cropped color_logo_with_background.png

Solriamfetol in Improving Sleep in Patients With Grade II-IV Glioma

Study Purpose

This phase II trial studies the side effects of solriamfetol in improving sleep in patients with grade II-IV glioma. Solriamfetol is a wakefulness-promoting drug. Giving solriamfetol may improve sleep, memory, fatigue, mood, or quality of life in patients with brain tumors (gliomas).

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:

WHO Grade 2-4 infiltrating glioma by histologic confirmation.
  • - Where appropriate results from clinically available testing of isocitrate dehydrogenase (IDH) gene mutation status (for all gliomas), chromosome 1p and 19q deletion status (for suspected oligodendrogliomas), and MGMT gene promoter methylation status (for malignant gliomas) must be available in the patient's chart.
  • - These studies are standard of care molecular studies that are performed as a part of routine clinical practice and allow for integrated molecular subtyping of primary glial tumors.
Epworth Sleepiness Scale (ESS) score >10 within 21 days of enrollment. Clinical and/or radiographic evidence of stable disease within 21 days of enrollment.
  • - Patients must have completed concurrent chemoradiation with recovery of all pre-existing toxicity to CTCAE Grade >1.
  • - Patient who are anticipated to undergo surgery and/or radiation therapy for management of their tumor during the duration of study treatment are NOT eligible.
  • - Patients who are anticipated to undergo adjuvant chemotherapy are eligible as long as there is no evidence of tumor progression by clinical exam and/or imaging within 21 days of enrollment (see 4.1.
2). This determination should be made by clinical documentation and if there is question discussed with the Study Chair. Adjuvant chemotherapy is not an exclusion.
  • - Patients who are currently undergoing chemotherapy, targeted therapy, immunotherapy, or salvage treatment and have stable disease by imaging are eligible and can continue the current anti-cancer therapy.
Patients who will require a new anti-cancer treatment or are anticipated to change anti-cancer treatments are not eligible. Age > 18 years. Karnofsky performance status ≥ 60% Life expectancy of greater than 4 months. Patients must have normal organ and marrow function as defined below: leukocytes >3,000/mcL absolute neutrophil count >1,500/mcL platelets >100,000/mcL total bilirubin 1.5 X institutional upper limits of normal AST(SGOT)/ALT(SGPT) <2.5 X institutional upper limit of normal creatinine within normal institutional limits OR creatinine clearance >50 mL/min/1.73 m2 for patients with creatinine levels above institutional normal.
  • - The effects of solriamfetol on the developing human fetus are unknown.
For this reason women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
  • - Ability to understand and the willingness to sign an IRB-approved informed consent document (either directly or via a legally authorized representative)

    Exclusion Criteria:

    - Receiving active radiation therapy (including patients who are within 28 days of completing radiation therapy) - Anticipated to undergo radiation therapy or require neurosurgical intervention during the period of active treatment(i.e. within the next 4 months) - Contraindication to solriamfetol based on drug-drug interactions or concurrent systemic illness that precludes drug treatment.
  • - Patients who have not recovered to < CTCAE grade 2 toxicities related to prior or current therapy are ineligible.
  • - Exception for laboratory-based or other adverse event that is stable and not anticipated to interfere with study related treatment must be reviewed and approved by the study chair.
  • - Customary bedtime later than midnight.
  • - Known and/or documented history of obstructive sleep apnea (OSA) - Uncontrolled behavioral or psychiatric disorder (including suicidal ideation) - Current excessive caffeine use (> 600 mg/day or > 6 cups of coffee/day) - Current or prior history of alcohol or drug abuse within the last 2 years as assessed by the treating clinician.
  • - Nicotine dependence that is currently interfering with sleep based on assessment by the treating clinician.
  • - Concurrent use of selective serotonin or norepinephrine reuptake inhibitors (e.g. selective serotonin reuptake inhibitor [SSRI], serotonin and norepinephrine reuptake inhibitors [SNRI]) within 14 days of study enrollment.
  • - Patients who are currently taking these agents may be tapered at the direction of the treating physician prior to study enrollment.
  • - Patients taking other medications such as narcotics, benzodiazepines, antipsychotics, antiepileptics, corticosteroids, or over-the-counter sleep aids can be enrolled.
It is recommended that the doses of these medications remain the same throughout the portion of active study treatment unless there is a medical indication for dose adjustment which will be determined by the treating physician.
  • - History of allergic reactions attributed to compounds of similar chemical or biologic composition to solriamfetol.
  • - Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
- Pregnant women are excluded from this study because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with solriamfetol, breastfeeding should be discontinued if the mother is treated with solriamfetol

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.

NCT03868943
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 2
Lead Sponsor

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

Wake Forest University Health Sciences
Principal Investigator

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

Roy Strowd, MD
Principal Investigator Affiliation Wake Forest University Health Sciences
Agency Class

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

Other, NIH
Overall Status Suspended
Countries United States
Conditions

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

Glioma, Glioblastoma
Additional Details

Primary Objective:

  • I. To estimate the safety of solriamfetol at 75 mg daily, 150 mg daily, 300 mg daily as assessed by NCI CTC Adverse Events (v5.0) in patients with primary gliomas compared to prior studies.
Secondary Objective(s):
  • I. To estimate the effect of solriamfetol on sleep by Epworth Sleepiness Scores (ESS) scores in patients with primary gliomas and compare the effect to previously published scores in patients with OSA.
  • II. To estimate the effect of solriamfetol on sleep quality by Pittsburgh Sleep Quality Index scores.
  • III. To estimate the effect of solriamfetol on neurocognitive function based on a disease-specific neurocognitive battery (see neurocognitive battery below) IV.
To estimate the effect of solriamfetol on patient-reported fatigue (Brief Fatigue Inventory, Cancer Fatigue Scale) & mood (Beck's Depression Inventory)
  • V. To estimate the effect of solriamfetol on patient-reported QOL (FACT-Br) VI.
To estimate the effect of solriamfetol on objective sleep-wake times by actigraphy and sleep diary (pre- vs.#46;post-treatment) Exploratory Objective(s)
  • I. To explore a biologic gradient effect of increasing doses of solriamfetol on actigraphy.
  • II. To explore differences in clinical activity of solriamfetol by corticosteroid use, antiepileptic use, and tumor grade.
OUTLINE: This is a dose-escalation study. Patients receive solriamfetol orally (PO) once daily (QD) for up to 6 weeks in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 30 days.

Arms & Interventions

Arms

Experimental: Solriamfetol

Given orally daily

Interventions

Drug: - Soliramfetol

Solriamfetol will be dosed by flexible dose titration starting at 75 mg daily in all patients and escalating after 7 days (1 week) to 150 mg daily and then after 7 days to 300 mg daily for a total duration of 3 weeks (flexible dose titration period).

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.

Winston-Salem, North Carolina

Status

Address

Wake Forest Baptist Comprehensive Cancer Center

Winston-Salem, North Carolina, 27157