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Safety and Efficacy Study in Recurrent or Progressive Grade III or IV IDH1 Mutated Glioma

Study Purpose

This multi-site, Phase 1/2a clinical trial is an open label study to identify the safety, pharmacokinetics, and efficacy of a repeated dose regimen of NEO100 (perillyl alcohol) for the treatment of patients with radiographically-confirmed progression of Grade IV glioma or recurrent primary or secondary Grade IV glioma or patients with progressed or recurrent Grade III glioma. The study will have two phases, Phase 1 and Phase 2a. Phase 1 is a standard cohort dose escalation 3+3 design used to determine the maximum tolerated dose (MTD) for Phase 2a. Fifteen (15) patients were enrolled into the Phase I portion of the clinical trial. The MTD for NEO100 was not reached in humans. As a result the NEO100 dose for Cohort 4 (288 mg/dose

  • - 1152 mg/day) was carried into the Phase 2a portion of the clinical trial.
Four
  • (4) patients were enrolled into this study prior to implementation of implementation of version 10 of the clinical trial restricting the Phase 2a population to patients with progressive or recurrent primary or secondary Grade IV gliomas expressing IDH1 mutations or progressive or recurrent primary or secondary Grade IV gliomas expressing IDH1 mutations.
None of the four
  • (4) patients expressed IDH1 mutations.
There will be 28 patients with progressive or recurrent primary or secondary Grade IV gliomas expressing IDH1 mutations or progressive or recurrent primary or secondary Grade IV gliomas expressing IDH1 mutations enrolled in Phase 2a of the clinical trial. Prior to implementing v10 of this protocol, four
  • (4) patients were enrolled.
These patients met the inclusion/exclusion criteria for v9 of the protocol and had wild type IDH1 status. For both phases of the study, NEO100 will be self-administered four times daily for a 28-day treatment cycle up to six treatment cycles until disease progression or death, whichever occurs first. At the completion of cycle six, patients will be given the option to continue receiving compassionate use treatment cycles.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Have radiographically-confirmed progression of, or recurrent, primary or secondary Grade IV glioma, including infratentorial (brainstem, cerebellar) glioma (confirmed by biopsy) and subcortical glioma.
; or.
  • - Have radiographically-confirmed progression of, recurrent, primary or secondary Grade III astrocytoma.
  • - All patients must be on a stable or decreasing dose of steroids for at least five days prior to the date of informed consent.
  • - Must have failed previous radiation treatment or combined treatment with temozolomide and radiation.
  • - If progression of disease occurs within three months of conformal radiation, it must be outside of the radiation field or proven by biopsy/resection.
  • - Must have an ECOG performance status of 0 - 2, or KPS ≥ 60.
  • - Must have an expected survival of at least three months.
  • - Must be willing to provide blood samples for pharmacokinetic study.
  • - Must have adequate organ and marrow function.
  • - Female patients of child-bearing potential and male patients must agree to use adequate contraception.
  • - Must have the ability to understand, and the willingness to sign, a written informed consent.
  • - Phase 2a: Patient must have a confirmed IDH1 mutation reverse transcription polymerase chain reaction (rtPCR) or immunohistochemistry (unless continuing into the Phase 2a portion of the study from the Phase I portion of the study).

Exclusion Criteria:

  • - The size of the tumor is multi-focal and > 30mm in size, as assessed at the baseline (pre-study) MRI evaluation.
  • - Patient has completed chemo-radiation within the last three months, unless new contrast enhancement is outside of radiation field, or there is tissue proven recurrence or progression.
  • - Patient has had surgery within seven days prior to the date of informed consent.
  • - Patient has had chemotherapy within 28 days prior to first administration of study drug.
  • - Patient has not recovered from adverse events due to chemotherapy, immunotherapy, or radiation therapy administered more than 28 days prior to first administration of study drug.
  • - Patient has had prior treatment with bevacizumab, a chemotherapy wafer implant (Gliadel), or any other FDA- approved chemotherapy except temozolomide.
  • - Patient has had more than one recurrence or progression of their tumors.
  • - Patient is receiving any other investigational agents.
  • - Patient has a history of allergic reactions attributed to perillyl alcohol.
  • - Patient has uncontrolled intercurrent illness.
  • - Patient has a history of new diagnosis or treatment of cancer other than malignant glioma within five years prior to start of the study, except for basal cell carcinoma or squamous cell carcinoma.

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT02704858
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 1/Phase 2
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Neonc Technologies, Inc.
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Tom Chen, MD, PhDVincent F Simmon, PhDPatrick Walters
Principal Investigator Affiliation NeOnc TechnologiesNeOnc TechnologiesNeOnc Technologies
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Industry
Overall Status Recruiting
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Glioblastoma Multiforme
Additional Details

Perillyl alcohol has previously been tested in 15 clinical studies in > 600 subjects This includes 13 studies in 255 subjects using oral administration sponsored by the National Cancer Institute and two studies in > 350 subjects using intranasal administration in Brazil. NEO100 is a highly purified (>99%) form of perillyl alcohol. Studies in Brazil suggest improved survival for patients with recurrent glioblastoma. Doses of 96 mg qid, 144mg qid, 192mg qid, and 288 mg qid administered intranasally to patients with recurrent GBM for up to 6 months, disease progression or death. From 3 to 6 patients will be evaluated after first cycle (28 days) until MTD is reached. MRI with gadolinium will be at base line, and at the beginning of even cycles. A total of 25 patients will be treated at the MTD. PK studies will be conducted during Phase 1 at first dosing, and after first dose of 3rd cycle.

Arms & Interventions

Arms

Experimental: NEO100 Phase 1

Intranasal delivery of NEO100 (perillyl alcohol) four times a day, escalation up to four different doses to determine maximum tolerated dose.

Experimental: NEO100 Phase 2A

Intranasal delivery of NEO100 (perillyl alcohol) four times a day. Treatment of total of 25 patients at maximum tolerated dose.

Interventions

Drug: - Perillyl alcohol

Intranasal administration

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

University of Southern California, Los Angeles, California

Status

Recruiting

Address

University of Southern California

Los Angeles, California, 90033

Site Contact

Aida Lozada, MA

[email protected]

323-865-3980

Ochsner Health, New Orleans, Louisiana

Status

Recruiting

Address

Ochsner Health

New Orleans, Louisiana,

Site Contact

Jennifer Flowers

[email protected]

224-218-2408

Northwell Health, New York, New York

Status

Recruiting

Address

Northwell Health

New York, New York,

Wake Forest University Health Sciences, Winston-Salem, North Carolina

Status

Recruiting

Address

Wake Forest University Health Sciences

Winston-Salem, North Carolina, 27157

Site Contact

Diann Mendenhall

[email protected]

224-218-2408

Cleveland Clinic, Cleveland, Ohio

Status

Recruiting

Address

Cleveland Clinic

Cleveland, Ohio, 44333

Site Contact

Teresa Allison

[email protected]

216-444-6459

Baylor Scott & White Health, Dallas, Texas

Status

Not yet recruiting

Address

Baylor Scott & White Health

Dallas, Texas,