Chlorpromazine and Standard of Care for Glioblastoma

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Varun Monga, MD profile photo
Overseen ByVarun Monga, MD
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine whether adding chlorpromazine, an antipsychotic medication typically used for other conditions, can enhance the effectiveness of standard treatment for glioblastoma, an aggressive brain cancer. The standard treatment includes chemotherapy with temozolomide and radiation therapy. Participants will receive this combined treatment to assess its potential in better managing the disease. This trial may suit those recently diagnosed with glioblastoma who have already undergone surgery and are ready to begin treatment within five weeks. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants the opportunity to contribute to groundbreaking research.

Do I need to stop my current medications to join the trial?

The trial information does not specify if you need to stop taking your current medications. However, you cannot be on other investigational drugs or have uncontrolled illnesses, which might suggest some restrictions. It's best to discuss your specific medications with the trial team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that chlorpromazine, a drug often used for mental health issues, might also help treat glioblastoma, a type of brain cancer. Studies have found that adding chlorpromazine to standard glioblastoma treatments is generally safe. The World Health Organization already considers it a safe drug.

In past research, patients handled chlorpromazine well when used with other cancer treatments. There were no major safety concerns, and using it with temozolomide, a common cancer drug, did not lead to unexpected side effects.

So far, evidence suggests that chlorpromazine is safe for glioblastoma when added to standard care. However, since this trial is in the early stages, safety is still being closely monitored.12345

Why do researchers think this study treatment might be promising for glioblastoma?

Researchers are excited about using chlorpromazine in glioblastoma treatment because it introduces a new approach alongside the standard therapies of radiation and temozolomide. Chlorpromazine, traditionally used as an antipsychotic, is being explored for its potential anti-cancer properties, making it a novel addition to the glioblastoma treatment arsenal. Unlike conventional treatments that focus solely on targeting cancer cells with radiation and chemotherapy, chlorpromazine may disrupt cancer cell growth and survival through different mechanisms, potentially enhancing overall treatment efficacy. This combination could offer a more comprehensive attack on the tumor, which is why there's significant interest in its potential benefits.

What evidence suggests that chlorpromazine might be an effective treatment for glioblastoma?

Research has shown that chlorpromazine, a drug typically used for mental health conditions, might help treat glioblastoma, a type of brain cancer. It alters how cancer cells obtain energy, potentially stopping their growth. Specifically, it affects the Warburg effect, a process cancer cells use to grow. In this trial, participants will receive chlorpromazine alongside standard chemoradiation, which includes temozolomide, a common chemotherapy drug for glioblastoma. Studies suggest that chlorpromazine works well with temozolomide to weaken the tumor. This combination could reduce the cancer cells' ability to survive and help slow the disease. Early studies have shown promising results, but further research is needed to confirm these findings.23467

Who Is on the Research Team?

Mohammed M. Milhem | University of Iowa ...

Mohammed Milhem, MBBS

Principal Investigator

University of Iowa Hospitals and Clinics Holden Comprehensive Cancer Center

Are You a Good Fit for This Trial?

This trial is for adults over 18 with newly diagnosed glioblastoma who have had recent surgery. They must be in a stable condition (ECOG 0-2), with good blood counts and liver function, and able to give informed consent. Excluded are those with heart issues, prior high-grade glioma treatments, other CNS diseases or malignancies that could affect the study, uncontrolled illnesses, or pregnant/breastfeeding women.

Inclusion Criteria

Plasma blood chemistries within 21 days of radiation fraction 1, as defined below:
My diagnosis was confirmed through a surgical procedure.
My treatment will start within 5 weeks after my last surgery.
See 11 more

Exclusion Criteria

I have had radiation therapy to my head or neck before.
I am allergic to medications similar to temozolomide or chlorpromazine.
I am not on any experimental drugs but may be using TTF as part of my standard care.
See 7 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Concomitant Chlorpromazine

Start 7 days prior to day 1 of concurrent Temozolomide and radiation. Will continue with Chlorpromazine through radiation therapy (temozolomide will cease after 49 days)

8 weeks
Weekly visits for radiation and monitoring

Interim Phase

Continue oral chlorpromazine daily dose post-radiation and prior to beginning adjuvant temozolomide

4 weeks

Adjuvant Phase

Start oral temozolomide once daily for 5 consecutive days of a 28 day cycle, and continue oral daily chlorpromazine. Treatment will continue for up to 6 cycles.

24 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Chlorpromazine
  • Radiation Therapy
  • Temozolomide
Trial Overview The study tests chlorpromazine combined with temozolomide and radiation therapy as a new treatment approach for glioblastoma multiforme. It's an early-phase trial to see if this repurposed drug can work well alongside standard cancer treatments.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Chlorpromazine with standard of care chemoradiationExperimental Treatment3 Interventions

Chlorpromazine is already approved in United States, European Union, Canada for the following indications:

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Approved in United States as Thorazine for:
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Approved in European Union as Largactil for:
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Approved in Canada as Chlorpromazine Hydrochloride for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Varun Monga, MD

Lead Sponsor

Trials
7
Recruited
130+

Mohammed Milhem

Lead Sponsor

Trials
9
Recruited
240+

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/38092755/
Chlorpromazine affects glioblastoma bioenergetics by ...The effect of CPZ can be epitomized as an inhibition of the Warburg effect and thus malignancy in GBM cells, while sparing RPE-1 cells.
Chlorpromazine affects glioblastoma bioenergetics by ...The experimental outcome strengthened the data concerning the ability of CPZ to decrease the content of nuclear PKM2 (Fig. S4). These results ...
NCT04224441 | Repurposing Chlorpromazine in the ...This study evaluates the addition of chlorpromazine to the first-line therapeutic protocol, i.e. maximal well-tolerated surgical resection followed by ...
Anticancer Properties of the Antipsychotic Drug ...Chlorpromazine synergized with temozolomide, the first-line therapeutic in GBM patients, in hindering GBM cell viability.
RACTAC, a phase II multicenter trialEfficacy and safety of chlorpromazine as an adjuvant therapy for glioblastoma in patients with unmethylated MGMT gene promoter: RACTAC, a phase ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/38162492/
Efficacy and safety of chlorpromazine as an adjuvant ...The addition of CPZ to standard TMZ in the first-line treatment of GBM patients with unmethylated MGMT gene promoter was safe and led to a longer PFS than ...
Abstract 4713: Chlorpromazine affects glioblastoma ...These findings suggest that chlorpromazine counteracts the Warburg effect and, consequently, malignancy in glioblastoma cells, while sparing ...
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