This is a multi-centered, radiation dose escalation, open, exploratory, Phase 1/2a clinical trial on the safety, efficacy and pharmacokinetic characteristics of BNCT in patients with recurrent high-grade gliomas. The Phase I clinical study is to explore the adequate radiation dose level of BNCT based on confirmation of the maximum tolerated dose (radiation dose) of BNCT in patients with recurrent high-grade gliomas and characterize the safety, efficacy and pharmacokinetics. To evaluate the primary objective of tolerability, subject population with history of exposure to a similar treatment recurrent high-grade glioma who received prior standard radiotherapy will be recruited. The Phase IIa is to confirm the efficacy and safety after irradiation of radiation dose confirmed in the Phase I clinical study. To evaluate the primary objective of efficacy, subject population with glioblastoma (The 2021 WHO Classification of Tumors of the Central Nervous System, Glioblastoma IDH-wild type, WHO Grade 4) will be recruited.
The subject receives the study drug administration and neutron irradiation in the BNCT clinic with all procedures performed under the control by the investigator affiliated to the study site. 500 mg/kg of the study drug is intravenously administered over 3 hours at a constant rate and neutron irradiation starts at 1 hour after the end of the study drug administration according to the previously established neutron irradiation plan. All patients will be evaluated for response using magnetic resonance imaging (MRI) using RANO and modified RANO criteria.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
7
Patients will be infused DMX-101 intravenously at a dose of 500mg/kg/hr over 3 hours. Thereafter, patient will receive neutron irradiation simultaneously for a certain period of time based on his Boronophenylalanine (BPA) concentration in the blood.
Patients will be infused DMX-101 intravenously at a dose of 500mg/kg/hr over 3 hours. Thereafter, patient will receive neutron irradiation simultaneously for a certain period of time based on his Boronophenylalanine (BPA) concentration in the blood.
Patients will be infused DMX-101 intravenously at a dose of 500mg/kg/hr over 3 hours. Thereafter, patient will receive neutron irradiation simultaneously for a certain period of time based on his Boronophenylalanine (BPA) concentration in the blood.
Gachon University Gil Medical Center
Incheon, South Korea
Phase I: To explore the adequate radiation dose level of BNCT based on confirmation of the maximum tolerated dose of BNCT
To explore the adequate radiation dose level of BNCT based on confirmation of the maximum tolerated dose (radiation dose) of BNCT in patients with recurrent high-grade gliomas
Time frame: During 90 days post-BNCT
Phase IIa: Proportion of 6-month PFS evaluated by central imaging according to the modified RANO criteria
Percentage of patients that are free from progressive disease for 6 months per modified RANO criteria
Time frame: 6 months
Proportion of 6-month PFS evaluated by central imaging according to the RANO criteria
Percentage of patients that are free from progressive disease for 6 months per RANO criteria
Time frame: Up to 6 months
Proportion of 6-month PFS evaluated by the investigator according to the modified RANO criteria
Percentage of patients that are free from progressive disease for 6 months per modified RANO criteria
Time frame: Up to 6 months
Median PFS evaluated by central imaging according to the modified RANO criteria
Median duration of progression free survival according to modified RANO criteria
Time frame: Up to 6 months
Median PFS evaluated by central imaging according to the RANO criteria
Median duration of progression free survival according to RANO criteria
Time frame: Up to 6 months
Median PFS evaluated by the investigator according to the modified RANO criteria
Median duration of progression free survival according to modified RANO criteria
Time frame: Up to 6 months
ORR evaluated by central imaging according to the modified RANO criteria
ORR will be defined as the percentage of patients with complete response (CR) or partial response (PR) according to the modified RANO criteria.
Time frame: Up to 6 months
ORR evaluated by central imaging according to the RANO criteria
ORR will be defined as the percentage of patients with complete response (CR) or partial response (PR) according to the RANO criteria.
Time frame: Up to 6 months
ORR evaluated by the investigator according to the modified RANO criteria
ORR will be defined as the percentage of patients with complete response (CR) or partial response (PR) according to the modified RANO criteria.
Time frame: Up to 6 months
Median OS
Median duration of overall survival for patients that are alive
Time frame: Up to 2 years
Proportion of 1-year OS
Percentage of patients that are alive for 1 year
Time frame: Up to 2 years
Pharmacokinetic parameters(AUClast) of borono-phenylalanine in subjects with recurrent high-grade glioma
The analysis is conducted using the Noncompartmental Analysis Method, and the results are summarized for each group in terms of descriptive statistics including the mean, standard deviation, minimum, median, and maximum values.
Time frame: Based on whole blood sample up to 48 hours after the end of infusion
Pharmacokinetic parameters(AUCinf) of borono-phenylalanine in subjects with recurrent high-grade glioma
The analysis is conducted using the Noncompartmental Analysis Method, and the results are summarized for each group in terms of descriptive statistics including the mean, standard deviation, minimum, median, and maximum values.
Time frame: Based on whole blood sample up to 48 hours after the end of infusion
Pharmacokinetic parameters(Cmax) of borono-phenylalanine in subjects with recurrent high-grade glioma
The analysis is conducted using the Noncompartmental Analysis Method, and the results are summarized for each group in terms of descriptive statistics including the mean, standard deviation, minimum, median, and maximum values.
Time frame: Based on whole blood sample up to 48 hours after the end of infusion
Pharmacokinetic parameters(Tmax) of borono-phenylalanine in subjects with recurrent high-grade glioma
The analysis is conducted using the Noncompartmental Analysis Method, and the results are summarized for each group in terms of descriptive statistics including the mean, standard deviation, minimum, median, and maximum values.
Time frame: sampling up to 48 hours after the end of infusion
Pharmacokinetic parameters(CL) of borono-phenylalanine in subjects with recurrent high-grade glioma
The analysis is conducted using the Noncompartmental Analysis Method, and the results are summarized for each group in terms of descriptive statistics including the mean, standard deviation, minimum, median, and maximum values.
Time frame: Based on whole blood sample up to 48 hours after the end of infusion
Pharmacokinetic parameters(Vz) of borono-phenylalanine in subjects with recurrent high-grade glioma
The analysis is conducted using the Noncompartmental Analysis Method, and the results are summarized for each group in terms of descriptive statistics including the mean, standard deviation, minimum, median, and maximum values.
Time frame: Based on whole blood sample up to 48 hours after the end of infusion
Pharmacokinetic parameters(Vss) of borono-phenylalanine in subjects with recurrent high-grade glioma
The analysis is conducted using the Noncompartmental Analysis Method, and the results are summarized for each group in terms of descriptive statistics including the mean, standard deviation, minimum, median, and maximum values.
Time frame: Based on whole blood sample up to 48 hours after the end of infusion
Pharmacokinetic parameters(t1/2β) of borono-phenylalanine in subjects with recurrent high-grade glioma
The analysis is conducted using the Noncompartmental Analysis Method, and the results are summarized for each group in terms of descriptive statistics including the mean, standard deviation, minimum, median, and maximum values.
Time frame: Based on whole blood sample up to 48 hours after the end of infusion
Pharmacokinetic parameters(MRT) of borono-phenylalanine in subjects with recurrent high-grade glioma
The analysis is conducted using the Noncompartmental Analysis Method, and the results are summarized for each group in terms of descriptive statistics including the mean, standard deviation, minimum, median, and maximum values.
Time frame: Based on whole blood sample up to 48 hours after the end of infusion
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