Part 1 is an open-label, single-arm, dose escalation study of MN-166 (ibudilast) and temozolomide (TMZ) combination treatment. Evaluate safety and tolerability of ibudilast (MN-166) and TMZ combination treatment for 1 cycle (28 days); determine dosage in dose-finding study. Part 2 will evaluate efficacy of fixed-dose MN-166 (ibudilast) and TMZ combination treatment for 6 cycles (\~6 months) until disease progression, unacceptable tolerability and/or toxicity or loss of life.
This is a single-center open-label, dose-escalation study to evaluate the safety, tolerability and efficacy of MN-166 (ibudilast) and Temozolomide combination treatment in patients with newly diagnosed or recurrent glioblastoma. To be eligible, subjects are histologically confirmed glioblastoma or gliosarcoma, or astrocytomas with molecular features of glioblastoma, WHO Grade 4. Recurrent glioblastoma patients must have a Karnofsky Performance Status (KPS) ≥70 or Eastern Cooperative Oncology Group (ECOG) performance status of 0-2. Patients having newly diagnosed glioblastoma, gliosarcoma, or astrocytomas with molecular features of glioblastoma must have a KPS ≥60 and ECOG score 0-1. This is divided into a dose-escalation phase (Part 1) followed by a fixed-dose phase (Part 2). Part 1 will evaluate the safety and tolerability of MN-166 when given in combination with temozolomide, and determine the dose of MN-166 to be used in Part 2 of the study. Up to 18 adult subjects are planned to be enrolled in Part 1. Part 2 will evaluate the efficacy of MN-166 and temozolomide combination treatment as measured by the proportion of subjects who are progression-free at 6 months. Other outcome measures include the evaluation of overall survival, response rate, and median six-month progression-free survival up to 2 years and up to 50 subjects are planned to be enrolled in Part 2.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
64
MN-166 is an anti-inflammatory/neuroprotective agent. MN-166 distributes well to the CNS (Sanftner et al. 2009) and it is a selective inhibitor of certain cyclic nucleotide phosphodiesterases (PDE) and the pro-inflammatory cytokine, macrophage migration inhibitory factor (MIF). At clinically-relevant plasma or CNS concentrations, MN-166 selectively inhibits macrophage migration inhibitory factor (MIF) (Cho et al 2010) and, secondarily, PDE3, 4 and 10 (Gibson et al 2006).
Temozolomide is an oral chemotherapy drug. It is an alkylating agent used as a treatment of some brain cancers; and a first-line treatment for glioblastoma multiforme.
Dana-Farber Cancer Institute
Boston, Massachusetts, United States
Evaluate safety and tolerability of ibudilast and temozolomide combination treatment
Determine the proportion of patients with * Treatment-emergent adverse events (TEAEs) as measured by the CTCAE v4.0 and * Treatment discontinuations due to TEAEs and Dose-Limiting Toxicities (DLTs).
Time frame: 1-6 months
Evaluate efficacy of ibudilast and TMZ combination treatment
Proportion of patients who are progression free at 6 months (PFS6) using the RANO criteria.
Time frame: 1-6 months
Evaluate Tmax
Time from start of dosing at which the maximum concentration is observed)
Time frame: 1-6 months
Cmax
Maximum observed concentration)
Time frame: 1-6 months
AUC
Area under the concentration versus time curve from the start of dose administration to the last quantifiable point within the dosing interval.
Time frame: 1-6 months
Terminal rate constant
Calculated from the terminal slope of the log-linear regression of concentration with time.
Time frame: 1-6 months
Terminal half-life
Time required for the plasma concentration of a drug to decrease 50% in the final stage of its elimination
Time frame: 1-6 months
Maximum tolerated dose determination
Determine maximum tolerable dose of ibudilast taken in combination with TMZ
Time frame: 1-6 months
Evaluate the safety of fixed-dose ibudilast in combination with TMZ
Reporting of treatment-emergent adverse events * Treatment-emergent adverse events (TEAEs) as measured by the CTCAE v4.0 and * Treatment discontinuations due to TEAEs and Dose-Limiting Toxicities (DLTs).
Time frame: 1-6 months
Evaluate overall survival, response rate, and median 6-month progression-free survival (PFS6)
Overall survival will be measured for each subject with time origin at the date of Study Day 1 until recorded date or death or last follow-up visit.
Time frame: 1-6 months
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