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Temozolomide

Phase 3

Glioblastoma | Small molecule | Oncology |Merck & Company, Inc.|Last Updated: Jun 7, 2017

Success Probability

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Market & Valuation

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Trial Design

RandomizedACTIVE_CONTROLLEDDMC
Total Trials2
Total Enrollment181

FDA Designations

No designations recorded

Clinical trial landscape

Temozolomide · 9 trials · 12 indications

Phase 3 2Phase 2 7
NCT00335075Efficacy and Safety of Temodal vs Semustine in Subjects With Recurrent Glioblastoma or Anaplastic Astrocytoma (Study P03644)Glioblastoma
COMPLETED151 Analytics
NCT00091572Temozolomide Versus Dacarbazine in Stage IV Metastatic Melanoma (Study P03267)Melanoma
COMPLETED859 Analytics
PHASE3COMPLETED
Efficacy and Safety of Temodal vs Semustine in Subjects With Recurrent Glioblastoma or Anaplastic Astrocytoma (Study P03644)
GlioblastomaUnlock trial analytics
PHASE3COMPLETED
Temozolomide Versus Dacarbazine in Stage IV Metastatic Melanoma (Study P03267)
MelanomaUnlock trial analytics

Study Endpoints

Primary Endpoints

Progression-free survival
2 months, 3 months, and 6 months
Overall Survival
The final analysis was to be performed when at least 616 deaths had occurred.

Overall Survival was defined as the time from the date of randomization to the date of death from any cause.

Clinical Response at the End of Temozolomide Induction
at the end of each cycle (approximately 4 weeks post start of cycle), up to a maximum 63 weeks

Complete Response (CR): \< 5% blasts in normocellular bone marrow (BM); Absolute Neutrophil Count (ANC) \> 1.0 x 10\^9/L, platelets \> 100 x 10\^9/L, and no extramedullary disease. CR with incomplete platelet recovery (CRp): All the criteria of CR but with platelets \< 100 x 10\^9/L but ≥ 50 x 10\^9/L and platelet transfusion independent. Morphologic leukemia-free state (MLFS): complete clearance of blasts from marrow and blood, but criteria for CR or CRp not met. Partial response (PR): decrease ≥ 50% BM blasts. Minimal Response (MR): decrease ≥ 25% but \<50% BM blasts.

MethylGuanine-DNA MethylTransferase [MGMT] Activity Measured From the Tumor Tissue During Surgery
14 days

An experimental assay was developed to measure MGMT levels.

Percentage of Participants Surviving at Six Months of Treatment Without Evidence of Disease Progression.
6 months

Progression-free survival as determined by Kaplan-Meier method.

Adverse Events With an Incidence of Greater Than or Equal to 20%
until 30 days after the completion of administration of monotherapy

Safety was assessed from the start of administration during the concomitant radiotherapy phase until 30 days after the completion of administration of monotherapy. Adverse events were classified under the system organ class using MedDRA-J Version 11.0.

Adverse Drug Reactions With an Incidence of Greater Than or Equal to 20%
until 30 days after the completion of administration of monotherapy

Safety was assessed from the start of administration during the concomitant radiotherapy phase until 30 days after the completion of administration of monotherapy.

Abnormal Changes in Laboratory Test Values With an Incidence of Greater Than or Equal to 20%
until 30 days after the completion of administration of monotherapy

Safety was assessed from the start of administration during the concomitant radiotherapy phase until 30 days after the completion of administration of monotherapy.

Overall response in Step 1
6 months
Incidence rate and severity of adverse events with administration of temozolomide in Step 1
7 months (during temozolomide administration for 6 months and follow-up for 1 month)
Best response related to brain metastases observed during the study period.
After 2 months of initial treatment. If response or stable disease evaluations were performed every 3 months. Subsequently, an additional check up was added by amendment: a follow up check was performed after 4 weeks.

Secondary Endpoints

Overall survival
6 months
Objective response
6 months
Scoring of health-related quality of life
6 months
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Temodal groupEXPERIMENTALSubjects treated with temozolomide.
Semustine groupACTIVE_COMPARATORSubjects treated with semustine.
AEXPERIMENTALtemozolomide 150 mg/m2/day PO, on 7 consecutive days every 14 days ("7 days on / 7 days off" continuously)
BACTIVE_COMPARATORdacarbazine 1000 mg/m2 IV, on Day 1 +/- 3 days every 3 weeks
TemozolomideEXPERIMENTALTemozolomide capsules orally, once daily: 1 induction cycle (200 mg/m\^2/day for 7 days in 1 28 day cycle), 1 consolidation cycle (200 mg/m\^2/day for 7 days in 1 28 day cycle), then 200 mg/m\^2/day for 7 days each 28-day cycle or for 5 days each 28-day cycle (12 cycle maximum). Alternatively participants could have received 100 mg/m\^2/day for 21 days of each 28-day cycle (12 cycle maximum).
Temozolomide treatmentEXPERIMENTAL -
No treatmentNO_INTERVENTION -
Single armEXPERIMENTALIt is the only arm of the study. Subjects receive a combination of radiotherapy and temozolomide, and then temozolomide monotherapy.
Subjects with melanomaEXPERIMENTAL -
Subjects with breast cancerEXPERIMENTAL -
Subjects with non-small cell lung cancerEXPERIMENTAL -

Interventions

NameTypeDescription
TemozolomideDRUGTemozolomide orally for 5 consecutive days (Day 1 through Day 5) every 28 days, at a dose of 150 mg/m2/day for subjects previously treated with chemotherapy, or 200 mg/m2/day for subjects who have not received previous chemotherapy.
SemustineDRUGSemustine orally once every 28 days at a dose of 150 mg/m2/day.
DacarbazineDRUGintravenous solution; dacarbazine 1000 mg/m2 IV (in the vein), on Day 1 +/- 3 days every 3 weeks; one cycle of dacarbazine is defined as a 3-week period; treatment will continue until progression of the disease, unacceptable toxicity, subject refusal, or opinion of the treating physician that it is in the subject's best interest to stop.
RadiotherapyRADIATIONRadiotherapy will be administered in combination with temozolomide during the concomitant radiotherapy phase. Radiotherapy will consist of a conventionally fractioned regimen, delivering a total dose of 60 Gy in 6 weeks, in a once daily schedule of 2 Gy per fraction, for a total of 30 fractions. Radiation will be provided by a linear accelerator of x ray energy of 4 MV or higher.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo

Inclusion Criteria: * Prior histologic confirmation of glioblastoma, anaplastic astrocytoma. * Evidence of tumor progression or recurrence. * Age \>=18 years. * Karnofsky performance status \>=60%. * Absolute neutrophil count \>=1,500/mm\^3, platelet count \>=100,000/mm\^3, hemoglobin \>=8g/dL. * S...

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