TORC1/2 Inhibitor INK128 Before and After Surgery in Treating Patients With Recurrent Glioblastoma

Status: Recruiting
Phase: N/A
Diagnosis: Brain/Neuro Cancer: Recurrent Glioblastoma
NCT ID: NCT02133183 (View complete trial on
DFCI Protocol ID: 14-095


This partially randomized pilot trial studies how much TORC1/2 inhibitor INK128 reaches the brain tumor and how well it works when given before and after surgery in treating patients with glioblastoma that has grown or recurred and requires surgery. TORC1/2 inhibitor INK128 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.


Conducting Institutions:
Dana-Farber Cancer Institute, Brigham and Women's Hospital

Overall PI:
Eudocia Lee, M.D., Dana Farber Cancer Institute

Site-responsible Investigators:

Dana-Farber Cancer Institute: Lisa Doherty,

Eligibility Criteria

Inclusion Criteria: - Patients must have histologically proven glioblastoma or gliosarcoma which is progressive or recurrent following radiation therapy +/- chemotherapy - Patients must have measurable, supratentorial contrast-enhancing progressive or recurrent glioblastoma or gliosarcoma by magnetic resonance imaging (MRI) imaging within 21 days of starting treatment; patient must be able to tolerate MRIs - Patients may have had treatment for no more than 2 prior relapses - Patients must have recovered from severe toxicity of prior therapy; the following intervals from previous treatments are required to be eligible: - 12 weeks from the completion of radiation - 6 weeks from a nitrosourea chemotherapy or mitomycin C - 3 weeks from a non-nitrosourea chemotherapy - 4 weeks from any investigational (not Food and Drug Administration [FDA]-approved) agents - 2 weeks from administration of a non-cytotoxic, FDA-approved agent (e.g., erlotinib, hydroxychloroquine, etc.) - Patients must be undergoing surgery that is clinically indicated as determined by their care providers - Patients must be eligible for surgical resection according to the following criteria: - Part 1 patients: Expectation that the surgeon is able to resect at least 350 mg of tumor from enhancing tumor and at least 350 mg from non-enhancing tumor with low risk of inducing neurological injury - Part 2 patients: Expectation that the surgeon is able to resect at least 1000 mg from enhancing tumor and at least 350 mg from non-enhancing tumor with low risk of inducing neurological injury - Patients must have a Karnofsky performance status >= 60% (i.e. the patient must be able to care for himself/herself with occasional help from others) - Absolute neutrophil count >= 1,500/mcL - Platelets >= 100,000/mcL - Hemoglobin >= 9 g/dL - Total bilirubin =< 1.5x upper limit of normal (ULN) - Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 × institutional upper limit of normal - Creatinine =< institutional upper limit of normal OR - Creatinine clearance >= 50 ml/min/1.73m^2 for patients with creatinine levels above institutional normal - Activated partial thromboplastin time (APTT) =< 1.5 x institutional upper limit of normal - Patients must be able to provide written informed consent - Women of childbearing potential must have a negative serum pregnancy test prior to study entry; women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and through 30 days after the last dose of study drug; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately; men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and through 30 days after the last dose of study drug - Patients must have no concurrent malignancy except curatively treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix, breast, or bladder; patients with prior malignancies must be disease-free for >= five years - Patients must be able to swallow whole capsules - Patients enrolled in Part 2 must have at least 20 (preferably 40) slides of archival tumor tissue from a prior surgery demonstrating GBM; patients enrolled in Part 1 will not be required to have archival tissue Exclusion Criteria: - Patients receiving any other investigational agents are ineligible - Patients with a history of allergic reactions attributed to compounds of similar chemical or biologic composition to MLN0128 are ineligible - Patients may not have had prior treatment with mTOR, peptidase inhibitor 3, skin-derived (PI3) kinase or Akt inhibitors - Patients may not have had prior treatment with bevacizumab/vascular endothelial growth factor receptor (VEGFR) inhibitors - Patients on enzyme-inducing anti-epileptic drugs (EIAED) are not eligible for treatment on this protocol; patients may be on non-enzyme inducing anti-epileptic drugs or not be taking any anti-epileptic drugs; patients previously treated with EIAED may be enrolled if they have been off the EIAED for 10 days or more prior to the first dose of MLN0128 - Patients must not have evidence of significant hematologic, renal, or hepatic dysfunction - Patients must not have evidence of significant intracranial hemorrhage - Patients with a history of any of the following within the last 6 months prior to study entry are ineligible: - Ischemic myocardial event, including angina requiring therapy and artery revascularization procedures - Ischemic cerebrovascular event, including TIA and artery revascularization procedures - Requirement for inotropic support (excluding digoxin) or serious (uncontrolled) cardiac arrhythmia (including atrial flutter/fibrillation, ventricular fibrillation or ventricular tachycardia) - Placement of a pacemaker for control of rhythm - New York Heart Association (NYHA) class III or IV heart failure - Pulmonary embolism - Patients with known significant active cardiovascular or pulmonary disease at the time of study entry are ineligible - Patients with baseline prolongation of the rate-corrected QT interval (QTc) (e.g., repeated demonstration of QTc interval > 480 milliseconds, or history of congenital long QT syndrome, or torsades de pointes) are ineligible - Patients with known diabetes mellitus which is poorly controlled (defined as hemoglobin A1c [HbA1c] > 7%) are ineligible; subjects with a history of transient glucose intolerance due to corticosteroid administration are allowed in this study if all other inclusion/exclusion have been met - Patients who have initiated treatment with bisphosphonates less than 30 days prior to the first administration of MLN0128 are ineligible; concurrent bisphosphonate use is only allowed if the bisphosphonate was initiated at least 30 days prior to the first administration of MLN0128 - Patients with known manifestations of malabsorption due to prior gastrointestinal (GI) surgery, GI disease, or for an unknown reason that may alter the absorption of MLN0128 are ineligible - Patients with uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements, are ineligible - Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated with MLN0128 - Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy are ineligible - Subjects taking strong cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) and cytochrome P450, family 2, subfamily C, polypeptide 19 (CYP2C19) inhibitors and/or inducers should be considered with caution; alternative treatments that are less likely to affect MLN0128 metabolism, if available, should be considered; if a subject requires treatment with 1 or more of the strong CYP3A4 and CYP2C19 inhibitors and/or inducers, the study doctor should be consulted
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