cropped color_logo_with_background.png

A Comparison of Continuous Bevacizumab (Avastin) Treatment or Placebo in Addition to Lomustine Followed by Standard of Care After Disease Progression in Participants With Glioblastoma

Study Purpose

This multicenter, double-blind, placebo-controlled, randomized study will evaluate the efficacy and safety of the addition of bevacizumab treatment to lomustine (in 2nd-line [2L] treatment) and SOC (in 3rd-line [3L] and subsequent lines of treatment) following first-line disease progression (PD1) in participants with newly diagnosed glioblastoma. All enrolled participants will receive 1L treatment with radiotherapy, temozolomide, and bevacizumab. At PD1, eligible participants will be randomized (1:1) to receive 2L treatment with either bevacizumab plus lomustine or placebo plus lomustine. After second-line disease progression (PD2), participants will receive 3L treatment and will continue blinded bevacizumab or placebo with the addition of an SOC agent. Following third-line disease progression (PD3), participants will receive subsequent lines of treatment and will either continue blinded bevacizumab or placebo (at the discretion of the investigator), or switch to open-label bevacizumab (at the choice of the participant).

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria at Enrollment (before PD1):

  • - Newly diagnosed, histologically confirmed glioblastoma not previously treated with chemotherapy or radiotherapy.
  • - If female and not postmenopausal (less than [<] 12 months of amenorrhea) or surgically sterile, must agree to use a highly effective contraceptive method during the treatment period and for at least 6 months after the last dose of study drug.
  • - Karnofsky performance status (KPS) greater than or equal to (>/=) 60.
  • - Mandatory tissue collection during pre-study surgery or biopsy for confirmation of the diagnosis and pathology.
  • - Craniotomy or intracranial biopsy site must be adequately healed.
Study treatment should be initiated > 28 days following the last surgical procedure.Inclusion Criteria at Randomization (following PD1):
  • - Documented PD1 according to RANO criteria.
  • - Eligibility for second-line treatment with lomustine and bevacizumab as investigational medicinal products.
  • - Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
  • - Bevacizumab well tolerated and not interrupted for longer than 60 days during first-line treatment.
  • - Tissue submission among participants for whom operation/re-operation is indicated before second-line treatment starts; operation/re-operation performed >/=28 days after last bevacizumab administration and second-line treatment initiated >/=28 days after surgical wound healed.
  • - Randomization within 28 days after PD1 among participants for whom operation/re-operation is not necessary.
  • - First administration of second-line treatment no later than 2 days from randomization.
Exclusion Criteria at Enrollment (before PD1):
  • - Any prior chemotherapy for glioblastoma and low-grade astrocytomas.
  • - Any prior radiotherapy to the brain or prior radiotherapy resulting in a potential overlap in the radiation field.
  • - Prior or current anti-angiogenic treatment.
  • - Treatment with any other investigational drug within 28 days or 2 investigational agent half-lives (whichever is longer) prior to first study treatment.
  • - Inadequate hematological, renal, or liver function.
  • - Inadequately controlled hypertension.
  • - Prior history of gastrointestinal perforation or abscess.
  • - Clinically significant cardiovascular disease.
  • - History or evidence of central nervous system disease unrelated to cancer unless adequately treated with standard medical therapy.
  • - History or evidence of inherited bleeding diathesis or significant coagulopathy at risk of bleeding.
  • - Serious non-healing wound, active ulcer, or untreated bone fracture.
  • - Known hypersensitivity to any component of bevacizumab/placebo or any of the study drugs.
  • - Active infection requiring IV antibiotics at start of study treatment.
  • - Other malignancy within 5 years prior to study enrollment, except for carcinoma in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer, or ductal carcinoma in situ treated with curative intent.
  • - Pregnant or lactating women.
- Participation in any other study

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT01860638
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 2
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Hoffmann-La Roche
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Clinical Trials
Principal Investigator Affiliation Hoffmann-La Roche
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Industry
Overall Status Completed
Countries Austria, Bulgaria, Canada, Croatia, Estonia, France, Greece, Italy, Latvia, Portugal, Romania, Spain, Sweden, Turkey, United Kingdom
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Glioblastoma
Arms & Interventions

Arms

Experimental: First-Line Bevacizumab followed by Bevacizumab + Lomustine/SOC

Participants will receive first-line treatment with radiotherapy, temozolomide, and bevacizumab. All three treatments will be given concurrently for the first 6 weeks, followed by 6 cycles (28 days each) of temozolomide plus bevacizumab, followed by bevacizumab monotherapy until PD1 or unacceptable toxicity. At PD1, participants randomized to bevacizumab will receive bevacizumab plus lomustine until PD2. Following PD2, participants will continue with blinded bevacizumab with the addition of appropriate SOC. Following PD3, for subsequent treatment lines blinded bevacizumab may continue or open-label bevacizumab may be given at the discretion of the investigator and the participant.

Placebo Comparator: First-Line Bevacizumab followed by Placebo + Lomustine/SOC

Participants will receive first-line treatment with radiotherapy, temozolomide, and bevacizumab. All three treatments will be given concurrently for the first 6 weeks, followed by 6 cycles (28 days each) of temozolomide plus bevacizumab, followed by bevacizumab monotherapy until PD1 or unacceptable toxicity. At PD1, participants randomized to placebo will receive placebo plus lomustine until PD2. Following PD2, participants will continue with blinded placebo with the addition of appropriate SOC. Following PD3, for subsequent treatment lines blinded bevacizumab may continue or open-label bevacizumab may be given at the discretion of the investigator and the participant.

Interventions

Drug: - Bevacizumab

Bevacizumab will be administered at a dose of 10 milligrams per kilogram (mg/kg) intravenous (IV) every 2 weeks (Q2W) throughout the study, with the exception of bevacizumab monotherapy prior to PD1, which will be given as 15 mg/kg IV every 3 weeks (Q3W).

Drug: - Lomustine

Lomustine will be administered at a dose of 90 milligrams per square meter (mg/m^2) orally (PO) every 6 weeks (Q6W), with a cap of 160 milligrams (mg) per dose. In the absence of hematologic toxicity following the first dose, the second and subsequent doses may be increased to 110 mg/m^2 PO Q6W, with a cap of 200 mg per dose.

Drug: - Placebo

Placebo will be administered via IV infusion, in a formulation matched to bevacizumab, Q2W after randomization.

Radiation: - Radiotherapy

Radiotherapy will be administered for a total dose of 60 Gray (Gy), administered in 2-Gy fractions, 5 days per week for 6 weeks during first-line treatment.

Drug: - Temozolomide

Temozolomide will be administered orally (PO) as 75 mg/m^2 per day for the first 6 weeks of first-line treatment (concurrent treatment), followed by 6 cycles (28 days each) as follows: 150 mg/m^2 per day for the first 5 days of Cycle 1, then 200 mg/m^2 per day (if permitted by the participant's hematological and non-hematological toxicity profile) for the first 5 days of Cycles 2-6.

Drug: - SOC Agent

The choice of SOC agent will be at the discretion of investigator. The SOC agent will be administered during third-line treatment and subsequent lines, as per standard practice.

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

International Sites

Graz, Austria

Status

Address

Medizinische Universität Graz; Universitätsklinik für Neurologie

Graz, , 8036

Innsbruck, Austria

Status

Address

Uniklinik fuer Neurologie, Medizinische Universitaet Innsbruck; Department fuer Neurologie

Innsbruck, , 6020

Linz, Austria

Status

Address

Kepler Universitätsklinikum GmbH - Neuromed Campus; Innere Medizin mit Neuroonkologie

Linz, , 4020

Salzburg, Austria

Status

Address

Lkh Salzburg - Univ. Klinikum Salzburg; Iii. Medizinische Abt.

Salzburg, , 5020

Wien, Austria

Status

Address

Medizinische Universität Wien; Univ.Klinik für Innere Medizin I - Abt. für Onkologie

Wien, , 1090

Wien, Austria

Status

Address

Kaiser-Franz-Josef-Spital; Neurologische Abteilung

Wien, , 1100

MBAL Serdika EOOD, Sofia, Bulgaria

Status

Address

MBAL Serdika EOOD

Sofia, , 1303

Calgary, Alberta, Canada

Status

Address

Tom Baker Cancer Centre; Dept of Medicine

Calgary, Alberta, T2N 4N2

Montreal, Quebec, Canada

Status

Address

McGill University; Montreal Neurological Institute; Oncology

Montreal, Quebec, H3A 2B4

Clinical Hospital Centre Zagreb, Zagreb, Croatia

Status

Address

Clinical Hospital Centre Zagreb

Zagreb, , 10000

Tartu, Estonia

Status

Address

Tartu University Hospital; Clinic of Hematology and Oncology

Tartu, , 50406

HOPITAL JEAN MINJOZ; Oncologie, Besancon, France

Status

Address

HOPITAL JEAN MINJOZ; Oncologie

Besancon, , 25030

Hopital Avicenne; Neurologie, Bobigny, France

Status

Address

Hopital Avicenne; Neurologie

Bobigny, , 93009

Bordeaux, France

Status

Address

Hopital Saint Andre; Département de Radiothérapie Et D'Oncologie Médicale

Bordeaux, , 33075

Bron, France

Status

Address

Hopital neurologique Pierre Wertheimer - CHU Lyon; Neurologie

Bron, , 69677

Caen, France

Status

Address

Hopital Cote De Nacre; Unite Neurologie Generale

Caen, , 14033

Dijon, France

Status

Address

Centre Georges Francois Leclerc; Oncologie 3

Dijon, , 21079

Lille, France

Status

Address

Hopital Roger Salengro; Service de Neurologie

Lille, , 59037

Marseille, France

Status

Address

Hopital de La Timone - CHU de Marseille; Service de neuro-oncologie - Hôpital Adultes - 12ème étage

Marseille, , 13385

Nancy, France

Status

Address

Hôpital Central; Departement de Neuro-Oncologie

Nancy, , 54000

Paris, France

Status

Address

Hopital Pitié Salpétrière - CHU; Service de neurologie 2 - Mazarin

Paris, , 75651

Hopital Purpan, Toulouse Cedex 9, France

Status

Address

Hopital Purpan

Toulouse Cedex 9, , 31059

Kifisia, Greece

Status

Address

Agioi Anargyroi Anticancer Hospital; Radiotherapeutic Clinic

Kifisia, , 14564

Hygeia Hospital, Marousi, Greece

Status

Address

Hygeia Hospital

Marousi, , 15123

Thessaloniki, Greece

Status

Address

Papageorgiou General Hospital; Medical Oncology

Thessaloniki, , 546 29

Ospedale Bellaria; U.O. Oncologia Medica, Bologna, Emilia-Romagna, Italy

Status

Address

Ospedale Bellaria; U.O. Oncologia Medica

Bologna, Emilia-Romagna, 40133

Roma, Lazio, Italy

Status

Address

IFO - Istituto Regina Elena; Oncologia Medica

Roma, Lazio, 00144

Milano, Lombardia, Italy

Status

Address

Fondazione IRCCS Istituto Neurologico C. Besta; Neuro-oncologia Sperimentale e Terapia Genica

Milano, Lombardia, 20133

Torino, Piemonte, Italy

Status

Address

Azienda Ospedaliera Le Molintte di Torino; Dipartimento Di Neurologia - Oncologia

Torino, Piemonte, 10126

Padova, Veneto, Italy

Status

Address

IRCCS Istituto Oncologico Veneto (IOV); Oncologia Medica Seconda

Padova, Veneto, 35128

Riga, Latvia

Status

Address

Riga East Clinical University hospital, Clinic Gailezers, Dept of Neurosurgery

Riga, , LV-1038

Coimbra, Portugal

Status

Address

IPO de Coimbra; Servico de Oncologia Medica

Coimbra, , 3000-075

Lisboa, Portugal

Status

Address

Hospital de Santa Maria; Servico de Oncologia Medica

Lisboa, , 1649-035

Porto, Portugal

Status

Address

Hospital de Sao Joao; Servico de Oncologia

Porto, , 4200-319

Bucuresti, Romania

Status

Address

Institutul Oncologic Prof. Dr. Al. Trestioreanu Bucuresti

Bucuresti, , 022328

Cluj-napoca, Romania

Status

Address

Institut Oncologic Ion Chiricuta; Departament Radioterapie

Cluj-napoca, , 400015

Spital Clinic Judetean Mures; Oncologie, Targu Mures, Romania

Status

Address

Spital Clinic Judetean Mures; Oncologie

Targu Mures, , 540142

Badalona, Barcelona, Spain

Status

Address

Hospital Universitari Germans Trias i Pujol; Servicio de Oncologia

Badalona, Barcelona, 08916

Córdoba, Cordoba, Spain

Status

Address

Hospital Universitario Reina Sofia; Servicio de Oncologia

Córdoba, Cordoba, 14004

San Sebastian, Guipuzcoa, Spain

Status

Address

IInstituto Oncologico de San Sebastian, Oncologikoa; Servicio de Oncologia

San Sebastian, Guipuzcoa, 20014

Palma De Mallorca, Islas Baleares, Spain

Status

Address

Hospital Universitario Son Espases; Servicio de Oncologia

Palma De Mallorca, Islas Baleares, 07014

Bilbao, Vizcaya, Spain

Status

Address

Hospital de Cruces; Servicio de Oncologia

Bilbao, Vizcaya, 48903

Badajoz, Spain

Status

Address

Hospital Universitario Infanta Cristina; Servicio de Oncologia

Badajoz, , 06080

Hospital del Mar; Servicio de Oncologia, Barcelona, Spain

Status

Address

Hospital del Mar; Servicio de Oncologia

Barcelona, , 08003

Hospital Duran i Reynals; Oncologia, Barcelona, Spain

Status

Address

Hospital Duran i Reynals; Oncologia

Barcelona, , 08907

Madrid, Spain

Status

Address

Hospital Ramon y Cajal; Servicio de Oncologia

Madrid, , 28034

Hosp. Clinico San Carlos, Madrid, Spain

Status

Address

Hosp. Clinico San Carlos

Madrid, , 28040

Madrid, Spain

Status

Address

Hospital Universitario 12 de Octubre; Servicio de Oncologia

Madrid, , 28041

Madrid, Spain

Status

Address

Hospital Universitario La Paz; Servicio de Oncologia

Madrid, , 28046

Madrid, Spain

Status

Address

HOSPITAL DE MADRID NORTE SANCHINARRO- CENTRO INTEGRAL ONCOLOGICO CLARA CAMPAL; Servicio de Oncologia

Madrid, , 28050

Malaga, Spain

Status

Address

Hospital Regional Universitario Carlos Haya; Servicio de Oncologia

Malaga, , 29010

Salamanca, Spain

Status

Address

Hospital Clinico Universitario de Salamanca; Servicio de Oncologia

Salamanca, , 37007

Universitetssjukhuset; Onkologkliniken, Linkoeping, Sweden

Status

Address

Universitetssjukhuset; Onkologkliniken

Linkoeping, , 58185

Umea, Sweden

Status

Address

Norrlands Universitetssjukhus; Cancer Centrum

Umea, , 901 85

Akademiska sjukhuset, Onkologkliniken, Uppsala, Sweden

Status

Address

Akademiska sjukhuset, Onkologkliniken

Uppsala, , 75185

Adana City Hospital, Medical Oncology, Adana, Turkey

Status

Address

Adana City Hospital, Medical Oncology

Adana, , 01060

Ankara, Turkey

Status

Address

Baskent Universitesi Tıp Fakultesi; Ic Hastalıkları Anabilim Dalı Tıbbi Onkoloji Bilim Dalı

Ankara, , 06490

Dokuz Eylul Uni ; Medical Oncology, Izmir, Turkey

Status

Address

Dokuz Eylul Uni ; Medical Oncology

Izmir, , 35340

Izmit, Turkey

Status

Address

Kocaeli University Faculty of Medicine; Medical oncology

Izmit, , 31380

Bristol Haematology and Oncology Centre, Bristol, United Kingdom

Status

Address

Bristol Haematology and Oncology Centre

Bristol, , BS2 8ED

Addenbrookes Hospital; Dept of Oncology, Cambridge, United Kingdom

Status

Address

Addenbrookes Hospital; Dept of Oncology

Cambridge, , CB2 2QQ

London, United Kingdom

Status

Address

University College Hospital; Department of Oncology

London, , N7 9NH

Manchester, United Kingdom

Status

Address

Christie Hospital Nhs Trust; Medical Oncology

Manchester, , M2O 4BX

Sutton, United Kingdom

Status

Address

Royal Marsden Hospital; Dept of Medical Oncology

Sutton, , SM2 5PT