1280 Participants Needed

Multiple Therapies for Glioblastoma

(GBM AGILE Trial)

Recruiting at 58 trial locations
RR
PI
Overseen ByPatient Information
Age: 18+
Sex: Any
Trial Phase: Phase 2 & 3
Sponsor: Global Coalition for Adaptive Research
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aims to find effective treatments for glioblastoma, an aggressive brain cancer. It tests various therapies, including chemotherapy drugs like lomustine and radiation, to determine which work best for newly diagnosed patients or those with recurring cancer. Participants must have a diagnosis of glioblastoma or gliosarcoma, confirmed by medical imaging and lab tests. This trial may suit individuals who have not yet received treatment for their glioma or are experiencing cancer recurrence after initial therapy. As a Phase 2 and Phase 3 trial, it evaluates the treatment's effectiveness in an initial group and represents the final step before FDA approval, offering hope for effective new therapies.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, it mentions that participants should not be receiving additional, concurrent, active therapy for glioblastoma outside of the trial.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that many treatments in the GBM AGILE trial have promising safety results from earlier studies.

For AZD1390, studies indicate it is generally safe when used with radiation therapy, with manageable side effects reported by patients.

Troriluzole is reported to be safe and well-tolerated with other treatments, with the most common dose being 420 mg daily. It is unlikely to cause liver problems.

Paxalisib has demonstrated a consistent safety record in past studies. The most common dose yielded positive results, and it is being considered for further approval.

VAL-083, when used with radiotherapy, was safe and tolerated by patients, but it did not prove more effective than standard treatments.

VT1021 has been found safe in patients with various solid tumors, including glioblastoma, and is advancing in further studies.

ADI-PEG 20, when combined with other treatments, showed safety without serious side effects that would limit the dose.

Finally, regorafenib's safety in recurrent glioblastoma is still under study, but its widespread use suggests it is generally safe.

These findings suggest that while side effects can occur, they are usually manageable, and the treatments are generally well-tolerated. However, individual experiences may vary, so discussing any concerns with healthcare providers is important.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for glioblastoma because they offer new ways to tackle this aggressive brain cancer. Unlike the standard treatments like temozolomide and radiation, which primarily target rapidly dividing cancer cells, some investigational drugs like Paxalisib target the PI3K/Akt/mTOR pathway, potentially disrupting cancer cell growth and survival. Others, like Troriluzole, aim to modulate glutamate pathways, which could help prevent tumor progression. Another innovative approach is ADI-PEG 20, which starves cancer cells by depleting arginine, an amino acid they need to grow. These novel mechanisms give hope for better outcomes in a disease with limited effective treatment options.

What evidence suggests that this trial's treatments could be effective for glioblastoma?

Research has shown that AZD1390, one of the treatments in this trial, might enhance the effectiveness of radiation therapy for glioblastoma (GBM). In one study, patients who received AZD1390 with radiation lived about 12.7 months on average, which is promising. Paxalisib, another treatment option in this trial, increased survival time by about 3.8 months compared to standard care. Regorafenib, also under study, improved survival in patients with recurring GBM, with one study showing a median survival of 7.4 months compared to 5.6 months with lomustine. Although some studies showed less promising results for VAL-083, it still demonstrated potential benefits for certain types of GBM. Each of these treatments is being further studied in this trial to assess their effectiveness against GBM.12367

Who Is on the Research Team?

TC

Tim Cloughesy, MD

Principal Investigator

GCAR CMO and GBM AGILE Global PI

Are You a Good Fit for This Trial?

This trial is for adults with Grade IV Glioblastoma, confirmed by specific tests. Participants must have a certain level of physical function (Karnofsky performance status ≥ 60% or ≥ 70%). They should have had an MRI recently and available tumor tissue samples. It's not suitable for those who don't meet these criteria.

Inclusion Criteria

I can provide tumor samples from my brain cancer surgery.
I am mostly independent and can care for myself.
I have a confirmed diagnosis of Grade IV brain cancer with specific genetic features.
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive various experimental therapies, including radiation and chemotherapy, based on their assigned treatment arm. This includes dose finding and maintenance phases.

6-12 weeks

Rest Period

Participants undergo a rest period following radiation therapy before starting maintenance therapy.

2-6 weeks

Maintenance Therapy

Participants continue with maintenance therapy cycles, which may include temozolomide and other drugs depending on the treatment arm.

up to 6 cycles of 28 days each

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments of overall survival and progression-free survival.

up to 2 years

What Are the Treatments Tested in This Trial?

Interventions

  • Lomustine
  • Paxalisib
  • Radiation
  • Regorafenib
  • Temozolomide
  • Troriluzole
  • VAL-083
  • VT1021
Trial Overview The study is testing multiple drugs like Lomustine, VAL-083, and Temozolomide alongside Radiation and others in patients with new or recurrent Glioblastoma. It's a global trial that adapts as it learns from the results to find the best treatment options.
How Is the Trial Designed?
14Treatment groups
Experimental Treatment
Active Control
Group I: VT1021 Treatment Arm - Enhanced Safety Management (ESM)Experimental Treatment1 Intervention
Group II: VT1021 Treatment Arm - Dose Finding PhaseExperimental Treatment1 Intervention
Group III: VT1021 Treatment ArmExperimental Treatment1 Intervention
Group IV: VAL-083 Treatment ArmExperimental Treatment1 Intervention
Group V: Troriluzole Treatment Arm - Enhanced Safety Management (ESM)Experimental Treatment1 Intervention
Group VI: Troriluzole Treatment Arm - Dose Finding PhaseExperimental Treatment1 Intervention
Group VII: Troriluzole Treatment ArmExperimental Treatment1 Intervention
Group VIII: Regorafenib Treatment ArmExperimental Treatment1 Intervention
Group IX: Paxalisib Treatment ArmExperimental Treatment1 Intervention
Group X: AZD1390 Treatment ArmExperimental Treatment1 Intervention
Group XI: ADI-PEG 20 Treatment Arm - Enhanced Safety Management (ESM)Experimental Treatment1 Intervention
Group XII: ADI-PEG 20 Treatment Arm - Dose Finding PhaseExperimental Treatment1 Intervention
Group XIII: ADI-PEG 20 Treatment ArmExperimental Treatment1 Intervention
Group XIV: Control ArmActive Control3 Interventions

Lomustine is already approved in United States, European Union, Canada for the following indications:

🇺🇸
Approved in United States as Gleostine for:
🇪🇺
Approved in European Union as Gleostine for:
🇨🇦
Approved in Canada as Gleostine for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Global Coalition for Adaptive Research

Lead Sponsor

Trials
7
Recruited
22,600+

AstraZeneca

Industry Sponsor

Trials
4,491
Recruited
290,540,000+

Sir Pascal Soriot

AstraZeneca

Chief Executive Officer since 2012

Veterinary Medicine from École nationale vétérinaire d'Alfort, MBA from HEC Paris

Dr. Cristian Massacesi

AstraZeneca

Chief Medical Officer since 2021

MD from Marche Polytechnic University, Oncology training at Royal Marsden Hospital, Kaplan Comprehensive Cancer Center, and European Institute of Oncology

Pascal Soriot

AstraZeneca

Chief Executive Officer since 2012

Veterinary Medicine from École nationale vétérinaire d'Alfort, MBA from HEC Paris

Cristian Massacesi

AstraZeneca

Chief Medical Officer since 2021

MD from Marche Polytechnic University, Medical Oncology training at Royal Marsden Hospital, Kaplan Comprehensive Cancer Center, and European Institute of Oncology

Bayer

Industry Sponsor

Trials
2,291
Recruited
25,560,000+
Founded
1863
Headquarters
Leverkusen, Germany
Known For
Pharmaceutical Innovations
Top Products
Aspirin, Aleve, Yaz, Nexavar

Bill Anderson

Bayer

Chief Executive Officer since 2023

BSc in Chemical Engineering from the University of Texas, MSc in Chemical Engineering and Management from MIT

Michael Devoy profile image

Michael Devoy

Bayer

Chief Medical Officer since 2014

MD, PhD

Kintara Therapeutics, Inc.

Industry Sponsor

Trials
5
Recruited
1,200+

Biohaven Pharmaceuticals, Inc.

Industry Sponsor

Trials
49
Recruited
30,100+

Vigeo Therapeutics, Inc.

Industry Sponsor

Trials
2
Recruited
1,100+

Polaris Group

Industry Sponsor

Trials
25
Recruited
3,400+
Headquarters
Cayman Islands
Known For
Anti-Cancer Therapies
Top Products
ADI-PEG 20

Kazia Therapeutics Limited

Industry Sponsor

Trials
12
Recruited
1,600+

Published Research Related to This Trial

In a study of 40 patients with inoperable glioblastoma multiforme, the combination of carmustine (BCNU) and temozolomide showed a promising objective response rate of 42.5%, indicating its potential effectiveness as a first-line chemotherapy before and after radiotherapy.
The treatment was generally well-tolerated, with manageable grade 3-4 toxicities such as thrombocytopenia and neutropenia, and no patients discontinued treatment due to side effects, suggesting a favorable safety profile for this combination therapy.
Temozolomide in combination with BCNU before and after radiotherapy in patients with inoperable newly diagnosed glioblastoma multiforme.Barrié, M., Couprie, C., Dufour, H., et al.[2022]
In a study of 31 adult patients with newly diagnosed glioblastoma, the combination of lomustine, temozolomide (TMZ), and involved-field radiotherapy showed promising efficacy, with a median overall survival time of 22.6 months and a 2-year survival rate of 44.7%.
The treatment had acceptable toxicity levels, with 16% of patients experiencing severe hematotoxicity, and the presence of MGMT gene-promoter methylation in tumors was linked to longer progression-free survival and overall survival.
Phase II trial of lomustine plus temozolomide chemotherapy in addition to radiotherapy in newly diagnosed glioblastoma: UKT-03.Herrlinger, U., Rieger, J., Koch, D., et al.[2018]
In a study of 39 patients with newly diagnosed glioblastoma, the combination of radiotherapy and chemotherapy (lomustine and temozolomide) resulted in a median overall survival of 23.1 months, with 47.4% of patients surviving for 2 years and 18.5% for 4 years.
Patients receiving an intensified dose of chemotherapy showed significantly higher survival rates compared to those on standard doses, with some patients in the intensified group surviving over 56 months, although this came with a higher risk of severe hematotoxicity.
Long-term survival of patients with glioblastoma treated with radiotherapy and lomustine plus temozolomide.Glas, M., Happold, C., Rieger, J., et al.[2022]

Citations

Efficacy of arginine depletion by ADI-PEG20 in an intracranial ...Monotherapy ADI-PEG20 significantly reduces the intracranial growth of ASS1 negative GBM and extends survival of mice carrying ASS1 negative GBM ...
ADI-PEG20 in combination with radiotherapy“Laboratory results showed that, using the drug ADI-PEG20 in combination with radiotherapy, led to a durable response with extended disease-free survival with ...
Polaris's ADI-PEG 20 Enters GBM AGILE TrialThis investigational drug has the potential to support improved outcomes for GBM patients, who deserve better options for their care.
Phase IB trial of pegylated arginine deiminase (ADI-PEG ...ADI-PEG 20 has shown efficacy as monotherapy in ASS1 negative mouse glioblastoma (GBM) models and the combination of ADI-PEG 20 with ...
Study Details | NCT04587830 | ADI-PEG 20 Plus ...A randomized, double-blind, placebo-controlled study. Weekly ADI-PEG 20 (36 mg/m2) or placebo will be combined with Stupp Protocol (Stupp 2005) radiotherapy ...
ADI-PEG20 in combination with radiotherapy“Laboratory results showed that, using the drug ADI-PEG20 in combination with radiotherapy, led to a durable response with extended disease-free survival with ...
Study Details | NCT03970447 | A Trial to Evaluate Multiple ...After 6 cycles, ADI-PEG 20 only for up to 104 weeks of total treatment. Recurrent GBM: Lomustine 100 mg/m2 orally on day 1 of a 42-day cycle in combination with ...
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