- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05476939
Biological Medicine for Diffuse Intrinsic Pontine Glioma (DIPG) Eradication 2.0 (BIOMEDE 2)
Biological Medicine for Diffuse Intrinsic Pontine Glioma (DIPG) Eradication
The BIOMEDE 2.0 study is the second stage of the BIOMEDE multi-arm, multistage rolling programme (adaptive platform protocol).
It is a multicenter, randomized, open-label, controlled phase-3 trial evaluating efficacy of ONC201 in comparison with everolimus (primary objective based on internal comparison) and subsequently to historical controls.
Two treatment groups will be compared. A switch between treatment groups is allowed after confirmation of the disease progression (real-time central review blinded to the treatment arm allocation). Study treatment will be continued until centrally confirmed disease progression (either radiologically or histologically), unacceptable toxicity or consent withdrawal.
The final conclusion of the trial will be successful for ONC201, if ONC201 is found significantly superior to everolimus in terms of centrally-reviewed PFS (Progression-free survival) from randomization (internal comparison) either overall, considering ND-DMG and DIPG-patients together, or in the subgroup of ND-DMG patients alone. In other cases, Everolimus will remain the standard arm unless it appears associated with an excess of toxicity compared to ONC201 which could then be discussed as a new standard.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Jacques GRILL, MD, PhD
- Phone Number: +33 (0)1 42 11 62 09
- Email: jacques.grill@gustaveroussy.fr
Study Contact Backup
- Name: Anne-Sophie BLANC, PharmD
- Phone Number: +33 (0)1 42 11 57 02
- Email: annesophie.blanc@gustaveroussy.fr
Study Locations
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Aarhus, Denmark, 8200
- Recruiting
- Aarhus Universitetshospital Skejby
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Contact:
- Torben Stamm MIKKELSEN, MD
- Phone Number: 0045 53 56 65 13
- Email: torbmikk@rm.dk
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Copenhagen, Denmark, 2100
- Recruiting
- Rigshospitalet
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Principal Investigator:
- Karsten NYSOM, MD, PhD
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Contact:
- Karsten NYSOM, MD, PhD
- Phone Number: 0045 3545 0809
- Email: karsten.nysom@regionh.dk
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Odense, Denmark, 5000
- Recruiting
- H.C. Andersen Children's Hospital, Odense Universitetshospital
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Contact:
- Michael CALLESEN, MD, PhD
- Phone Number: 0045 23 23 46 51
- Email: Michael.callesen@rsyd.dk
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Principal Investigator:
- Michael CALLESEN, MD, PhD
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Amiens, France, 80054
- Recruiting
- CHU d'Amiens-Picardie Site Sud
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Principal Investigator:
- Camille KHANFAR, MD
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Contact:
- Camille KHANFAR, MD
- Email: khanfar.camille@chu-amiens.fr
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Angers, France, 49933
- Recruiting
- CHU d'Angers - Bâtiment Robert Debré
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Contact:
- Claire BRISSET, MD
- Phone Number: +33 (0)2 41 35 38 63
- Email: claire.brisset@chu-angers.fr
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Principal Investigator:
- Claire BRISSET, MD
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Angers, France, 49055
- Recruiting
- Institut de Cancérologie de l'Ouest (ICO) - Site Paul Papin
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Contact:
- Paule AUGEREAU, MD
- Email: paule.augereau@ico.unicancer.fr
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Principal Investigator:
- Paule AUGEREAU, MD
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Besançon, France, 25030
- Recruiting
- CHU Besançon - Hôpital Jean Minjoz
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Principal Investigator:
- Véronique LAITHIER, MD
-
Contact:
- Véronique LAITHIER, MD
- Email: vlaithier@chu-besancon.fr
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Bordeaux, France, 33000
- Recruiting
- CHU de Bordeaux - Groupe hospitalier Saint André - Hôpital Saint André
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Principal Investigator:
- Charlotte BRONNIMANN, MD
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Contact:
- Charlotte BRONNIMANN, MD
- Email: charlotte.bronnimann@chu-bordeaux.fr
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Bordeaux, France, 33076
- Recruiting
- CHU de Bordeaux - Groupe hospitalier Pellegrin - Hôpital des enfants
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Principal Investigator:
- Céline ICHER de BOUYN, MD
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Contact:
- Céline ICHER de BOUYN, MD
- Email: celine.icher@chu-bordeaux.fr
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Brest, France, 29609
- Recruiting
- CHRU de Brest - Hopital Morvan
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Principal Investigator:
- Liana CARAUSU, MD
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Contact:
- Liana CARAUSU, MD
- Email: liana.carausu@chu-brest.fr
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Caen, France, 14033
- Recruiting
- CHU de Caen - Hopital Cote de Nacre
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Principal Investigator:
- Marianna DEPARIS, MD
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Contact:
- Marianna DEPARIS, MD
- Email: deparis-m@chu-caen.fr
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Clermont-Ferrand, France, 63003
- Recruiting
- CHU Estaing
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Contact:
- Justyna KANOLD, MD, PhD
- Email: jkanold@chu-clermontferrand.fr
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Principal Investigator:
- Justyna KANOLD, MD, PhD
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Clermont-Ferrand, France, 63011
- Recruiting
- Centre Jean Perrin
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Contact:
- Xavier DURANDO, MD, PhD
- Email: xavier.durando@clermont.unicancer.fr
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Principal Investigator:
- Xavier DURANDO, MD, PhD
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Dijon, France, 21079
- Recruiting
- CHU François Mitterrand
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Principal Investigator:
- Claire BRIANDET, MD
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Contact:
- Claire BRIANDET, MD
- Email: claire.briandet@chu-dijon.fr
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Grenoble, France, 38700
- Recruiting
- CHU Grenoble Alpes - Hôpital Couple-Enfant
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Principal Investigator:
- Anne PAGNIER, MD
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Contact:
- Anne PAGNIER, MD
- Email: apagnier@chu-grenoble.fr
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Grenoble, France, 38700
- Not yet recruiting
- CHU Grenoble Alpes - Hôpital Albert Michallon
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Contact:
- Caroline PASTERIS, MD
- Email: CPasteris@chu-grenoble.fr
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Principal Investigator:
- Caroline PASTERIS, MD
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Lille, France, 59020
- Recruiting
- Centre Oscar Lambret
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Contact:
- Sandra RAIMBAULT, MD
- Email: s-raimbault@o-lambret.fr
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Principal Investigator:
- Sandra RAIMBAULT, MD
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Lille, France, 59037
- Not yet recruiting
- Hôpital Roger Salengro
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Principal Investigator:
- Enora VAULEON, MD
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Contact:
- Enora VAULEON, MD
- Phone Number: +33 (0)3 21 26 94 52
- Email: enora.vauleon@chu-lille.fr
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Limoges, France, 87042
- Recruiting
- Hôpital de la mère et de l'enfant
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Principal Investigator:
- Christophe PIGUET, MD
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Contact:
- Christophe PIGUET, MD
- Email: Christophe.Piguet@chu-limoges.fr
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Lyon, France, 69373
- Recruiting
- Centre Leon Berard
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Principal Investigator:
- Pierre LEBLOND, MD, PhD
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Contact:
- Pierre LEBLOND, MD, PhD
- Email: Pierre.leblond@ihope.fr
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Lyon, France, 69500
- Recruiting
- Hopital Pierre Wertheimer
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Principal Investigator:
- François DUCRAY, MD, PhD
-
Contact:
- François DUCRAY, MD, PhD
- Phone Number: 33 (0)4 72 68 13 21
- Email: françois.ducray@chu-lyon.fr
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Marseille, France, 13005
- Recruiting
- Hopital De La Timone
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Principal Investigator:
- Nicolas ANDRE, MD, PhD
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Contact:
- Nicolas ANDRE, MD, PhD
- Email: nicolas.andre@ap-hm.fr
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Montpellier, France, 34090
- Recruiting
- Hopital Arnaud de Villeneuve
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Principal Investigator:
- Gilles PALENZUELA, MD
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Contact:
- Gilles PALENZUELA, MD
- Email: g-palenzuela@chu-montpellier.fr
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Nancy, France, 54500
- Recruiting
- CHRU Nancy Brabois - Hôpital d'Enfants
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Contact:
- Marie-Sophie MERLIN, MD
- Phone Number: +33 (0)3 83 15 47 34
- Email: M.MERLIN@chru-nancy.fr
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Principal Investigator:
- Marie-Sophie MERLIN, MD
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Nancy, France, 54035
- Recruiting
- CHRU Nancy - Hôpital Central
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Contact:
- Luc TAILLANDIER, MD, PhD
- Email: l.taillandier@chru-nancy.fr
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Principal Investigator:
- Luc TAILLANDIER, MD, PhD
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Nice, France, 06202
- Recruiting
- CHU de Nice - Hôpital L'Archet 2
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Principal Investigator:
- Gwenaëlle DUHIL DE BENAZE, MD
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Contact:
- Gwenaëlle DUHIL DE BENAZE, MD
- Email: duhil-de-benaze.g@chu-nice.fr
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Nice, France, 06000
- Recruiting
- CHU de Nice - Hôpital Pasteur 2
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Principal Investigator:
- Veronique Bourg, MD
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Contact:
- Véronique BOURG, MD
- Phone Number: 33 (0)4 92 03 82 80
- Email: bourg.v@chu-nice.fr
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Paris, France, 75010
- Recruiting
- Hôpital Saint Louis
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Contact:
- Stefania CUZZUBBO, MD
- Email: stefania.cuzzubbo@aphp.fr
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Principal Investigator:
- Stefania CUZZUBBO, MD
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Paris, France, 75248
- Recruiting
- Institut Curie
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Contact:
- Franck BOURDEAUT, MD
- Email: Franck.bourdeaut@curie.fr
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Principal Investigator:
- Franck BOURDEAUT, MD
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Paris, France, 75013
- Recruiting
- Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix
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Principal Investigator:
- Mehdi Touat, MD
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Contact:
- Mehdi TOUAT, MD
- Email: mehdi.touat@aphp.fr
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Poitiers, France, 86021
- Recruiting
- CHU Poitiers
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Contact:
- Anamaria STETCO, MD
- Phone Number: +33 (0)5 49 44 33 02
- Email: Anamaria-Ioana.STETCO@chu-poitiers.fr
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Principal Investigator:
- Anamaria STETCO, MD
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Reims, France, 51092
- Recruiting
- CHU de Reims - American Memorial Hospital 2
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Contact:
- Grégory GUIMARD, MD
- Email: gguimard@chu-reims.fr
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Principal Investigator:
- Grégory GUIMARD, MD
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Rennes, France, 35042
- Recruiting
- Centre Eugène Marquis
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Contact:
- Elodie VAULEON, MD
- Email: e.vauleon@rennes.unicancer.fr
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Principal Investigator:
- Elodie Vauleon, MD
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Rennes, France, 35203
- Recruiting
- CHU Rennes - Hôpital Sud
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Principal Investigator:
- Chloé PUISEUX, MD
-
Contact:
- Chloé PUISEUX, MD
- Email: Chloe.PUISEUX@chu-rennes.fr
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Rouen, France, 76000
- Recruiting
- CHU Rouen Normandie - Hôpital Charles-Nicolle
-
Contact:
- Pascale SCHNEIDER, PhD
- Email: Pascale.Schneider@chu-rouen.fr
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Principal Investigator:
- Pascale SCHNEIDER, MD, PhD
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Saint-Denis, France, 97400
- Recruiting
- CHU de Saint-Denis de La Réunion
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Principal Investigator:
- Yves REGUERRE, MD
-
Contact:
- Yves REGUERRE, MD
- Phone Number: 262 (0)2 62 90 61 10
- Email: yves.reguerre@chu-reunion.fr
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Saint-Etienne, France, 42270
- Recruiting
- CHU de Saint-Étienne - Hôpital Nord
-
Contact:
- Sandrine THOUVENIN, MD, PhD
- Email: sandrine.thouvenin@chu-st-etienne.fr
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Principal Investigator:
- Sandrine THOUVENIN, MD, PhD
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Saint-Pierre, France, 97488
- Not yet recruiting
- CHU de Saint-Pierre de La Réunion Sud
-
Contact:
- Mohamed KHETTAB, MD
- Phone Number: 262 (0) 2 62 35 90 00
- Email: mohamed.khettab@chu-reunion.fr
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Principal Investigator:
- Mohamed KHETTAB, MD
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Strasbourg, France, 67200
- Recruiting
- Hôpital de Hautepierre
-
Principal Investigator:
- Natacha ENTZ-WERLE, MD, PhD
-
Contact:
- Natacha ENTZ-WERLE, MD, PhD
- Email: Natacha.entz-werle@chru-strasbourg.fr
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Strasbourg, France, 67065
- Recruiting
- Centre Régional Lutte Contre le Cancer Paul STRAUSS
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Principal Investigator:
- Roland SCHOTT, MD
-
Contact:
- Roland SCHOTT, MD
- Email: r.schott@icans.eu
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Suresnes, France, 92150
- Not yet recruiting
- Hopital Foch
-
Contact:
- Nadia YOUNAN, MD
- Phone Number: +33 (0)1 46 25 31 41
- Email: n.younan@hopital-foch.com
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Principal Investigator:
- Nadia YOUNAN, MD
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Toulouse, France, 31059
- Recruiting
- Hopital Des Enfants
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Contact:
- Anne Isabelle BERTOZZI SALAMON, MD
- Email: bertozzi.ai@chu-toulouse.fr
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Principal Investigator:
- Anne Isabelle BERTOZZI SALAMON, MD
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Toulouse, France, 31059
- Recruiting
- Institut Universitaire du Cancer de Toulouse-Oncopole (IUCT-O) - Institut Claudius Regaud
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Principal Investigator:
- Delphine LARRIEU-CIRON, MD
-
Contact:
- Delphine LARRIEU-CIRON, MD
- Phone Number: 33 (0)5 31 15 56 74
- Email: LarrieuCiron.Delphine@iuct-oncopole.fr
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Tours, France, 37000
- Recruiting
- CHRU Tours - Hôpital Clocheville
-
Contact:
- Marion GILLIBERT-YVERT, MD
- Email: m.gillibert-yvert@chu-tours.fr
-
Principal Investigator:
- Marion GILLIBERT-YVERT, MD
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Tours, France, 37044
- Recruiting
- CHRU Tours - Hôpital Bretonneau
-
Contact:
- Bérangère NARCISO-RAHARIMANANA, MD
- Email: b.narciso-raharimanana@chu-tours.fr
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Principal Investigator:
- Bérangère NARCISO-RAHARIMANANA, MD
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-
Val de Marne
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Villejuif, Val de Marne, France, 94805
- Recruiting
- Gustave Roussy
-
Principal Investigator:
- Jacques GRILL, MD, PhD
-
Contact:
- Jacques GRILL, MD, PhD
- Email: jacques.grill@gustaveroussy.fr
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-
-
-
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Barcelona, Spain, 8035
- Recruiting
- Hospital Vall D´Hebron
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Contact:
- Anna LLORT, MD
- Email: Anna.llort@vallhebron.cat
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Madrid, Spain, 28009
- Recruiting
- Hospital Universitario Niño Jesus
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Principal Investigator:
- Alvaro Lassaletta, MD
-
Contact:
- Álvaro LASSALETTA, MD
- Phone Number: 00 34 915 03 59 38
- Email: alvaro.lassaletta@salud.madrid.org
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Valencia, Spain, 46026
- Recruiting
- Hospital Universitario y Politecnico de la Fe
-
Contact:
- Adela CAÑETE NIETO, MD
- Email: canyete_ade@gva.es
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-
-
-
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Stockholm, Sweden, 17176
- Recruiting
- Karolinska University Hospital
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Principal Investigator:
- Klas BLOMGREN, MD, PhD
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Contact:
- Klas BLOMGREN, MD, PhD
- Phone Number: 0046 8 123 747 57
- Email: klas.blomgren@regionstockholm.se
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Eligibility criteria for the inclusion (registration) in BIOMEDE 2.0 study:
Diagnosis Criteria:
- Diagnosis of DIPG (clinical and radiological). As biopsy is not standard for these tumors, an informed consent is required for the necessary histological verification. [Biopsy-part of BIOMEDE 2.0 trial]. OR
- Histological diagnosis of DIPG (i.e. H3K28M or EZHIP positive Diffuse Midline Glioma located in the pons) in case the tumor biopsy was performed before study entry. The diagnosis will be defined by 1/ diffuse glioma, 2/ H3K28M mutation or loss of H3K28 trimethylation together with EZHIP overexpression. In this situation, patient will sign the consent after the diagnosis to allow central review and biomarkers assessment thereafter. OR
- Molecular diagnosis of DIPG (i.e. H3K28M) in case a liquid biopsy (CSF or blood) was performed before study entry, in a patient who could not undergo a tumor biopsy because it was too dangerous according to the patient's clinical condition. The diagnosis will be defined by 1/ DIPG, 2/ H3K28M mutation. In this situation, patient will sign the consent after the diagnosis to allow collection of the molecular report. OR
- Non-DIPG diffuse midline gliomas (ND-DMG), H3K28M mutant or with H3K28 trimethylation loss together with EZHIP overexpression, will be eligible for the trial after biopsy or surgery. As biopsy and surgery is considered as standard practice for these locations, informed consent for the biopsy will not be necessary. Patient will sign the consent after the diagnosis to allow central review and biomarkers assessment thereafter. OR
- Non-DIPG diffuse midline gliomas (ND-DMG) will be eligible for the trial before the biopsy in case the diagnosis is clinically or radiologically suspected. Informed consent for the biopsy and molecular analysis will be necessary. Then, if the central pathology review concludes to a ND-DMG with H3K28M mutant or H3K28 trimethylation loss together with EZHIP overexpression, these patients will be eligible for the treatment part of the trial.
- Eligible for a biopsy, or biopsy material available for the biomarker assessment.
- Age > 6 months, with no upper age limit. Children between 6 months and 3 years will be discussed on a case by case basis for inclusion in the study for the feasibility of the stereotactic biopsy.
- Eligible for cerebral or craniospinal radiotherapy.
- Tumor at diagnosis: no prior chemotherapy for the present cancer; no prior cerebral radiation therapy even for another neoplasm. Surgery is allowed when performed for diagnostic or therapeutic purpose.
- Metastatic diseases or spinal tumors allowed; in this case, patients would receive craniospinal or spinal radiotherapy and medical treatment (everolimus or ONC201) will be postponed and only started after the end of radiotherapy.
- Patients must be affiliated to a social security system or beneficiary of the same according to local requirements.
- Written informed consent from parents/legal representative, patient, and age-appropriate assent before any study-specific procedures are conducted according to local, regional or national guidelines.
Non eligibility criteria for the inclusion (registration) in BIOMEDE 2.0 study:
- Uncontrolled spontaneous massive intratumor bleeding. Patients with post-operative bleeding will be allowed to enter the study provided the hemorrhage is controled. Same rule applies for the other post-operative complications (infection, CSF leakage, absence of wound closure, subdural collection…).
- Any other concomitant anti-cancer treatment not foreseen by this protocol is not allowed, except corticosteroids and Bevacizumab which are allowed during the protocol. Bevacizumab is not allowed before and until 15 days after the surgery. The use of bevacizumab and corticosteroids will be taken into account when judging the possibility of progression/pseudoprogression.
- Any other cancer diagnosed during the last 5 years.
- Uncontrolled intercurrent illness or active infection.
- Any other co-morbid condition that in the investigator's opinion would impair study participation.
- Unable for medical follow-up (geographic, social or mental reasons).
- Patient previously treated with irradiation on the brainstem for another neoplasm.
- Participation in another clinical study with an investigational product while on study treatment.
- Patient under guardianship or deprived of his/her liberty by a judicial or administrative decision or incapable of giving his/her consent.
Eligibility criteria for the randomization in BIOMEDE 2.0 study:
- Patient enrolled in the BIOMEDE 2.0 study.
- Life expectancy > 12 weeks after the start of study treatment.
- Histological diagnosis of DIPG (as per the WHO criteria) confirmed by central pathology review, OR Typical radiology of a DIPG (mandatory central radiological review) as well as the short clinical history (less than three months of pre-existing symptoms) in case of suspected DIPG but no histological confirmation (tumor biopsy performed but not informative), or suspected DIPG with detection of H3K28M mutation in the CSF or blood (ctDNA analysis in the CSF or blood), OR Histological diagnosis of ND-DMG confirmed by central pathology review, with mutation in the histone H3.1, H3.2, H3.3 genes, or loss of H3K28me3 and EZHIP overexpression by immunohistochemistry.
- Karnofsky performance status scale or Lansky Play Scale > 50%. The PS should not take the neurologic deficit per se into account. NB: Children and adults with a worse performance status due to glioma-related motor paresis can be included.
- Highly effective and appropriate contraception for patients (male and female) of reproductive potential during their entire participation in the study and during 6 months after the end of treatment.
- Negative pregnancy test (serum beta-HCG or urinary test) evaluated within one week prior randomization in sexually active females of reproductive potential.
- Absolute neutrophil count > 1.0 x 10^9/l, Platelets > 100 x 10^9/l.
- Total bilirubin < 1.5 x ULN, AST and ALT< 2.5 x ULN.
- Serum creatinine < 1.5 X ULN for age. If serum creatinine > 1.5 x ULN, creatinine clearance must be > 70 ml/min/1.73 m² (as per local practice).
- Normal coagulation tests within the local reference ranges.
- Written informed consent from parents/legal representative, patient, and age-appropriate assent before randomization according to local, regional or national guidelines.
Non Eligibility criteria for the randomization in BIOMEDE 2.0 study:
- Current organ toxicity > grade 2 according to the NCI-CTCAE version 5.0, especially cardiovascular or renal disease (including but not limited to: congenital long QT syndrome, nephrotic syndrome, glomerulopathy, uncontrolled high blood pressure despite adequate treatment).
Patients with the following cardiac history cannot take ONC201:
- Prolongation of QT/QTcF interval (QTc interval > 480 milliseconds) preferably using Frederica's QT correction formula on two ECGs separated by at least 48 hours.
- A history of Torsades de pointes or heart failure, hypokalemia, or family history of prolonged QT Syndrome.
- Required concomitant use of medication(s) known to prolong the QT/QTc interval.
In this case, patients will be treated in the Everolimus arm without randomization (except if contra-indication to Everolimus).
- Pregnant or breastfeeding women.
- Patients with chronic HBV disease compatible with the trial are not excluded from the study. These patients randomized to everolimus treatment will have regular viral load monitoring throughout the study.
- Patients taking strong P450 inhibitors or inducers or PgP inhibitors are not excluded from the study but drug concentration of everolimus should be monitored carefully to avoid toxicity. Preferably alternative medications should be considered.
- Patient with known congenital galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption will not be randomized and will be treated in the ONC201 arm (except if contra-indication to ONC201).
- Patients with known hypersensitivity to any component of Everolimus (active substance, other rapamycin derivatives or excipients) will not be randomized and will be treated in the ONC201 arm (except if contra-indication to ONC201).
- Patients with known hypersensitivity to any component of ONC201 (drug product or excipients) will not be randomized and will be treated in the Everolimus arm (except if contra-indication to Everolimus).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Active Comparator: everolimus
Tablets of 2.5 mg or 10 mg. The prescribed dose is 5 mg/m²/day, orally, once daily. Dose will be capped at 10 mg once daily. Treatment will be continued until unacceptable toxicity, centrally confirmed tumor progression (either radiologically or histologically) and/or withdrawal of patient, parents or legal representative consent. At the time of centrally confirmed relapse or progression, patients will stop treatment and will be allowed to switch to the other arm in case no better option is available after considering the results of the molecular profiling. In case of switch (everolimus to ONC201 or vice-versa), the patient will observe a wash-out period of 7 days before starting:
|
Tablets of 2.5 mg or 10 mg.
The prescribed dose is 5 mg/m²/day, orally, once daily.
Dose will be capped at 10 mg once daily.
Other Names:
All patients will be treated with 30 conventional single daily fractions of 1.8 Gy to a total of 54 Gy over a planned period of 6 weeks. Dose may be increased up to 60 Gy for adult patients with supratentorial ND-DMG. The clinical target volume will include all the areas of abnormality on T2/FLAIR sequences with a 1-cm margin. Radiotherapy will have to start within a maximum of 4 weeks for DIPG, up to 6 weeks for other DMG H3K28-altered (ND-DMG), after the biopsy or last surgery. The study medication will be started at Day 1 (+3 days max) of radiotherapy. Reirradiation is permitted only at disease progression according to local practice. In case of metastatic disease or intramedullary tumors, patients can be included in the study. In this situation, radiotherapy will have to start within a maximum of 4 weeks for DIPG, up to 6 weeks for other DMG H3K28-altered (ND-DMG), after the biopsy or last surgery while targeted treatment will start at the end of the irradiation. |
|
Experimental: Dordaviprone (ONC201)
Capsules of 125 mg. The prescribed dose is 375 mg/m², orally, once daily at Day 1 and Day 2 of each week. Dose will be capped at 625 mg per dose. Treatment will be continued until unacceptable toxicity, centrally confirmed tumor progression (either radiologically or histologically), and/or withdrawal of patient, parents or legal representative consent. At the time of centrally confirmed relapse or progression, patients will stop treatment and will be allowed to switch to the other arm in case no better option is available after considering the results of the molecular profiling. In case of switch (everolimus to ONC201 or vice-versa), the patient will observe a wash-out period of 7 days before starting:
|
All patients will be treated with 30 conventional single daily fractions of 1.8 Gy to a total of 54 Gy over a planned period of 6 weeks. Dose may be increased up to 60 Gy for adult patients with supratentorial ND-DMG. The clinical target volume will include all the areas of abnormality on T2/FLAIR sequences with a 1-cm margin. Radiotherapy will have to start within a maximum of 4 weeks for DIPG, up to 6 weeks for other DMG H3K28-altered (ND-DMG), after the biopsy or last surgery. The study medication will be started at Day 1 (+3 days max) of radiotherapy. Reirradiation is permitted only at disease progression according to local practice. In case of metastatic disease or intramedullary tumors, patients can be included in the study. In this situation, radiotherapy will have to start within a maximum of 4 weeks for DIPG, up to 6 weeks for other DMG H3K28-altered (ND-DMG), after the biopsy or last surgery while targeted treatment will start at the end of the irradiation. Capsules of 125mg. The prescribed dose is 375mg/m², orally, once daily at Day 1 and Day 2 of each week. Dose will be capped at 625 mg per dose. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Progression-free survival
Time Frame: Until 2 years after inclusion of the last patient
|
Defined as the time between date of randomization and unequivocal clinical, cytological or radiological progression confirmed by central review, or death whatever the cause.
|
Until 2 years after inclusion of the last patient
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall survival (for all the comparisons to historical controls)
Time Frame: Until 5 years after randomization of the last patient
|
Defined from the date of radiological diagnosis to the date of death from any cause.
|
Until 5 years after randomization of the last patient
|
|
Overall survival (for the internal comparison between randomized groups)
Time Frame: Until 5 years after randomization of the last patient
|
Defined from the date of randomization to the date of death from any cause.
|
Until 5 years after randomization of the last patient
|
|
Progression-free survival after first progression
Time Frame: Until 5 years after randomization of the last patient
|
It will also be computed from the date of progression to the date of subsequent progression or death from any cause, in order to describe the outcome after progression.
|
Until 5 years after randomization of the last patient
|
|
Complication rate of the diagnostic biopsy-based procedure
Time Frame: Until 5 years after randomization of the last patient
|
Until 5 years after randomization of the last patient
|
|
|
Severity of the complications (including prolongation of the hospital stay) of the diagnostic biopsy-based procedure
Time Frame: Until 5 years after randomization of the last patient
|
Until 5 years after randomization of the last patient
|
|
|
Duration of the complications (including delay for starting treatment) of the diagnostic biopsy-base procedure
Time Frame: Until 5 years after randomization of the last patient
|
Until 5 years after randomization of the last patient
|
|
|
Safety profile of the drugs
Time Frame: Until 5 years after randomization of the last patient
|
Using the NCI-CTC v5.0 criteria, during radiotherapy and during the entire duration of the administration of the drug, considering all adverse events except adverse events unequivocally related to the disease (pseudo)-progression.
|
Until 5 years after randomization of the last patient
|
|
Relative benefit/risk ratio of ONC201 compared to everolimus
Time Frame: Until 5 years after randomization of the last patient
|
It will be assessed using the Q-TWiST approach (Quality-adjusted time without symptoms of disease or adverse event) evaluated from survival times (overall survival and progression-free survival) and adverse events data (date of occurrence of grade 3+ adverse event).
|
Until 5 years after randomization of the last patient
|
Collaborators and Investigators
Collaborators
Investigators
- Study Chair: Jacques GRILL, MD, PhD, Gustave Roussy, Cancer Campus, Grand Paris
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
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Neoplasms by Site
- Neoplasms
- Neoplasms by Histologic Type
- Neoplasms, Glandular and Epithelial
- Glioma
- Neoplasms, Neuroepithelial
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Nervous System Neoplasms
- Central Nervous System Neoplasms
- Brain Neoplasms
- Brain Stem Neoplasms
- Infratentorial Neoplasms
- Diffuse Intrinsic Pontine Glioma
- Organic Chemicals
- Therapeutics
- Macrolides
- Lactones
- Sirolimus
- Everolimus
- TIC10 compound
- Radiotherapy
Other Study ID Numbers
- 2014/2126 (CSET number)
- 2014-001929-32 (EudraCT Number)
- 2023-506027-29-00 (Ctis)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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