The goal of this study is to learn about a type of brain cancer called high-grade glioma. This study is for people who have previously received treatment for brain cancer, but the cancer has come back or gotten worse after treatment. The main question this study aims to answer is: is it safe for participants to take bicalutamide while receiving brain radiation treatment? Participants will: * Take bicalutamide every day for 6 months * Receive radiation treatment to the brain * Keep a diary of the when they take the bicalutamide and any side effects experienced * Visit the clinic once every 8 weeks for checkups and tests
Participants will be enrolled according to a standard cohort 3+3 dose-escalation/de-escalation study design at a starting dose of 150 mg of bicalutamide. Up to six (6) subjects will be enrolled to a given dose level until the Maximum Tolerated Dose (MTD) is reached, or until a maximum dose of 600 mg is reached. The MTD is defined as the dose below which two (2) or more of six (6) subjects experience a dose limiting toxicity (DLT). If the starting dose exceeds the MTD, the dose will be decreased until a minimum dose of 25 mg is reached. Primary Objective: 1\. To evaluate the safety when combining partial brain re-irradiation with bicalutamide. Side effects of the study drug combined with radiation therapy (RT) will be assessed per CTCAE 5.0. Secondary Objectives: 1. To estimate the rate of objective response rate (ORR) in subjects with treatment. Response Assessment in Neuro-Oncology (RANO) criteria will be used to estimate ORR. 2. To estimate the 6-month progression-free survival rate. 3. To evaluate the impact of combining bicalutamide with brain re-irradiation on quality of survival, as measured by changes to scores on the Montreal Cognitive Assessment (MoCA) and Karnofsky performance status.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Participants will receive daily oral bicalutamide for six (6) months. The dose will be determined by the cohort to which the participant is enrolled as well as the toxicities experienced by previously enrolled cohorts.
Participants will receive 35 Gy delivered in 10 fractions, administered once daily on weekdays.
University of Nebraska Medical Center
Omaha, Nebraska, United States
The incidence of adverse events (AEs) in participants receiving study treatment (combining partial brain re-irradiation with bicalutamide)
The incidence of adverse events (AEs) will be described for each dose level cohort as well as the two highest dose levels combined. Toxicities will be assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Toxicities will be graded on a scale ranging from 1 to 5, with higher numbers indicating a higher severity grade.
Time frame: Up to 26 months
The incidence of serious adverse events (SAEs) in participants receiving study treatment (combining partial brain re-irradiation with bicalutamide)
The incidence of serious adverse events (SAEs) will be described for each dose level cohort as well as the two highest dose levels combined. Toxicities will be assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Toxicities will be graded on a scale ranging from 1 to 5, with higher numbers indicating a higher severity grade.
Time frame: Up to 26 months
Rate of objective response (ORR) in participants receiving treatment
The rate of objective response (ORR) in subjects receiving treatment will be assessed using Response Assessment in Neuro-Oncology (RANO) Criteria. MRI and clinical features are used to classify response as one of four categories that range from complete response to disease progression.
Time frame: Up to 44 months
Six-month Progression-free Survival Rate
Progression-free survival (PFS) will be estimated using the Kaplan-Meier method which estimates event probability occurring at a specific time point among subject who have not already experienced that event. PFS is defined as the time from the date of consent to disease progression or death.
Time frame: Up to 26 months
The impact of study treatment on quality of survival (Montreal Cognitive Assessment)
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To evaluate the impact of combining bicalutamide with brain re-irradiation on the quality of survival, score changes on the Montreal Cognitive Assessment (MoCA) will be measured at protocol-specified time points throughout the study. Maximum score on the assessment is 30 (scores of 30 to 26 indicate no impairment, 25 to 18 mild cognitive impairment, 17 to 10 moderate cognitive impairment, less than 10 severe cognitive impairment.
Time frame: Up to 44 months
The impact of study treatment on quality of survival (Karnofsky Performance Scale)
To evaluate the impact of combining bicalutamide with brain re-irradiation on the quality of survival, scores changes on the Karnofsky Performance Scale will be measured. This scale ranges from 0 to 100: 100 indicates normal health and survival decreases with decreasing scores.
Time frame: Up to 44 months