Trial Outcomes & Findings for Thalidomide and Temozolomide in Relapsed or Progressive CNS Disease or Neuroblastoma (NCT NCT00098865)

NCT ID: NCT00098865

Last Updated: 2014-10-07

Results Overview

Feasibility in this study was defined as completion of 6 months of thalidomide with temozolomide therapy. The corresponding therapy completion rate is defined as the proportion of patients who completed 6 months of therapy.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

15 participants

Primary outcome timeframe

6 months

Results posted on

2014-10-07

Participant Flow

15 patients were enrolled between 2002 to 2007 at the Dana-Farber Cancer Institute.

For pediatric patients with relapsed or progressive brain tumors and neuroblastoma.

Participant milestones

Participant milestones
Measure
Thalidomide and Temozolomide
Thalidomide: Oral thalidomide on days 1-28 of a 28 day cycle initiated at 3 mg/kg and increased to maximum dose of 24 mg/kg or 1000 mg as tolerated. Temozolomide: Oral temozolomide on days 1-5 of 28 day cycle given at 200 mg/m2 or 150 mg/m2 for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal radiation. Patients were treated for 6 cycles unless disease progression or excessive toxicity. Treatment could continue beyond 6 cycles if absent disease progression
Overall Study
STARTED
15
Overall Study
COMPLETED
6
Overall Study
NOT COMPLETED
9

Reasons for withdrawal

Reasons for withdrawal
Measure
Thalidomide and Temozolomide
Thalidomide: Oral thalidomide on days 1-28 of a 28 day cycle initiated at 3 mg/kg and increased to maximum dose of 24 mg/kg or 1000 mg as tolerated. Temozolomide: Oral temozolomide on days 1-5 of 28 day cycle given at 200 mg/m2 or 150 mg/m2 for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal radiation. Patients were treated for 6 cycles unless disease progression or excessive toxicity. Treatment could continue beyond 6 cycles if absent disease progression
Overall Study
Progressive Disease
6
Overall Study
Adverse Event
2
Overall Study
Alternative Therapy
1

Baseline Characteristics

Thalidomide and Temozolomide in Relapsed or Progressive CNS Disease or Neuroblastoma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Thalidomide and Temozolomide
n=15 Participants
Thalidomide: Oral thalidomide on days 1-28 of a 28 day cycle initiated at 3 mg/kg and increased to maximum dose of 24 mg/kg or 1000 mg as tolerated. Temozolomide: Oral temozolomide on days 1-5 of 28 day cycle given at 200 mg/m2 or 150 mg/m2 for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal radiation. Patients were treated for 6 cycles unless disease progression or excessive toxicity. Treatment could continue beyond 6 cycles if absent disease progression.
Age, Categorical
<=18 years
14 Participants
n=39 Participants
Age, Categorical
Between 18 and 65 years
1 Participants
n=39 Participants
Age, Categorical
>=65 years
0 Participants
n=39 Participants
Sex: Female, Male
Female
9 Participants
n=39 Participants
Sex: Female, Male
Male
6 Participants
n=39 Participants
Region of Enrollment
United States
15 participants
n=39 Participants
Disease Type
Brain Tumor
8 participants
n=39 Participants
Disease Type
Neuroblastoma
7 participants
n=39 Participants

PRIMARY outcome

Timeframe: 6 months

Population: The analysis dataset is comprised of all treated patients.

Feasibility in this study was defined as completion of 6 months of thalidomide with temozolomide therapy. The corresponding therapy completion rate is defined as the proportion of patients who completed 6 months of therapy.

Outcome measures

Outcome measures
Measure
Thalidomide and Temozolomide
n=15 Participants
Thalidomide: Oral thalidomide on days 1-28 of a 28 day cycle initiated at 3 mg/kg and increased to maximum dose of 24 mg/kg or 1000 mg as tolerated. Temozolomide: Oral temozolomide on days 1-5 of 28 day cycle given at 200 mg/m2 or 150 mg/m2 for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal radiation. Patients were treated for 6 cycles unless disease progression or excessive toxicity. Treatment could continue beyond 6 cycles if absent disease progression temozolomide: The lower 150/m2 Temozolomide dose was for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal raditation. thalidomide: Calculated dose was rounded down to the nearest 50mg, or up to 50mg if calculated dose was less than 50mg. Patients increased the daily dose by 50mg (one capsule) on a weekly basis unitl either unacceptable toxicity or a maximum dose.
Therapy Completion Rate
.40 proportion of participants
Interval 0.19 to 0.64

SECONDARY outcome

Timeframe: Assessed every 8 weeks while on treatment and every 3 months for one year off-study

Overall response is the best response during 6 months of therapy measured by radiographic response. Complete Response (CR): Disappearance of all detectable tumors by imaging, if initially positive, as well as 2 consecutively negative CSF cytologic examinations (if the initial cytology was positive). Partial Response (PR): \> 50% reduction in the sum of the products of the maximum perpendicular diameter of all measurable lesions; or 2 consecutively negative CSF cytologies and a \< 50% reduction in tumor size. Stable Disease (SD): \< 50% reduction in the sum of the products of the maximum perpendicular diameters of all measurable lesions, and persistently negative or positive CSF cytology Progressive Disease (PD): \> 25% increase in the size of any measurable lesion, the appearance of a new radiographically demonstrable lesion, or the conversion of negative CSF cytology to positive, as confirmed by at least one repeat CSF cytology

Outcome measures

Outcome measures
Measure
Thalidomide and Temozolomide
n=15 Participants
Thalidomide: Oral thalidomide on days 1-28 of a 28 day cycle initiated at 3 mg/kg and increased to maximum dose of 24 mg/kg or 1000 mg as tolerated. Temozolomide: Oral temozolomide on days 1-5 of 28 day cycle given at 200 mg/m2 or 150 mg/m2 for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal radiation. Patients were treated for 6 cycles unless disease progression or excessive toxicity. Treatment could continue beyond 6 cycles if absent disease progression temozolomide: The lower 150/m2 Temozolomide dose was for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal raditation. thalidomide: Calculated dose was rounded down to the nearest 50mg, or up to 50mg if calculated dose was less than 50mg. Patients increased the daily dose by 50mg (one capsule) on a weekly basis unitl either unacceptable toxicity or a maximum dose.
Overall Response
Partial Response
1 participants
Overall Response
Stable Disease
9 participants
Overall Response
Progressive Disease
4 participants
Overall Response
Unevaluable
1 participants

SECONDARY outcome

Timeframe: Assessed after treatment discontinued every 3 months up to 2 years.

Population: The analysis dataset is comprised of all treated patients.

Time from registration to death. Patients alive at last follow-up were censored.

Outcome measures

Outcome measures
Measure
Thalidomide and Temozolomide
n=15 Participants
Thalidomide: Oral thalidomide on days 1-28 of a 28 day cycle initiated at 3 mg/kg and increased to maximum dose of 24 mg/kg or 1000 mg as tolerated. Temozolomide: Oral temozolomide on days 1-5 of 28 day cycle given at 200 mg/m2 or 150 mg/m2 for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal radiation. Patients were treated for 6 cycles unless disease progression or excessive toxicity. Treatment could continue beyond 6 cycles if absent disease progression temozolomide: The lower 150/m2 Temozolomide dose was for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal raditation. thalidomide: Calculated dose was rounded down to the nearest 50mg, or up to 50mg if calculated dose was less than 50mg. Patients increased the daily dose by 50mg (one capsule) on a weekly basis unitl either unacceptable toxicity or a maximum dose.
Overall Survival
12.8 months
Interval 6.7 to 41.2

Adverse Events

Thalidomide and Temzolomide

Serious events: 9 serious events
Other events: 14 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Thalidomide and Temzolomide
n=15 participants at risk
Thalidomide: Oral thalidomide on days 1-28 of a 28 day cycle initiated at 3 mg/kg and increased to maximum dose of 24 mg/kg or 1000 mg as tolerated. Temozolomide: Oral temozolomide on days 1-5 of 28 day cycle given at 200 mg/m2 or 150 mg/m2 for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal radiation. Patients were treated for 6 cycles unless disease progression or excessive toxicity. Treatment could continue beyond 6 cycles if absent disease progression.
Blood and lymphatic system disorders
Hemoglobin
13.3%
2/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Blood and lymphatic system disorders
Hematologic-other
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Blood and lymphatic system disorders
Febrile neutropenia
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Eye disorders
Vision-blurred
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Gastrointestinal disorders
Constipation
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
General disorders
Fatigue
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Immune system disorders
Allergic reaction
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Infections and infestations
Infection w/ unk ANC catheter related
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Infections and infestations
Infection-other
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
Leukocytes
26.7%
4/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
Lymphopenia
13.3%
2/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
Neutrophils
33.3%
5/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
Platelets
26.7%
4/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
ALT, SGPT
13.3%
2/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Metabolism and nutrition disorders
Hypokalemia
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Psychiatric disorders
Depression
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Skin and subcutaneous tissue disorders
Rash/desquamation
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Vascular disorders
Hypotension
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.

Other adverse events

Other adverse events
Measure
Thalidomide and Temzolomide
n=15 participants at risk
Thalidomide: Oral thalidomide on days 1-28 of a 28 day cycle initiated at 3 mg/kg and increased to maximum dose of 24 mg/kg or 1000 mg as tolerated. Temozolomide: Oral temozolomide on days 1-5 of 28 day cycle given at 200 mg/m2 or 150 mg/m2 for patients who had previously received significant therapy to the bone marrow (chemotherapy or radiation) or cranial spinal radiation. Patients were treated for 6 cycles unless disease progression or excessive toxicity. Treatment could continue beyond 6 cycles if absent disease progression.
Blood and lymphatic system disorders
Hemoglobin
53.3%
8/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Cardiac disorders
Cardiac-other
13.3%
2/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Ear and labyrinth disorders
Hearing-other
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Gastrointestinal disorders
Constipation
40.0%
6/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Gastrointestinal disorders
Diarrhea w/o prior colostomy
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Gastrointestinal disorders
Nausea
13.3%
2/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Gastrointestinal disorders
Vomiting
33.3%
5/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Gastrointestinal disorders
Abdomen, pain
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
General disorders
Fatigue
53.3%
8/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
General disorders
Fever w/o neutropenia
20.0%
3/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
General disorders
Rigors/chills
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
General disorders
Constitutional, other
20.0%
3/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
General disorders
Pain-other
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Infections and infestations
Infection-other
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
Leukocytes
60.0%
9/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
Lymphopenia
33.3%
5/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
Neutrophils
40.0%
6/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
Platelets
46.7%
7/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
Alkaline phosphatase
13.3%
2/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
ALT, SGPT
53.3%
8/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
AST, SGOT
40.0%
6/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Investigations
Creatinine
20.0%
3/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Metabolism and nutrition disorders
Bicarbonate
53.3%
8/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Metabolism and nutrition disorders
Hypocalcemia
13.3%
2/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Metabolism and nutrition disorders
Hyperglycemia
13.3%
2/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Metabolism and nutrition disorders
Hypermagnesemia
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Metabolism and nutrition disorders
Hypomagnesemia
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Metabolism and nutrition disorders
Hypophosphatemia
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Metabolism and nutrition disorders
Hyperkalemia
20.0%
3/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Metabolism and nutrition disorders
Hyponatremia
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Musculoskeletal and connective tissue disorders
Musculoskeletal/soft tissue-other
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Nervous system disorders
Ataxia
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Nervous system disorders
Memory impairment
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Nervous system disorders
Neuropathy-motor
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Nervous system disorders
Neuropathy-sensory
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Nervous system disorders
Neurologic-other
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Nervous system disorders
Head/headache
20.0%
3/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Psychiatric disorders
Insomnia
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Psychiatric disorders
Euphoria
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Renal and urinary disorders
Incontinence urinary
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Respiratory, thoracic and mediastinal disorders
Cough
20.0%
3/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Skin and subcutaneous tissue disorders
Dry skin
6.7%
1/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Skin and subcutaneous tissue disorders
Alopecia
13.3%
2/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.
Skin and subcutaneous tissue disorders
Rash/desquamation
20.0%
3/15 • Clinical assessment of drug toxicities was performed every clinic visit including CBC and serum biochemistries were collected every 2 weeks for the first 8 weeks of therapy and then monthly.

Additional Information

Mark W. Kieran, MD, PhD

DFCI

Phone: 617-632-4907

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60