Phase II multicentric Italian trial on repositioning of the antipsychotic drug chlorpromazine and its combination with temozolomide in patients with MGMT unmethylated glioblastoma: The RACTAC trial.

Authors

null

Giuseppe Lombardi

Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy

Giuseppe Lombardi , Marco Giorgio Paggi , Silvia Matteoni , Veronica Villani , Dario Benincasa , Claudia Abbruzzese , Giulia Cerretti , Marta Padovan , Mario Caccese , Antonio Silvani , Andrea Pace

Organizations

Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy, Cellular Networks and Molecular Therapeutic Targets, Proteomics Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy, Cellular Networks and Molecular Therapeutic Targets, Proteomics Unit, IRCCS-Regina Elena National Cancer Institute,, Rome, Italy, Neuro-Oncology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena Cancer Institute, Rome, Italy, Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy, Neurooncology Unit, IRCCS Regina Elena Cancer Institute, Rome, Italy

Research Funding

No funding received

Background: The poor prognosis of patients affected by glioblastoma (GBM) prompts the search for new and more effective therapies, particularly for GBMs with unmethylated MGMT. In this regard, drug repurposing, can represent a safe and inexpensive way to bring novel pharmacological approaches from bench to bedside. Chlorpromazine, a medication in use since six decades for the therapy of psychiatric disorders, shows in vitro features that make it eligible for repositioning in GBM therapy. In our experimentation on six GBM cell lines, chlorpromazine inhibited cell viability in an apoptosis-independent way, induced polyploidy, reduced cloning efficiency as well as neurosphere formation and downregulated the expression of stemness genes. Notably, we found that chlorpromazine synergized with temozolomide, in reducing cell viability and strongly cooperated in reducing cloning efficiency and inducing cell death in vitro for all the GBM cell lines assayed. Methods: With these assumptions, we started a multicentric single arm Phase II clinical trial on newly diagnosed GBM patients with unmethylated MGMT by adding chlorpromazine to temozolomide in the adjuvant phase of the standard first-line therapeutic protocol. The experimental procedure involves the combination of CPZ with standard treatment with TMZ in the adjuvant phase of the Stupp protocol after radiochemotherapy combination. CPZ is administered orally at a dose of 50 mg/day – GG 1-28 – of every cycle of the adjuvant treatment with TMZ. At present, 38 patients out of 41 patients planned have been enrolled. Clinical trial information: NCT04224441.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Biologic Correlates

Clinical Trial Registration Number

NCT04224441

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr TPS2073)

DOI

10.1200/JCO.2022.40.16_suppl.TPS2073

Abstract #

TPS2073

Poster Bd #

411a

Abstract Disclosures