CHLOROBRAINA Phase I Trial for the Addition of Chloroquine, an Autophagy Inhibitor, to Concurrent Chemoradiation for Newly Diagnosed Glioblastoma
Chloroquine
+ Radiotherapy
+ Temozolomide
Astrocytoma+7
+ Glioblastoma
+ Glioma
Treatment Study
Summary
Study start date: August 1, 2016
Actual date on which the first participant was enrolled.This trial has been designed as an open label, single center combination phase I trial. The primary objective is to determine the maximum tolerated dose (MTD) for chloroquine (CQ) in combination with concurrent radiotherapy with daily temozolomide in patients with a newly diagnosed GBM. Eligible patients will receive radiotherapy and chemotherapy according to standard protocol for newly diagnosed GBM. This consists of 33 daily fractions of 1.8 Gy to the tumor and surrounding margin in combination with TMZ 75 mg/m² per os daily (po qd) and six adjuvant cycles of TMZ 150 - 200 mg/m² po qd. Treatment will be combined with daily intake of escalating doses of chloroquine. Chloroquine will start with week before the start of radiotherapy and end on the last day of radiotherapy. The rate of subject entry and escalation to the next dose level will depend upon assessment of the safety profile of patients entered at the previous dose level. Toxicity will be evaluated according to the NCI common Terminology Criteria for Adverse Events (CTCAE), Version 4.0. The 3 + 3 cohort method is used. A minimum of three patients will be entered at each dose level. All three will be followed during the concomitant radiotherapy and a 4 week observation period before escalation to the next dose level. The start dose is 200mg chloroquine daily. Before opening the next higher dose level all toxic effects at the preceding dose level will be reviewed and expansion or escalation will be undertaken as appropriate
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.13 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.Over 18 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
Inclusion Criteria: * Histologically confirmed grade IV supratentorial astrocytoma (glioblastoma multiforme) * Tumor tissue available for histopathological analysis (MGMT, EGFRvIII) * Diagnosis must have been made by biopsy or resection ≤ 3 months prior to study entry * 18 years or older * Karnofsky performance status ≥ 70 * Absolute neutrophil count at least 1.5 x 109/L and platelets at least 100 x109/L * Adequate renal function * Adequate hepatic function * absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule. * Females must have negative results for pregnancy tests performed * No breast feeding. * If male, subject must be surgically sterile or practicing a method of contraception Exclusion Criteria: * Prior radiotherapy * Prior chemotherapy * Recent (\< 3 months) severe cardiac disease (NYHA class \>1) (congestive heart failure, infarction) * History of cardiac arrythmia (multifocal premature ventricular contractions, uncontrolled atrial fibrillation, bigeminy, trigeminy, ventricular tachycardia) which is symptomatic and requiring treatment (CTC AE 4.0), or asymptomatic sustained ventricular tachycardia. Asymptomatic atrial fibrillation controlled on medication is allowed. * Cardiac conduction disturbances or medication potentially causing them * Treatment with investigational drugs in 4 weeks prior to or during this study * If the subject has clinically significant and uncontrolled major medical condition(s) including but not limited to: * uncontrolled nausea/vomiting/diarrhea: * active uncontrolled infection, including HIV and hepatitis (HBV, HCV) * psychiatric illness/social situation that would limit compliance with study requirements * any medical condition, with the opinion of the study investigator, places the subject at an unacceptably high risk for toxicities. * The subject has had another active malignancy within the past 3 years except for any cancer in situ that the principal Investigator considers to be cured. * Chronic systemic immune therapy (with the exception of corticosteroids) * Concurrent cytochrome P450 enzyme-inducing anticonvulsant drugs (e.g., phenytoin, carbamazepine, phenobarbital, primidone, or oxcarbazepine) * Known glucose-6-phosphate dehydrogenase deficiency * Psoriasis or porphyria * Known hypersensitivity to 4-aminoquinoline compound * Retinal or visual field changes unrelated to the tumor location prior to 4-aminoquinoline compound use
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.One single intervention group is designated in this study
This study does not include a placebo group
Treatment Groups
Group I
ExperimentalStudy Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 1 location
Maastricht Radiation Oncology
Maastricht, NetherlandsOpen Maastricht Radiation Oncology in Google Maps