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Lomustine With and Without Reirradiation for First Progression of Glioblastoma: a Randomized Phase III Study

Study Purpose

Despite comprehensive multimodal treatment of newly diagnosed glioblastoma, almost all patients suffer from tumour relapse. Currently, no standard of care exists to treat these tumour relapses. Treatment options include repeated surgery (if feasible), systemic therapy (bevacizumab, lomustine, temozolomide re-challenge), reirradiation and best supportive care. Currently, the superiority of combined chemoradiation versus chemotherapy alone remains unproven. Given that lomustine is the standard chemotherapeutic agent for the treatment of recurrent glioblastoma in Europe and the unclear efficacy of reirradiation, we want to explore whether combining lomustine and reirradiation may be a better treatment than lomustine alone. The results of the prospective randomized trial proposed here should demonstrate a significant improvement in overall survival when lomustine is combined with reirradiation in patients with recurrent glioblastoma compared to lomustine alone without adversely affecting quality of survival. The trial will be stopped based on overall survival in a preplanned futility and efficacy interim analysis.

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:

  • - 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.

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.

NCT05904119
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 3
Lead Sponsor

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

European Organisation for Research and Treatment of Cancer - EORTC
Principal Investigator

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

Matthias Preusser, Prof.Giuseppe Minniti, Dr.
Principal Investigator Affiliation EORTC Study CoordinatorEORTC Study Coordinator
Agency Class

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

Other
Overall Status Recruiting
Countries Austria, Belgium, Czechia, Denmark, France, Germany, Italy, Netherlands, Spain, Switzerland
Conditions

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

First Progression of Glioblastoma
Arms & Interventions

Arms

Active Comparator: Control group

Lomustine alone

Experimental: Experimental group

Lomustine plus reirradiation

Interventions

Drug: - Lomustine

Oral administration of Lomustine

Radiation: - Reirradiation

Given at least 6 months after the end of prior radiotherapy

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

Innsbruck 2775220, Austria

Status

Recruiting

Address

A.O Landeskrankenhaus - Innsbruck Universitaetsklinik

Innsbruck 2775220, , 6020

Linz 2772400, Austria

Status

Recruiting

Address

Kepler University Hospital - Neuromed campus

Linz 2772400, , 4020

Vienna 2761369, Austria

Status

Recruiting

Address

Universitaetsklinikum Wien - AKH unikliniken

Vienna 2761369, ,

AZORG, Aalst 2803448, Belgium

Status

Recruiting

Address

AZORG

Aalst 2803448, , 9300

Cliniques Universitaires Saint-Luc, Brussels 2800866, Belgium

Status

Recruiting

Address

Cliniques Universitaires Saint-Luc

Brussels 2800866, , 1200

Gilly 2797532, Belgium

Status

Recruiting

Address

Grand Hopital de Charleroi - Site Les Viviers

Gilly 2797532, , 6060

U.Z. Leuven - Campus Gasthuisberg, Leuven 2792482, Belgium

Status

Recruiting

Address

U.Z. Leuven - Campus Gasthuisberg

Leuven 2792482, , 3000

Masaryk Memorial Cancer Institute, Brno 3078610, Czechia

Status

Recruiting

Address

Masaryk Memorial Cancer Institute

Brno 3078610, ,

Aarhus 2624652, Denmark

Status

Recruiting

Address

Aarhus University Hospitals - Region Midtjylland - Aarhus University Hospital-Skejby

Aarhus 2624652, , 8200

Amiens 3037854, France

Status

Recruiting

Address

CHU d'Amiens - CHU Amiens Picardie - Site Sud

Amiens 3037854, , 80054

CLCC - Jean Perrin, Clermont-Ferrand 3024635, France

Status

Recruiting

Address

CLCC - Jean Perrin

Clermont-Ferrand 3024635, , 63000

CHRU de Lille, Lille 2998324, France

Status

Recruiting

Address

CHRU de Lille

Lille 2998324, , 59037

Lyon 2996944, France

Status

Recruiting

Address

CHU de Lyon - CHU Lyon - Hopital neurologique Pierre Wertheimer

Lyon 2996944, ,

Institut du Cancer de Montpellier, Montpellier 2992166, France

Status

Recruiting

Address

Institut du Cancer de Montpellier

Montpellier 2992166, ,

CHU de Nice - Hôpital Pasteur, Nice 2990440, France

Status

Recruiting

Address

CHU de Nice - Hôpital Pasteur

Nice 2990440, , 06000

Paris 2988507, France

Status

Recruiting

Address

Assistance Publique Hopitaux Paris- APHP - APHP Sorbonne Univ - Hopital la Pitie-Salpetriere (233)

Paris 2988507, , 75013

Paris 2988507, France

Status

Recruiting

Address

Assistance Publique Hopitaux Paris- APHP - APHP Nord - Univ De Paris Cite - Hop. Saint Louis

Paris 2988507, ,

Saint-Herblain 2979590, France

Status

Recruiting

Address

Institut de Cancerologie de l´Ouest (ICO) - Saint Herblain

Saint-Herblain 2979590, , 44805

Univ. Knappschaft Krankenhaus Bochum, Bochum 2947416, Germany

Status

Recruiting

Address

Univ. Knappschaft Krankenhaus Bochum

Bochum 2947416, , 44892

Universitaetsklinikum Koeln, Cologne 2886242, Germany

Status

Recruiting

Address

Universitaetsklinikum Koeln

Cologne 2886242, , 50937

Erlangen 2929567, Germany

Status

Recruiting

Address

Universitaetsklinikum Erlangen-Schwabachanlage

Erlangen 2929567, ,

Heidelberg 2907911, Germany

Status

Recruiting

Address

Universitaetsklinikum Heidelberg - UniversitaetsKlinikum Heidelberg - Head Hospital

Heidelberg 2907911, , 69120

Leipzig 2879139, Germany

Status

Recruiting

Address

Universitätsklinikum Leipzig-Klinik für Strahlentherapie und Radioonkologie

Leipzig 2879139, , 04103

Munich 2867714, Germany

Status

Recruiting

Address

Ludwig-Maximilians-Universitaet Muenchen - Campus Grosshadern

Munich 2867714, , 81377

Universitaetsklinikum Regensburg, Regensburg 2849483, Germany

Status

Recruiting

Address

Universitaetsklinikum Regensburg

Regensburg 2849483, ,

Tübingen 2820860, Germany

Status

Recruiting

Address

Universitaetsklinikum Tuebingen- Crona Kliniken

Tübingen 2820860, , 72076

IRCCS-Ospedale Bellaria-Bologna, Bologna 3181928, Italy

Status

Recruiting

Address

IRCCS-Ospedale Bellaria-Bologna

Bologna 3181928, , 40139

Legnago 3174922, Italy

Status

Recruiting

Address

ULSS 9 Scaligera Veneto - Azienda Unita Locale Socio-Sanitaria N. 9-Mater Salutis Hospital

Legnago 3174922, , 37045

Istituto Clinico Humanitas, Milan 6951411, Italy

Status

Recruiting

Address

Istituto Clinico Humanitas

Milan 6951411, , 20089

IRCCS - Istituto Oncologico Veneto, Padua 3171728, Italy

Status

Recruiting

Address

IRCCS - Istituto Oncologico Veneto

Padua 3171728, , 35128

Roma 8957247, Italy

Status

Recruiting

Address

Azienda ospedaliero Univ Policlinico Umberto I

Roma 8957247, , 00161

Medisch Spectrum Twente, Enschede 2756071, Netherlands

Status

Recruiting

Address

Medisch Spectrum Twente

Enschede 2756071, , 7512 KZ

Leiden University Medical Centre, Leiden 2751773, Netherlands

Status

Recruiting

Address

Leiden University Medical Centre

Leiden 2751773, ,

Erasmus MC, Rotterdam 2747891, Netherlands

Status

Recruiting

Address

Erasmus MC

Rotterdam 2747891, ,

Tilburg 2746301, Netherlands

Status

Recruiting

Address

ETZ Tilburg - ETZ - St. Elisabethziekenhuis

Tilburg 2746301, , 5022

Badalona 3129028, Barcelona, Spain

Status

Recruiting

Address

Hospital Germans Trias i Pujol (Institut Catala D'Oncologia)

Badalona 3129028, Barcelona,

Badalona 3129028, Spain

Status

Recruiting

Address

Institut Catala d'Oncologia - ICO Badalona - Hospital Germans Trias i Pujol (Institut Catala D'Oncologia) (381)

Badalona 3129028, , 08916

L'Hospitalet de Llobregat 3120619, Spain

Status

Recruiting

Address

ICO L'Hospitalet - Hospital Duran i Reynals (Institut Catala D'Oncologia)

L'Hospitalet de Llobregat 3120619, , 08908

Hospital Universitario 12 de Octubre, Madrid 3117735, Spain

Status

Recruiting

Address

Hospital Universitario 12 de Octubre

Madrid 3117735, , 28041

Bellinzona 2661567, Switzerland

Status

Recruiting

Address

Oncology Institute of Southern Switzerland (IOSI) - Ospedale San Giovanni

Bellinzona 2661567, , 6500