Combining Lomustine with Reirradiation for Glioblastoma Progression
Lomustine With and Without Reirradiation for First Progression of Glioblastoma: a Randomized Phase III Study
This study is testing if adding a chemotherapy drug called lomustine to reirradiation can help people with glioblastoma live longer after their cancer has progressed.
Quick facts
| Phase | Phase 3 |
|---|---|
| Study type | Interventional |
| Enrollment | 411 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | European Organisation for Research and Treatment of Cancer - EORTC Research network |
| Drugs / interventions | chemotherapy, bevacizumab |
| Locations | 43 sites (Innsbruck and 42 other locations) |
| Trial ID | NCT05904119 on ClinicalTrials.gov |
What this trial studies
This clinical trial investigates the effectiveness of combining lomustine, a standard chemotherapy drug, with reirradiation in patients experiencing the first progression of glioblastoma after initial treatment. The study aims to determine if this combination leads to improved overall survival compared to lomustine alone. Patients eligible for the trial must have measurable disease and a confirmed diagnosis of glioblastoma, with treatment starting at least six months after prior radiotherapy. The trial is randomized and phase III, indicating a robust methodology to assess the treatment's efficacy.
Who should consider this trial
Good fit: Ideal candidates are patients with first progression of glioblastoma who have undergone prior standard chemoradiotherapy and meet specific eligibility criteria.
Not a fit: Patients with glioblastoma who have not had prior treatment or those with other types of brain tumors may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could significantly improve survival rates for patients with recurrent glioblastoma.
How similar studies have performed: While the combination of chemotherapy and reirradiation is a common approach, the specific efficacy of this combination in glioblastoma is still being evaluated, making this study both relevant and necessary.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Before patient's enrolment, written informed consent must be given according to ICH/GCP, and national/local regulations. * Patients with first progression or recurrent glioblastoma after standard chemoradiotherapy (any treatment other than use of nitroureas) having occurred at least 6 months after the end of prior radiotherapy * Measurable disease according to RANO criteria with a maximum tumour diameter of 5 cm (local investigator assessment) * In case of surgery for recurrence: fully recovered from surgery, confirmation of recurrence by histology, and patient fit for treatment as per local investigator assessment. * Histologically proven diagnosis of glioblastoma, IDH wildtype per WHO 2021 classification and local assessment of tissue from diagnosis or recurrence * Initial treatment of newly diagnosed glioblastoma by maximal safe resection and postsurgical concurrent conventionally fractionated or abbreviated (minimum 15 fractions) chemoradiotherapy with or without maintenance chemotherapy with temozolomide (patient must have received at least one dose) * Stable or decreasing dose of steroids for 7 days prior to enrolment * Age ≥ 18 years * WHO Performance status of 0-2 * Women of childbearing potential (WOCBP) must have a negative 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 during the study treatment period and for at least 6 months after the last dose of study treatment. A highly effective method of birth control is defined as a method which results in a low failure rate (i.e., less than 1% per year) when used consistently and correctly. * Female subjects who are breast feeding should discontinue nursing prior to the first dose of study treatment and until 6 months after the last study treatment. * Non-sterile males must use contraception during treatment and for 6 months after the last dose. * Non-sterile males must avoid sperm donation for the duration of the study and for at least 6 months after the last dose of study treatment. Exclusion Criteria: * Any prior anticancer treatment for recurrent glioblastoma (except surgery) * Significant reduction in thrombocyte and/or leukocyte counts as well as severe renal impairment according to investigator's opinion * History or present acute leukaemia or any myeloid disease * Known hypersensitivity to the active components or excipients of lomustine * Known coeliac disease or wheat allergy * Live attenuated vaccine in the 3 months prior to lomustine initiation * Any serious or uncontrolled medical condition (e.g., infections, chronic alcoholism, drug addiction) or abnormality, in the judgment of the investigator that prohibits obtaining informed consent, safe participation and study completion * Known contraindication to imaging tracer or any product of contrast media and Magnetic Resonance Imaging (MRI) contraindications * Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be assessed and discussed with the patient before the enrolment in the trial.
Where this trial is running
Innsbruck and 42 other locations
- A.O Landeskrankenhaus - Innsbruck Universitaetsklinik — Innsbruck, Austria (Recruiting)
- Kepler University Hospital - Neuromed campus — Linz, Austria (Recruiting)
- Universitaetsklinikum Wien - AKH unikliniken — Vienna, Austria (Recruiting)
- Azorg — Aalst, Belgium (Recruiting)
- Cliniques Universitaires Saint-Luc — Brussels, Belgium (Recruiting)
- Universitair Ziekenhuis Gent — Ghent, Belgium (Recruiting)
- Grand Hopital de Charleroi - Site Les Viviers — Gilly, Belgium (Recruiting)
- U.Z. Leuven - Campus Gasthuisberg — Leuven, Belgium (Recruiting)
- Masaryk Memorial Cancer Institute — Brno, Czechia (Recruiting)
- Aarhus University Hospitals - Region Midtjylland - Aarhus University Hospital-Skejby — Aarhus, Denmark (Recruiting)
- CHU d'Amiens - CHU Amiens Picardie - Site Sud — Amiens, France (Recruiting)
- CLCC - Jean Perrin — Clermont-Ferrand, France (Recruiting)
- CHRU de Lille — Lille, France (Recruiting)
- CHU de Lyon - CHU Lyon - Hopital neurologique Pierre Wertheimer — Lyon, France (Recruiting)
- Institut du Cancer de Montpellier — Montpellier, France (Recruiting)
- CHU de Nice - Hôpital Pasteur — Nice, France (Recruiting)
- Assistance Publique Hopitaux Paris- APHP - APHP Sorbonne Univ - Hopital la Pitie-Salpetriere (233) — Paris, France (Recruiting)
- Assistance Publique Hopitaux Paris- APHP - APHP Nord - Univ De Paris Cite - Hop. Saint Louis — Paris, France (Recruiting)
- Institut de Cancerologie de l´Ouest (ICO) - Saint Herblain — Saint-Herblain, France (Recruiting)
- Univ. Knappschaft Krankenhaus Bochum — Bochum, Germany (Recruiting)
- Universitaetsklinikum Koeln — Cologne, Germany (Recruiting)
- Universitaetsklinikum Erlangen-Schwabachanlage — Erlangen, Germany (Recruiting)
- Universitaetsklinikum Heidelberg - UniversitaetsKlinikum Heidelberg - Head Hospital — Heidelberg, Germany (Recruiting)
- Universitätsklinikum Leipzig-Klinik für Strahlentherapie und Radioonkologie — Leipzig, Germany (Recruiting)
- Ludwig-Maximilians-Universitaet Muenchen - Campus Grosshadern — Munich, Germany (Recruiting)
- Universitaetsklinikum Regensburg — Regensburg, Germany (Recruiting)
- Universitaetsklinikum Tuebingen- Crona Kliniken — Tübingen, Germany (Recruiting)
- IRCCS-Ospedale Bellaria-Bologna — Bologna, Italy (Recruiting)
- ULSS 9 Scaligera Veneto - Azienda Unita Locale Socio-Sanitaria N. 9-Mater Salutis Hospital — Legnago, Italy (Recruiting)
- Istituto Clinico Humanitas — Milan, Italy (Recruiting)
- IRCCS - Istituto Oncologico Veneto — Padova, Italy (Recruiting)
- Azienda ospedaliero Univ Policlinico Umberto I — Roma, Italy (Recruiting)
- Medisch Spectrum Twente — Enschede, Netherlands (Recruiting)
- Leiden University Medical Centre — Leiden, Netherlands (Recruiting)
- Erasmus MC — Rotterdam, Netherlands (Recruiting)
- ETZ Tilburg - ETZ - St. Elisabethziekenhuis — Tilburg, Netherlands (Recruiting)
- Oslo University Hospital - Radiumhospitalet — Oslo, Norway (Recruiting)
- St Olavs University Hospital - St. Olavs Hospital, Trondheim University Hospital — Trondheim, Norway (Recruiting)
- Hospital Germans Trias i Pujol (Institut Catala D'Oncologia) — Badalona, Barcelona, Spain (Recruiting)
- Institut Catala d'Oncologia - ICO Badalona - Hospital Germans Trias i Pujol (Institut Catala D'Oncologia) (381) — Badalona, Spain (Recruiting)
- ICO L'Hospitalet - Hospital Duran i Reynals (Institut Catala D'Oncologia) — L'Hospitalet de Llobregat, Spain (Recruiting)
- Hospital Universitario 12 de Octubre — Madrid, Spain (Recruiting)
- Oncology Institute of Southern Switzerland (IOSI) - Ospedale San Giovanni — Bellinzona, Switzerland (Recruiting)
Study contacts
- Principal investigator: Matthias Preusser, Prof. — EORTC Study Coordinator
- Study coordinator: Eortc
- Email: eortc@eortc.org
- Phone: +3227741611
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.