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Protective VEGF Inhibition for Isotoxic Dose Escalation in Glioblastoma

Phase 2
Recruiting
Conditions
Glioblastoma
Interventions
Radiation: Dose escalation of radiation dose beyond the therapeutic standard
Registration Number
NCT05871021
Lead Sponsor
Ludwig-Maximilians - University of Munich
Brief Summary

Glioblastoma is the most aggressive brain tumor and often recurs locally despite intensive treatment. Standard chemoradiotherapy with 60 Gy may not be sufficient to control the tumor, and dose escalation seems to be warranted, but causes more toxicity. To address this, the multicentric PRIDE trial employs two cycles of bevacizumab to achieve dose escalation isotoxically. The goal is improved survival without significantly increasing side effects. The study uses a simultaneous integrated boost with a total dose of 75 Gy in 2.5 Gy per fraction.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
146
Inclusion Criteria
  • IDH wild-type, MGMT unmethylated glioblastoma patients
  • Informed consent
  • Age ≥18 and ≤ 70 years, smoking or non-smoking, of any ethnic origin
  • ECOG 0-2
  • Neutrophil counts > 1500/μl; Platelet counts > 100.000/μl; Hemoglobin > 8 g/dl; Serum creatinine < 1.5-fold upper limit of normal (ULN); Bilirubin, AST or ALT < 2.5-fold ULN unless attributed to anticonvulsants; Alkaline phosphatase < 2.5-fold ULN
  • Adequate contraception
  • Serum creatinine ≤ 1.5 x ULN AND patients with urine dipstick for proteinuria < 2+. Patients with ≥ 2+ proteinuria on dipstick urinalysis at baseline should show urine protein to creatinine ratio ≤ 1
Exclusion Criteria
  • Evidence of recent hemorrhage on postoperative MRI of the brain
  • Subjects on any drug suspected to interfere with bevacizumab at the time of study inclusion
  • Immuno-compromised patients, including known seropositivity for human immunodeficiency virus (HIV)
  • Known hypersensitivity to any component of the investigational drugs or excipients (allergy to or other intolerability of bevacizumab or excipients)
  • Any other significant medical illness or medically significant laboratory finding that would, in the investigator's judgement, make the patient inappropriate for this study, or would increase the risk associated with the patients' participation in the study
  • Incapability to undergo MRI
  • Prior treatment with bevacizumab for any indication
  • Significant cardiovascular disease defined as congestive heart failure (NYHA Class II, III, IV), unstable angina pectoris, or myocardial infarction within 6 months prior to enrolment
  • Inadequately controlled hypertension (de-fined as a blood pressure of > 150 mmHg systolic and/or >100 mmHg diastolic on medication), or any prior history of hypertensive crisis or hypertensive encephalopathy
  • History of stroke or transient ischemic attack within 6 months prior to enrolment
  • Significant vascular disease (e.g. aortic aneurysm, aortic dissection or recent peripheral arterial thrombosis) within 6 months prior to enrolment
  • Evidence or history of recurrent thromboembolism (> 1 episode of deep venous thrombosis / peripheral embolism) during the past 2 years
  • Evidence of bleeding diathesis or coagulopathy (in the absence of therapeutic anticoagulation)
  • Chronic daily intake of aspirin > 325 mg/day or clopidogrel > 75 mg /day
  • History of intracranial abscess within 6 months prior to inclusion
  • History of abdominal or tracheo-oesophageal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrolment
  • History of ≥ grade 2 hemoptysis according to NCI-CTC criteria within 1 month prior to inclusion
  • Serious non-healing wound, ulcer or bone fracture

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
75 Gy with two cycles of bevacizumabDose escalation of radiation dose beyond the therapeutic standard-
Primary Outcome Measures
NameTimeMethod
OSDate of study inclusion (informed consent) to death or end of F/U

Overall Survival

Secondary Outcome Measures
NameTimeMethod
Safety and tolerabilityDate of study inclusion (informed consent) to death or end of F/U

Safety and tolerability of dose escalation with bevacizumab according to CTCAE v5.0

PFSDate of study inclusion (informed consent) to death or progression

Progression-free survival

PFS-66 months after the date of study inclusion (informed consent)

6 months rate of progression-free survival

Exploratory objectiveDate of study inclusion (informed consent) to death or end of F/U

Validation of prognostic 4-miRNA signature-based risk score

QoLDate of study inclusion (informed consent) to death or end of F/U

Quality of life as determined by EORTC QLQ-C30/QLQ-BN 20

Cognitive functionDate of study inclusion (informed consent) to death or end of F/U

Cognitive function determined by standard test batteries

Trial Locations

Locations (1)

Department of Radiation Oncology

🇩🇪

Munich, Germany

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