Primary Chemotherapy With Temozolomide Versus Radiotherapy in Patients With Low Grade Gliomas After Stratification for Genetic 1p Loss: A Phase III Study
Overview
- Phase
- Phase 3
- Intervention
- radiation therapy
- Conditions
- Brain and Central Nervous System Tumors
- Sponsor
- European Organisation for Research and Treatment of Cancer - EORTC
- Enrollment
- 709
- Locations
- 89
- Primary Endpoint
- Progression-free survival
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. It is not yet known whether radiation therapy is more effective than temozolomide in treating gliomas.
PURPOSE: This randomized phase III trial is studying radiation therapy to see how well it works compared to temozolomide in treating patients with gliomas.
Detailed Description
OBJECTIVES: Primary * Compare the progression-free survival of patients with low-grade gliomas treated with radiotherapy vs temozolomide. Secondary * Compare the overall survival of patients treated with these regimens. * Determine whether the incidence of late toxicity can be decreased in patients who are randomized to receive temozolomide. * Compare the toxic effects of these regimens in these patients. * Compare the quality of life of patients treated with these regimens. OUTLINE: This is a randomized, controlled, multicenter study. Patients are stratified according to participating center, chromosome 1p status (deleted vs normal vs undeterminable), contrast enhancement on MRI (yes vs no), age (\< 40 years vs ≥ 40 years), and WHO performance status (0 or 1 vs 2). Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients undergo radiotherapy once daily, 5 days a week, for a total of 28 fractions (i.e., 5½ weeks). * Arm II: Patients receive oral temozolomide once daily on days 1-21. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity. Quality of life is assessed at baseline and then every 3 months until disease progression. After completion of study treatment, patients are followed every 6 months for survival. Peer Reviewed and Funded or Endorsed by Cancer Research UK PROJECTED ACCRUAL: A minimum of 699 patients (a total of 466 randomized \[233 per treatment arm\]) will be accrued for this study within 5 years.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Arms & Interventions
radiotherapy
Radiotherapy (control arm), 50.4 Gy, standard fractionation (28 x 1.8 Gy), conformal techniques
Intervention: radiation therapy
Temozolomide
Temozolomide 75 mg/m2 daily x 21 days, q 28 days until progression or for max. 12 cycles (experimental arm)
Intervention: temozolomide
Outcomes
Primary Outcomes
Progression-free survival
Time Frame: 5 years
Secondary Outcomes
- Overall survival(5 years)
- Adverse events as measured by CTCAE v3.0(As indicated in the protocol)
- Quality of life as measured by QLQ-C30 v3.0 and EORTC BN-20(every 3 months until progression, and then every 6 months until death)
- Mini-Mental State Examination(every 3 months until progression, and then every 6 months until death)