Patient case: 50-year-old male with glioblastoma; genetic feature: IDH1 (R132H)

Clinical trial: Study of Imatinib Mesylate in Combination With Hydroxyurea Versus Hydroxyurea Alone as an Oral Therapy in Patients With Temozolomide Resistant Progressive Glioblastoma

Summary: This is a Phase III study comparing Imatinib mesylate and hydroxyurea combination therapy with hydroxyurea monotherapy in patients with temozolomide resistant progressive glioblastoma.


Eligibility: Inclusion Criteria:
  -  Signed informed consent prior to initiation of any study procedure.
  -  Patients >= 18 years of age.
  -  Histological confirmed diagnosis of glioblastoma multiforme / astrocytoma World Health Organization (WHO) grade IV by a reference pathologist
  -  Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1 or 2.
  -  Adequate hepatic, renal and bone marrow function as defined by the following: total bilirubin < 1.5 x Upper Limit of Normal (ULN), ALT and AST < 2.5 x ULN, creatinine < 1.5 x ULN, absolute neutrophil count > 1.5 x109/L, platelets > 100 x109/L and hemoglobin > 10 g/dL.
  -  Female patients of childbearing potential with a negative pregnancy test within 7 days of initiation of study drug dosing. Postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. Male and female patients of reproductive potential who agree to employ an effective barrier method of birth control throughout the study, and for up to 3 months following discontinuation of study drug.
  -  Life expectancy of >3 months.
  -  MRI available every 6 weeks for disease management
  -  No intercerebral inflammation
  -  Irradiation therapy 54 to 62 gy finished or less according to national standard
  -  Chemotherapy at least 1 temozolomide containing regimen finished, no established chemotherapy regiment available and progression under chemotherapy or in between 6 months following the last chemotherapy.
  -  Leucocytes > 2.500/µl, to be controlled once a week
  -  Thrombocytes > 80.000/µl, to be controlled once a week
  -  Ensured compliance
  -  Patients who had a second or third resection after disease progression cannot be included earlier than 2 weeks following the resection. MRI should be performed not later than 72 h post operation. If patients are to be included later than 4 weeks after the resection, a new baseline MRI must be performed.
  Exclusion Criteria:
  -  Female patients who are pregnant or breast-feeding.
  -  Patients who have been treated with any investigational agent(s) within 28 days of the first day of administration of study drug.
  -  Patients with uncontrolled medical disease such as diabetes mellitus, thyroid dysfunction, neuropsychiatric disorders, infection, angina or Grade 3 or 4 cardiac problems as defined by the New York Heart Association Criteria.
  -  Patients with other malignant disorders.
  -  Patient with acute or known chronic liver disease (i.e., chronic active hepatitis, cirrhosis).
  -  Patients who are known to be HIV positive (no specific tests are required for confirmation of eligibility).
  -  Expected incompliance according to treatment, treatment diary and examination schedule
  -  Not confirmed histological diagnosis glioblastoma multiforme/astrocytoma WHO grade IV
  -  Other drugs with potential cytostatic main or side effect
  -  No or inadequate chemotherapy or irradiation therapy
  -  Patients without hematological recovery after previous chemotherapy who have been treated with Chemotherapy within 28 days of the first day of administration of study drug.
  Other protocol-specific inclusion /exclusion criteria may apply.

Relevance to patient case: not relevant