NCT05331521 A Clinical Study to Improve Brain Function and Quality of Life of Patients With Newly Diagnosed Brain Tumors (Gliomas).
| NCT ID | NCT05331521 |
| Status | Recruiting |
| Phase | Phase 3 |
| Sponsor | University Hospital Heidelberg |
| Condition | Oligodendroglioma |
| Study Type | INTERVENTIONAL |
| Enrollment | 406 participants |
| Start Date | 2021-04-07 |
| Primary Completion | 2033-03-31 |
Eligibility & Interventions
Eligibility Fast-Check
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What to Expect as a Participant
You will actively receive the study intervention — which may be a drug, biologic, device, or procedure.
Phase 3 trials are large pivotal studies comparing the treatment to current standard of care or placebo. Your participation directly contributes to the evidence needed for regulatory approval.
This trial targets 406 participants in total. It began in 2021-04-07 with a primary completion date of 2033-03-31.
⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.
Brief Summary
Oligodendrogliomas in the novel edition of the Central Nervous System (CNS) World Health Organization (WHO) classification are now molecularly defined by isocitrate dehydrogenase (IDH)1 or IDH2 mutations and 1p/19q co-deletion. The prognosis of these molecularly defined tumors is to be determined in new series since survival data from older histology-based studies and population-based registries are confounded by the inclusion of 20-70% not molecularly matching subsets. Also, the optimal treatment is a matter of ongoing investigations. An extensive, but safe surgery is associated with improved outcome as is the addition of chemotherapy with procarbazine, CCNU (lomustine), and vincristine (PCV) to the partial brain radiotherapy (RT). However, the exact timing of postsurgical therapy especially for tumors of the WHO grade 2 and acknowledging some variability in grading as well as the choice of chemotherapy, temozolomide instead of PCV (CODEL: NCT00887146 randomizing CNS WHO grade 2 and 3 oligodendrogliomas to chemoradiation(CHRT)therapy with PCV or with temozolomide) or the need for primary radiotherapy RT are subjects of clinical studies (POLCA: NCT02444000 randomizing patients with newly diagnosed CNS WHO grade 3 oligodendrogliomas to standard CHRT with PCV or PCV alone). Given the young age of patients with CNS WHO grade 2 and 3 oligodendrogliomas and the relevant risk of neurocognitive, functional and quality-of-life impairment with the current aggressive standard of care treatment, chemoradiation with PCV, of the tumor located in the brain optimizing care is the major challenge. NOA-18/IMPROVE CODEL aims at improving qualified overall survival (qOS) for adult patients with CNS WHO grade 2 and 3 oligodendrogliomas by randomizing between standard chemoradiation with up to six six-weekly cycles with PCV and six six-weekly cycles with lomustine and temozolomide (CETEG), thereby delaying radiotherapy (RT) and adding the chemoradiotherapy (CHRT) concept at progression after initial radiation-free chemotherapy, allowing for an effective salvage treatment and delaying potentially deleterious side effects. QOS represents a new concept and is defined as OS without functional and/or cognitive and/or quality of life (QOL) deterioration regardless whether tumor progression or toxicity is the main cause.
Eligibility Criteria
Inclusion Criteria: 1. Histologically confirmed, newly diagnosed CNS WHO grade 2 or 3 glioma. 2. Tumor carries an isocitrate dehydrogenase (IDH) mutation (determined by immunohistochemistry (IHC) and/or deoxyribonucleic acid (DNA) sequencing). 3. Tumor is co-deleted for 1p/19q (determined by copy number variations, fluorescence in situ hybridization (FISH), multiplex ligation-dependent probe amplification (MLPA) or other appropriate methods). 4. Biopsy (with sufficient tissue for molecular pathology) or resection. 5. Age: ≥18 years. 6. Karnofsky Performance status (KPI) ≥60%. 7. Life expectancy \>6 months. 8. Availability of formalin-fixed paraffin-embedded (FFPE) or fresh-frozen tissue and ethylenediamine tetraacetic acid (EDTA) blood for biomarker research. 9. Standard magnetic resonance imaging (MRI) ≤ 72 h post-surgery according to the present national and international guidelines. 10. Craniotomy or intracranial biopsy site must be adequately healed. 11. ≥ 2 weeks and ≤ 3 months from surgery without any interim radio- or chemotherapy or experimental intervention. 12. Willing and able to comply with regular neurocognitive and health-related quality of life tests/questionnaires. 13. Indication for postsurgical cytostatic/-toxic therapy. 14. Written Informed consent. 15. Female patients with reproductive potential have a negative pregnancy test (serum or urine) day -6 until day 0 of screening (and 3 days prior to first IMP-intake or RT). Female patients are surgically sterile or agree to use adequate contraception during the period of therapy and 7 months after the end of study treatment, or women have been postmenopausal for at least 2 years. 16. Male patients are willing to use contraception Exclusion Criteria: 1. Participation in other ongoing interventional clinical trials. 2. Inability to undergo MRI. 3. Abnormal (≥ Grade 2 CTCAE v5.0 laboratory values for hematology (Hb, WBC, neutrophils, or platelets), liver (serum bilirubin, ALT, or AST) or renal function (serum creatinine). 4. Clinically active tuberculosis; known HIV infection or active Hepatitis B (HBV) or Hepatitis C (HCV) infection, or active infections requiring oral or intravenous antibiotics or that can cause a severe disease and pose a severe danger to lab personnel working on patients' blood or tissue (e.g. rabies). 5. Any prior anti-cancer therapy or co-administration of anti-cancer therapies other than those administered/allowed in this study. History of low-grade glioma that did not require prior treatment with chemotherapy or radiotherapy is not an exclusion criterion. 6. Immunosuppression, not related to prior treatment for malignancy. 7. History of other malignancies (except for adequately treated basal or squamous cell carcinoma or carcinoma in situ) within the last 5 years unless the patient has been disease-free for 5 years. 8. Any clinically significant concomitant disease (including hereditary fructose intolerance) or condition that could interfere with, or for which the treatment might interfere with, the conduct of the study or the absorption of oral medications or that would, in the opinion of the Principal Investigator, pose an unacceptable risk to the patient in this study. 9. Any psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol requirements and/or follow-up procedures; those conditions should be discussed with the patient before trial entry. 10. Pregnancy or breastfeeding. 11. History of hypersensitivity to the investigational medicinal product or to any drug with similar chemical structure or to any excipient present in the pharmaceutical form of the investigational medicinal product. (E.g.: In the discretion of the investigator patients are allowed to take part in the study even if they suffer from celiac disease: Cecenu contains very small amounts of gluten (from wheat starch). It is considered gluten-free and is tolerated by patients suffering from celiac disease. One capsule contains no more than 4 micrograms of Gluten.) 12. QTc time prolongation \>500 ms. 13. Patients under restricted medication for procarbazine, lomustine, vincristine and temozolomide. 14. Liver disease characterized by: 1. ALT or AST (≥ Grade 2 CTCAE v5.0) confirmed on two consecutive measurements OR 2. Impaired excretory function (e.g., hyperbilirubinemia) or synthetic function or other conditions of decompensated liver disease such as coagulopathy, hepatic encephalopathy, hypoalbuminemia, ascites, and bleeding from esophageal varices (≥ Grade 2 CTCAE v5.0) OR 3. Acute viral or active autoimmune, alcoholic, or other types of acute hepatitis. 15. Known uncorrected coagulopathy, platelet disorder, or history of non-drug induced thrombocytopenia. 16. History of autoimmune disease, including but not limited to myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener's granulomatosis, Sjögren's syndrome, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis; autoimmune-related hypothyroidism (patients on a stable dose of thyroid replacement hormone are eligible for this study) and type I diabetes mellitus (patients on a stable dose of insulin regimen are eligible for this study). 17. Vaccination with life vaccines during treatment and 4 weeks before start of treatment. 18. Existing neuromuscular diseases, especially neural muscular atrophy with segmental demyelination (demyelinising form of Charcot-Marie-Tooth syndrome). 19. Chronic constipation and subileus. 20. Combination treatment with mitomycin (risk of a pronounced bronchospasm and acute shortness of breath). 21. Hypersensitivity to dacarbazine (DTIC). 22. Patients with hereditary galactose intolerance, complete lactase deficiency or glucose-galactose malabsorption (Temodal contains Lactose). 23. Patients with clinical wheat allergy.
Contact & Investigator
Wolfgang Wick, Prof. Dr.
PRINCIPAL INVESTIGATOR
University Hospital Heidelberg
Frequently Asked Questions
Who can join the NCT05331521 clinical trial?
This trial is open to participants of all sexes, aged 18 Years or older, studying Oligodendroglioma. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.
What phase is the NCT05331521 trial and what does that mean for participants?
Phase 3 trials are large-scale studies comparing the new treatment to existing standards of care or a placebo. They provide the evidence needed for regulatory approval. This trial targets 406 participants.
Is NCT05331521 currently recruiting?
Yes, NCT05331521 is actively recruiting participants. Contact the research team at wolfgang.wick@med.uni-heidelberg.de for enrollment information.
Where is the NCT05331521 trial being conducted?
This trial is being conducted at Heidelberg, Germany, Berlin, Germany, Bochum, Germany, Bonn, Germany and 11 additional locations.
Who is sponsoring the NCT05331521 clinical trial?
NCT05331521 is sponsored by University Hospital Heidelberg. The principal investigator is Wolfgang Wick, Prof. Dr. at University Hospital Heidelberg. The trial plans to enroll 406 participants.