AZD7451 for Recurrent Gliomas
Condition: Glioblastoma Multiforme
MeSH terms: Glioblastoma
Study type: Interventional
Phase: Phase 1

Summary: 
      Background:

      - AZD7451 is a drug that may help interfere with brain tumor cell growth. It can prevent
      glioma cells from entering into normal brain tissue, and slow or stop the growth of
      additional tumors. Researchers want to see if AZD7451 is effective against gliomas that have
      not responded to surgery, radiation, or chemotherapy.

      Objectives:

      - To see if AZD7451 is a safe and effective treatment for gliomas that have not responded to
      standard treatments.

      Eligibility:

      - Individuals at least 18 years of age who have gliomas that have not responded to standard
      treatments.

      Design:

        -  Participants will be screened with a physical exam, medical history, blood and urine
           tests, heart function tests, an eye exam, and imaging studies.

        -  Participants will take AZD7451 daily by mouth for 28-day cycles of treatment.

        -  Participants will keep a medication diary and record any side effects. Treatment will be
           monitored with frequent blood tests and imaging studies.

        -  Treatment will continue as long as there are no serious side effects and the tumor does
           not start growing again....
    

Detailed description: 
      BACKGROUND:

      Recurrent glioma patients have very limited treatment options. A major cause of gliomarelated
      morbidity and mortality is the extensive infiltrative and invasive nature of glioma cells.
      Thus, inhibition of glioma invasion is a potentially promising strategy.

      Work in the Neuro-Oncology Branch laboratory of Dr. Howard Fine has identified TrkA as an
      important signaling receptor for mediating glioma cell invasion. Both genetic and
      pharmacological inhibition of Trk potently inhibits glioma invasion and tumor progression in
      vitro and in vivo. AZD7451 is a first in-class inhibitor of Trk.

      OBJECTIVES:

      To establish the maximally tolerated dose (MTD) of continuous twice a day AZD7451 dosing in
      patients with recurrent glioblastoma not on enzyme-inducing anti-epileptic drugs (EIAED).

      To generate pharmacokinetic data on continuous twice a day AZD7451 dosing.

      ELIGIBILITY:

      Patients with histologically proven glioblastoma are eligible for this study. Patients should
      have failed prior standard treatment with radiotherapy.

      DESIGN:

      This study will accrue up to 60 evaluable patients. Cohorts of 3 to 6 patients will receive
      continuous AZD7451 twice a day orally for 28 days. The MTD will be based on the tolerability
      observed during the first 4 weeks of treatment only. Up to three patients may be enrolled
      simultaneously at each dose level. The dose of AZD7451 can be progressively escalated if only
      0/3 or 1/6 patients experience a dose limiting toxicity at the prior dose level.

      At the end of Cycle 1, patients may choose to continue to receive AZD7451 until disease
      progression or until they experience unmanageable drug related toxicity, as long as they are
      continuing to derive clinical benefit and do not fulfill any of the criteria for removal from
      protocol therapy. Each cycle during this extension period will last 28 days.
    

Intervention name(s): AZD7451
Intervention type(s): Drug
Intervention description(s): Depending on dose level, AZD7451 will be given once daily for 28 day cycles.
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Brain; Angiogenesis; Radiotherapy; Malignant; Tumor; Glioma; Glioblastoma Multiforme; Brain Tumor