Purpose

This phase II trial studies how well dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSC-MRI) works in measuring relative cerebral blood volume (rCBV) for early response to bevacizumab in patients with glioblastoma that has come back. DSC-MRI may help evaluate changes in the blood vessels within the cancer to determine a patient?s response to treatment.

Category

IRB Number
20170313HU
NCT Number
NCT03115333
Sponsor
ECOG-ACRIN Cancer Research Group -



Study Contact

Principal Investigator
Andrew Brenner

Frances Crawford
210-450-5037
crawfordf1@uthscsa.edu

Myrna Montenegro
210-450-5954
montenegro@uthscsa.edu

Kathleen Rodriguez
210-450-1365
rodriguezk3@uthscsa.edu

Benjamin Schleif
210-450-1366
schleifb@uthscsa.edu

Morgan Seekatz
210-450-1133
seekatz@uthscsa.edu



Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

    • Histologically proven intracranial glioblastoma or gliosarcoma at initial surgery

      • Patients will be eligible if the original histology was low-grade glioma and a subsequent diagnosis of glioblastoma or gliosarcoma is made (high-grade transformation)
    • Karnofsky performance status >= 70
    • Women must not be pregnant or breast-feeding
    • Progression of disease assessed by local site using Revised Assessment in Neuro-Oncology (RANO) criteria, with plan to give whole-dose bevacizumab therapeutically, either as single therapy or in conjunction with other chemotherapeutic regimens; patients getting bevacizumab to support additional radiation therapy or immunotherapy, or primarily for reduction of edema rather than for tumor treatment, are excluded; this must be the patient?s initial recurrence
    • Patient must not have been treated previously with immunotherapies (vaccines, checkpoint inhibitors, T-cells)
    • Intratumoral hemorrhage (acute, subacute, or chronic) as seen on hemosiderin-sensitive (gradient-echo) MRI may preclude patient inclusion because of anticipated limited evaluation due to magnetic susceptibility artifact on the heavily T2-weighted DSC-MRI images; if the region of enhancing tumor not affected by blooming artifact on the hemosiderin-sensitive images does not meet the 10 x 10 x 10 mm ?measurable enhancement? threshold specified elsewhere, the patient is ineligible
    • Progressive enhancement (> 25% increase in contrast enhancing volume compared to nadir) on MRI within 14 days of registration, >= 42 days since completion of radiation/temozolomide therapy, and >= 28 days since surgical resection or cytotoxic chemotherapy; measurable enhancement is defined as two perpendicular in-plane diameters of at least 10 mm and at least 10 mm in the 3rd orthogonal direction

    • Patients must be able to tolerate brain MRI scans with dynamic intravenous gadolinium-based contrast agent injections

      • Ability to withstand 22 gauge intravenous (IV) placement
      • No history of untreatable claustrophobia
      • No magnetic resonance (MR) incompatible implants/devices or metallic foreign bodies

      • No contraindication to intravenous contrast administration

        • Adequate organ function, including adequate renal function defined as estimated glomerular filtration rate (eGFR) >= 40 mL/min/1.73 m^2 as calculated per institution standard of care, and meeting local site requirements for intravenous administration of gadolinium-based MRI contrast agents
      • No known allergy-like reaction to gadolinium or moderate or severe allergic reactions to one or more allergens as defined by the American College of Radiology (ACR); patient may be eligible if willing to undergo pre-treatment as defined by the institution's policy and/or ACR guidance
      • Weight compatible with limits imposed by the MRI scanner table
    • Patient must be scheduled to receive treatment with a standard dose regimen of bevacizumab (bevacizumab infusion on days 1 and 15 of a 28-day treatment cycle); patient can be treated with bevacizumab alone or in combination with other chemotherapi

Exclusion Criteria

    e Inclusion Criteria)

Study Design

Phase
Phase 2
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Diagnostic
Masking
None (Open Label)
Condition
  • Gliosarcoma
  • Recurrent Glioblastoma

    • Arm Groups

    ArmDescriptionIntervention
    Experimental

    Diagnostic (DSC-MRI)

    		Patients undergo DSC-MRI within 3 days before bevacizumab initiation and at day 15.
  • Diagnostic Test: Dynamic Susceptibility Contrast-Enhanced Magnetic Resonance Imaging

    Undergo DSC-MRI

    Other names:

    • DSC-MRI
    • Dynamic Susceptibility Contrast-Enhanced MRI
    • DYNAMIC SUSCEPTIBILITY-CONTRAST MRI

    •