Vatalanib in Treating Patients With Recurrent or Progressive Meningioma
Condition: Brain and Central Nervous System Tumors; Sarcoma
MeSH terms: Meningioma; Nervous System Neoplasms; Central Nervous System Neoplasms
Intervention: vatalanib
Intervention MeSH terms: Vatalanib
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 25.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: adult grade I meningioma; adult grade II meningioma; adult grade III meningioma; adult malignant hemangiopericytoma; adult anaplastic meningioma; adult papillary meningioma; adult melanocytic lesion; recurrent adult brain tumor

Summary:

      RATIONALE: Vatalanib may stop the growth of tumor cells by blocking blood flow to the tumor
      and by blocking some of the enzymes needed for cell growth.

      PURPOSE: This phase II trial is studying how well vatalanib works in treating patients with
      recurrent or progressive meningioma.
    

Eligibility criteria:

        DISEASE CHARACTERISTICS:

          -  Histologically confirmed meningioma, including the following subtypes:

               -  Benign meningioma

               -  Malignant meningioma

                    -  Steroid dosage stable for ≥ 5 days

               -  Atypical meningiomas

               -  Hemangiopericytoma

          -  May or may not have neurofibromatosis (NF) type 1 or 2 disease

               -  Patients with a history of NF may have other stable CNS tumors, such as
                  schwannoma, acoustic neuroma, or ependymoma only if those lesions have been
                  stable for the past 6 months

          -  Progressive or recurrent disease by MRI or CT scan

               -  Prior radiotherapy allowed provided evidence of disease progression is documented
                  by positron emission tomography, thallium scanning, magnetic resonance
                  spectroscopy, or surgery to rule out radiation necrosis for patients treated with
                  radiosurgery

          -  Recent resection of recurrent or progressive tumor allowed provided both of the
             following criteria are met:

               -  At least 4 weeks since prior surgery and recovered

               -  Evaluable residual disease

        PATIENT CHARACTERISTICS:

          -  Karnofsky performance status 60-100%

          -  Life expectancy > 12 weeks

          -  Absolute neutrophil count ≥ 2,000/mm³

          -  Platelet count ≥ 100,000/mm³

          -  Hemoglobin ≥ 10 g/dL (transfusion allowed)

          -  SGOT and SGPT < 2 times upper limit of normal (ULN)

          -  Bilirubin ≤ 1.5 times ULN

          -  Creatinine < 1.5 mg/dL

          -  Negative proteinuria dipstick OR total urinary protein ≤ 500 mg AND creatinine
             clearance ≥ 50 mL/min

          -  PT, INR, and PTT ≤ 1.5 times ULN

          -  Not pregnant or nursing

          -  Negative pregnancy test

          -  Fertile patients must use effective contraception during and for up to 6 months after
             completion of study treatment

          -  No history of any other cancer except nonmelanoma skin cancer or carcinoma in situ of
             the cervix, unless in complete remission and off all therapy for that disease for ≥ 3
             years

          -  No disease that would obscure toxicity or dangerously alter drug metabolism

          -  No bleeding disorders

          -  No severe and/or uncontrolled medical conditions that would limit compliance with
             study requirements, including any of the following:

               -  Uncontrolled high blood pressure

               -  History of labile hypertension

               -  History of poor compliance with an antihypertensive regimen

               -  Unstable angina pectoris

               -  Symptomatic congestive heart failure

               -  Myocardial infarction within the past 6 months

               -  Serious uncontrolled cardiac arrhythmia

               -  Uncontrolled diabetes

               -  Active or uncontrolled infection

               -  Interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the
                  lung

               -  Impairment of gastrointestinal (GI) function or GI disease that may significantly
                  alter the absorption of vatalanib (i.e., ulcerative disease, uncontrolled nausea,
                  vomiting, or diarrhea, malabsorption syndrome, bowel obstruction, or inability to
                  swallow tablets)

               -  QTc > 450 (male) or > 470 (female)

               -  Congenital or acquired long QTc syndrome

        PRIOR CONCURRENT THERAPY:

          -  See Disease Characteristics

          -  Recovered from prior therapy

          -  At least 4 weeks since prior radiotherapy, including external-beam radiotherapy,
             interstitial brachytherapy, or gamma-knife radiosurgery

          -  At least 4 weeks since prior investigational agents

          -  More than 4 weeks since prior cytotoxic therapy (6 weeks for nitrosoureas)

          -  More than 4 weeks since prior immunotherapy

          -  More than 2 weeks since prior noncytotoxic or biologic therapies

          -  At least 2 weeks since prior drugs that affect hepatic metabolism (steroids should be
             tapered off if not clinically indicated)

          -  At least 2 weeks since prior and no concurrent enzyme-inducing anticonvulsant drugs

          -  No prior antivascular endothelial growth factor therapy

          -  No other concurrent investigational agents or anticancer therapy (including
             chemotherapy, radiotherapy, hormonal therapy, or immunotherapy)

          -  No concurrent warfarin

          -  No concurrent grapefruit or grapefruit juice