A Phase II, Open-Label Study to Evaluate the Safety, Tolerability, and Efficacy of Disulfiram and Copper Gluconate When Added to Standard Temozolomide Treatment in Patients With Newly Diagnosed Resected Unmethylated Glioblastoma Multiforme
Disulfiram
+ Copper gluconate
+ Temozolomide
Astrocytoma+7
+ Glioblastoma
+ Glioma
Treatment Study
Summary
Study start date: March 28, 2018
Actual date on which the first participant was enrolled.Glioblastoma is the most common malignant primary brain tumor and one of the most devastating cancers. The current standard of care for glioblastoma includes maximal safe resection followed by radiotherapy and temozolomide, which results in a median progression-free survival of less than 7 months, and median overall survival (OS) of less than 15 months. Moreover, patients with unmethylated glioblastoma respond poorly to this current standard treatment. This clinical trial evaluates the potential role of continuous, upfront use of Disulfiram in combination with Copper gluconate in enhancing temozolomide effect in the treatment of unmethylated Glioblastoma multiforme (GBM) patients.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.15 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: * Age 18 or older * Diagnosis of histologically confirmed glioblastoma (WHO grade IV). Subjects with an original histologic diagnosis of low grade glioma or anaplastic glioma (WHO grade II or III) are eligible if a subsequent histological diagnosis of glioblastoma is made * Patients whose tumor is determined to be unmethylated * Patients with incomplete resection as determined by residual, measurable gadolinium or contrast-enhancing lesion or lesions * Recent resection of glioblastoma within 4 weeks of study entry. Patients who have only had a tumor biopsy and who are considered unresectable are eligible (but based on the study accrual this subset of patients with unresectable tumor may be considered for separate analysis) * Eastern Cooperative Oncology Group Performance Status (ECOG PS) of ≤ 2 (see appendix A) * Willing to remain abstinent from consuming alcohol while on DSF * No prior radiation or chemotherapy * Meets the following laboratory criteria: * Absolute neutrophil count ≥ 1,500/mcL (microliter) * Platelets ≥ 100,000/mcL * Hemoglobin \> 10.0 g/dL (grams/deciliter) (transfusion and/or ESA (erythropoiesis-stimulating agent) allowed) * Total bilirubin and alkaline phosphatase ≤ 2x institutional upper limit of normal (ULN) * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 3 x ULN * Blood urea nitrogen (BUN) and creatinine \< 1.5 x ULN * Able to take oral medication * Able to understand and willing to sign an institutional review board (IRB)-approved written informed consent document (legally authorized representative permitted) Exclusion Criteria: * Radiographic evidence of leptomeningeal dissemination, extensive intraparenchymal dissemination, infratentorial tumor, or metastatic disease to sites remote from the supratentorial brain * Enrolled in another clinical trial testing a novel therapy or drug * Received prior radiation therapy or chemotherapy for glioblastoma * History of allergic reaction/hypersensitivity to DSF (without alcohol) or copper. * Treatment with the following medications that may interfere with metabolism of DSF: warfarin (unless otherwise chosen by the study PI who will actively adjust Coumadin dose to consistently maintain a safe, therapeutic international normalized ratio (INR) \< 3, theophylline, amitriptyline, isoniazid, metronidazole, phenytoin, phenobarbital, chlorzoxazone, halothane, imipramine, chlordiazepoxide, diazepam. (Note: lorazepam and oxazepam are not affected by the P450 system and are not contraindicated with DSF). * Active severe hepatic or renal disease * Grade 2 or higher peripheral neuropathy or ataxia per NCI CTCAE version 4.0 (2009) * History of idiopathic seizure disorder schizophrenia, or psychosis unrelated to glioblastoma, corticosteroid, or anti-epileptic medications * History of Wilson's or Gilbert's disease * Current excessive use of alcohol
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
Aurora Health Care, Aurora St. Luke's Medical Center
Milwaukee, United StatesOpen Aurora Health Care, Aurora St. Luke's Medical Center in Google Maps