Bevacizumab and Ascorbic Acid in Patients Treating With Recurrent High Grade Glioma

NCT ID: NCT02833701

Last Updated: 2023-10-24

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

TERMINATED

Clinical Phase

PHASE1

Total Enrollment

9 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-03-31

Study Completion Date

2019-03-31

Brief Summary

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This phase I trial studies the side effects and best dose of ascorbic acid when given together with bevacizumab in treating patients with high grade glioma that has come back (recurrent). Monoclonal antibodies, such as bevacizumab may interfere with the ability of tumor cells to grow and spread. Ascorbic acid contains ingredients that may prevent or slow the growth of high grade glioma. Giving bevacizumab and ascorbic acid together may work better in treating patients with high grade glioma.

Detailed Description

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PRIMARY OBJECTIVES:

I. To evaluate the toxicities and determine the recommended dose of intravenous ascorbic acid given three times weekly in combination with intravenous bevacizumab every two weeks in patients with recurrent high grade glioma.

SECONDARY OBJECTIVES:

I. To evaluate changes in the levels of serum ascorbic acid (using high performance liquid chromatography \[HPLC\] with coulometric electrochemical detection) during therapy with ascorbic acid and bevacizumab.

II. Radiographic assessment of disease status after 2 cycles of therapy with ascorbic acid and bevacizumab.

III. To evaluate progression-free and overall survival of patients with recurrent high grade glioma treated with therapy with ascorbic acid and bevacizumab. Patients with stable or responsive disease after every 2 cycles will continue on therapy with ascorbic acid and bevacizumab until intolerance or progressive disease.

IV. To descriptively examine quality of life (QOL) using European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire QLQ-C30 during treatment.

OUTLINE: This is a dose-escalation study of ascorbic acid.

Patients receive ascorbic acid intravenously (IV) over 90-120 minutes three times per week (at least 24 hours apart) and bevacizumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 2 months for 1 year.

Conditions

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Glioblastoma Glioma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment (bevacizumab and ascorbic acid)

Patients receive ascorbic acid IV over 90-120 minutes three times per week (at least 24 hours apart) and bevacizumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.

Group Type EXPERIMENTAL

Ascorbic Acid

Intervention Type DIETARY_SUPPLEMENT

Given IV

Bevacizumab

Intervention Type BIOLOGICAL

Given intravenously (IV)

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Interventions

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Ascorbic Acid

Given IV

Intervention Type DIETARY_SUPPLEMENT

Bevacizumab

Given intravenously (IV)

Intervention Type BIOLOGICAL

Laboratory Biomarker Analysis

Correlative studies

Intervention Type OTHER

Quality-of-Life Assessment

Ancillary studies

Intervention Type OTHER

Other Intervention Names

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2-(1,2-dihydroxyethyl)-4,5-dihydroxy-furan-3-one Asorbicap C Vitamin C-Long Ce-Vi-Sol Cecon Cenolate Cetane Cevalin L-Ascorbic Acid VIT C Vitamin C Vitamin-C Anti-VEGF Anti-VEGF Humanized Monoclonal Antibody Anti-VEGF rhuMAb Avastin Bevacizumab Biosimilar BEVZ92 Bevacizumab Biosimilar BI 695502 Immunoglobulin G1 (Human-Mouse Monoclonal rhuMab-VEGF Gamma-Chain Anti-Human Vascular Endothelial Growth Factor), Disulfide With Human-Mouse Monoclonal rhuMab-VEGF Light Chain, Dimer Recombinant Humanized Anti-VEGF Monoclonal Antibody rhuMab-VEGF Quality of Life Assessment

Eligibility Criteria

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Inclusion Criteria

* Patients must have pathologically proven diagnosis of high grade glioma
* Patients must have received prior radiation therapy and standard temozolomide; patients who have received additional therapies for previous progressions will be considered eligible
* Patients must be three or more months from the end of chemoradiotherapy or have biopsy or imaging consistent with disease progression
* Patients must have recovered from toxicity of prior therapy
* Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 or better
* Absolute neutrophil count (ANC) \>= 1,500/mm\^3
* Hemoglobin \>= 8 g/dL
* Platelet count \>= 100,000/mm\^3
* Serum creatinine that is at or below 2.0 mg/dL
* Serum aspartate transaminase (AST) and alanine transaminase (ALT) less than 1.5 times the upper limits of normal
* Serum alkaline phosphatase less than 2.5 times the upper limits of normal
* The patient must be aware of the neoplastic nature of his/her disease and willingly provide written, informed consent after being informed of the procedure to be followed, the experimental nature of the therapy, alternatives, potential benefits, side-effects, risks, and discomforts
* Women of reproductive potential must be non-pregnant and non-nursing and must agree to employ an effective barrier method of birth control throughout the study and for up to 6 months following treatment
* Women of child-bearing potential must have a negative pregnancy test within 7 days of initiating study; (no childbearing potential is defined as age 55 years or older and no menses for two years or any age with surgical removal of the uterus and/or both ovaries)

Exclusion Criteria

* History of uncontrollable allergic reactions to bevacizumab or ascorbic acid
* Known human immunodeficiency virus (HIV)-positivity AND actively being treated with highly active antiretroviral therapy (HAART)
* History of glucose-6-phosphate dehydrogenase deficiency
* History of oxalate nephrolithiasis or urine oxalate \>60 mg/dL
* Anuria, dehydration, severe pulmonary congestion or pulmonary edema or fixed low cardiac input
* Prior hypersensitivity to bevacizumab or toxicity requiring discontinuation of bevacizumab
* Clinically significant cardiovascular disease defined as follows:

* Inadequately controlled hypertension (i.e., systolic blood pressure \[SBP\] \> 160 mm Hg and/or diastolic pressure \[DBP\] \> 90 mm Hg despite antihypertensive therapy)
* History of cerebrovascular accident (CVA) within 6 months
* Myocardial infarction or unstable angina within 6 months
* Evidence or history of bleeding diathesis (greater than normal risk of bleeding, i.e., Hereditary Hemorrhagic Telangiectasia type I or HHT-1) or coagulopathy in the absence of therapeutic anti-coagulation or any hemorrhage/bleeding event \> grade 3 within 4 weeks prior to registration; note: patients with full-dose anticoagulants are eligible provided the patient has been on a stable dose for at least 2 weeks of low molecular weight heparin; therapeutic Coumadin and aspirin doses \> 325 mg daily are not allowed
* Active wound, a serious or non-healing wound, an active ulcer or untreated bone fracture
* History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess =\< 6 months prior to registration
* Major surgical procedure, open biopsy or significant traumatic injury =\< 28 days prior to registration
* Any other clinically significant medical disease or condition laboratory abnormality or psychiatric illness that, in the Investigator's opinion, may interfere with protocol adherence or a subject's ability to give informed consent
* Patients who are on the following drugs and cannot have a drug substitution: flecainide, methadone, amphetamines, quinidine, and chlorpropamide; Note: high dose ascorbic acid may affect urine acidification and, as a result, may affect clearance rates of these drugs
* Simultaneous participation in other therapeutic clinical trials will not be allowed
* Inability to co-operate with the requirements of the protocol
* Pregnant and nursing women are excluded from this study
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

University of Nebraska

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nicole A Shonka, MD

Role: PRINCIPAL_INVESTIGATOR

University of Nebraska

Locations

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University of Nebraska Medical Center

Omaha, Nebraska, United States

Site Status

Countries

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United States

Other Identifiers

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NCI-2016-00239

Identifier Type: REGISTRY

Identifier Source: secondary_id

P30CA036727

Identifier Type: NIH

Identifier Source: secondary_id

View Link

0769-15-FB

Identifier Type: -

Identifier Source: org_study_id

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