S0001 RT and Carmustine With or Without O6BG in Patients With New Glioblastoma Multiforme or Gliosarcoma

NCT ID: NCT00017147

Last Updated: 2013-01-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

183 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-09-30

Study Completion Date

2012-11-30

Brief Summary

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RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. O6-benzylguanine may help carmustine kill more tumor cells by making tumor cells more sensitive to the drug. It is not yet known whether radiation therapy and carmustine are more effective with or without O6-benzylguanine.

PURPOSE: Randomized phase III trial to compare the effectiveness of radiation therapy plus carmustine with or without O6-benzylguanine in treating patients who have newly diagnosed glioblastoma multiforme or gliosarcoma.

Detailed Description

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OBJECTIVES:

* Compare the overall survival, failure-free survival, and progression-free survival of patients with newly diagnosed glioblastoma multiforme or gliosarcoma treated with radiotherapy and carmustine with or without O6-benzylguanine.
* Compare the frequency and severity of toxic effects of these regimens in these patients.
* Correlate the survival of these patients with the expression of O6-alkylguanine-DNA alkyltransferase.

OUTLINE: This is a randomized study. Patients are stratified according to age (under 50 vs 50 and over), prior surgery (biopsy only vs resection), and Zubrod performance status (0-1 vs 2). Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients undergo radiotherapy daily 5 days a week over 7 weeks for a total of 34 fractions. Patients also receive chemotherapy comprising O6-benzylguanine IV over 1 hour followed 6 hours later by carmustine IV over 1 hour on day 1 of radiotherapy. Chemotherapy repeats every 6 weeks for a maximum of 7 courses in the absence of disease progression or unacceptable toxicity.
* Arm II: Patients undergo radiotherapy as in arm I. Patients receive carmustine IV as in arm I.

Patients are followed at week 48, every 4 months for 1 year, and then every 6 months for 4 years.

PROJECTED ACCRUAL: A total of 375 patients will be accrued for this study within 5 years.

Conditions

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Malignant Neoplasms of Eye, Brain and Other Parts of Central Nervous System

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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O6-BG + BCNU + Radiation Therapy

O6-BG: 120 mg/m\^2 IV over 1 hour on day 1 of each cycle BCNU: 40 mg/m\^2 IV over 1 hour on day 1 of each cycle 6 hours after O6-BG dose. Radiation Therapy: 5 days/week using one fraction per day and a dose of 180 cGy per fraction. Initial target volume is dose of 5040 cGy in 28 fractions with boost target volume of 1080 cGy in 6 fractions.

Group Type EXPERIMENTAL

carmustine

Intervention Type DRUG

40 mg/m\^2 IV over 1 hour on day 1 of each cycle 6 hours after O6-BG dose for experimental arm with O6=BG.

200 mg/m\^2 IV over 1 hour on day 2 of each cycle for the active comparator arm.

radiation therapy

Intervention Type RADIATION

5 days/week using one fraction per day and a dose of 180 cGy per fraction. Initial target volume is dose of 5040 cGy in 28 fractions with boost target volume of 1080 cGy in 6 fractions.

O6-Benzylguanine

Intervention Type DRUG

120 mg/m\^2 IV over 1 hour on day 1 of each cycle

BCNU + Radiation Therapy

BCNU: 40 mg/m\^2 IV over 1 hour on day 1 of each cycle. Radiation Therapy: 5 days/week using one fraction per day and a dose of 180 cGy per fraction. Initial target volume is dose of 5040 cGy in 28 fractions with boost target volume of 1080 cGy in 6 fractions.

Group Type ACTIVE_COMPARATOR

carmustine

Intervention Type DRUG

40 mg/m\^2 IV over 1 hour on day 1 of each cycle 6 hours after O6-BG dose for experimental arm with O6=BG.

200 mg/m\^2 IV over 1 hour on day 2 of each cycle for the active comparator arm.

radiation therapy

Intervention Type RADIATION

5 days/week using one fraction per day and a dose of 180 cGy per fraction. Initial target volume is dose of 5040 cGy in 28 fractions with boost target volume of 1080 cGy in 6 fractions.

Interventions

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carmustine

40 mg/m\^2 IV over 1 hour on day 1 of each cycle 6 hours after O6-BG dose for experimental arm with O6=BG.

200 mg/m\^2 IV over 1 hour on day 2 of each cycle for the active comparator arm.

Intervention Type DRUG

radiation therapy

5 days/week using one fraction per day and a dose of 180 cGy per fraction. Initial target volume is dose of 5040 cGy in 28 fractions with boost target volume of 1080 cGy in 6 fractions.

Intervention Type RADIATION

O6-Benzylguanine

120 mg/m\^2 IV over 1 hour on day 1 of each cycle

Intervention Type DRUG

Other Intervention Names

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O6-BG

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed glioblastoma multiforme or gliosarcoma

* Biopsy or surgical resection within the past 28 days

* MRI\* with gadolinium performed before registration
* Patients who undergo a simple biopsy only require preoperative MRI\* with gadolinium
* No more than 2 noncontiguous tumor sites based on T2-weighted MRI (in 3 dimensions)\*
* No prior radiotherapy-delivered cephalad to the interspace between the seventh cervical and the first thoracic vertebral body NOTE: \*If an MRI is not medically feasible, patients may have a CT scan with contrast

PATIENT CHARACTERISTICS:

Age:

* 18 and over

Performance status:

* Zubrod 0-2

Life expectancy:

* Not specified

Hematopoietic:

* Absolute neutrophil count at least 3,000/mm\^3
* Platelet count at least 100,000/mm\^3
* Hemoglobin at least 8 g/dL

Hepatic:

* Bilirubin no greater than 2 times upper limit of normal (ULN)
* SGOT/SGPT no greater than 2 times ULN
* Alkaline phosphatase no greater than 2 times ULN
* PT/PTT no greater than 1.2 times ULN

Renal:

* Not specified

Cardiac:

* No severe cardiac disease, including any of the following:

* Uncontrolled arrhythmias or conduction defects
* Major problems with edema (e.g., residual swelling in the legs from deep vein thrombosis)
* Recent coronary artery disease
* Poorly controlled hypertension (i.e., diastolic blood pressure greater than 110 mm Hg and/or systolic blood pressure greater than 180 mm Hg)

Pulmonary:

* DLCO at least 70% of predicted
* No severe pulmonary disease

Other:

* HIV negative
* No severe Cushing's syndrome
* No known allergies to any of the study drugs
* No major psychiatric illness
* No poorly controlled diabetes complicated by steroid treatment
* No other medical illness that cannot be adequately controlled or that would preclude study participation
* No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated stage I or II cancer currently in complete remission
* Not pregnant or nursing
* Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* Not specified

Chemotherapy:

* No prior chemotherapy
* No other concurrent antitumor chemotherapy

Endocrine therapy:

* No concurrent hormonal therapy except postmenopausal estrogen replacement therapy
* Corticosteroids at stable or decreasing dose for tumor edema allowed

Radiotherapy:

* See Disease Characteristics
* No prior radiotherapy
* No other concurrent radiotherapy (including intensity-modulated radiotherapy) to the index lesion(s)

Surgery:

* See Disease Characteristics
* No concurrent antitumor surgery

Other:

* No other concurrent investigational drugs
* No other concurrent antineoplastic drugs or therapy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

SWOG Cancer Research Network

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Deborah T. Blumenthal, MD

Role: STUDY_CHAIR

University of Utah

Alexander M. Spence, MD

Role: STUDY_CHAIR

University of Washington

Keith J. Stelzer, MD, PhD

Role: STUDY_CHAIR

Celilo Cancer Center at Mid-Columbia Medical Center

Locations

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Alaska Regional Hospital Cancer Center

Anchorage, Alaska, United States

Site Status

Banner Good Samaritan Medical Center

Phoenix, Arizona, United States

Site Status

CCOP - Western Regional, Arizona

Phoenix, Arizona, United States

Site Status

St. Joseph's Hospital and Medical Center

Phoenix, Arizona, United States

Site Status

Banner Thunderbird Medical Center

Phoenix, Arizona, United States

Site Status

North Bay Cancer Center

Fairfield, California, United States

Site Status

Memorial Hospital Cancer Center

Colorado Springs, Colorado, United States

Site Status

St. Anthony Central Hospital

Denver, Colorado, United States

Site Status

University of Colorado Cancer Center at University of Colorado Health Sciences Center

Denver, Colorado, United States

Site Status

North Colorado Medical Center

Greeley, Colorado, United States

Site Status

McKee Medical Center

Loveland, Colorado, United States

Site Status

St. Anthony North Hospital

Westminster, Colorado, United States

Site Status

Exempla Lutheran Medical Center

Wheat Ridge, Colorado, United States

Site Status

West Florida Cancer Institute at West Florida Hospital - Pensacola

Pensacola, Florida, United States

Site Status

Piedmont Hospital

Atlanta, Georgia, United States

Site Status

CCOP - Atlanta Regional

Atlanta, Georgia, United States

Site Status

Northside Hospital Cancer Center

Atlanta, Georgia, United States

Site Status

Saint Joseph's Hospital of Atlanta

Atlanta, Georgia, United States

Site Status

WellStar Cobb Hospital

Austell, Georgia, United States

Site Status

Charles B. Eberhart Cancer Center at DeKalb Medical Center

Decatur, Georgia, United States

Site Status

Northeast Georgia Medical Center

Gainesville, Georgia, United States

Site Status

Gwinnett Medical Center

Lawrenceville, Georgia, United States

Site Status

Kennestone Cancer Center at Wellstar Kennestone Hospital

Marietta, Georgia, United States

Site Status

Southern Regional Medical Center

Riverdale, Georgia, United States

Site Status

Hematology Oncology Associates of Eastern Idaho

Idaho Falls, Idaho, United States

Site Status

Saint Anthony's Hospital at Saint Anthony's Health Center

Alton, Illinois, United States

Site Status

University of Illinois at Chicago Cancer Center

Chicago, Illinois, United States

Site Status

Veterans Affairs Medical Center - Chicago Westside Hospital

Chicago, Illinois, United States

Site Status

Decatur Memorial Hospital Cancer Care Institute

Decatur, Illinois, United States

Site Status

Good Samaritan Regional Health Center

Mount Vernon, Illinois, United States

Site Status

Regional Cancer Center at Memorial Medical Center

Springfield, Illinois, United States

Site Status

St. Francis Hospital and Health Centers

Beech Grove, Indiana, United States

Site Status

Genesis Regional Cancer Center at Genesis Medical Center

Davenport, Iowa, United States

Site Status

Genesis Medical Center - West Campus

Davenport, Iowa, United States

Site Status

Cancer Center of Kansas - Chanute

Chanute, Kansas, United States

Site Status

Cancer Center of Kansas - Dodge City

Dodge City, Kansas, United States

Site Status

Cancer Center of Kansas, P.A. - El Dorado

El Dorado, Kansas, United States

Site Status

Veterans Affairs Medical Center - Kansas City

Kansas City, Kansas, United States

Site Status

Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status

Cancer Center of Kansas - Kingman

Kingman, Kansas, United States

Site Status

Southwest Medical Center

Liberal, Kansas, United States

Site Status

Cancer Center of Kansas - Newton

Newton, Kansas, United States

Site Status

Cancer Center of Kansas, P.A. - Parsons

Parsons, Kansas, United States

Site Status

Pratt Cancer Center of Kansas

Pratt, Kansas, United States

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Cancer Center of Kansas - Salina

Salina, Kansas, United States

Site Status

Salina Regional Health Center

Salina, Kansas, United States

Site Status

Stormont-Vail Cancer Center

Topeka, Kansas, United States

Site Status

St. Francis Comprehensive Cancer Center

Topeka, Kansas, United States

Site Status

Cancer Center of Kansas - Wellington

Wellington, Kansas, United States

Site Status

Associates in Womens Health

Wichita, Kansas, United States

Site Status

Cancer Center of Kansas, P.A.

Wichita, Kansas, United States

Site Status

Cancer Center of Kansas, P.A. - Wichita

Wichita, Kansas, United States

Site Status

CCOP - Wichita

Wichita, Kansas, United States

Site Status

Via Christi Cancer Center at Via Christi Regional Medical Center

Wichita, Kansas, United States

Site Status

Wesley Medical Center

Wichita, Kansas, United States

Site Status

Cancer Center of Kansas - Winfield

Winfield, Kansas, United States

Site Status

Baton Rouge General Regional Cancer Center

Baton Rouge, Louisiana, United States

Site Status

Mary Bird Perkins Cancer Center - Baton Rouge

Baton Rouge, Louisiana, United States

Site Status

MBCCOP - LSU Health Sciences Center

New Orleans, Louisiana, United States

Site Status

Medical Center of Louisiana - New Orleans

New Orleans, Louisiana, United States

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Battle Creek Health System Cancer Care Center

Battle Creek, Michigan, United States

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Mecosta County General Hospital

Big Rapids, Michigan, United States

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CCOP - Grand Rapids

Grand Rapids, Michigan, United States

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Lacks Cancer Center at Saint Mary's Mercy Medical Center

Grand Rapids, Michigan, United States

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Spectrum Health Cancer Care - Butterworth Campus

Grand Rapids, Michigan, United States

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Metropolitan Hospital

Grand Rapids, Michigan, United States

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Holland Community Hospital

Holland, Michigan, United States

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Hackley Hospital

Muskegon, Michigan, United States

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Northern Michigan Hospital

Petoskey, Michigan, United States

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William Beaumont Hospital - Royal Oak Campus

Royal Oak, Michigan, United States

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Munson Medical Center

Traverse City, Michigan, United States

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University of Mississippi Medical Center

Jackson, Mississippi, United States

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St. Francis Medical Center

Cape Girardeau, Missouri, United States

Site Status

Southeast Missouri Regional Cancer Center at Southeast Missouri Hospital

Gape Girardeau, Missouri, United States

Site Status

Freeman Cancer Institute at Freeman Health System

Joplin, Missouri, United States

Site Status

CCOP - Kansas City

Kansas City, Missouri, United States

Site Status

St. John's Regional Health Center

Springfield, Missouri, United States

Site Status

Hulston Cancer Center at Cox Medical Center South

Springfield, Missouri, United States

Site Status

CCOP - St. Louis-Cape Girardeau

St Louis, Missouri, United States

Site Status

David C. Pratt Cancer Center at St. John's Mercy

St Louis, Missouri, United States

Site Status

CCOP - Montana Cancer Consortium

Billings, Montana, United States

Site Status

Deaconess Billings Clinic - Downtown

Billings, Montana, United States

Site Status

Hematology-Oncology Centers of the Northern Rockies - Billings

Billings, Montana, United States

Site Status

Northern Rockies Radiation Oncology Center

Billings, Montana, United States

Site Status

St. Vincent Healthcare

Billings, Montana, United States

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Deaconess Billings Clinic Cancer Center

Billings, Montana, United States

Site Status

Bozeman Deaconess Hospital

Bozeman, Montana, United States

Site Status

Internal Medicine Associates of Bozeman

Bozeman, Montana, United States

Site Status

St. James Community Hospital

Butte, Montana, United States

Site Status

Great Falls Clinic

Great Falls, Montana, United States

Site Status

Sletten Regional Cancer Institute

Great Falls, Montana, United States

Site Status

St. Peter's Hospital

Helena, Montana, United States

Site Status

Glacier Oncology, PLLC

Kalispell, Montana, United States

Site Status

Kalispell Medical Oncology

Kalispell, Montana, United States

Site Status

Eastern Montana Cancer Center

Miles City, Montana, United States

Site Status

Community Medical Center

Missoula, Montana, United States

Site Status

Montana Cancer Center at St. Patrick Hospital and Health Sciences Center

Missoula, Montana, United States

Site Status

Montana Cancer Specialists at Montana Cancer Center

Missoula, Montana, United States

Site Status

Good Samaritan Health Systems

Kearney, Nebraska, United States

Site Status

James P. Wilmot Cancer Center at University of Rochester Medical Center

Rochester, New York, United States

Site Status

Presbyterian Cancer Center at Presbyterian Hospital

Charlotte, North Carolina, United States

Site Status

Wayne Memorial Hospital, Incorporated

Goldsboro, North Carolina, United States

Site Status

Adena Regional Medical Center

Chillicothe, Ohio, United States

Site Status

Cleveland Clinic Taussig Cancer Center

Cleveland, Ohio, United States

Site Status

Riverside Methodist Hospital Cancer Care

Columbus, Ohio, United States

Site Status

CCOP - Columbus

Columbus, Ohio, United States

Site Status

Grant Riverside Cancer Services

Columbus, Ohio, United States

Site Status

Mount Carmel West Hospital

Columbus, Ohio, United States

Site Status

Doctors Hospital at Ohio Health

Columbus, Ohio, United States

Site Status

Grandview Hospital

Dayton, Ohio, United States

Site Status

Good Samaritan Hospital

Dayton, Ohio, United States

Site Status

David L. Rike Cancer Center at Miami Valley Hospital

Dayton, Ohio, United States

Site Status

Samaritan North Cancer Care Center

Dayton, Ohio, United States

Site Status

Veterans Affairs Medical Center - Dayton

Dayton, Ohio, United States

Site Status

CCOP - Dayton

Dayton, Ohio, United States

Site Status

Grady Memorial Hospital

Delaware, Ohio, United States

Site Status

Community Oncology Group - Independence

Independence, Ohio, United States

Site Status

Charles F. Kettering Memorial Hospital

Kettering, Ohio, United States

Site Status

Fairfield Medical Center

Lancaster, Ohio, United States

Site Status

Strecker Cancer Center at Marietta Memorial Hospital

Marietta, Ohio, United States

Site Status

Middletown Regional Hospital

Middletown, Ohio, United States

Site Status

Licking Memorial Cancer Care Program at Licking Memorial Hospital

Newark, Ohio, United States

Site Status

Mercy Medical Center Oncology Unit

Springfield, Ohio, United States

Site Status

Community Hospital of Springfield and Clark County

Springfield, Ohio, United States

Site Status

UVMC Cancer Care Center at Upper Valley Medical Center

Troy, Ohio, United States

Site Status

Mount Carmel Cancer Services at Mount Carmel St. Ann's Hospital

Westerville, Ohio, United States

Site Status

Cleveland Clinic - Wooster

Wooster, Ohio, United States

Site Status

Ruth G. McMillan Cancer Center at Greene Memorial Hospital

Xenia, Ohio, United States

Site Status

Genesis - Good Samaritan Hospital

Zanesville, Ohio, United States

Site Status

Legacy Mount Hood Medical Center

Glesham, Oregon, United States

Site Status

Providence Milwaukie Hospital

Milwaukie, Oregon, United States

Site Status

Legacy Good Samaritan Hospital & Medical Center Comprehensive Cancer Center

Portland, Oregon, United States

Site Status

Providence Cancer Center at Providence Portland Medical Center

Portland, Oregon, United States

Site Status

CCOP - Columbia River Oncology Program

Portland, Oregon, United States

Site Status

Providence St. Vincent Medical Center

Portland, Oregon, United States

Site Status

Institute of Oncology at Vilnius University

Portland, Oregon, United States

Site Status

Salem Hospital Regional Cancer Center

Salem, Oregon, United States

Site Status

Legacy Meridian Park Hospital

Tualatin, Oregon, United States

Site Status

Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical Center

Kingsport, Tennessee, United States

Site Status

Brooke Army Medical Center

Fort Sam Houston, Texas, United States

Site Status

Wilford Hall Medical Center

Lackland Air Force Base, Texas, United States

Site Status

CCOP - Scott and White Hospital

Temple, Texas, United States

Site Status

Huntsman Cancer Institute at University of Utah

Salt Lake City, Utah, United States

Site Status

Danville Regional Medical Center

Danville, Virginia, United States

Site Status

St. Joseph Hospital Community Cancer Center

Bellingham, Washington, United States

Site Status

Olympic Hematology and Oncology

Bremerton, Washington, United States

Site Status

St. Francis Hospital

Federal Way, Washington, United States

Site Status

Skagit Valley Hospital Cancer Care Center

Mount Vernon, Washington, United States

Site Status

Capital Medical Center

Olympia, Washington, United States

Site Status

Fred Hutchinson Cancer Research Center

Seattle, Washington, United States

Site Status

Group Health Central Hospital

Seattle, Washington, United States

Site Status

Harborview Medical Center

Seattle, Washington, United States

Site Status

Swedish Cancer Institute at Swedish Medical Center - First Hill Campus

Seattle, Washington, United States

Site Status

University Cancer Center at University of Washington Medical Center

Seattle, Washington, United States

Site Status

North Puget Oncology at United General Hospital

Sedro-Woolley, Washington, United States

Site Status

Cancer Care Northwest - Spokane South

Spokane, Washington, United States

Site Status

Allenmore Hospital

Tacoma, Washington, United States

Site Status

CCOP - Northwest

Tacoma, Washington, United States

Site Status

St. Clare Hospital

Tacoma, Washington, United States

Site Status

Southwest Washington Medical Center Cancer Center

Vancouver, Washington, United States

Site Status

Central Washington Hospital

Wenatchee, Washington, United States

Site Status

Wenatchee Valley Clinic

Wenatchee, Washington, United States

Site Status

Welch Cancer Center

Sheridan, Wyoming, United States

Site Status

Countries

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United States

References

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Blumenthal DT, Wade M, Rankin CJ, et al.: MGMT methylation in newly-diagnosed glioblastoma multiforme (GBM): from the S0001 phase III study of radiation therapy (RT) and O6-benzylguanine, (O6BG) plus BCNU versus RT and BCNU alone for newly diagnosed GBM. [Abstract] J Clin Oncol 24 (Suppl 18): A-1512, 2006.

Reference Type RESULT

Quezado M, Ronchetti R, Rapkiewicz A, Santi M, Blumenthal DT, Rushing EJ. Chromogenic in situ hybridization accurately identifies EGFR amplification in small cell glioblastoma multiforme, a common subtype of primary GBM. Clin Neuropathol. 2005 Jul-Aug;24(4):163-9.

Reference Type RESULT
PMID: 16033132 (View on PubMed)

Blumenthal DT, Rankin C, Stelzer KJ, Spence AM, Sloan AE, Moore DF Jr, Padula GD, Schulman SB, Wade ML, Rushing EJ. A Phase III study of radiation therapy (RT) and O(6)-benzylguanine + BCNU versus RT and BCNU alone and methylation status in newly diagnosed glioblastoma and gliosarcoma: Southwest Oncology Group (SWOG) study S0001. Int J Clin Oncol. 2015 Aug;20(4):650-8. doi: 10.1007/s10147-014-0769-0. Epub 2014 Nov 19.

Reference Type DERIVED
PMID: 25407559 (View on PubMed)

Other Identifiers

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S0001

Identifier Type: OTHER

Identifier Source: secondary_id

U10CA032102

Identifier Type: NIH

Identifier Source: secondary_id

View Link

CDR0000068656

Identifier Type: -

Identifier Source: org_study_id

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