Advanced Imaging-Guided Standard Versus Dose-Intensified Radiation Therapy for the Treatment of Newly Diagnosed Glioblastoma, SAGA 2.0 Trial
Stereotactic Advanced-Imaging Guided Radiotherapy for Glioblastoma (SAGA 2.0)
This clinical trial studies how well advanced imaging-guided standard dose versus (vs.) dose-intensified radiation therapy (RT) and dose-intensified accelerated RT works in treating patients with newly diagnosed glioblastoma. Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill tumor cells and shrink tumors. During dose-intensified RT, a higher dose than normal of radiation therapy is delivered over 6 weeks. During dose-intensified accelerated RT, the higher dose of radiation therapy is delivered over a shorter amount of time (2 weeks) than normal (6 weeks). Patients also undergo an advanced brain imaging positron emission tomography (PET)/computed tomography (CT) scan (using a radioactive drug called either FET or FDOPA) prior to RT to that may help doctors better plan the treatment. Dose-intensified and dose-intensified accelerated radiation therapy may be effective in treating patients with newly diagnosed glioblastoma. Giving dose-intensified RT or dose-intensified accelerated RT guided by advanced imaging may work better than standard dose RT in treating patients with newly diagnosed glioblastoma.
IND Numbers: 61300, 140882, 176402, 154793, 167879
Studieoversigt
Status
Betingelser
Intervention / Behandling
- Procedure: Biospecimen Collection
- Procedure: Magnetic Resonance Imaging
- Andet: Questionnaire Administration
- Procedure: Computed Tomography
- Stråling: F-18 Fluoroethyltyrosine
- Medicin: Fluorodopa F 18
- Stråling: Dose-intensified Photon Beam Radiation Therapy
- Procedure: Positron Emission Tomography
- Stråling: Proton Beam Radiation Therapy
- Stråling: Proton Beam Radiation Therapy
- Stråling: Proton Beam Radiation Therapy
- Stråling: Proton Beam Radiation Therapy
- Medicin: Temozolomide
- Stråling: Standard Photon Beam Radiation Therapy
- Stråling: Dose-intensified Accelerated Photon Beam Radiation Therapy
- Stråling: Accelerated Photon Beam Radiation Therapy
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Fase 3
Kontakter og lokationer
Studiesteder
-
-
Arizona
-
Scottsdale, Arizona, Forenede Stater, 85259
- Mayo Clinic in Arizona
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Ledende efterforsker:
- Sujay A. Vora
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Kontakt:
- Sujay A. Vora
- Telefonnummer: 480-342-2000
- E-mail: vora.sujay@mayo.edu
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Florida
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Jacksonville, Florida, Forenede Stater, 32224-9980
- Mayo Clinic in Florida
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Ledende efterforsker:
- Daniel Trifiletti
-
Kontakt:
- Daniel Trifiletti
- Telefonnummer: 904-953-2000
- E-mail: trifiletti.daniel@mayo.edu
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Minnesota
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Albert Lea, Minnesota, Forenede Stater, 56007
- Mayo Clinic Health System in Albert Lea
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Kontakt:
- John E. Yeakel
- Telefonnummer: 507-668-2063
- E-mail: yeakel.john@mayo.edu
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Ledende efterforsker:
- John E. Yeakel
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Mankato, Minnesota, Forenede Stater, 56001
- Mayo Clinic Health Systems-Mankato
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Kontakt:
- Jason T. Hayes
- Telefonnummer: 507-668-2063
- E-mail: hayes.jason@mayo.edu
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Ledende efterforsker:
- Jason T. Hayes
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Rochester, Minnesota, Forenede Stater, 55905
- Mayo Clinic in Rochester
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Kontakt:
- William Breen
- Telefonnummer: 507-284-3261
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Ledende efterforsker:
- William Breen
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Wisconsin
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Eau Claire, Wisconsin, Forenede Stater, 54701
- Mayo Clinic Health System-Eau Claire Clinic
-
Kontakt:
- Now Bahar Alam
- Telefonnummer: 715-464-8124
- E-mail: alam.nowbahar@mayo.edu
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Ledende efterforsker:
- Now Bahar Alam
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La Crosse, Wisconsin, Forenede Stater, 54601
- Mayo Clinic Health System-Franciscan Healthcare
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Kontakt:
- Abigail L. Stockham
- Telefonnummer: 608-392-7332
- E-mail: stockham.abigail@mayo.edu
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Ledende efterforsker:
- Abigail L. Stockham
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Age ≥ 18 years
- Histological confirmation of glioblastoma (IDH-wildtype)
- Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) ≤ 3 at baseline
- Provide written informed consent or have a Legally Authorized Representative (LAR) who is responsible for the care and well-being of the potential study participant, provide consent in accordance with ethical, regulatory, and institutional requirements
- Willing to return to enrolling institution for follow-up either in-person or by video visit (where indicated)
Exclusion Criteria:
- Known to be pregnant or nursing
- Unable to undergo MRI scans with contrast (such as patients with devices or metal in head that is MRI incompatible)
- Unable to undergo amino acid PET (FET or FDOPA) scan (such as allergy to the contrast/tracer, or technical or patient factors per the discretion of the treating physician)
- Prior radiation (including tile-based brachytherapy) or chemotherapy for glioblastoma (note: prior cancer diagnoses and treatment for other cancers are not exclusion criteria, and multiple surgeries prior to enrollment is not an exclusion criteria)
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Arm A (dose-intensified radiation therapy)
Patients undergo thirty treatment fractions of dose-intensified proton or photon radiation therapy QD (Monday-Friday) over 6 weeks in the absence of disease progression or unacceptable toxicity. Patients may also receive SOC temozolomide during and/or after radiation therapy at the discretion of the treating team. Additionally, patients receive FET via injection or FDOPA IV and undergo PET/CT prior to treatment and optionally during treatment and follow-up. Patients also undergo MRI and blood sample collection throughout the study. |
Undergo blood sample collection
Andre navne:
Undergo MRI
Andre navne:
Ancillary studies Undergo FET or FDOPA PET/CT
Andre navne:
Given via injection
Andre navne:
Given IV
Andre navne:
Undergo dose-intensified photon radiation therapy
Andre navne:
Undergo FET or FDOPA PET/CT
Andre navne:
Undergo dose-intensified proton radiation therapy
Andre navne:
Undergo standard proton radiation therapy
Andre navne:
Undergo dose-intensified accelerated proton radiation therapy
Andre navne:
Undergo accelerated proton radiation therapy
Andre navne:
Given SOC temozolomide
Andre navne:
|
|
Aktiv komparator: Arm B (standard radiation therapy)
Patients undergo thirty treatment fractions of standard proton or photon radiation therapy QD (Monday-Friday) over 6 weeks in the absence of disease progression or unacceptable toxicity. Patients may also receive SOC temozolomide during and/or after radiation therapy at the discretion of the treating team. Additionally, patients receive FET via injection or FDOPA IV and undergo PET/CT prior to treatment and optionally during treatment and follow-up. Patients also undergo MRI and blood sample collection throughout the study. |
Undergo blood sample collection
Andre navne:
Undergo MRI
Andre navne:
Ancillary studies Undergo FET or FDOPA PET/CT
Andre navne:
Given via injection
Andre navne:
Given IV
Andre navne:
Undergo FET or FDOPA PET/CT
Andre navne:
Undergo dose-intensified proton radiation therapy
Andre navne:
Undergo standard proton radiation therapy
Andre navne:
Undergo dose-intensified accelerated proton radiation therapy
Andre navne:
Undergo accelerated proton radiation therapy
Andre navne:
Given SOC temozolomide
Andre navne:
Undergo standard photon radiation therapy
Andre navne:
|
|
Eksperimentel: Arm C (dose-intensified accelerated radiation therapy)
Patients undergo ten treatment fractions of dose-intensified accelerated proton or photon radiation therapy QD (Monday-Friday) over 2 weeks in the absence of disease progression or unacceptable toxicity. Patients may also receive SOC temozolomide during and/or after radiation therapy at the discretion of the treating team. Additionally, patients receive FET via injection or FDOPA IV and undergo PET/CT prior to treatment and optionally during treatment and follow-up. Patients also undergo MRI throughout the study. |
Undergo MRI
Andre navne:
Undergo FET or FDOPA PET/CT
Andre navne:
Given via injection
Andre navne:
Given IV
Andre navne:
Undergo FET or FDOPA PET/CT
Andre navne:
Undergo dose-intensified proton radiation therapy
Andre navne:
Undergo standard proton radiation therapy
Andre navne:
Undergo dose-intensified accelerated proton radiation therapy
Andre navne:
Undergo accelerated proton radiation therapy
Andre navne:
Given SOC temozolomide
Andre navne:
Undergo dose-intensified accelerated photon radiation therapy
Andre navne:
|
|
Aktiv komparator: Arm D (accelerated radiation therapy)
Patients undergo ten treatment fractions of accelerated proton or photon radiation therapy QD (Monday-Friday) over 2 weeks in the absence of unacceptable toxicity. Patients may also receive SOC temozolomide during and/or after radiation therapy at the discretion of the treating team. Additionally, patients receive FET via injection or FDOPA IV and undergo PET/CT prior to treatment and optionally during treatment and follow-up. Patients also undergo MRI throughout the study. |
Undergo MRI
Andre navne:
Undergo FET or FDOPA PET/CT
Andre navne:
Given via injection
Andre navne:
Given IV
Andre navne:
Undergo FET or FDOPA PET/CT
Andre navne:
Undergo dose-intensified proton radiation therapy
Andre navne:
Undergo standard proton radiation therapy
Andre navne:
Undergo dose-intensified accelerated proton radiation therapy
Andre navne:
Undergo accelerated proton radiation therapy
Andre navne:
Given SOC temozolomide
Andre navne:
Undergo accelerated photon radiation therapy
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Overall survival (Cohort 1)
Tidsramme: Up to 18 months
|
Overall survival (OS) is defined as the time from registration until death due to any cause. Will be summarized by treatment arm using the difference in proportions test. |
Up to 18 months
|
|
Overall survival (Cohort 2)
Tidsramme: Up to 12 months
|
Overall survival (OS) is defined as the time from registration until death due to any cause. A Bayesian pick-the-winner design will be used to identify the more promising treatment arm based on 12-month overall survival. |
Up to 12 months
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Incidence of grade 3+ central nervous system (CNS) toxicity, regardless of attribution (Overall CNS toxicity)
Tidsramme: Up to 36 months post-radiation therapy (RT)
|
CNS toxicities will be graded according to Common Terminology Criteria for Adverse Events (CTCAE) 5.0. For each treatment arm, CNS toxicity will be summarized as: the number and proportion of patients experiencing at least one qualifying grade ≥ 3 CNS toxicity event. Between-arm comparisons will be performed descriptively. |
Up to 36 months post-radiation therapy (RT)
|
|
Incidence of grade 3+ higher CNS toxicity at least possibly attributable to radiation therapy (Treatment-related CNS toxicity)
Tidsramme: Up to 36 months post-RT
|
As assessed by the treating investigator. CNS toxicities will be graded according to CTCAE 5.0. Events classified as possibly, probably, or definitely related to radiation therapy will be included. For each treatment arm, CNS toxicity will be summarized as: the number and proportion of patients experiencing at least one qualifying grade ≥ 3 CNS toxicity event. |
Up to 36 months post-RT
|
|
Quality of life (Cohort 1) - EORTC QLQ-C30
Tidsramme: Up to 6 months post-RT
|
The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 is a 30-item questionnaire a questionnaire used to assess the quality of life of cancer patients. Twenty-eight questions are answered on a scale of 1-4 (1=not at all, 2=a little, 3=quite a bit, and 4= very much), and two questions are answered on a scale of 1-7 (1= very poor and 7=excellent). Higher summary scores indicate better health related quality of life. |
Up to 6 months post-RT
|
|
Quality of life (Cohort 1) - EORTC QLQ-BN20
Tidsramme: Up to 6 months post-RT
|
The EORTC QLQ-BN20 is a 20-item questionnaire related to symptoms experienced by patients with brain cancer during the past week. Questions are answered on a scale of 1-4 where 1=not at all, 2=a little; 3-quite a bit; and 4=very much. Higher scores indicate greater severity of symptoms. |
Up to 6 months post-RT
|
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Neurocognitive outcomes (Cohort 1)
Tidsramme: Up to 1 month post-RT
|
As measured by Mayo Test Drive (MTD), a web-based platform for remote self-administered cognitive assessment. The primary comparison will be the between-arm difference in mean change over time (arm-by-time interaction). Higher or average composite scores indicate functioning consistent with healthy cognitive peers for participant's age, sex, and education. Significantly negative scores suggest performance drops in memory and processing. An MTD score is a screening and monitoring tool, not a medical diagnosis. Lower scores do not automatically indicate Alzheimer's or dementia; they can be influenced by other factors such as fatigue, high stress, medications, technical issues during the test, or mild age-related changes. |
Up to 1 month post-RT
|
Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Ledende efterforsker: William Breen, Mayo Clinic in Rochester
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Neoplasmer
- Neoplasmer efter histologisk type
- Neoplasmer, kirtel og epitel
- Astrocytom
- Gliom
- Neoplasmer, Neuroepithelial
- Neuroektodermale tumorer
- Neoplasmer, kimceller og embryonale
- Neoplasmer, nervevæv
- Glioblastom
- Organiske kemikalier
- Heterocykliske forbindelser, 1-ring
- Heterocykliske forbindelser
- Undersøgelsesteknikker
- Terapeutik
- Kliniske laboratorieteknikker
- Diagnostiske teknikker og procedurer
- Diagnose
- Azoler
- Fysiske fænomener
- Dacarbazine
- Triazener
- Imidazoler
- Uorganiske kemikalier
- Elementer
- Kemiteknikker, analytisk
- Spektrumanalyse
- Ioner
- Elektrolytter
- Elektromagnetiske fænomener
- Magnetiske fænomener
- Strålebehandling
- Elektromagnetisk stråling
- Gasser
- Elementære partikler
- Lys
- Optiske fænomener
- Stråling, ikke -ioniserende
- Tung ionstrålebehandling
- Kationer, monovalent
- Kationer
- Brint
- Nukleoner
- Temozolomid
- Stråling
- Håndtering af eksemplar
- Magnetisk resonansspektroskopi
- Fotoner
- Fluorodopa F 18
- Protonterapi
- Protoner
- (18F) fluoroethyltyrosin
Andre undersøgelses-id-numre
- GMROR2661
- NCI-2026-07628 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- 26-003443 (Anden identifikator: Mayo Clinic Institutional Review Board)
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
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