- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04304300
Radiotherapy in IDH Mutated Glioma: Evaluation of Late Outcomes (RIGEL)
Rationale: Standard postoperative treatment of isocitrate dehydrogenase 1/2 mutated grade 2 and 3 glioma (IDHmG) consists of radiotherapy and chemotherapy. The improving prognosis of these patients leads towards more emphasis on the long-term effects of treatment. Specifically radiotherapy has been implicated in the development of delayed neurocognitive deterioration. The impact of modern radiotherapy techniques (such as intensity modulated radiotherapy, volumetric modulated radiotherapy and proton beam therapy) and chemotherapy on general toxicity, late neurocognitive outcomes and imaging changes is currently unclear.
Objectives:
- To report treatment outcomes and radiation-induced toxicity from a prospective, multicentre observational cohort of IDHmG patients treated with radiotherapy and chemotherapy,
- To integrate radiotherapeutic dose distributions, imaging changes and neuropsychological outcome in IDHmG.
- To evaluate the Dutch selection criteria for proton therapy applied to IDHmG based on the outcomes collected in this observational study.
- To assess the impact of proton and photon therapy on health-related quality of life (HRQoL) and health-related economics (HR-E) in IDHmG patients.
- To collect genetic material for future translational research into the interaction between germline DNA, prognosis and radiation-induced toxicity.
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: This project is a multicentre, observational cohort of patients undergoing radiotherapy and chemotherapy for IDHmG. The protocol closely follows the local guidelines for clinical follow-up. Specific to the study are extra questionnaires and specific imaging acquired during scheduled MRI's. Routine neuropsychological investigation is standard of care in Erasmus Medical Center (Erasmus MC), but not in all participating centers. We feel the additional burden of participation in this study to be low.
Study Overview
Status
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Jaap Jaspers, MD
- Phone Number: +31 107042982
- Email: j.jaspers@erasmusmc.nl
Study Locations
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-
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Amsterdam, Netherlands, 1081 HV
- Not yet recruiting
- Amsterdam UMC
-
Contact:
- Frank Lagerwaard, MD, PhD
- Phone Number: +31 20 4440436
- Email: fj.lagerwaard@vumc.nl
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Delft, Netherlands, 2629 JH
- Recruiting
- HollandPTC
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Contact:
- Marco van Vulpen, Prof. MD
- Phone Number: +31 88 5018800
- Email: m.van.vulpen@hollandptc.nl
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Leiden, Netherlands, 2333 ZA
- Not yet recruiting
- Leiden University Medical Center
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Contact:
- Ida Coremans, MD, PhD
- Phone Number: 071 5263525
- Email: i.e.m.coremans@lumc.nl
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Leidschendam, Netherlands, 2262BA
- Not yet recruiting
- Haaglanden Medical Center
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Contact:
- Ruud Wiggenraad, MD, PhD
- Phone Number: +31 88 979 2071
- Email: r.wiggenraad@haaglandenmc.nl
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Zuid Holland
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Rotterdam, Zuid Holland, Netherlands, 3015 CE
- Recruiting
- Erasmus MC
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Contact:
- Alejandra Mendez Romero, MD PhD
- Phone Number: +31 (0)10 7035829
- Email: a.mendezromero@erasmusmc.nl
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Principal Investigator:
- Alejandra Méndez Romero, MD, PhD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Histologically confirmed glioma, World Health Organisation (WHO) grade 2 or 3, IDH mutated
- Indication for standard treatment with radiotherapy and chemotherapy. For WHO grade 2 tumors 50.4 Gy relative biological equivalent (RBE) in 28 fractions. For WHO grade 3 tumors 59.4 Gy (RBE) in 33 fractions.
- Ability to comply with the protocol, including neuropsychological testing and imaging.
- Ability to understand the requirements of the study and to give written informed consent, as determined by the treating physician.
- Written informed consent.
Exclusion Criteria:
- Any prior chemotherapy for IDHmG. This includes upfront postoperative chemotherapy.
- Any prior cranial radiotherapy, including but not limited to radiotherapy for IDHmG.
- Prior invasive malignancy, except non-melanoma skin cancer, completely resected cervical or prostate cancer (with current prostate specific antigen (PSA) of less than or equal to 0.1 ng/mL).
- Extensive white matter disease visible on pre-therapy imaging (Fazekas grade ≥2)
- Contra-indication for magnetic resonance (MR) imaging (i.e. metal implants, claustrophobia)
- Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule in the participating hospitals
- Any other serious medical condition that could interfere with follow-up.
- Severe aphasia or language barrier interfering with assessing endpoints (i.e. completion of questionnaires or neurocognitive performance)
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
---|
Study group
Glioma, IDH mutated, grade 2 and 3
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Toxicity (selected CTCAE 5.0 items)
Time Frame: 24 months
|
The Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 displays Grade 1 to 5, ranging from 'mild' to 'death'.
The case report form will include a predefined set of CTCAE items of expected radiotherapy related toxicities.
In addition, other CTCAE toxicities grade ≥ 2 that are likely, possibly or definitely related to the radiotherapy should be recorded in the case report form (CRF), when they occur.
All items will include a causality assessment: likely or definitely attributable to radiotherapy, unrelated or unlikely attributable to radiotherapy, or not assessable.
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24 months
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Neurocognitive testing
Time Frame: 24 months
|
Neurocognitive functioning will be assessed with a standard and well established short neuropsychological test battery, developed for use in clinical trials.
The following tests are included: Hopkins Verbal Learning Test (HVLT), Trail Making Test part A and B (TMT A/B), Controlled Oral Word Association (COWA), Medical Outcomes Study Cognitive Functioning Scale (MOS), Diagnostic Instrument for Mild Aphasia (DIMA)
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24 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Next intervention free survival (NIFS)
Time Frame: 48 months
|
NIFS is defined as time from first irradiation to date of initiation of further treatment after radio- and/or chemotherapy or death (any cause), whichever occurs first.
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48 months
|
Progression Free Survival (PFS)
Time Frame: 48 months
|
PFS is defined as the time from first irradiation to progressive disease, according to (any of) the Response Asessment in Neuro Oncology (RANO) criteria for progressive disease in low grade glioma.
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48 months
|
Overall Survival (OS)
Time Frame: 48 months
|
OS is defined as time from first irradiation to date of death from any cause.
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48 months
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Health Related Quality of Life (HRQOL)
Time Frame: 24 months
|
HRQoL will be assessed with the EORTC quality of life questionnaire (QLQ-C30) supplemented by the neuro-oncological module (QLQ-BN20) and the Euro Quality of Life questionnaire (EQ5D-5L)
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24 months
|
Health - Related Economics
Time Frame: 24 months
|
For the Health Related Economics (HR-E) analyses, the EQ5D - 5L questionnaire will be used in conjunction with the Productivity Costs Questionnaire (iPCQ) and the Medical Consumption Questionnaire (iMCQ).
These questionaires are optional.
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24 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Radiological data
Time Frame: 4 months
|
If feasible, pre- and 4 months post-treatment a scan protocol will be used that, besides the standard clinical imaging, will focus on (micro-)structural and microvascular characteristics that could predict neurocognitive outcome and treatment efficacy.
This feasibility is site-specific.
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4 months
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- NL69780.078.19
- Netherlands Trial Register (REGISTRY: NL7993)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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