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Preoperativ radiokirurgi for behandling av høygradig gliom, NeoGlioma-studien

29. september 2026 oppdatert av: Mayo Clinic

Preoperativ radiosurgery in High Grad Glioma: En fase I/IIA klinisk studie: NeoGlioma-studien

This phase I trial finds out the possible benefits and/or side effects of radiosurgery before surgery (preoperative) in treating patients with high grade glioma. Radiosurgery uses special equipment to position the patient and precisely give a single large dose of radiation to the tumor. This method may kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue. Giving pre-operative radiosurgery may improve the odds of brain tumor control and reduce treatment-related side effects.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

PRIMARY OBJECTIVE:

I. To evaluate the feasibility, safety and maximum tolerated dose (MTD) of preoperative radiosurgery in the treatment of patients with biopsy-proven high-grade glioma prior to conventional therapy.

SECONDARY OBJECTIVES:

I. Acute clinical toxicity profile using Common Terminology Criteria for Adverse Events (CTCAE) version 5 (defined as within 4 weeks of completion of postoperative radiotherapy.

II. Radiographic tumor control at 12 months following surgery (per Response Assessment in Neuro-Oncology [RANO] criteria).

III. Rate of pseudoprogression at first post radiation scan (RANO criteria). IV. Overall survival at 12 months following surgery.

CORRELATIVE RESEARCH OBJECTIVE:

I. Evaluation of the tumor repair pathways triggered by radiation, tumor vascular changes, tumor microenvironment immune profiling, cell cultures, and the creation of orthotopic xenograft models for future study.

OUTLINE: This is a dose-escalation study.

Patients undergo magnetic resonance imaging (MRI)-guided stereotactic biopsy. Within 14 days of registration, patients undergo either standard of care surgery or radiosurgery in 1 fraction. Within 14 days, patients who underwent radiosurgery then undergo surgery. Within 4-6 weeks, all patients then receive standard of care radiation therapy over 30 fraction and temozolomide daily with or without tumor treating fields (TTF) at the discretion of the treating neuro-oncologist. Additionally, patients undergo MRI and blood sample collection and optional biopsy throughout the study.

After completion of study treatment, patients are followed up every 2-3 months for 12 months and then every 3 months for up to 3 years after registration.

Studietype

Intervensjonell

Registrering (Antatt)

28

Fase

  • Fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

  • Forente stater
    • Arizona
      • Phoenix, Arizona, Forente stater, 85054
        • Rekruttering
        • Mayo Clinic in Arizona
        • Ta kontakt med:
        • Hovedetterforsker:
          • Sujay Vora, MD
    • Florida
      • Jacksonville, Florida, Forente stater, 32224-9980
        • Rekruttering
        • Mayo Clinic in Florida
        • Ta kontakt med:
        • Hovedetterforsker:
          • Daniel M. Trifiletti, MD

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Age >= 18 years
  • Clear clinical and radiographic evidence of primary high grade glioma (HGG) as judged by the Mayo multidisciplinary neuro-oncology team (World Health Organization [WHO] grade III-IV, including glioblastoma) regardless of IDH and MGMT status
  • Patients who underwent a previous biopsy confirming high grade glioma are eligible for enrollment
  • Planned neurosurgical resection of tumor
  • Judged to not be at risk of significant clinical risk (i.e. herniation) with radiation-induced edema prior to resection
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2
  • Negative pregnancy test done =< 14 days prior to registration, for women of childbearing potential only. Patients over 50 years of age who decline pregnancy testing are still eligible without a pregnancy test.
  • Ability to complete questionnaire(s) by themselves or with assistance
  • Provide written informed consent
  • Willing to receive adjuvant radiotherapy at enrolling institution at the time of registration
  • Willing to provide tissue and/or blood samples for correlative research purposes

Exclusion Criteria:

  • Any of the following:

    • Pregnant women
    • Nursing women who are unwilling to cease during therapy
    • Men or women of childbearing potential who are unwilling to employ adequate contraception

  • Prior history of cranial radiotherapy

  • Unwillingness to participate in study

  • Investigator discretion that enrollment on the study would pose undo harm or risk to the patient

  • Non-MRI compatible implanted medical device

  • Use of systemic anti-cancer therapy within the previous 3 months

  • Medical contraindication to craniotomy and tumor resection

  • Pathologic confirmation of grade I-II glioma, brain metastasis, or other brain tumor

    • Note: Patients with a history of grade I-II glioma are eligible if they have only received surgery as treatment and now there is concern for transformation to grade III-IV tumor

  • Primary spinal cord glioma or primary brainstem glioma

  • Residual tumor of excessive volume or eloquent location per investigator discretion

  • Patients who are unwilling or unable to comply with study procedures

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Sekvensiell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Treatment (stereotactic biopsy, radiosurgery, surgery)

Patients undergo MRI-guided stereotactic biopsy. Within 14 days of registration, patients undergo either standard of care surgery or radiosurgery in 1 fraction. Within 14 days, patients who underwent radiosurgery then undergo surgery. Within 4-6 weeks, all patients then receive standard of care radiation therapy over 30 fraction and temozolomide daily with or without TTF at the discretion of the treating neuro-oncologist. Additionally, patients undergo MRI and blood sample collection and optional biopsy throughout the study.
Fremgangsmåte: Biospecimen Collection

Undergo blood sample collection

Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling
Fremgangsmåte: Magnetic Resonance Imaging

Undergo MRI

Andre navn:
  • MR
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medisinsk bildebehandling, magnetisk resonans / kjernemagnetisk resonans
  • MR Imaging
  • MR-skanning
  • NMR-avbildning
  • NMRI
  • kjernemagnetisk resonansavbildning
  • Magnetisk resonanstomografi (MR)
  • sMRI
  • Magnetisk resonansavbildning (prosedyre)
  • MR-er
  • Strukturell MR
Stråling: Radiation Therapy

Undergo radiation therapy

Andre navn:
  • Kreft Strålebehandling
  • ENERGY_TYPE
  • Bestråle
  • Bestrålt
  • Bestråling
  • Stråling
  • Stråleterapi, NOS
  • Radioterapeutika
  • Strålebehandling
  • RT
  • Terapi, stråling
Fremgangsmåte: Therapeutic Conventional Surgery

Undergo surgery

Fremgangsmåte: Biopsy

Undergo biopsy

Andre navn:
  • Bx
  • BIOPSY_TYPE
Stråling: Radiosurgery

Undergo radiosurgery

Andre navn:
  • Ablasjon, radiokirurgisk
  • Strålekirurgi
Fremgangsmåte: Stereotactic Biopsy

Undergo MRI-guided stereotactic biopsy

Legemiddel: Temozolomide

Drug

Andre navn:
  • Temodar
  • SCH 52365
  • Temodal
  • Temcad
  • Metazolastone
  • RP-46161
  • Temomedac
  • TMZ
  • CCRG-81045
  • Imidazo[5,1-d]-1,2,3,5-tetrazin-8-karboksamid, 3,4-dihydro-3-metyl-4-okso-
  • M & B 39831
  • M og B 39831
  • Gliotem
  • Temizol
Fremgangsmåte: Tumor Treating Fields Therapy

Undergo TTF

Andre navn:
  • TTFields
  • Alternerende elektrisk feltterapi
  • TTF

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Proportion of patients experiencing any acute grade 3 or greater unplanned adverse event
Tidsramme: Up to 4 weeks postoperative radiotherapy

Assessed per Common Terminology Criteria for Adverse Events (CTCAE) version (v)5.0. The toxicity rate will be estimated using a binomial estimator and a one-sided 95% confidence interval (CI) of the rate will be computed with normal approximation.
Up to 4 weeks postoperative radiotherapy
Acute clinical toxicity
Tidsramme: Up to 4 weeks postoperative radiotherapy

Assessed per CTCAE v5.0. The maximum grade for each type of acute adverse events will be recorded for each patient. Data will be summarized as frequencies and relative frequencies by treatment arm. Additionally, the relationship of the adverse event(s) to the study treatment will be taken into consideration. Rates will be compared between arms using chi-squared tests.
Up to 4 weeks postoperative radiotherapy
Maximum tolerated dose (MTD) of preoperative radiosurgery
Tidsramme: Up to 4 weeks postoperative radiotherapy

After the trial is completed, the MTD will be based on isotonic regression. The dose for which the isotonic estimate of the toxicity rate is closest to the target toxicity rate will be selected as the MTD. If there are ties, the higher dose level will be selected when the isotonic estimate is lower than the target toxicity rate; and the lower dose level will be selected when the isotonic estimate is greater than or equal to the target toxicity rate.
Up to 4 weeks postoperative radiotherapy

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Radiographic tumor control
Tidsramme: At 12 months post-surgery

Assessed per Response Assessment in Neuro-Oncology (RANO) criteria. The cumulative incidence of radiographic tumor recurrence will be estimated using a competing risks method (Gooley et al.). The competing risks will be death.
At 12 months post-surgery
Rate of pseudoprogression
Tidsramme: At first post radiation scan

Assessed per RANO criteria. Data will be summarized as frequencies and relative frequencies overall and by treatment dose. Additionally, the relationship of the pseudoprogression(s) to the study treatment will be taken into consideration.
At first post radiation scan
Overall survival
Tidsramme: At 12 months post-surgery

Overall survival (OS) is defined as the time from study enrollment to death by any cause. Will be estimated with a Kaplan-Meier estimator and curve for patients treated with preoperative radiosurgery. Estimates will be given for specific time points along with 95% CIs.
At 12 months post-surgery

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Tumor tissue evaluation of tumor changes
Tidsramme: Up to 14 days Post-radiosurgery

Any excess tissue recovered from the surgical specimen (after standard of care pathologic evaluation) will undergo a series of advanced testing, potentially including but not limited to evaluation of the tumor repair pathways triggered by radiation, tumor vascular changes, tumor microenvironment immune profiling, cell cultures, and the creation of orthotopic xenograft models for future study. Analysis will be completed outside the scope of this protocol.
Up to 14 days Post-radiosurgery

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Mayo Clinic

Etterforskere

  • Hovedetterforsker: Daniel M. Trifiletti, MD, Mayo Clinic

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Hjelpsomme linker

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

23. mai 2023

Primær fullføring (Antatt)

15. mars 2027

Studiet fullført (Antatt)

15. mars 2028

Datoer for studieregistrering

Først innsendt

23. august 2021

Først innsendt som oppfylte QC-kriteriene

26. august 2021

Først lagt ut (Faktiske)

1. september 2021

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

30. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

29. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • MC210710
  • 20-013209 (Annen identifikator: Mayo Clinic Institutional Review Board)

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Ja

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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