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NCT Number: NCT05052957

hSTAR GBM (Hematopoetic Stem Cell (HPC) Rescue for GBM)

This phase II trial studies the effect of P140K MGMT hematopoietic stem cells, O6-benzylguanine, temozolomide, and carmustine in treating participants with supratentorial glioblastoma or gliosarcoma who have recently had surgery to remove most or all of the brain tumor (resected). Chemotherapy drugs, such as 6-benzylguanine, temozolomide, and carmustine, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing. Placing P140K MGMT, a gene that has been created in the laboratory into bone marrow making the bone more resistant to chemotherapy, allowing intra-patient dose escalation which kills more tumor cells while allowing bone marrow to survive.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

University Hospitals Cleveland Medical Center

Cleveland, Ohio, 44106, United States

Location status: Recruiting

Location contact

Leland Metheny, MD

CONTACT

[email protected]

216-844-0130

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Participants with histologically confirmed, newly diagnosed, supratentorial glioblastoma or gliosarcoma who have undergone tumor resection are eligible up to 35 days postoperatively. Participants with primarily infratentorial disease, or with multifocal, or leptomeningeal dissemination of disease will be excluded. In general, participants will not have > 1 cm residual measurable or evaluable disease after surgical tumor resection.
  • Participant must have unmethylated MGMT
  • Absence of IDH1 or IDH2 mutation on tumor tissue by a CLIA-approved immunohistochemistry or DNA sequencing test on local testing.
  • Participants aged 18 years or older.
  • ECOG performance status 0-1or Karnofsky ≥ 70.
  • Life expectancy of at least 12 weeks.
  • No plan for hypofractionated radiation therapy
  • Adequate hematologic and hepatic function:
  • CBC/differential obtained within 28 days prior to registration:
  • Absolute neutrophil count (ANC) ≥ 1,000 cells/mm3 Note: the use of G-CSF or other intervention to achieve Absolute neutrophil count (ANC) ≥ 1,000 cells/mm3 is acceptable)
  • Platelets ≥ 50,000 cells/mm3 (Note: the use of transfusion or other intervention to achieve Platelets ≥ 50,000 cells/mm3 is acceptable)
  • Hemoglobin ≥ 9.0 g/dl (Note: the use of transfusion or other intervention to achieve Hgb ≥9.0 g/dl is acceptable)
  • Adequate hepatic function within 28 days prior to registration:
  • Bilirubin ≤ 3 ULN
  • ALT and AST ≤ 3 x ULN
  • Participants of child-bearing potential must agree to use single barrier contraception from time of trial entry to completion of the last cycle of chemotherapy.
  • Must be willing and able to understand and provide informed consent.
  • Participant must be considered to be clinically stable.
  • The participant will be identified as a candidate for an autologous transplant via an evaluation by a transplant physician per standard of care.
  • No evidence of active infection.
  • Participant must have the ability to understand and willingness to sign an informed consent document.

Exclusion criteria

  • Any known medical or hereditary condition associated with immunosuppression; or other medical illness, which may jeopardize participant safety.
  • Pregnant or lactating women. There is data to indicate that BCNU and TMZ is teratogenic and carcinogenic. Thus, its use in pregnant women would confer unnecessary risk to the fetus.
  • Participants with a corrected DLCO or FEV1 < 50% of predicted.
  • Participants with known diagnosis heart failure or cardiac insufficiency and an LVEF of < 40%.
  • Inability to undergo repeated MRI evaluation; or allergy or intolerance of Gadoliniumcontaining contrast agent.
  • Active illicit drug use or diagnosis of active alcoholism.
  • Prior diagnosis of any malignant disease with the exception of non-melanomatous skin cancer, or carcinoma in situ of the cervix, bladder, prostate, or breast, unless the participant has been disease-free/in remission for ≥2 years prior to date of study enrollment.
  • Known human immunodeficiency virus infection or acquired immunodeficiency syndrome related illness.
  • Serologic status reflecting active hepatitis B or C infection. Individuals that are positive for hepatitis B core antibody, hepatitis B surface antigen (HBsAg), or hepatitis C antibody must have a negative polymerase chain reaction (PCR) prior to enrollment. (PCR positive individuals will be excluded).

Treatment and study plan

P140K-MGMT

Biological

Ex Vivo Cultured P140K MGMT CD34+ Cells. The transduced cells are a biological product and production is detailed in the Cellular Therapy Lab standard operating procedures and IND 14099

O6-benzylguanine

Drug

O6BG is a low molecular-weight purine analog which selectively and irreversibly inactivates the DNA-repair enzyme, O6- alkylguanine DNA-alkyltransferase.

Other names: BG

Photon Based Radiotherapy

Radiation

Standard of care, photon-based radiotherapy (60Gy in 30 fractions) will be performed in both arms without concomitant TMZ between to 6 weeks post-operatively. Radiotherapy will be performed at UH-SCC.

Temozolomide

Drug

Temozolomide is not directly active but undergoes rapid non-enzymatic conversion at physiologic pHto the reactive compoundMTIC. The cytotoxicity of MTIC is thought to be primarily due to alkylationof DNA. Alkylation (methylation) occurs mainly at the O6 and N7 positions of guanine

Other names: TMZ

Filgrastim

Drug

Filgrastim is a 175 amino acid protein manufactured by recombinant DNA technology. Endogenous filgrastim is a glycoprotein produced by monocytes, fibroblasts, and endothelial cells, which regulates the production of neutrophils within the bone marrow.

Other names: G-CSF,Granulocyte-Colony Stimulating Factor

carmustine

Drug

BCNU is a lipid soluble agent which has alkylating properties, plus an isocyanate metabolite which interferes with DNA and RNA synthesis.

Other names: BCNU,bis-chloronitrosourea

Primary outcomes

  1. Percent of participants able to complete treatment

    Time frame: 10 years after start of study

    To evaluate and compare the feasibility of introducing and expressing P140K MGMT cDNA using a lentiviral-based provirus in autologous hematopoietic stem cells harvested from newly diagnosed IDH-1 WT GBM with unmethylated MGMT promoter using two different sequences of stem cell mobilization.

    • What percent of patients who enter trial can complete treatment.
  2. Incidence of adverse events

    Time frame: Up to 30 days post-treatment

    proportion of participants experiencing a grade 3 or higher AE/SAE

  3. Overall Survival

    Time frame: Up to 15 years post-treatment

    Median overall survival in months.

Secondary outcomes

  1. Myelosuppression

    Time frame: 5 years

    To determine what proportion of patients who receive P140K MGMT transduced CD34 cells tolerate BG and dose escalated TMZ without myelosuppression.

    We will report % of patients who suffer grade I-5 SAES related to myelosuppression.

  2. Detection of P140K transduced BG and TMZ resistant cells

    Time frame: 5 years

    % of patients with detectable P-140K-MGMT

  3. Enrichment of P140K-MGMT

    Time frame: 5 years

    What % of patients have enrichment of P140K-MGMT.

  4. Tumor Response using imaging

    Time frame: 5 years

    Tumor response assessed via iRANO criteria

  5. PFS using imaging

    Time frame: 5 years

    PFS measured from the date of initial histological diagnosis to progression (as defined above), death, last contact, or last tumor assessment before the start of further anti-tumor therapy

Study contacts

Contact information is provided by the study sponsor or research team.

Melissa Bratley, RN

CONTACT

[email protected]

1-800-641-2422

Sponsors and collaborators

Lead sponsor

Leland Metheny

Other

Collaborators

  • National Cancer Institute (NCI)

Registry information

Official study title

Phase II Trial O6-benzylguanine(BG) and Temozolomide(TMZ) Therapy of Glioblastoma Multiforme (GBM) With Infusion of Autologous P140K MGMT+Hematopoietic Progenitors to Protect Hematopoiesis

Acronym: hSTAR GBM

Important dates

Study start
2023
Primary completion
2026
Study completion
2027
First posted
Sep 22, 2021
Registry last updated
Sep 10, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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