ACTIVE_NOT_RECRUITING

A Study to Compare Treatment With the Drug Selumetinib Alone Versus Selumetinib and Vinblastine in Patients With Recurrent or Progressive Low-Grade Glioma

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This phase III trial investigates the best dose of vinblastine in combination with selumetinib and the benefit of adding vinblastine to selumetinib compared to selumetinib alone in treating children and young adults with low-grade glioma (a common type of brain cancer) that has come back after prior treatment (recurrent) or does not respond to therapy (progressive). Selumetinib is a drug that works by blocking a protein that lets tumor cells grow without stopping. Vinblastine blocks cell growth by stopping cell division and may kill cancer cells. Giving selumetinib in combination with vinblastine may work better than selumetinib alone in treating recurrent or progressive low-grade glioma.

Official Title

A Phase 3 Study of Selumetinib (NSC# 748727) or Selumetinib in Combination With Vinblastine for Non-NF1, Non-TSC Patients With Recurrent or Progressive Low-Grade Gliomas (LGGs) Lacking BRAFV600E or IDH1 Mutations

Quick Facts

Study Start:2021-02-16
Study Completion:2026-12-30
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:ACTIVE_NOT_RECRUITING

Study ID

NCT04576117

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:2 Years to 25 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD, ADULT
Inclusion CriteriaExclusion Criteria
  1. * Feasibility phase: patients must be \>= 2 years and =\< 21 years of age at the time of enrollment
  2. * Efficacy phase: patients must be \>= 2 years and =\< 25 years of age at the time of enrollment
  3. * All patients \> 21 years of age at the time of enrollment must have had initial diagnosis of low-grade glioma by 21 years of age
  4. * Patients must have a body surface area (BSA) of \>= 0.5 m\^2 at enrollment
  5. * Patients must have eligibility confirmed by rapid central pathology and central molecular screening reviews performed on APEC14B1
  6. * Non-neurofibromatosis type 1 (non-NF1), non-tuberous sclerosis complex (non-TSC) low-grade glioma (LGG) without a BRAFV600E or IDH1 mutation
  7. * Patients must have progressive or recurrent LGG. Note: Biopsy may be at either initial diagnosis or recurrence
  8. * Patients must have measurable disease, defined as having a two-dimensional measurable tumor volume of \>= 1 cm\^2
  9. * Tumor size will be measured to include both solid and cystic components of the tumor (whether or not tumor is enhancing) + fluid attenuated inversion recovery (FLAIR) signal
  10. * Eligible histologies will include all tumors considered low-grade glioma or low-grade astrocytoma (World Health Organization \[WHO\] grade 1 and II) by the WHO Classification of Tumors of the Central Nervous System - 4th Edition Revised, with the exception of subependymal giant cell astrocytoma
  11. * Patients with metastatic disease or multiple independent primary LGGs are eligible
  12. * Patients must be progressive or recurrent after having been treated with at least one prior tumor-directed therapy before enrollment
  13. * Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study
  14. * Myelosuppressive chemotherapy: Must not have received within 2 weeks of entry onto this study (4 weeks if prior nitrosourea);
  15. * Biologic (anti-neoplastic agent): At least 7 days since the completion of therapy with a biologic agent;
  16. * Radiation therapy (RT): \>= 2 weeks (wks) for local palliative RT (small port); \>= 6 months must have elapsed if prior craniospinal RT or if \>= 50% radiation of pelvis; \>= 6 wks must have elapsed if other substantial bone marrow (BM) radiation;
  17. * Antibodies: \>= 21 days must have elapsed from infusion of last dose of antibody, and toxicity related to prior antibody therapy must be recovered to =\< grade 1;
  18. * MEK inhibitor or vinblastine: Must not have received treatment with a MEK inhibitor or vinblastine within 6 months of study enrollment
  19. * Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 mL/min/1.73 m\^ 2 or a serum creatinine based on age/sex as follows (within 7 days prior to enrollment):
  20. * 2 to \< 6 years: 0.8 mg/dL (male) 0.8 mg/dL (female)
  21. * 6 to \< 10 years: 1 mg/dL (male) 1 mg/dL (female)
  22. * 10 to \< 13 years: 1.2 mg/dL (male) 1.2 mg/dL (female)
  23. * 13 to \< 16 years: 1.5 mg/dL (male) 1.4 mg/dL (female)
  24. * \>= 16 years: 1.7 mg/dL (male) 1.4 mg/dL (female)
  25. * Total bilirubin =\< 1.5 x upper limit of normal (ULN) for age (within 7 days prior to enrollment) (children with a diagnosis of Gilbert's syndrome will be allowed on study regardless of their total and indirect \[unconjugated\] bilirubin levels as long as their direct \[conjugated\] bilirubin is \< 3.1 mg/dL)
  26. * Serum glutamic pyruvic transaminase (SGPT) (alanine aminotransferase \[ALT\]) =\< 135 U/L (within 7 days prior to enrollment)
  27. * Note: For the purpose of this study, the ULN for SGPT (ALT) has been set to the value of 45 U/L
  28. * Albumin \>= 2 g/L (within 7 days prior to enrollment)
  29. * Left ventricular ejection fraction (LVEF) \>= 53% (or institutional normal; if the LVEF result is given as a range of values, then the upper value of the range will be used) by echocardiogram (within 4 weeks prior to enrollment)
  30. * Corrected QT interval (QTc interval) =\< 450 msec by electrocardiogram (EKG) (within 4 weeks prior to enrollment)
  31. * Absolute neutrophil count \>= 1,000/uL (unsupported) (within 7 days prior to enrollment)
  32. * Platelets \>= 100,000/uL (unsupported) (within 7 days prior to enrollment)
  33. * Hemoglobin \>= 8 g/dL (may be supported) (within 7 days prior to enrollment)
  34. * Patients with a known seizure disorder should be stable and should not have experienced a significant increase in seizure frequency within 2 weeks prior to enrollment
  35. * Stable neurological examination for \>= 1 week
  36. * HYPERTENSION:
  37. * Patients 2-17 years of age must have a blood pressure that is =\< 95th percentile for age, height, and sex at the time of enrollment (with or without the use of anti-hypertensive medications);
  38. * Patients \>= 18 years of age must have a blood pressure =\< 130/80 mmHg at the time of enrollment (with or without the use of anti-hypertensive medications)
  39. * Note for patients of all ages: Adequate blood pressure can be achieved using medication for the treatment of hypertension
  40. * All patients must have ophthalmology toxicity assessments performed within 4 weeks prior to enrollment
  41. * For all patients, an MRI of the brain (with orbital cuts for optic pathway tumors) and/or spine (depending on the site\[s\] of primary disease) with and without contrast must be performed within 4 weeks prior to enrollment
  42. * Note: If surgical resection or biopsy is performed at the time of progression or recurrence, a post-operative MRI is required
  43. * Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1, or 2. Use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age
  44. * Patients must have the ability to swallow whole capsules
  1. * Prior therapy with vinblastine and/or a MEK inhibitor is permitted, with the following exceptions:
  2. * Patients must not have had progressive disease while on therapy with vinblastine or a MEK inhibitor;
  3. * Patients must not have discontinued vinblastine or selumetinib due to toxicity
  4. * Patients with a concurrent malignancy or history of treatment (other than surgery) for another tumor within the last year are ineligible
  5. * Patients with diffuse intrinsic pontine tumors as seen on MRI (\> 2/3 of pons involvement on imaging) are not eligible even if biopsy reveals grade I/II histology
  6. * Patients may not be receiving any other investigational agents
  7. * Patients must not have known hypersensitivity to selumetinib, vinblastine, or similar compounds
  8. * CYP3A4 agents: Patients must not have received fluconazole or drugs that are strong inducers or inhibitors of CYP3A4 within 7 days prior to study enrollment
  9. * Patients with any serious medical or psychiatric illness/condition, including substance use disorders or ophthalmological conditions, likely in the judgment of the investigator to interfere or limit compliance with study requirements/treatment
  10. * Patients who, in the opinion of the investigator, are not able to comply with the study procedures are not eligible
  11. * PRE-EXISTING CONDITIONS (CARDIAC):
  12. * Known genetic disorder that increases risk for coronary artery disease. Note: The presence of dyslipidemia in a family with a history of myocardial infarction is not in itself an exclusion unless there is a known genetic disorder documented;
  13. * Symptomatic heart failure
  14. * New York Heart Association (NYHA) class II-IV prior or current cardiomyopathy
  15. * Severe valvular heart disease
  16. * History of atrial fibrillation
  17. * PRE-EXISTING CONDITIONS (OPHTHALMOLOGIC CONDITIONS):
  18. * Current or past history of central serous retinopathy
  19. * Current or past history of retinal vein occlusion or retinal detachment
  20. * Patients with uncontrolled glaucoma
  21. * If checking pressure is clinically indicated, patients with intraocular pressure (IOP) \> 22 mmHg or upper limit of normal (ULN) adjusted by age are not eligible
  22. * Any multivitamin containing vitamin E must be stopped prior to study enrollment even if it contains less than 100% of the daily recommended dosing for vitamin E
  23. * Surgery within 2 weeks prior to enrollment, with the exception of a surgical biopsy, placement of a vascular access device or cerebrospinal fluid (CSF) diverting procedure such as endoscopic third ventriculostomy (ETV) and ventriculoperitoneal (VP) shunt
  24. * Note: Patients must have healed from any prior surgery
  25. * Patients who have an uncontrolled infection are not eligible
  26. * Female patients who are pregnant are not eligible since fetal toxicities and teratogenic effects have been noted for several of the study drugs. A pregnancy test is required for female patients of childbearing potential
  27. * Lactating females who plan to breastfeed their infants
  28. * Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation and for 12 weeks after stopping study therapy are not eligible
  29. * Note: Women of child-bearing potential and males with sexual partners who are pregnant or who could become pregnant (i.e., women of child-bearing potential) should use effective methods of contraception for the duration of the study and for 12 weeks after stopping study therapy to avoid pregnancy and/or potential adverse effects on the developing embryo
  30. * All patients and/or their parents or legal guardians must sign a written informed consent
  31. * All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met

Contacts and Locations

Principal Investigator

Daniel C Bowers
PRINCIPAL_INVESTIGATOR
Children's Oncology Group

Study Locations (Sites)

Children's Hospital of Alabama
Birmingham, Alabama, 35233
United States
Arkansas Children's Hospital
Little Rock, Arkansas, 72202-3591
United States
Loma Linda University Medical Center
Loma Linda, California, 92354
United States
Children's Hospital Los Angeles
Los Angeles, California, 90027
United States
Kaiser Permanente-Oakland
Oakland, California, 94611
United States
Children's Hospital of Orange County
Orange, California, 92868
United States
Lucile Packard Children's Hospital Stanford University
Palo Alto, California, 94304
United States
Children's Hospital Colorado
Aurora, Colorado, 80045
United States
Connecticut Children's Medical Center
Hartford, Connecticut, 06106
United States
Yale University
New Haven, Connecticut, 06520
United States
Alfred I duPont Hospital for Children
Wilmington, Delaware, 19803
United States
Children's National Medical Center
Washington, District of Columbia, 20010
United States
Golisano Children's Hospital of Southwest Florida
Fort Myers, Florida, 33908
United States
University of Florida Health Science Center - Gainesville
Gainesville, Florida, 32610
United States
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood, Florida, 33021
United States
Nemours Children's Clinic-Jacksonville
Jacksonville, Florida, 32207
United States
Arnold Palmer Hospital for Children
Orlando, Florida, 32806
United States
Nemours Children's Hospital
Orlando, Florida, 32827
United States
Johns Hopkins All Children's Hospital
Saint Petersburg, Florida, 33701
United States
Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa, Florida, 33607
United States
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta, Georgia, 30329
United States
Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
United States
Lurie Children's Hospital-Chicago
Chicago, Illinois, 60611
United States
University of Illinois
Chicago, Illinois, 60612
United States
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
United States
Riley Hospital for Children
Indianapolis, Indiana, 46202
United States
Ascension Saint Vincent Indianapolis Hospital
Indianapolis, Indiana, 46260
United States
University of Iowa/Holden Comprehensive Cancer Center
Iowa City, Iowa, 52242
United States
Norton Children's Hospital
Louisville, Kentucky, 40202
United States
Children's Hospital New Orleans
New Orleans, Louisiana, 70118
United States
Maine Children's Cancer Program
Scarborough, Maine, 04074
United States
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
United States
Walter Reed National Military Medical Center
Bethesda, Maryland, 20889-5600
United States
Dana-Farber Cancer Institute
Boston, Massachusetts, 02215
United States
C S Mott Children's Hospital
Ann Arbor, Michigan, 48109
United States
Children's Hospital of Michigan
Detroit, Michigan, 48201
United States
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids, Michigan, 49503
United States
Corewell Health Children's
Royal Oak, Michigan, 48073
United States
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis, Minnesota, 55404
United States
University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, 55455
United States
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
United States
University of Mississippi Medical Center
Jackson, Mississippi, 39216
United States
Children's Mercy Hospitals and Clinics
Kansas City, Missouri, 64108
United States
Cardinal Glennon Children's Medical Center
Saint Louis, Missouri, 63104
United States
Washington University School of Medicine
Saint Louis, Missouri, 63110
United States
Children's Hospital and Medical Center of Omaha
Omaha, Nebraska, 68114
United States
University of Nebraska Medical Center
Omaha, Nebraska, 68198
United States
Morristown Medical Center
Morristown, New Jersey, 07960
United States
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick, New Jersey, 08903
United States
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
United States
Albany Medical Center
Albany, New York, 12208
United States
Roswell Park Cancer Institute
Buffalo, New York, 14263
United States
The Steven and Alexandra Cohen Children's Medical Center of New York
New Hyde Park, New York, 11040
United States
Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York, New York, 10016
United States
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
United States
State University of New York Upstate Medical University
Syracuse, New York, 13210
United States
New York Medical College
Valhalla, New York, 10595
United States
Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina, 28203
United States
Duke University Medical Center
Durham, North Carolina, 27710
United States
East Carolina University
Greenville, North Carolina, 27834
United States
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
United States
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
United States
Children's Hospital Medical Center of Akron
Akron, Ohio, 44308
United States
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229
United States
Nationwide Children's Hospital
Columbus, Ohio, 43205
United States
Dayton Children's Hospital
Dayton, Ohio, 45404
United States
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
United States
Oregon Health and Science University
Portland, Oregon, 97239
United States
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
United States
Saint Christopher's Hospital for Children
Philadelphia, Pennsylvania, 19134
United States
Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, 15224
United States
Prisma Health Richland Hospital
Columbia, South Carolina, 29203
United States
BI-LO Charities Children's Cancer Center
Greenville, South Carolina, 29605
United States
East Tennessee Childrens Hospital
Knoxville, Tennessee, 37916
United States
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, 37232
United States
Dell Children's Medical Center of Central Texas
Austin, Texas, 78723
United States
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
United States
Cook Children's Medical Center
Fort Worth, Texas, 76104
United States
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston, Texas, 77030
United States
M D Anderson Cancer Center
Houston, Texas, 77030
United States
Children's Hospital of San Antonio
San Antonio, Texas, 78207
United States
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
United States
Primary Children's Hospital
Salt Lake City, Utah, 84113
United States
Children's Hospital of The King's Daughters
Norfolk, Virginia, 23507
United States
VCU Massey Comprehensive Cancer Center
Richmond, Virginia, 23298
United States
Seattle Children's Hospital
Seattle, Washington, 98105
United States
Providence Sacred Heart Medical Center and Children's Hospital
Spokane, Washington, 99204
United States
Madigan Army Medical Center
Tacoma, Washington, 98431
United States
West Virginia University Healthcare
Morgantown, West Virginia, 26506
United States
University of Wisconsin Carbone Cancer Center - University Hospital
Madison, Wisconsin, 53792
United States
Children's Hospital of Wisconsin
Milwaukee, Wisconsin, 53226
United States

Collaborators and Investigators

Sponsor: National Cancer Institute (NCI)

  • Daniel C Bowers, PRINCIPAL_INVESTIGATOR, Children's Oncology Group

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2021-02-16
Study Completion Date2026-12-30

Study Record Updates

Study Start Date2021-02-16
Study Completion Date2026-12-30

Terms related to this study

Additional Relevant MeSH Terms

  • Recurrent Low Grade Astrocytoma
  • Recurrent WHO Grade 2 Glioma
  • Refractory Low Grade Astrocytoma
  • Refractory Low Grade Glioma
  • Refractory WHO Grade 1 Glioma