Glioblastomas are extremely resistant to treatment, including radiotherapy and/or chemotherapy. Mitogen-activated protein kinase (MAPK) cascades are key signaling pathways involved in the regulation of normal cell proliferation, survival and differentiation. Activation of p38 MAPK has been associated with a poor prognosis among patients with glioblastoma during the temozolomide (TMZ) era and represents a compensatory response by tumor cell to environmental stress such as radiation or chemotherapy. LY2228820 is a potent and selective inhibitor of p38 MAPK, and reduces phosphorylation of its cellular target, MAPK-activated protein kinase 2 (MAPKAPK-2) . LY2228820 is a good candidate to target malignant glioma resistance to the gold standard treatment combining radiation and TMZ by acting on both tumor and stromal cells. The primary objectives of this study were to determine the recommended dose of LY2228820 in combination with TMZ and radiotherapy during chemoradiotherapy period (phase I) and to estimate the 6-month progression free survival (PFS) rate of patients treated with LY2228820 when administered at the recommended dose in combination with radiotherapy and concomitant TMZ (phase II)
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
CHU Amiens Sud-Salouel
Amiens, France
Institut Bergonié
Bordeaux, France
Centre François Baclesse
Caen, France
Centre Jean Perrin
Clermont-Ferrand, France
Centre Georges François Leclerc
Dijon, France
Centre Paul Strauss
Strasbourg, France
maximum tolerated dose (MTD) (phase I) of LY2228820 in combination with TMZ and radiotherapy during chemoradiotherapy period
defined as the highest dose tested in which a dose limiting toxicity (DLT) is experienced by no more than 33% of patients during chemoradiotherapy period.
Time frame: from D1 Week 0 (first dose of LY2228820) to D63 Week 8.
6-month Progression Free Survival (PFS) rate (phase II) defined as the rate of patients who not presented a progression at 6 months from the first dose of LY2228820
Time frame: 6 months from the first dose of LY2228820
Safety profile according to NCI Common Toxicity Criteria for Adverse Effect (CTCAE) criteria version 4.03.
Time frame: from baseline to 30 days after treatment (concomitant and adjuvant treatment) (week 35)
PFS
disease progression assessed per Response Assessment in Neuro-Oncology (RANO) criteria
Time frame: from the first dose of LY2228820 to disease progression or death for any reason, up to 24 months
Overall Survival
Time frame: from the first dose of LY2228820 to death, up to 24 months
12-month PFS rate defined as the rate of patients who not presented a progression at 12 months from the first dose of LY2228820
Time frame: 12 months from the first dose of LY2228820
Objective response rate according to RANO criteria for patients with incomplete resection or only biopsy
Time frame: from the first dose of LY2228820 to treatment completion
The neurologic status evaluated by clinical assessment and Mini-Mental State Examination (MMSE) and evaluation of corticosteroid dosage
Time frame: from baseline to progression, up to 24 months
Pharmacokinetic of LY2228820 and TMZ (AUC0-12h)
Time frame: D7 Week 0, D28 Week 3, D35 Week 4
MAPKAPK-2 activation
in tumor and stromal cells and Peripheral Blood Mononucleated Cells (PBMCs)
Time frame: baseline (tumor) D1 D7 week 0, D28 Week 3, D35 Week 4 (PBMCs)
Validated biomarker of glioblastoma (MGMT, IDH1 (isocitrate dehydrogenase 1), pTEN (phosphatase and tensin homolog), p53)
on tumor
Time frame: baseline
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