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Completed

NCT Number: NCT01149109

Efficacy and Safety Study of Lomustine/Temozolomide Combination Therapy vs. Standard Therapy for Glioblastoma Patients

The prognosis of patients with newly diagnosed glioblastoma is dismal despite recent therapeutic improvements Using standard therapy with temozolomide (TMZ) and radiotherapy (60 Gy), the median overall survival time (mOS) is 14.6 months (Stupp et al., 2005). Since in a previous non-randomized bicentric phase II trial, primary combination chemotherapy with lomustine (CCNU) and TMZ was highly effective (mOS 23 months; UKT-03 trial; Herrlinger et al., 2006; Glas et al., 2009) the proposed trial further investigates the efficacy of CCNU/TMZ in a randomized multicenter phase III setting against standard therapy. In case the projected phase III trial confirms the phase II data, CCNU/TMZ combination would be significantly better than TMZ monotherapy and would thus be the new standard treatment for newly diagnosed GBM patients with a methylated MGMT promotor. Thus, this trial has the potential to profoundly change the standard therapy of this most aggressive brain tumor. Since in the previous trial only patients with a methylated MGMT (mMGMT) promoter had a benefit from CCNU/TMZ (mOS in the mMGMT group 34 months, in the non-mMGMT group 12.5 months; Glas et al., 2009) while patients with a non-methylated MGMT did not have any benefit, the trial is restricted to mMGMT patients.The CeTeG trial randomizes in a 1:1 fashion newly diagnosed GBM patients (18-70 years) for either standard TMZ therapy (concomitant and 6 courses à 4 weeks of adjuvant TMZ therapy) or experimental CCNU/TMZ therapy (6 courses à 6 weeks). Both arms include standard radiotherapy (RT) of the tumor site (30 x 2 Gy). Assuming that CCNU/TMZ therapy increases the median overall survival (mOS) from 48.9% (standard TMZ) to 70% (CCNU/TMZ; 75% in the previous phase II trial, Glas et al., 2009), 2 x 68 patients have to be accrued. Patients will be accrued over 24 months and each patient will be followed for at least 24 months adding up to a total minimal duration of the time from first patient in until the end of the follow-up time of 48 months. The primary endpoint is overall survival; secondary endpoints include progression-free survival, response rate, acute and late toxicity, and quality of life.

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Key information

Age range

18 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Depatment of Neurosurgery, Charité, University Hospital Berlin, Berlin, Germany

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • written informed consent
  • patients have to be in a cognitive state that allows them to understand the rationale and necessity of study therapy and procedures.
  • newly diagnosed histologically proven GBM or gliosarcoma WHO Grad IV
  • methylated MGMT promoter in the tumor
  • estimated life expectancy of at least 12 weeks
  • Karnofsky Performance Score (KPS) ≥ 70%
  • patient compliance and geographic proximity that allow adequate follow up
  • male and female patients with reproductive potential must use an approved contraceptive method
  • pre-menopausal female patients with childbearing potential: a negative serum pregnancy test must be obtained prior to treatment start
  • Adequate organ function as described below:

Adequate bone marrow reserve:

white blood cell (WBC) count > 3000/µl, granulocyte count >1500/µl, platelets > 100000/µl, haemoglobin ≥ 10 g/dl Adequate liver function bilirubin < 1.5 times above upper limit of normal range (ULN), ALT and AST < 3 times ULN creatinine < 1.5 times ULN

Adequate blood clotting:

PT and PTT within normal limits Negative HIV test

Exclusion criteria

  • prior malignancy
  • prior chemotherapy
  • prior radiotherapy to the brain
  • concurrent administration of any other anti-tumor therapy
  • allergy or other intolerability of temozolomide, CCNU, dacarbazine or other nitrosourea derivatives
  • unable to undergo MRI
  • past medical history of diseases with poor prognosis
  • known HIV infection, active Hepatitis B or C infection
  • any active infection
  • female patients that are pregnant or breastfeeding
  • patients with reproductive potential who do not accept to use contraception
  • treatment in another clinical trial
  • any psychological, cognitive, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up scheduled visits (at the discretion of investigator)

Treatment and study plan

Temozolomide and lomustine

Drug

Other names: Temodal, Temomedac, CeCeNu

Temozolomide

Drug

Other names: Temodal, Temomedac

Primary outcomes

  1. overall survival

    Time frame: after follow up (4 years)

Secondary outcomes

  1. progression free survival

    Time frame: after follow up (4 years)

  2. best response rate determined by MRI

    Time frame: after follow up (4 years)

  3. frequency of delay of the next Lomustine/Temozolomide or Temozolomide course

    Time frame: during treatment period (2 years)

  4. acute toxicity during radiotherapy and chemotherapy according to CTC AE V3.0

    Time frame: during treatment period (2 years)

  5. quality of life

    Time frame: including follow up (4 years)

  6. Evaluation of late neurotoxicity

    Time frame: after follow up (4 years)

Sponsors and collaborators

Lead sponsor

University Hospital, Bonn

Other

Registry information

Official study title

Phase III Trial of CCNU/Temozolomide (TMZ) Combination Therapy vs. Standard TMZ Therapy for Newly Diagnosed MGMT-methylated Glioblastoma Patients

Acronym: CeTeG

Important dates

Study start
2010
Primary completion
2017
Study completion
2017
First posted
Jun 23, 2010
Registry last updated
Jun 14, 2017

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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