Condition category
Cancer
Date applied
27/05/2011
Date assigned
27/05/2011
Last edited
23/06/2015
Prospective/Retrospective
Retrospectively registered
Overall trial status
Completed
Recruitment status
No longer recruiting

Contact information

Type

Scientific

Primary contact

Dr Fiona Dungey

ORCID ID

Contact details

Cancer Research UK & UCL Cancer Trials Centre
90 Tottenham Court Road
London
W1T 4TJ
United Kingdom

Additional identifiers

EudraCT number

2010-021531-13

ClinicalTrials.gov number

NCT01310855

Protocol/serial number

9563

Study information

Scientific title

Multi-centre, randomised, double-blind phase II study comparing cediranib (AZD2171) plus gefitinib (Iressa, ZD1839) with cediranib plus placebo in subjects with recurrent/progressive glioblastoma (DORIC Trial)

Acronym

DORIC

Study hypothesis

This is a phase II, randomised, double-blind placebo-controlled study in patients with recurrent or progressive glioblastoma (WHO grade IV). Patients are to receive cediranib in combination with gefitinib or cediranib with placebo. The primary endpoint is Progression Free Survival.

Ethics approval

First MREC approval on 17/02/2011, ref:10/H0715/77

Study design

Randomised interventional trial

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

Hospitals

Trial type

Treatment

Patient information sheet

Not available in web format

Condition

Brain Tumour

Intervention

This is a randomised double blind multicentre phase II trial of daily cediranib +/- gefitinib for patients with recurrent/progression Glioblastoma. Patients will continue treatment until confirmed progression, patient decision or the development of unacceptable toxicity. Follow up for the trial is continuous unless the patient requests otherwise. A translational component will examine the roles of potential biomarkers and stratify the results based on known indicators of prognosis such as MGMT methylation and IDH 1 and 2. Doses: Cediranib 30mg daily, Gefitinib 500mg or matching placebo daily

Intervention type

Drug

Phase

Phase II

Drug names

Cediranib, gefitinib

Primary outcome measures

1. Progression free survival
2. Timepoint(s): throughout trial

Secondary outcome measures

1. Overall survival, timepoint(s): date of death
2. Overall survival rate at 12 months, timepoint(s): 12 months
3. Progression free survival at 6 months, timepoint(s): 6 months
4. Radiographic response rate, timepoint(s): at each MRI scan (6 weekly)
5. Safety and tolerability, timepoint(s): throughout trial
6. Steroid use, timepoint(s): thoughout trial
7. Time to deterioration of neurological status or death, timepoint(s): throughout trial, death
8. Time to sustained increase in steroid dosage, timepoint(s): throughout trial

Overall trial start date

24/05/2011

Overall trial end date

24/11/2012

Reason abandoned

Eligibility

Participant inclusion criteria

1. Provision of informed consent
2. Age ≥18 years
3. Life expectancy ≥ 12 weeks
4. Histological/cytological confirmation of glioblastoma (WHO grade IV)
5. Patients with measurable disease (contrast-enhancing tumour ≥10 mm by shortest diameter on 2 axial slices) by MRI imaging within 7 days prior to enrolment. (If patients have recently had a routine MRI scan, this should be assessed before deciding whether or not to screen the patient, and booking the screening/baseline MRI.)
6. Patients must have been on no steroids or a stable dose of steroids (dexamethasone) for at least 5 days before the baseline MRI
7. Patients must have completed standard first-line treatment for glioblastoma including surgery (with exception, if patient does not receive surgery as part of first-line treatment due to anatomical location, based on neurosurgeon's assessment), cranial radiotherapy and chemotherapy with concomitant temozolomide
7.1. It is not essential that the entire Stupp regimen of 6 cycles of adjuvant temozolomide following chemoradiotherapy has been completed
7.2. The last dose of temozolomide must be more than 28 days from enrolment
7.3. Gliadel® wafers are permitted, as it is part of local treatment
7.4. No other previous treatment for glioblastoma is permitted (other than steroids)
8. Patients must have a Karnofsky Performance Score of 70 or above
9. Patients must have a mini-mental status examination score of 15 or greater
10. Patients who require either oral anticoagulants (coumadin, warfarin) or low molecular weight heparin are eligible provided there is increased vigilance with respect to monitoring INR.
11. For inclusion in the genetic research, patients must fulfil the following criterion:
11.1. Provision of informed consent for genetic research (separate consent required for tumour biopsy, blood sample, and post mortem donations)
11.2. If a patient declines to participate in any of the genetic research, there will be no penalty or loss of benefit to the patient
11.3. The patient will not be excluded from other aspects of the study described in this Clinical Study Protocol, so long as they consent to the main study

Participant type

Patient

Age group

Adult

Gender

Both

Target number of participants

UK Sample Size: 112

Participant exclusion criteria

1. Patients on enzyme-inducing anti-epileptic drugs within 2 weeks prior to study enrolment
Note: Patients are eligible if they switched to non-enzyme inducing agents and discontinued enzyme-inducing agents for more than or equal to 2 weeks prior to randomisation
2. Inadequate bone marrow reserve as demonstrated by an absolute neutrophil count ≤1.5 x 109 /L or platelet count ≤100 x 109 /L or requiring regular blood transfusions to maintain haemoglobin >9g/dL
3. Serum bilirubin ≥1.5 x ULRR (except for patients with known documented cases of Gilbert’s Syndrome)
4. ALT or AST ≥5 x ULRR
5. Serum creatinine >1.5 x ULRR or a creatinine clearance of ≤50mL/min calculated by Cockcroft-Gault
6. Greater than +1 proteinuria on two consecutive dipsticks taken no less than 1 week apart unless urinary protein <1.5g in a 24 hr period or UPC (Urine Protein: Creatinine) ratio <1.5
7. History of significant gastrointestinal impairment, as judged by the investigator, that would significantly affect the absorption of cediranib or gefitinib, including the ability to swallow the tablet whole
8. Patients with a history of poorly controlled hypertension with resting blood pressure >150/100mmHg in the presence or absence of a stable regimen of anti-hypertensive therapy, or patients who are requiring maximal doses of calcium channel blockers to stabilise blood pressure
9. Any evidence of severe or uncontrolled diseases (e.g. unstable or uncompensated respiratory, cardiac, hepatic or renal disease)
10. Unresolved toxicity >CTC AE grade 1 from previous anti-cancer therapy (including radiotherapy) except alopecia (if applicable)
11. Mean QTc with Bazetts correction >470msec in screening ECG or history of familial, long QT syndrome
12. Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
13. Significant haemorrhage (>30mL bleeding/episode in previous 3 months) or haemoptysis (>5mL fresh blood in previous 4 weeks)
14. Recent (<14 days) major surgery or brain biopsy
15. Recent craniotomy (<28 days) prior to first dose, or a surgical incision that is not fully healed
16. Pregnant or breast-feeding women or women of childbearing potential with a positive pregnancy test prior to receiving study medication
17. Known hypersensitivity to cediranib, gefitinib or any of its excipients
18. History of other malignancies (except for adequately treated basal or squamous cell carcinoma or carcinoma in situ) within 5 years, unless the patient has been disease free for 2 years and they have tissue diagnosis of the target lesion
19. Known infection with hepatitis B or C or HIV
20. Involvement in the planning and conduct of the study (applies to both UCL CTC, AstraZeneca staff and staff at the study site)
21. Past medical history of interstitial lung disease, idiopathic pulmonary fibrosis, drug-induced interstitial disease, radiation pneumonitis which required steroid treatment or any evidence of clinically active interstitial lung disease
22. Previous enrolment as part of the present study
23. Treatment with an investigational drug within 30 days prior to the first dose of cediranib/gefitinib
24. Other concomitant anti-cancer therapy except steroids (dexamethasone only)
25. Previous anti-angiogenesis (e.g. bevacizumab, sorafenib, sunitinib) therapy
26. Previous anti-EGFR treatments (e.g. cetuximab, panitumumab or small molecule tyrosine kinase inhibitors etc.) or downstream targets e.g. mTOR inhibitors
27. Patients with evidence of any intratumoural or peritumoural haemorrhage deemed significant by the treating physician
28. Patients who have received any form of cranial radiation within 3 months prior to study entry (excluding imaging)
29. Patients who have progressed within 3 months of completion of standard cranial radiation
30. Patients that have received radiosurgery or brachytherapy
31. Patients on >8mg/day dexamethasone or equivalent steroids on any day of the 2 weeks prior to randomisation

Recruitment start date

24/05/2011

Recruitment end date

08/08/2012

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Cancer Research UK & UCL Cancer Trials Centre
London
W1T 4TJ
United Kingdom

Sponsor information

Organisation

University College London (UK)

Sponsor details

Gower Street
London
WC1E 6BT
United Kingdom

Sponsor type

University/education

Website

Funders

Funder type

Industry

Funder name

AstraZeneca (UK)

Alternative name(s)

Funding Body Type

private sector organisation

Funding Body Subtype

corporate

Location

United Kingdom

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

Publication citations

Additional files

Editorial Notes