- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04121455
Glioblastoma Treatment With Irradiation and Olaptesed Pegol (NOX-A12) in MGMT Unmethylated Patients (GLORIA)
Single-arm Dose-escalation Phase 1/2 Study of Olaptesed Pegol (NOX-A12) in Combination With Irradiation in Inoperable or Partially Resected First-line Glioblastoma Patients With Unmethylated MGMT Promoter With a 3-arm Expansion Group Including Fully Resected Patients and Combination With Bevacizumab or Pembrolizumab
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
-
Bonn, Germany
- Klinik und Poliklinik für Neurologie Schwerpunkt Klinische Neuroonkologie
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Essen, Germany
- Klinik für Neurologie
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Leipzig, Germany
- Klinik für Strahlentherapie und Radioonkologie
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Mannheim, Germany
- Klinik für Strahlentherapie und Radioonkologie
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Münster, Germany
- Klinik für Neurologie mit Institut für Translationale Neurologie
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Tübingen, Germany
- Abteilung Neurologie mit interdisziplinärem Schwerpunkt Neuroonkologie
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria Dose Escalation Cohorts:
- Written informed consent
- Age ≥18 years
- Patient agreement to diagnostic and scientific work-up of glioblastoma tissue obtained during the preceding surgery or biopsy
- Patient agrees to subcutaneous port implantation
- Newly diagnosed, histologically confirmed, supratentorial WHO grade IV glioblastoma
- Status post biopsy or incomplete resection
- Unmethylated MGMT promoter status
- Maximum Eastern Cooperative Oncology Group (ECOG) score 2
- Estimated minimum life expectancy 3 months
- Stable or decreasing dose of corticosteroids during the week prior to inclusion
The following laboratory parameters should be within the ranges specified:
- Total bilirubin ≤ 1.5 x upper limit normal (ULN)
- Creatinine ≤ 1.5 x ULN or glomerular filtration rate ≥ 60 mL/min/1.73m²
- ALT (alanine transaminase) ≤ 3 x ULN
- AST (aspartate transaminase) ≤ 3 x ULN
- Female patients of child-bearing potential must have a negative serum pregnancy test within 21 days prior to enrollment and agree to use a highly effective method of birth control (failure rate less than 1% per year when used consistently and correctly such as contraceptive implants, vaginal rings, sterilization, or sexual abstinence)" during and for 3 months following last dose of drug (more frequent pregnancy tests may be conducted if required per local regulations)
- Male patients must use an effective barrier method of contraception during study and for 3 months following the last dose if sexually active with a FCBP
Inclusion Criteria Expansion Group:
- Written informed consent
- Age ≥ 18 years
- Patient agreement to diagnostic and scientific work-up of glioblastoma tissue obtained during the preceding surgery or biopsy (e.g., MGMT promoter analysis, cytogenetic markers such as IDH-1 mutations, etc.)
- Patient agrees to subcutaneous port implantation
- Newly diagnosed, histologically confirmed, supratentorial WHO grade IV glioblastoma
- a) Status post biopsy or incomplete (detectable residual tumor as per postoperative T1-weighted, contrast-enhanced MRI scan) or complete resection (Arm A) OR b) Status post complete resection (Arm B) OR c) Status post complete or incomplete resection (circumscribed enhancing tumor ≤ 5.0 cm in largest diameter as per postoperative T1-weighted, contrast-enhanced MRI scan) (Arm C)
- Unmethylated MGMT promoter status
- Maximum Eastern Cooperative Oncology Group (ECOG) score 2
- Estimated minimum life expectancy 3 months
- Stable or decreasing dose of corticosteroids during the week prior to inclusion
The following laboratory parameters should be within the ranges specified:
- Total bilirubin ≤ 1.5 x upper limit normal (ULN)
- Creatinine ≤ 1.5 x ULN or glomerular filtration rate ≥ 60 mL/min/1.73m²
- ALT (alanine transaminase) ≤ 3 x ULN
- AST (aspartate transaminase) ≤ 3 x ULN
- Female patients of child-bearing potential must have a negative serum pregnancy test within 21 days prior to enrollment and agree to use a highly effective method of birth control (failure rate less than 1% per year when used consistently and correctly such as contraceptive implants, vaginal rings, sterilization, or sexual abstinence) during and for 3 months (6 months Arm A, 4 months Arm C) following last dose of drug (more frequent pregnancy tests may be conducted if required per local regulations)
- Male patients must use an effective barrier method of contraception during study and for 3 months (6 months Arm A, 4 months Arm C) following the last dose if sexually active with a FCBP
Exclusion Criteria Dose Escalation Cohorts:
- Inability to understand and collaborate throughout the study or inability or unwillingness to comply with study requirements
- Participation in any clinical research study with administration of an investigational drug or therapy within 30 days from screening visit or observation period of competing studies
- Contra-indication or known hypersensitivity to MRI contrast agents, olaptesed pegol or polyethylene glycol
- Cytostatic therapy (chemotherapy) within the past 5 years
- History of other cancers (except for adequately treated basal or squamous cell skin cancer, in situ cervical cancer, or other cancer from which the patient was disease-free for ≥ 5 years)
- Clinically significant or uncontrolled cardiovascular disease
- Prior radiotherapy to the head
- Any other previous or concomitant experimental glioblastoma treatments
- Placement of Gliadel® wafer, seeds, or ferromagnetic nanoparticles
- Pregnancy or lactation
- Uncontrolled intercurrent illness; patients must be free of any clinically relevant disease (other than glioma) that would, in the treating investigator's opinion, interfere with the conduct of the study or study evaluations
- Treatment not initiated within 6 weeks after first biopsy or surgery of glioblastoma
- Prior enrolment into this study
Exclusion Criteria Expansion Group Arms A and B:
- Inability to understand and collaborate throughout the study or inability or unwillingness to comply with study requirements
- Participation in any clinical research study with administration of an investigational drug or therapy within 30 days from screening visit or observation period of competing studies
- Contra-indication or known hypersensitivity to MRI contrast agents, bevacizumab (Arm A only) olaptesed pegol or polyethylene glycol
- Planned hypofractionated radiotherapy
- Cytostatic therapy (chemotherapy) within the past 5 years
- History of other cancers (except for adequately treated basal or squamous cell skin cancer, in situ cervical cancer, or other cancer from which the patient was disease-free for ≥ 5 years)
- Secondary malignancy which is currently active
Clinically significant or uncontrolled cardiovascular disease, including
- Myocardial infarction in the previous 12 months
- Uncontrolled angina
- Congestive heart failure (New York Heart Association functional classification of ≥2)
- Diagnosed or suspected congenital long QT syndrome
- QTc prolongation on an electrocardiogram prior to entry (>470 ms)
- Uncontrolled hypertension (blood pressure ≥ 160/95 mmHg)
- Heart rate <50/min on the baseline electrocardiogram
- History of ventricular arrhythmias of any clinically significant type (such as ventricular tachycardia, ventricular fibrillation or torsades de pointes)
- Cerebrovascular accident
- Prior radiotherapy to the head
- Any other previous or concomitant experimental glioblastoma treatments
- Placement of Gliadel® wafer, seeds, or ferromagnetic nanoparticles
- Patients with a history of arterial or venous thrombosis (or any other disease) requiring permanent intake of anticoagulants (Arm A only)
- Pregnancy or lactation
- Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, chronic liver disease (e.g., cirrhosis, hepatitis), diabetes mellitus, or subjects with either of the following: fasting blood glucose (FBG defined as fasting for at least 8 hours) ≥ 200 mg/dL (7.0 mmol/L), or HbA1c ≥ 8%, chronic renal disease, pancreatitis, chronic pulmonary disease, auto-immune diseases, or psychiatric illness/social situations that would limit compliance with study requirements. Patients must be free of any clinically relevant disease (other than glioma) that would, in the treating investigator's opinion, interfere with the conduct of the study or study evaluations
- Prolongation of coagulation factors ≥ 2.5 x ULN (Arm A only)
- Treatment not initiated within 6 weeks after first biopsy or surgery of glioblastoma
- Prior enrolment into this study
Exclusion Criteria Expansion Group Arms C:
- Inability to understand and collaborate throughout the study or inability or unwillingness to comply with study requirements
- Participation in any clinical research study with administration of an investigational drug or therapy within 30 days from screening visit or observation period of competing studies
- Contra-indication or known hypersensitivity to MRI contrast agents olaptesed pegol or polyethylene glycol or pembrolizumab (≥ Grade 3)
- Biopsy-only of GBM with less than 20% of tumor removed
- Presence of extracranial metastatic or leptomeningeal disease
- Severe hypersensitivity (≥ Grade 3) to other monoclonal antibodies
- Receiving immunosuppressive therapy
- Previous or current treatment with an anti-CTLA-4, anti-PD-1, anti-PD-L1, or anti-PDL2 agent
- Planned hypofractionated radiotherapy
- Cytostatic therapy (chemotherapy) within the past 5 years
- History of other cancers or secondary malignancy which is currently active (except for adequately treated basal or squamous cell skin cancer, in situ cervical cancer, or other cancer from which the patient was disease-free for ≥ 5 years)
Clinically significant or uncontrolled cardiovascular disease, including
- Myocardial infarction in the previous 12 months
- Uncontrolled angina
- Congestive heart failure (New York Heart Association functional classification of ≥2)
- Diagnosed or suspected congenital long QT syndrome
- QTc prolongation on an electrocardiogram prior to entry (>470 ms)
- Uncontrolled hypertension (blood pressure ≥ 160/95 mmHg)
- Heart rate <50/min on the baseline electrocardiogram
- History of ventricular arrhythmias of any clinically significant type (such as ventricular tachycardia, ventricular fibrillation or torsades de pointes)
- Cerebrovascular accident
- Prior radiotherapy to the head
- Evidence of acute intracranial / intra-tumoral hemorrhage
- Any other previous or concomitant experimental glioblastoma treatments
- Placement of Gliadel® wafer, seeds, or ferromagnetic nanoparticles
- Pregnancy or lactation
- Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, chronic liver disease (e.g., cirrhosis, hepatitis), diabetes mellitus, or subjects with either of the following: fasting blood glucose (FBG defined as fasting for at least 8 hours) ≥ 200 mg/dL (7.0 mmol/L), or HbA1c ≥ 8%, chronic renal disease, pancreatitis, chronic pulmonary disease, auto-immune diseases or psychiatric illness/social situations that would limit compliance with study requirements. Patients must be free of any clinically relevant disease (other than glioma) that would, in the treating investigator's opinion, interfere with the conduct of the study or study evaluations.
- Received a live vaccine within 30 days prior to the first dose of study drug.
- Known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Previously treated brain metastases may participate provided these remain stable
- Known history of HIV infection, hepatitis B or hepatitis C infection
- Active autoimmune disease that has required systemic treatment in past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs)
- History of (non-infectious) pneumonitis / interstitial lung disease that required steroids or current pneumonitis / interstitial lung disease
- Immunodeficiency diagnosis or receiving chronic systemic steroid therapy (exceeding 10 mg daily of prednisone) or any other form of immunosuppressive therapy
- High dose of corticosteroids (> 4mg/day of dexamethasone or equivalent for at least 3 consecutive days) within two weeks prior to the first dose of study drug
- Treatment not initiated within 6 weeks after first biopsy or surgery of glioblastoma
- Prior enrolment into this study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Cohort 1: 200 mg Olaptesed pegol + Radiotherapy
olaptesed pegol weekly for 26 weeks administered i.v. by continuous infusion plus radiotherapy during weeks 1-6
|
Olaptesed pegol continuous administration for 26 weeks
Other Names:
Radiotherapy in weeks 1-6; cumulative dose of 60 Gy in 2 Gy fractions
|
Experimental: Cohort 2: 400 mg Olaptesed pegol + Radiotherapy
olaptesed pegol weekly for 26 weeks administered i.v. by continuous infusion plus radiotherapy during weeks 1-6
|
Olaptesed pegol continuous administration for 26 weeks
Other Names:
Radiotherapy in weeks 1-6; cumulative dose of 60 Gy in 2 Gy fractions
|
Experimental: Cohort 3: 600 mg Olaptesed pegol + Radiotherapy
olaptesed pegol weekly for 26 weeks administered i.v. by continuous infusion plus radiotherapy during weeks 1-6
|
Olaptesed pegol continuous administration for 26 weeks
Other Names:
Radiotherapy in weeks 1-6; cumulative dose of 60 Gy in 2 Gy fractions
|
Experimental: Expansion group, Arm A: 600 mg Olaptesed pegol + Radiotherapy + 10 mg/kg Bevacizumab
olaptesed pegol weekly for 26 weeks administered i.v. by continuous infusion, bevacizumab every two weeks for 26 weeks plus radiotherapy during weeks 1-6, incompletely or not resected patients
|
Olaptesed pegol continuous administration for 26 weeks
Other Names:
Radiotherapy in weeks 1-6; cumulative dose of 60 Gy in 2 Gy fractions
Bevacizumab every 2 weeks i.v. for 26 weeks
Other Names:
|
Experimental: Expansion group, Arm B: 600 mg Olaptesed pegol + Radiotherapy
olaptesed pegol weekly for 26 weeks administered i.v. by continuous infusion plus radiotherapy during weeks 1-6, completely resected patients
|
Olaptesed pegol continuous administration for 26 weeks
Other Names:
Radiotherapy in weeks 1-6; cumulative dose of 60 Gy in 2 Gy fractions
|
Experimental: Expansion group, Arm C: 600 mg Olaptesed pegol + Radiotherapy + 200 mg Pembrolizumab
olaptesed pegol weekly for 26 weeks administered i.v. by continuous infusion, pembrolizumab every three weeks for 26 weeks plus radiotherapy during weeks 1-6, incompletely resected patients
|
Olaptesed pegol continuous administration for 26 weeks
Other Names:
Radiotherapy in weeks 1-6; cumulative dose of 60 Gy in 2 Gy fractions
Pembrolizumab every 3 weeks i.v. for 26 weeks
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety - Number of patients with treatment-related adverse events as assessed by CTCAE
Time Frame: 26 weeks
|
Number of patients with treatment-related adverse events as assessed by CTCAE
|
26 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Efficacy - progression free survival at 6 months (PFS-6)
Time Frame: 6 months
|
Progression free survival at 6 months (PFS-6) in %
|
6 months
|
Efficacy - Median progression-free survival (mPFS)
Time Frame: 24 months
|
Median progression-free survival (mPFS) in months
|
24 months
|
Efficacy - Median overall survival (mOS)
Time Frame: 24 months
|
Median overall survival (mOS) in months
|
24 months
|
Efficacy - Tumor vascularization as per vascular MRI
Time Frame: 24 months
|
Changes from baseline in tumor vascularization over time as %cerebral blood volume
|
24 months
|
Plasma level of olaptesed pegol
Time Frame: 26 weeks
|
concentration of olaptesed pegol in plasma in µmol/L
|
26 weeks
|
Quality of Life (QoL) EORTC QLQ-C30 Module
Time Frame: 24 months
|
Quality of Life measures are recorded according to EORTC QLQ30 module, which is validated for cancer patients in general and measured as a unit of scale.
This is a standard tool for assessing patient reported quality of Life along time during treatment.
|
24 months
|
Quality of Life (QoL) EORTC QLQ BN-20 Module
Time Frame: 24 months
|
Quality of Life measures are recorded according to EORTC QLQ BN-20 module, which is validated for brain tumor patients and measured as a unit of scale.
This is a standard tool for assessing patient reported quality of Life along time during treatment.
|
24 months
|
Neurologic functions as measured by the NANO scale
Time Frame: 24 months
|
Change from baseline in neurologic performance scores by Neurologic Assessment in Neuro-Oncology (NANO) scale as an objective and quantifiable metric of neurologic function evaluable during a routine office examination.
The NANO Scale evaluates 9 major domains of neurologic function, with each domain being scored on a range from 0 to 2 or 3.
|
24 months
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms, Glandular and Epithelial
- Astrocytoma
- Glioma
- Neoplasms, Neuroepithelial
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Glioblastoma
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Immune Checkpoint Inhibitors
- Bevacizumab
- Pembrolizumab
Other Study ID Numbers
- SNOXA12C401
- 2018-004064-62 (EudraCT Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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