Phase I trial to study the effectiveness of radiation therapy and gadolinium texaphyrin in
treating patients who have supratentorial glioblastoma multiforme. Radiation therapy uses
high-energy x-rays to damage tumor cells. Drugs such as gadolinium texaphyrin may make the
tumor cells more sensitive to radiation therapy.
I. Determine the frequency and grade of toxicity of gadolinium texaphyrin as a
radiosensitizer at two dose levels in patients with supratentorial glioblastoma multiforme
undergoing stereotactic radiosurgery.
II. Compare the tumor, normal brain, and plasma concentrations of this drug regimen to 1.5
and 8 Tesla MRI images in this patient population.
III. Determine if the 8 Tesla images provide more data than the 1.5 Tesla images in terms of
the radiosensitizing drug distribution in the tumor in these patients.
OUTLINE: This is a dose escalation study.
Within 5 weeks following surgery, patients receive daily external beam radiotherapy five
days a week for 5 weeks. Within 2 weeks following completion of radiotherapy, patients
receive gadolinium texaphyrin IV over 2 hours followed 3 hours later by stereotactic
radiosurgery. Patients undergoing surgical debulking of tumor prior to external beam
radiotherapy receive gadolinium texaphyrin IV over 2 hours, 3 hours prior to surgery in
addition to the dose prior to stereotactic radiosurgery.
Cohorts of 3-6 patients receive escalating doses of gadolinium texaphyrin until the maximum
tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2
of 3 or 2 of 6 patients experience dose limiting toxicity.
Patients are followed monthly for 3 months, and then every 3 months for 5 years or until
PROJECTED ACCRUAL: Approximately 12-18 patients will be accrued for this study within 12-18
- Histologically confirmed supratentorial glioblastoma multiforme by stereotactic
biopsy, open biopsy, or resection
- Maximum diameter of the tumor mass must be no greater than 4 cm in any dimension,
including following debulking surgery
- Tumor must be at least 1.0 cm from the optic chiasm and brainstem
- No oligodendrogliomas, meningiomas, or grade I, II, or III astrocytomas
- No infratentorial tumors
- No multifocal glioblastoma multiforme
- Tumor enhances on MRI
- Must have visible tumor on postoperative MRI following surgical resection
- Performance status - Karnofsky 60-100%
- At least 3 months
- Hemoglobin at least 10.0 g/dL
- Absolute neutrophil count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
- Bilirubin no greater than 1.5 mg/dL
- SGPT no greater than 60 U/L
- Creatinine no greater than 1.3 mg/dL
- Blood urea nitrogen no greater than 24 mg/dL
- Neurological function status 0-3
- No evidence of neuropathy
- No glucose-6-phosphate dehydrogenase deficiency
- No known history of porphyria
- History of prior malignancies allowed
- HIV positive status allowed
- No medical contraindication to MRI imaging (i.e., pacemaker, aneurysm clip, or
nonsecure metal fragment close to a critical structure)
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception prior to and during study
- At least 6 weeks since prior chemotherapy
- Concurrent steroids allowed
- No prior radiotherapy to the brain or upper neck
- No greater than 5 weeks since prior surgery and recovered