RATIONALE: Drugs used in chemotherapy, such as CC-8490, work in different ways to stop tumor
cells from dividing so they stop growing or die.
PURPOSE: Phase I trial to study the effectiveness of CC-8490 in treating patients who have
recurrent or refractory high-grade gliomas.
- Determine the maximum tolerated dose of CC-8490 in patients with recurrent or
refractory high-grade gliomas.
- Determine, preliminarily, the toxic effects of this drug in these patients.
- Determine the pharmacokinetics of this drug in these patients.
- Determine, preliminarily, the potential anti-glioma activity of this drug in these
OUTLINE: This is a dose-escalation study.
Patients receive oral CC-8490 once daily on days 1 and 3-28 (course 1 only). Beginning with
course 2 and for all subsequent courses, patients receive oral CC-8490 once daily on days
1-28. Treatment repeats every 28 days for up to 12 courses in the absence of disease
progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of CC-8490 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. Once the MTD is determined, a total of 10
patients are treated at that dose.
Patients are followed within 2 weeks.
PROJECTED ACCRUAL: A total of 34 patients will be accrued for this study.
- Histologically confirmed supratentorial malignant glioma, including any of the
- Glioblastoma multiforme
- Anaplastic astrocytoma
- Anaplastic oligodendroglioma
- Anaplastic mixed oligoastrocytoma
- Malignant glioma/astrocytoma not otherwise specified OR
- Clinical and radiographic diagnosis of progressive low-grade glioma
- Radiographically diagnosed infiltrating brain stem gliomas not amenable to biopsy
- Recurrent or progressive disease as determined by 1 of the following:
- CT scan or MRI within the past 21 days
- Biopsy within the past 12 weeks
- Failed prior radiotherapy
- 18 and over
- Karnofsky 60-100%
- More than 8 weeks
- Granulocyte count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3 (transfusion independent)
- Hemoglobin at least 8 g/dL (transfusion allowed)
- Bilirubin no greater than 1.5 mg/dL
- AST and ALT no greater than 2 times upper limit of normal
- No significant active hepatic disease that would preclude study participation
- Creatinine no greater than 1.5 mg/dL OR
- Creatinine clearance at least 60 mL/min
- No significant active renal disease that would preclude study participation
- No significant active cardiac disease that would preclude study participation
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 2 months after study
- No other malignancy within the past 3 years except nonmelanoma skin cancer or
carcinoma in situ of the cervix
- No significant active psychiatric disease that would preclude study participation
- No other condition or laboratory abnormality that would preclude study participation
- Able to swallow capsules whole
PRIOR CONCURRENT THERAPY:
- At least 2 weeks since prior interferon
- No concurrent immunotherapy
- At least 2 weeks since prior vincristine
- At least 3 weeks since prior procarbazine
- At least 4 weeks since prior temozolomide or carboplatin
- At least 6 weeks since prior nitrosoureas
- No other concurrent anticancer chemotherapy
- At least 2 weeks since prior tamoxifen
- Concurrent steroids allowed provided dose has been stable for at least 5 days prior
to study enrollment
- See Disease Characteristics
- At least 2 weeks since prior radiotherapy
- No concurrent radiotherapy
- At least 2 weeks since prior resection of a recurrent or progressive tumor
- At least 2 weeks since other prior non-cytotoxic therapy
- At least 4 weeks since other prior cytotoxic therapies
- More than 28 days since prior experimental study drugs
- No other concurrent investigational agents