CeCil: A randomized, noncomparative phase II clinical trial of the effect of radiation therapy (RT) plus temozolomide (TMZ) combined with cilengitide or cetuximab on the 1-year overall survival of patients with newly diagnosed MGMT-promoter unmethylated glioblastoma.

Authors

null

V. Verschaeve

GHDC, Charleroi, Belgium

V. Verschaeve , L. A. D'Hondt , L. M. J. Verbeke , F. Van Fraeyenhove , S. Du Four , J. Duerinck , B. Neyns

Organizations

GHDC, Charleroi, Belgium, Cliniques Universitaires UCL de Mont-Godinne, Namur, Belgium, OLV Hospital Aalst, Aalst, Belgium, ZNA Middelheim, Antwerp, Belgium, UZ Brussel, Brussels, Belgium

Research Funding

Pharmaceutical/Biotech Company

Background: The overall survival (OS) of newly diagnosed glioblastoma (GB) patients (pts) treated with RT and TMZ is correlated with the methylation status of the MGMT-promoter. Pts with an unmethylated MGMT-promoter in particular have a poor prognosis and are in need of new active treatment options. Cilengitide, a selective αvβ3/5 integrin inhibitor, and cetuximab, a monoclonal EGFR-targeted antibody, have demonstrated anti-tumor activity against GB and can be safely combined with RT and TMZ. Methods: CeCil is an academia sponsored, multi-center, randomized phase II clinical trial of postoperative RT with daily concomitant TMZ (75 mg/m²/day) followed by 6 adjuvant cycles of TMZ (75-100 mg/m²/d x21d q 28d). Pts are randomized (1:1) to additional treatment with either cilengitide 2000 mg 2x weekly i.v., or cetuximab 1x weekly i.v. (400 mg/m² for the 1st administration and 250mg/m² for subsequent administrations). Cilengitide and cetuximab administration is started 1 week prior to RT/TMZ and is continued for up to 52 consecutive weeks in non-progressive pts. The 1-year OS-rate is the primary endpoint. Secondary endpoints include the PFS, and safety. Eligibility criteria include histologically confirmed, newly diagnosed GB without a methylated MGMT promoter (pts with an “unmethylated” or “invalid” test result are eligible), age ≥ 18 year, performance status of 0-1, and prior tumor resection or open biopsy. Recruitment is a 2-step process: after informed consent, histopathological diagnosis of glioblastoma and MGMT–promoter methylation status are centrally determined; GB-confirmed patients with an “unmethylated” or “invalid” test result are randomized (stratification by RPA classes: III vs. IV-V) between the two treatment arms. According to a one-stage Fleming design (a: 0.05; b: 0.05), with P0=60% and P1=80%, 54 pts will be recruited per study-arm. At least 39 pts must be alive at 12 months to validate the predefined hypothesis of activity. Accrual is ongoing in 7 medical centers in Belgium. ClinicalTrials.gov identifier: NCT01044225.

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Abstract Details

Meeting

2011 ASCO Annual Meeting

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session

Track

Special Sessions,Clinical Trials

Sub Track

Central Nervous System Tumors

Clinical Trial Registration Number

NCT01044225

Citation

J Clin Oncol 29: 2011 (suppl; abstr TPS134)

Abstract #

TPS134

Poster Bd #

40D

Abstract Disclosures