The proposed phase I/II study of disulfiram (DSF) for patients with presumed glioblastoma multiforme (GBM) based on magnetic resonance imaging (MRI) or biopsy, including administration before surgery and during adjuvant chemoradiotherapy. Patients will be treated with 3 days of preoperative DSF/copper (Cu) prior to their surgery (or biopsy), which will be followed by collection of tumor samples during surgery for analysis of drug uptake. After the surgery, patients will receive standard radiation therapy (RT) and temozolomide (TMZ) with the addition of concurrent DSF/Cu.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
35
Washington University School of Medicine
St Louis, Missouri, United States
Maximum Tolerated Dose (MTD) of DSF (Dose-escalation Phase Only)
* The maximum tolerated dose (MTD) of DSF is defined as the dose level at which 20% of the cohort experience dose-limiting toxicity (DLT) within 18 weeks from start of RT (or 12 weeks from the end of RT if there is a delay in RT). MTD is assessed from the first dose of DSF in combination with TMZ and RT; patients will not be assessed for DLT during the pre-surgery period when they are receiving the lead-in doses of DSF. * A DLT is defined as a clinically significant adverse event or abnormal laboratory value assessed as unrelated to disease progression, intercurrent illness, or concomitant medications/TMZ which occurs within 18 weeks following the first dose of DSF with RT+TMZ (corresponding to approximately 6 weeks during RT and 12 weeks after RT)
Time frame: Estimated to be 2 years and 28 weeks
Kaplan-Meier Estimate of Overall Survival (Dose-expansion Phase Only)
Time frame: 1 year
Kaplan-Meier Estimate of Overall Survival (Dose-expansion Phase Only)
Time frame: 2 years
Kaplan-Meier Estimate of Overall Survival (Dose-expansion Phase Only)
Time frame: 3 years
Mean Overall Survival (Dose-expansion Phase Only)
Time frame: Through completion of follow-up (up to 5 years)
Toxicity of DSF When Given Concurrently With Radiation Therapy and Temozolomide as Measured by the Grade and Frequency of Grade 2 or Greater Adverse Events Related to DSF
The descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 will be utilized for all toxicity reporting.
Time frame: Through completion of DSF treatment (up to 38 weeks)
Intratumor and Plasma Concentration of DSF Metabolite (Ditiocarb-copper Complex)
Will be determined using mass spectrometer
Time frame: At the time of surgery (day 4)
Mean Progression-free Survival (PFS)
Will be determined from the first day of RT to the time of tumor progression or death, whichever occurs first. Tumor progression will be determined using the RANO criteria.
Time frame: Through completion of follow-up (up to 5 years)
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