suppressive agents other than corticosteroids
Prior treatment with radiotherapy or chemotherapy for a brain tumor, irrespective of the grade of the tumor
Evidence of > grade 1 CNS hemorrhage on baseline MRI on CT scan
Systemic treatment with inducers or strong inhibitors of cytochrome P450 within four days before enrollment or planned treatment during the time period of the study.
Metal in the body (except dental fillings) e.g., pacemaker, infusion pump, metal aneurysm clip, metal prosthesis, joint, rod or plate.
Severe allergy to contrast agent.
Inadequately controlled hypertension
Active or history of postural hypotension and autonomic dysfunction
Clinically significant (i.e. active) cardiovascular disease or cerebrovascular disease, for example cerebrovascular accidents ≤ 6 months prior to study enrollment, myocardial infarction ≤ 6 months prior to study enrollment, unstable angina, New York Heart Association (NYHA) Grade II or greater congestive heart failure (CHF), or serious cardiac arrhythmia uncontrolled by medication or potentially interfering with protocol treatment
History or evidence upon physical/neurological examination of central nervous system disease (e.g. seizures) unrelated to cancer unless adequately controlled by medication or potentially interfering with protocol treatment
Significant vascular disease (e.g., aortic aneurysm requiring surgical repair or recent arterial thrombosis) within 6 months prior to start of study treatment
A marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval >480 milliseconds (ms) (CTCAE grade 1)
A known history of additional risk factors for Torsades de Pointes (TdP) (e.g., congestive heart failure, hypokalemia, known family history of Long QT Syndrome).
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT02655601.