RTOG 0913: A phase 1 study of daily everolimus (RAD001) in combination with radiation therapy and temozolomide in patients with newly diagnosed glioblastoma

Prakash Chinnaiyan, Minhee Won, Patrick Y. Wen, Amyn Mohammed Rojiani, Merideth Wendland, Thomas A. Dipetrillo, Benjamin W. Corn, Minesh P. Mehta

Research output: Contribution to journalArticle

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Abstract

Purpose: To determine the safety of the mammalian target of rapamycin inhibitor everolimus (RAD001) administered daily with concurrent radiation and temozolomide in newly diagnosed glioblastoma patients. Methods and Materials: Everolimus was administered daily with concurrent radiation (60 Gy in 30 fractions) and temozolomide (75 mg/m2 per day). Everolimus was escalated from 2.5 mg/d (dose level 1) to 5 mg/d (dose level 2) to 10 mg/d (dose level 3). Adjuvant temozolomide was delivered at 150 to 200 mg/m2 on days 1 to 5, every 28 days, for up to 12 cycles, with concurrent everolimus at the previously established daily dose of 10 mg/d. Dose escalation continued if a dose level produced dose-limiting toxicities (DLTs) in fewer than 3 of the first 6 evaluable patients. Results: Between October 28, 2010, and July 2, 2012, the Radiation Therapy Oncology Group 0913 protocol initially registered a total of 35 patients, with 25 patients successfully meeting enrollment criteria receiving the drug and evaluable for toxicity. Everolimus was successfully escalated to the predetermined maximum tolerated dose of 10 mg/d. Two of the first 6 eligible patients had a DLT at each dose level. DLTs included gait disturbance, febrile neutropenia, rash, fatigue, thrombocytopenia, hypoxia, ear pain, headache, and mucositis. Other common toxicities were grade 1 or 2 hypercholesterolemia and hypertriglyceridemia. At the time of analysis, there was 1 death reported, which was attributed to tumor progression. Conclusions: Daily oral everolimus (10 mg) combined with both concurrent radiation and temozolomide followed by adjuvant temozolomide is well tolerated, with an acceptable toxicity profile. A randomized phase 2 clinical trial with mandatory correlative biomarker analysis is currently under way, designed to both determine the efficacy of this regimen and identify molecular determinants of response.

Original languageEnglish (US)
Pages (from-to)880-884
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume86
Issue number5
DOIs
StatePublished - Aug 1 2013

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temozolomide
Glioblastoma
radiation therapy
Radiotherapy
dosage
toxicity
Radiation
Radiation Dosage
Febrile Neutropenia
Mucositis
Radiation Oncology
Maximum Tolerated Dose
Hypertriglyceridemia
Sirolimus
Everolimus
Hypercholesterolemia
Exanthema
Drug-Related Side Effects and Adverse Reactions
radiation
Gait

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

RTOG 0913 : A phase 1 study of daily everolimus (RAD001) in combination with radiation therapy and temozolomide in patients with newly diagnosed glioblastoma. / Chinnaiyan, Prakash; Won, Minhee; Wen, Patrick Y.; Rojiani, Amyn Mohammed; Wendland, Merideth; Dipetrillo, Thomas A.; Corn, Benjamin W.; Mehta, Minesh P.

In: International Journal of Radiation Oncology Biology Physics, Vol. 86, No. 5, 01.08.2013, p. 880-884.

Research output: Contribution to journalArticle

Chinnaiyan, Prakash ; Won, Minhee ; Wen, Patrick Y. ; Rojiani, Amyn Mohammed ; Wendland, Merideth ; Dipetrillo, Thomas A. ; Corn, Benjamin W. ; Mehta, Minesh P. / RTOG 0913 : A phase 1 study of daily everolimus (RAD001) in combination with radiation therapy and temozolomide in patients with newly diagnosed glioblastoma. In: International Journal of Radiation Oncology Biology Physics. 2013 ; Vol. 86, No. 5. pp. 880-884.
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AU - Rojiani, Amyn Mohammed

AU - Wendland, Merideth

AU - Dipetrillo, Thomas A.

AU - Corn, Benjamin W.

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