A Randomized Trial of Delayed Radiotherapy in Patients 1p/19q Codeleted Low-grade Oligodendrogliomas Requiring a Treatment Other Than Surgery
试验速览
- 阶段
- 3 期
- 状态
- 招募中
- 入组人数
- 280
- 试验地点
- 26
- 主要终点
- Survival without neurocognitive deterioration
研究概览
简要总结
Because of their prolonged survival, patients with 1p/19q-codeleted low-grade oligodendrogliomas treated with RT + PCV are at risk of neurocognitive deterioration. We make the hypothesis that withholding radiotherapy until tumor progression could reduce the risk of neurocognitive deterioration without impairing overall survival.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Tumor is co-deleted for 1p and 19q based and IDH-mutant (IDH1 or IDH2) according to local diagnosis
- •Histological confirmation of low-grade oligodendroglioma by central pathological review according to WHO 2016 classification
- •Age ≥ 18 years
- •Patients with one or several prior surgical procedure for a low-grade oligodendroglioma and who undergo a resurgery are eligible if they have not received prior radiotheray or chemotherapy and if the last histological diagnosis is a low-grade oligodendroglioma prior use of specific HDI prohibitions is permitted
- •Patients who undergo an initial follow-up after surgery or re-surgery are eligible if there is no evidence of anaplastic transformation on MRI (no new contrast enhancement, no obvious modification of the growth rate)
- •Patients requiring an oncological treatment other than surgery because of one or more of the following characteristics:
- •Progressive disease defined as documented growth prior to inclusion
- •Symptomatic disease defined as the presence of neurological or cognitive symptoms or refractory seizures defined as having both persistent seizures interfering with everyday life activities other than driving a car and three lines of anti-epileptic drug regimen had not worked, including at least one combination regimen.
- •Age ≥ 40 and any surgical therapy
- •Age < 40 with prior and subtotal resection or biopsy (i.e., anything less than gross total resection)
- •Willing and able to complete neurocognitive examination and the QOL
- •Karnofsky performance status ≥ 60
- •Laboratory values obtained between 21 days before inclusion andrandomization, respecting the following criteria:
- •Absolute neutrophil count (ANC) ≥1500 /mm3
- •Platelet count ≥100,000 / mm3
- •Hemoglobin > 9.0 g/dL
- •Total bilirubin ≤ 1.5 x upper limit of normal (ULN)
- •SGOT (AST) ≤ 3 x ULN
- •Negative serum or urine pregnancy test done ≤ 7 days prior to registration, for women of childbearing potential only.
- •Provide informed written consent
排除标准
- •Pregnant and nursing women
- •Men or women of childbearing potential who are unwilling to employ adequate contraception for up to 6 months following the completion of PCV.
- •Received any prior radiation therapy or chemotherapy for any CNS neoplasm.
- •Co-morbid systemic illnesses or other severe concurrent disease which would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens.
- •Concomitant serious immunocompromised status (other than that related to concomitant steroids).
- •Uncontrolled intercurrent illness or psychiatric illness/social situations that would limit compliance with study requirements.
- •Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm (except specific inhibitors of IDH)
- •Other active malignancy within 5 years of registration. Exceptions: Non-melanotic skin cancer or carcinoma-in-situ of the cervix.
- •Contra-indication to CCNU: hypersensitivity to CCNU, wheat allergy, association to yellow fever vaccin
- •Contra-indication to Procarbazine: severe renal failure, severe hepatic failure, hypersensitivity to procarbazine, association to yellow fever vaccin
- •Contra-indication to Vincristine: hypersensitivity to vincristine, neuromuscular disorder (for example demyelinating Charcot-Mary Tooth neuropathy), severe renal failure, severe hepatic failure.
- •Not depending from the french system of health assurance
研究组 & 干预措施
PCV alone
Administration of 6 cycles of PCV chemotherapy alone.
干预措施: PCV chemotherapy (Drug)
RT + PCV
Radiotherapy followed by administration of PCV chemotherapy.
干预措施: Radiotherapy and PCV chemotherapy (Drug)
结局指标
主要结局
Survival without neurocognitive deterioration
时间窗: During 9 years
Survival without neurocognitive deterioration (whatever the cause of deterioration, i.e toxicity or tumor progression) defined as the time from study randomization to failure in any of the 6 cognitive domains that will be explored (i.e memory, working memory, language, visuo-spatial ability, cognitive executive functions, behavioral executive functions) or death due to any cause, whichever occurs first.
次要结局
- Progression free survival(During 9 years)
- Overall survival(During 9 years)
