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FR901228 in Treating Patients With Recurrent High-Grade Gliomas

A Phase I-II Trial of Depsipeptide in Patients With Recurrent High-Grade Gliomas

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00085540
Enrollment
50
Registered
2004-06-11
Start date
2005-01-31
Completion date
2009-03-31
Last updated
2017-01-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Adult Anaplastic Astrocytoma, Adult Anaplastic Oligodendroglioma, Adult Giant Cell Glioblastoma, Adult Gliosarcoma, Recurrent Adult Brain Tumor

Brief summary

This phase I/II trial is studying the side effects and best dose of FR901228 and to see how well it works in treating patients with recurrent high-grade gliomas. FR901228 may stop the growth of tumor cells by blocking the enzymes necessary for their growth

Detailed description

PRIMARY OBJECTIVES: I. Determine the maximum tolerated dose (MTD) of FR901228 (depsipeptide) in patients with recurrent malignant gliomas who are taking enzyme-inducing antiepileptic drugs (EIAEDs). (Phase I) II. Determine the safety profile of this drug in these patients. (Phase I) III. Determine the pharmacokinetics and pharmacodynamics of this drug in these patients. (Phase I) IV. Determine the clinical efficacy of this drug, as measured by 6-month progression-free survival and objective tumor response, in these patients. (Phase II) V. Determine the safety profile of this drug when administered at the phase I MTD concurrently with or without EIAEDs in these patients. (Phase II) OUTLINE: This is a multicenter, phase I, dose-escalation study followed by a phase II study. Patients are stratified according to study phase (I vs II), concurrent use of enzyme-inducing anti-epileptic drugs (EIAEDs) (yes vs no), histology (recurrent glioblastoma multiforme/gliosarcoma vs recurrent anaplastic glioma), pre-operative candidacy (yes vs no), and measurable/evaluable disease (yes vs no). Patients are assigned to 1 of 2 treatment groups (group A: no EIAEDs or group B: concurrent use of EIAEDs). Phase I (group B only): Patients receive FR901228 (depsipeptide) IV over 4 hours on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of FR901228 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of up to 6 patients experience dose-limiting toxicity. Phase II (groups A and B): Group A (phase II): Patients receive FR901228 as in phase I at dose level 1. Group B (phase II): Patients receive FR901228 as in phase I at the MTD.

Interventions

Given IV

Sponsors

National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Phase I and phase II: * Histologically confirmed recurrent intracranial malignant glioma, including any of the following: * Glioblastoma multiforme * Gliosarcoma * Anaplastic astrocytoma * Anaplastic oligodendroglioma * Anaplastic mixed oligoastrocytoma * Malignant astrocytoma not otherwise specified * Unequivocal evidence of tumor progression by MRI or CT scan while on a steroid dosage that has been stable for at least 5 days * Patients previously treated with interstitial brachytherapy or stereotactic radiosurgerymust have confirmation of true progressive disease (rather than radiation necrosis) by positron-emission tomography, thallium scan, magnetic resonance spectroscopy, or surgical documentation * Must have failed prior radiotherapy that was completed at least 6 weeks ago * No more than 2 prior therapies (initial treatment and treatment for 1 relapse)\* * Surgical resection for relapsed disease with no anticancer therapy for up to 12 weeks, followed by a second surgical resection, is considered treatment for 1 relapse * Patients in group B must have been receiving enzyme-inducing antiepileptic drugs (EIAEDs) for at least the past 2 weeks * Performance status - Karnofsky 60-100% * More than 8 weeks * WBC ≥ 3,000/mm\^3 * Absolute neutrophil count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 * Hemoglobin ≥ 10 g/dL (transfusions allowed) * SGOT \< 2 times upper limit of normal (ULN) * Bilirubin \< 2 times ULN * Creatinine \< 1.5 mg/dL * No congestive heart failure (i.e., New York Heart Association class II-IV, ejection fraction \< 40% by MUGA scan or \< 50% by echocardiogram and/or MRI) * No myocardial infarction within the past year * No uncontrolled dysrhythmias * No poorly controlled angina * No significant left ventricular hypertrophy by EKG * No cardiac ischemia (ST depression of 2 mm) by EKG * No hypertrophic or restrictive cardiomyopathy from prior treatment or other causes * No uncontrolled hypertension (i.e., blood pressure ≥ 160/95 mm Hg) * No cardiac arrhythmia requiring antiarrhythmic medication * No known cardiac abnormalities (e.g., congenital long QT syndrome and QTc interval \> 480 milliseconds) * No history of sustained ventricular tachycardia, ventricular fibrillation, Torsade de Pointes, or cardiac arrest unless controlled with concurrent automatic implantable cardioverter defibrillator * No known history of coronary artery disease (e.g., Canadian class II-IV angina) * No other significant cardiac disease * No other malignancy within the past 3 years except nonmelanoma skin cancer or carcinoma in situ of the cervix * No active infection * No significant uncontrolled medical illness that would preclude study participation * No disease that would obscure toxicity or dangerously alter drug metabolism * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective barrier contraception during and for at least 2 weeks after study participation * Fertile male patients must continue barrier contraception for 3 months after study participation * At least 1 week since prior interferon or thalidomide * No concurrent prophylactic filgrastim (G-CSF) * No concurrent anticancer immunotherapy * At least 2 weeks since prior vincristine * At least 6 weeks since prior nitrosoureas * At least 3 weeks since prior procarbazine * No prior FR901228 (depsipeptide) * No other concurrent anticancer chemotherapy * See Disease Characteristics * At least 1 week since prior tamoxifen * No concurrent anticancer hormonal therapy * See Disease Characteristics * No concurrent anticancer radiotherapy * See Disease Characteristics * Prior recent resection of recurrent or progressive tumor allowed if patient has recovered * Recovered from all prior therapy * At least 2 weeks since prior EIAEDs (patients in Group A only) * At least 4 weeks since prior cytotoxic therapy * At least 4 weeks since prior investigational agents * At least 1 week since prior isotretinoin * At least 1 week since other prior non-cytotoxic therapy (except radiosensitizers) * No concurrent valproic acid * No concurrent hydrochlorothiazide * No concurrent medication that causes QTc prolongation * No other concurrent anticancer therapy * No other concurrent investigational drugs

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Dose-limiting Toxicities Due to Romidepsin Graded According to the NCI Common Toxicity Criteria (CTCAE Version 3.0) (Phase I)First 4 weeks of treatmentdose limiting toxicity defined as: ANC \</=1000 or Platelets \<100K; SGOT \>/= 3X ULN and T. Bili \>/= 1.5 ULN grade 3 Nausea, vomiting, fatigue and asymptomatic hypocalcemia (treatment may continue after discuss with PI)
6 Months Progression-free Survival (Phase II)At 6 monthsevaluated patients with glioblastoma (GBM (35 patients)

Secondary

MeasureTime frameDescription
Response Rate Associated With Depsipeptide Therapy (Phase II)Up to 2 yearsRECIST Complete Response (CR): Complete disappearance of all measurable and evaluable disease. No new lesions. No evidence of non-evaluable disease. Patients must be on no steroids. Partial Response (PR): Greater than or equal to 50% decrease under baseline in the sum of products of perpendicular diameters of all measurable lesions. No progression of evaluable disease. No new lesions. Stable/No Response: Does not qualify for CR, PR, or progression. The designation of Stable/No Response requires a minimum of 8 weeks duration. Progression: 25% increase in the sum of products of all measurable lesions over smallest sum observed (over baseline if no decrease) OR clear worsening of any evaluable disease, OR appearance of any new lesion/site, OR clear clinical worsening or failure to return for evaluation due to death or deteriorating condition

Countries

United States

Participant flow

Participants by arm

ArmCount
Phase 1 Dose Escalation - Romidepsin
Patients receive FR901228 (romidepsin) IV over 4 hours on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Dose escalation two dose levels: Romidepsin (depsipeptide): 13.3mg/m2 and 17.7mg/m2 Pharmacokinetics depsipeptide: Given IV
8
Phase 2 Dose From Phase 1 - Romidepsin
Patients receive FR901228 (romidepsin) as in phase I at dose level 1. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity Romidepsin (depsipeptide): 13.3mg/m2 depsipeptide: Given IV
40
Total48

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyProtocol Violation01
Overall StudyWithdrawal by Subject01

Baseline characteristics

CharacteristicTotalPhase 1 Dose Escalation - RomidepsinPhase 2 Dose From Phase 1 - Romidepsin
Age, Continuous54 years52 years55 years
Gender
Female
13 Participants3 Participants10 Participants
Gender
Male
35 Participants5 Participants30 Participants
Histology
Anaplastic glioma
7 participants2 participants5 participants
Histology
Gliobastoma
41 participants6 participants35 participants
Karnofsky Performance Status Scale (KPS)
60-80
25 units on a scale4 units on a scale21 units on a scale
Karnofsky Performance Status Scale (KPS)
90-100
23 units on a scale4 units on a scale19 units on a scale
Prior chemotherapy regimens1 number of chemotherapy regimens1 number of chemotherapy regimens1 number of chemotherapy regimens
Prior Radiotherapy48 participants8 participants40 participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
8 / 840 / 40
serious
Total, serious adverse events
0 / 80 / 40

Outcome results

Primary

6 Months Progression-free Survival (Phase II)

evaluated patients with glioblastoma (GBM (35 patients)

Time frame: At 6 months

Population: evaluation of patients with GBM histology

ArmMeasureValue (NUMBER)
Phase 1 Dose Escalation - Romidepsin6 Months Progression-free Survival (Phase II)3 percentage of participants
Primary

Number of Participants With Dose-limiting Toxicities Due to Romidepsin Graded According to the NCI Common Toxicity Criteria (CTCAE Version 3.0) (Phase I)

dose limiting toxicity defined as: ANC \</=1000 or Platelets \<100K; SGOT \>/= 3X ULN and T. Bili \>/= 1.5 ULN grade 3 Nausea, vomiting, fatigue and asymptomatic hypocalcemia (treatment may continue after discuss with PI)

Time frame: First 4 weeks of treatment

ArmMeasureValue (NUMBER)
Phase 1 Dose Escalation - RomidepsinNumber of Participants With Dose-limiting Toxicities Due to Romidepsin Graded According to the NCI Common Toxicity Criteria (CTCAE Version 3.0) (Phase I)0 participants
Secondary

Response Rate Associated With Depsipeptide Therapy (Phase II)

RECIST Complete Response (CR): Complete disappearance of all measurable and evaluable disease. No new lesions. No evidence of non-evaluable disease. Patients must be on no steroids. Partial Response (PR): Greater than or equal to 50% decrease under baseline in the sum of products of perpendicular diameters of all measurable lesions. No progression of evaluable disease. No new lesions. Stable/No Response: Does not qualify for CR, PR, or progression. The designation of Stable/No Response requires a minimum of 8 weeks duration. Progression: 25% increase in the sum of products of all measurable lesions over smallest sum observed (over baseline if no decrease) OR clear worsening of any evaluable disease, OR appearance of any new lesion/site, OR clear clinical worsening or failure to return for evaluation due to death or deteriorating condition

Time frame: Up to 2 years

Population: GBM patients - no responses

ArmMeasureValue (NUMBER)
Phase 1 Dose Escalation - RomidepsinResponse Rate Associated With Depsipeptide Therapy (Phase II)0 participants

Source: ClinicalTrials.gov · Data processed: Mar 29, 2026