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临床试验/2023-505829-14-00
2023-505829-14-00招募中3 期

A randomized, open-label, multicentric, two-arm pivotal trial of SonoCloud-9 combined with carboplatin (CBDCA) vs standard of care lomustine (CCNU) or temozolomide (TMZ) in patients undergoing planned resection for first recurrence glioblastoma

Carthera, Carthera32 个研究点 分布在 9 个国家目标入组 301 人开始时间: 2023年11月7日最近更新:

试验速览

阶段
3 期
状态
招募中
发起方
入组人数
301
试验地点
32
主要终点
Overall survival (OS), defined as the time from the date of randomization to the date of death due to any cause or censored at the time of last follow-up, calculated according to the Kaplan Meier method.

研究概览

简要总结

To evaluate and compare the survival outcome of patients with first recurrence of glioblastoma undergoing surgical debulking/resection followed by either implantation of the SC9 device and repeat BBB opening in association with carboplatin chemotherapy or standard of care 2nd line chemotherapy with either lomustine or temozolomide (per best physician’s choice and best practice)

入排标准

年龄范围
18 years 至 65+ years(65+ Years, 18-64 Years)
接受健康志愿者

入选标准

  • Histologically proven glioblastoma (WHO criteria 2021), absence of IDH mutation demonstrated by negative IDH1 R132H staining on IHC.
  • Patient able to understand clinical trial information and willing to provide signed and informed consent
  • Patient of childbearing potential must have a negative pregnancy test within 14 days of inclusion and must agree to use a medically-acceptable method of birth control during the treatment period and, if randomized in the experimental arm, for at least 1 month after the last cycle of carboplatin
  • A male patient must agree to use condoms during the treatment period and, if randomized in the experimental arm, for at least 3 months after the last cycle of carboplatin; the patient must also refrain from donating sperm during this period.
  • Patient must be a beneficiary of a health plan that covers routine patient care costs. Patient must be a beneficiary of or affiliated with a social security scheme (according to country-specific requirements)
  • Patient must have received prior first line therapy that must have contained both: a) Prior surgery or biopsy and standard fractionated radiotherapy (1.8-2 Gy/fraction, >56 Gy<66 Gy) or hypofractionated radiotherapy (15 x 2.66 Gy or similar regimen) b) One line of maintenance chemotherapy and/or immune- or biological therapy, (with or without TTFields)
  • First, unequivocal disease progression with a) measurable tumor (>100 mm2 or 1 cm3, based on RANO criteria) documented (e.g., increase of 25% in tumor diameter) on MRI performed within 14 days of inclusion and, b) interval of a minimum of 12 weeks since the completion of prior radiotherapy, unless there is a new lesion outside the radiation field or unequivocal evidence of viable tumor on histopathological sampling
  • Patient is candidate for craniotomy and at least 50% resection of enhancing region
  • Maximal enhancing tumor diameter prior to inclusion ≤ 5 (+/- 7%) cm on T1w. (In case of planned lobectomy, post operative peritumoral brain or residual size ≤5 cm)
  • WHO performance status ≤ 2 (equivalent to Karnofsky Performance Status, KPS ≥ 70)
  • Age ≥ 18 years
  • Participant must be recovered from acute toxic effects (≤grade 2) of all prior anticancer therapies. Interval since last therapy to presumed date of surgery of at least: a) ≥ 4 weeks or 5 half-lives (whichever is shorter) for i) Cytotoxic ii) Other small chemical entity (e.g., targeted therapy) iii) For biologics (e.g., antibodies, except bevacizumab) b) ≥ 6 weeks of prior bevacizumab
  • Adequate hematologic, hepatic, and renal laboratory values within 14 days of inclusion i.e.: a) Hemoglobin ≥ 10 g/dL, platelets ≥ 100,000/mm3, neutrophils ≥ 1500/mm
  • b) Liver function test with ≤ grade 1 alterations, except if due to antiepileptic drug therapy or isolated increased bilirubin due to Gilbert syndrome c) Estimated renal function of at least 60 mL/min using Appendix 12.5 formula d) AST(SGOT)/ALT(SPGT) ≤ 3 X institutional ULN (upper Limit of Normal)

排除标准

  • Multifocal enhancing tumor on T1w (unless all localized in a 5 cm diameter area)
  • Uncontrolled epilepsy or evidence of intracranial pressure
  • Patient with known intracranial aneurism or having presented intra-tumor significant spontaneous hemorrhage
  • Patient with unremovable coils, clips, shunts, intravascular stents, and/or wafer, or reservoirs that may be in the zone targeted by the device (extending to the contralateral bone).nd prior authorization by the Sponsor, patient may be eligible: - if anticoagulation therapy can be interrupted prior to surgery and before each treatment intervention, - if anti-platelet aggregation therapy can be discontinued before randomization through end-of-trial intervention.
  • Patient with medical need to be on continued anti-platelet aggregation therapy and/or anticoagulation. Patients for whom anticoagulation/platelet aggregation can be temporarily interrupted may be eligible after discussion and prior authorization by the sponsor.
  • Patient receiving enzyme-inducing antiepileptic drugs (namely phenytoin, carbamazepine and derivatives, phenobarbital), unless switched on another antiepileptic regimen
  • History of other malignancy within 2 years prior to study start with the exception of adequately treated basal cell carcinoma, squamous cell carcinoma, non-melanomatous skin cancer. prostate cancer or carcinoma in situ of the uterine cervix
  • Patient with known or suspected active or chronic infections
  • Patient with known significant cardiac disease, known to have right-to-left shunts, severe pulmonary hypertension (pulmonary artery pressure > 90 mm Hg), uncontrolled systemic hypertension, or acute respiratory distress syndrome
  • Known, non-manageable, sensitivity/allergy to gadolinium, or other intravascular contrast agents
  • Patient with impaired thermo-regulation or temperature sensation
  • Posterior fossa tumor
  • Pregnant, or breastfeeding patient
  • Any other serious patient medical or psychological condition that may interfere with adequate and safe delivery of treatment and care (e.g., positive human immunodeficiency virus [HIV] status, potential blood-borne infections,…), circumstance (e.g., sinus opening during surgery), psychological, morphological characteristics (e.g., skin characteristics, bone thickness), or any pre-existing comorbidities that in the investigator’s opinion may prevent the implantation of the device, may impair the ability of the patient to receive treatment with SonoCloud-9 or may be confounding for evaluation of the clinical trial endpoints
  • Patients under guardianship, curatorship, under legal protection or deprived of liberty by an administrative or judicial decision
  • Occurrence of any major medical illnesses or impairments (e.g., increased infectious risk, diagnostic of a second malignancy that requires treatment which would interfere with this study) or of contra-indications, that in the Investigator’s opinion may hamper the ability of the patient to receive treatment with SonoCloud-9 or may be confounding for evaluation of the clinical endpoints. The examples are of illustrative intent only, and not exhaustive.
  • Known actionable BRAF/ and/or mutated patients
  • Patient at risk of surgery site infection (e.g., 2 or more previous craniotomies/neurosurgery within the last 3 months, poor skin condition, and/or previously infected surgical field, or any other condition that is of increased infectious risk in the opinion of the neurosurgeon)
  • Patient treated at high, stable -or average- dose of corticosteroids (≥ 6 mg/day dexamethasone or equivalent) in the 7 days prior to inclusion. Patients on dexamethasone for reasons other than mass effect may still be enrolled.
  • Contra-indication to carboplatin, CCNU or TMZ
  • Known history of hypersensitivity reactions to perflutren lipid microsphere components or to any of the inactive ingredients in ultrasound resonator
  • Patient has received bevacizumab for other reasons (such as tumor progression) than treating edema
  • Peripheral neuropathy or neuropathy ≥ grade 2

结局指标

主要结局

Overall survival (OS), defined as the time from the date of randomization to the date of death due to any cause or censored at the time of last follow-up, calculated according to the Kaplan Meier method.

Overall survival (OS), defined as the time from the date of randomization to the date of death due to any cause or censored at the time of last follow-up, calculated according to the Kaplan Meier method.

次要结局

  • Tumor Growth Rate Tumor Growth Rate will be determined by measuring hyperintense tumor volume using T1w contrast-enhancing tumor-related region from post-surgery MRI baseline to unequivocal progression MRI (i.e., suspected radiologic progression confirmed by repeat scan) or W20-22 MRI whichever comes first
  • Progression Free Survival (PFS) Progression-free survival is defined as the time from randomization date to the earlier of the following events: unequivocal tumor progression as determined per RANO criteria or death due to any cause
  • Frequency and severity of adverse events scored according to the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0, from surgery to End-of-Trial Intervention visit
  • Overall survival at 9, 12, 18 and 24 months defined as rate of patients alive at 9 and 24 months (OS9, OS12, OS18, OS24)
  • Response rate (in patients with evaluable disease, per RANO criteria)
  • Rate of patients who are progression-free at 3, 6 and 9 months (PFS3, PFS6, PFS9)
  • Patient Reported Outcome will be assessed using the EQ-5D-5L, the EORTC QLQ-C30, and the EORTC QLQ-BN20 quality of life questionnaires at inclusion (baseline), 6 and 12 weeks after start of treatment as well as End-of-Trial Intervention visit. Patient Reported Outcome will be collected in all patients, irrespective of treatment arm and irrespective of subsequent line therapy initiated in the meantime.

研究者

发起方
Carthera, Carthera
申办方类型
Pharmaceutical company, Pharmaceutical company
责任方
Principal Investigator
主要研究者

Charlotte Schmitt

Scientific

Carthera

研究点 (32)

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