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A Phase III Trial of With Marizomib in Patients With Newly Diagnosed Glioblastoma

Phase 3
Completed
Conditions
Newly Diagnosed Glioblastoma
Interventions
Radiation: radiotherapy
Registration Number
NCT03345095
Lead Sponsor
European Organisation for Research and Treatment of Cancer - EORTC
Brief Summary

The standard of care for newly diagnosed glioblastoma includes surgery, involved-field radiotherapy, and concomitant and six cycles of maintenance temozolomide chemotherapy, however the prognosis remains dismal. Marizomib has been tested in patients with newly diagnosed and recurrent glioblastoma in phase I and phase II studies. In patients with recurrent glioblastoma, marizomib was administered as a single agent or in combination with bevacizumab (NCT02330562). Based on encouraging observations, a phase I/II trial of marizomib in combination with Temozolomide+Radiotherapy(TMZ/RT) followed by Temozolomide (TMZ) in newly diagnosed glioblastoma has been launched (NCT02903069) which explores safety and tolerability of this triple combination and which shall help to determine the dose for further clinical trials in glioblastoma. In this context, given that marizomib has been established as a safe addition to the standard TMZ/RT --\>TMZ, a phase III study is considered essential to establishing its impact on overall survival.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
749
Inclusion Criteria
  • Histologically confirmed newly diagnosed glioblastoma (WHO grade IV)

  • Tumor resection (gross total or partial), or biopsy only

  • Availability of formalin-fixed paraffin-embedded (FFPE) tumor block or 24 unstained slides for o6-methylguanine-DNA-methyltransferase (MGMT) analysis

  • Patient must be eligible for standard TMZ/RT + TMZ

  • Karnofsky performance score (KPS) ≥ 70

  • Recovered from effects of surgery, postoperative infection and other complications of surgery (if any)

  • The patient is at least 18 years of age on day of signing informed consent

  • Stable or decreasing dose of steroids for at least 1 week prior to inclusion

  • The patient has a life expectancy of at least 3 months

  • Patient has undergone a brain MRI within 14 days of randomization but after intervention (resection or biopsy)

  • The patient shows adequate organ functions as assessed by the specified laboratory values within 2 weeks prior to randomization defined as adequate bone marrow, renal and hepatic function within the following ranges:

    • white blood cell count (WBC) ≥ 3×10*9/L
    • absolute neutrophil count (ANC) ≥ 1.5×10*9/L
    • Platelet count of ≥ 100×10*9/L independent of transfusion
    • Hemoglobin ≥ 10 g/dl
    • Total Bilirubin ≤ 1.5 upper limit of normal (ULN)
    • Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) ≤ 2.5 × ULN
    • Serum creatinine < 1.5 x ULN or creatinine clearance (CrCl) > 30 mL/min(using the Cockcroft-Gault formula)
  • Women of child bearing potential (WOCBP) must have a negative urine or serum pregnancy test within 7 days prior to the first dose of study treatment.

  • Patients of childbearing / reproductive potential must agree to use adequate birth control measures, as defined by the investigator, during the study treatment period and for at least 6 months after the last study treatment. A highly effective method of birth control is defined as those which result in low failure rate (i.e. less than 1 percent per year) when used consistently and correctly. Patients must also agree not to donate sperm during the study and for 6 months after receiving the last dose of study treatment.

  • Women who are breast feeding must agree to discontinue nursing prior to the first dose of study treatment and until 6 months after the last study treatment.

  • Ability to take oral medication

  • Ability to understand the requirements of the study, provide written informed consent and authorization of use and disclosure of protected health information, and agree to abide by the study restrictions and return for the required assessments.

  • Before patient registration/randomization, written informed consent must be given according to International Council for Harmonisation (ICH) / Good clinical practice (GCP), and national/local regulations.

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Experimental ArmTemozolomideRadiotherapy + Temozolomide + Marizomib followed by adjuvant Temozolomide + Marizomib
Experimental ArmradiotherapyRadiotherapy + Temozolomide + Marizomib followed by adjuvant Temozolomide + Marizomib
Standard ArmTemozolomideRadiotherapy + Temozolomide followed by adjuvant Temozolomide
Standard ArmradiotherapyRadiotherapy + Temozolomide followed by adjuvant Temozolomide
Experimental ArmMarizomibRadiotherapy + Temozolomide + Marizomib followed by adjuvant Temozolomide + Marizomib
Primary Outcome Measures
NameTimeMethod
Overall Survival (OS)From the date of randomization up to the date of death, assessed up to 49 months

Overall Survival (OS): OS is defined as the number of days from date of randomization to the date of death due to any cause. If a patient has not died, the data will be censored at the last date documented to be alive.

Secondary Outcome Measures
NameTimeMethod
Progression Free Survival (PFS)From the date of randomization until the date of first objective progression or the date of patient's death whichever occurs first, assessed up to 49 months

PFS is defined as the number of days from date of randomization to the date of earliest disease progression based on Response Assessment in Neuro-Oncology criteria (by investigator) or to the date of death due to any cause, if disease progression does not occur. Patients for whom neither death nor progression have been documented were censored on the date of the last radiological assessment that the patient was progression-free. If a patient with no post-baseline radiological assessment then the data were censored at the date of randomization. Patients with two or more missing response assessments prior to a visit with documented disease progression (or death) were censored at the last visit where the patient was documented to be progression free. Patients who received new anti-cancer therapy or cancer-related surgery prior to progression or death were not censored at the last assessment where the patient was documented as progression free prior to the new therapy.

Health-related Quality of Life (HRQol)From randomization until progression, assessed up to 49 months

HRQoL will be assessed with the EORTC Quality of Life Questionnaire (QLQ-C30) version 3.

Mini Mental State Examination (MMSE)From the date of randomization until end of treatment, assessed up to 49 months

MMSE is a brief, standardized tool to grade patients' neurocognitive function. It is an 11-question measure that tests five areas of neurocognitive function: orientation, registration, attention and calculation, recall, and language. The maximum score is 30 which corresponds to the best neurocognitive function. The patient's neurocognitive function are considered 'impaired' if the MMSE score is 26 or less and 'normal' if it is 27 or more. Since its creation in 1975, MMSE has been validated and extensively used in both clinical practice and research.

Trial Locations

Locations (81)

University of California

🇺🇸

San Francisco, California, United States

Saint John Regional Hospital

🇨🇦

Saint John, New Brunswick, Canada

University Hospital of Geneva

🇨🇭

Geneva, Switzerland

University of Florida

🇺🇸

Gainesville, Florida, United States

Medical University Vienna - General Hospital AKH

🇦🇹

Vienna, Austria

Catharina Ziekenhuis

🇳🇱

Eindhoven, North Brabant, Netherlands

Centre Hospitalier Universitaire Vaudois

🇨🇭

Lausanne, Switzerland

Kantonsspital

🇨🇭

Saint Gallen, Switzerland

UniversitaetsSpital

🇨🇭

Zürich, Switzerland

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

John Wayne Cancer Institute

🇺🇸

Santa Monica, California, United States

University of California at Irvine

🇺🇸

Orange, California, United States

Ohio State University Comprehensive Cancer Center

🇺🇸

Columbus, Ohio, United States

Innsbruck Universitaetsklinik

🇦🇹

Innsbruck, Austria

Kepler University Hospital

🇦🇹

Linz, Austria

Onze Lieve Vrouw Ziekenhuis

🇧🇪

Aalst, Belgium

GasthuisZusters Antwerpen - Sint-Augustinus

🇧🇪

Antwerpen, Belgium

Hopitaux Universitaires Bordet-Erasme - Hopital Universitaire Erasme

🇧🇪

Bruxelles, Belgium

Cliniques Universitaires Saint-Luc

🇧🇪

Bruxelles, Belgium

Universitair Ziekenhuis Gent

🇧🇪

Gent, Belgium

C.H.U. Sart-Tilman

🇧🇪

Liège, Belgium

Grand Hopital de Charleroi - Grand Hôpital de Charleroi - Site Notre Dame

🇧🇪

Charleroi, Belgium

London Regional Cancer Center

🇨🇦

London, Ontario, Canada

Centre Hospitalier Universitaire de Sherbrooke-Fleurimont

🇨🇦

Sherbrooke, Quebec, Canada

Windsor Regional Cancer Centre

🇨🇦

Windsor, Ontario, Canada

BCCA - Abbotsford Centre

🇨🇦

Abbotsford, Canada

Tom Baker Cancer Centre

🇨🇦

Calgary, Canada

QEII Health Sciences Centre-Capital District Health Authority

🇨🇦

Halifax, Canada

Hamilton Health Sciences, Juravinski Cancer Centre

🇨🇦

Hamilton, Canada

Kingston Health Sciences Centre

🇨🇦

Kingston, Canada

Montreal Neurological Institute and Hospital McGill University

🇨🇦

Montréal, Canada

CHUM - Centre Hospitalier de l'Université de Montreal - Hopital Notre-Dame

🇨🇦

Montréal, Canada

Hopital Du Sacre-Coeur De Montreal

🇨🇦

Montréal, Canada

CHU de Quebec-Hopital l'Enfant-Jesus (HEJ)

🇨🇦

Québec, Canada

Allan Blair Cancer Centre

🇨🇦

Regina, Canada

Sault Area Hospital

🇨🇦

Sault Ste. Marie, Canada

Regional Cancer Program of Hopital Reg. de Sudbury Reg. Hospital

🇨🇦

Sudbury, Canada

Odette Cancer Centre - Sunnybrook Health Sciences Centre

🇨🇦

Toronto, Canada

Centre hospitalier regional de Trois-Rivieres

🇨🇦

Trois-Rivières, Canada

University Health Network - Oci / Princess Margaret Hospital

🇨🇦

Toronto, Canada

BC Cancer Agency

🇨🇦

Vancouver, Canada

Bcca - Vancouver Island Cancer Centre

🇨🇦

Victoria, Canada

Aarhus University Hospitals - Aarhus University Hospital

🇩🇰

Aarhus, Denmark

Cancercare Manitoba

🇨🇦

Winnipeg, Canada

CHU de Lyon - CHU Lyon - Hopital neurologique Pierre Wertheimer

🇫🇷

Bron, France

CHRU de Lille

🇫🇷

Lille, France

Institut de Cancerologie de l'Ouest

🇫🇷

Nantes, France

Centre Hospitalier Departemental Vendée

🇫🇷

La Roche-sur-Yon, Vendee, France

Assistance Publique - Hopitaux de Paris - La Pitie Salpetriere

🇫🇷

Paris, France

Gustave Roussy

🇫🇷

Villejuif, France

Universitaetsklinikum Bonn

🇩🇪

Bonn, Germany

Klinikum Der J.W. Goethe Universitaet-Klinik und Poliklinik fur Neurochirurgie

🇩🇪

Frankfurt, Germany

Universitaetsklinik Erlangen-Neurologische Klinik

🇩🇪

Erlangen, Germany

UniversitaetsKlinikum Heidelberg - Head Hospital

🇩🇪

Heidelberg, Germany

Universitaetsklinikum Leipzig-Klinik für Strahlentherapie und Radioonkologie

🇩🇪

Leipzig, Germany

UniversitaetsMedizin Mannheim

🇩🇪

Mannheim, Germany

Technische Universitaet Muenchen - Klinikum Rechts Der Isar

🇩🇪

Muenchen, Germany

Spaarne Gasthuis - Vrije Universiteit Medisch Centrum

🇳🇱

Amsterdam, Netherlands

Universitaetskliniken Regensburg

🇩🇪

Regensburg, Germany

Universitaetsklinikum Tuebingen- Crona Kliniken

🇩🇪

Tuebingen, Germany

The Netherlands Cancer Institute-Antoni Van Leeuwenhoekziekenhuis

🇳🇱

Amsterdam, Netherlands

Medisch Centrum Haaglanden - Westeinde

🇳🇱

Den Haag, Netherlands

University Medical Center Groningen

🇳🇱

Groningen, Netherlands

Academisch Ziekenhuis Maastricht

🇳🇱

Maastricht, Netherlands

Erasmus MC

🇳🇱

Rotterdam, Netherlands

Universitair Medisch Centrum - Academisch Ziekenhuis

🇳🇱

Utrecht, Netherlands

Radboud University Medical Center Nijmegen

🇳🇱

Nijmegen, Netherlands

Institut Catala d'Oncologia - ICO Badalona - Hospital Germans Trias i Pujol (Institut Catala D'Oncologia)

🇪🇸

Badalona, Spain

Oslo University Hospital - Radiumhospitalet

🇳🇴

Oslo, Norway

Hospital Clinic Universitari de Barcelona

🇪🇸

Barcelona, Spain

Institut Catala D'Oncologia

🇪🇸

L'Hospitalet De Llobregat, Spain

Hospital Universitario 12 De Octubre

🇪🇸

Madrid, Spain

Clinica Universidad de Navarra - Clinica Universitaria De Navarra

🇪🇸

Pamplona, Spain

NHS Lothian - Western General Hospital

🇬🇧

Edinburgh, United Kingdom

Guy's and St Thomas' NHS - Guy s and St Thomas' NHS - Guy's Hospital

🇬🇧

London, United Kingdom

Sheffield Teaching Hospitals NHS Foundation Trust - Weston Park Hospital

🇬🇧

Sheffield, United Kingdom

University Hospitals Copenhagen - Rigshospitalet

🇩🇰

Copenhagen, Denmark

Mayo Clinic Scottsdale

🇺🇸

Scottsdale, Arizona, United States

Penn State College of Medicine, Hershey Medical Center-Penn State Neuroscience Institute

🇺🇸

Hershey, Pennsylvania, United States

Ottawa Health Research Institute

🇨🇦

Ottawa, Ontario, Canada

Johannes Gutenberg Universitaetskliniken - Mainz University Medical Center

🇩🇪

Mainz, Germany

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