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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 and TMZ
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 and TMZ as noted for the Phase 1 portion. Furthermore, ADI-PEG 20 or placebo treatment may continue after adjuvant TMZ if there is no progressive disease, for up to a total of 2 years of ADI-PEG 20 or placebo treatment. In addition, after 24 weeks (6 cycles) subjects may also continue adjuvant TMZ along with ADI-PEG 20 or placebo, in the absence of disease progression, as noted above, if clinically indicated in the investigator's judgement. MRI is to be performed post-surgery(biopsy), and then at 1, 3 and 6 months after completion of radiotherapy and then every 3 months for up to 24 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ADI-PEG 20 plus Radiotherapy and Temozolomide | Experimental | ADI-PEG 20 Dose: 36 mg/m2 given weekly Route of Administration: Intramuscular (IM) Radiotherapy Dose: 60 Gy in 30 daily (Monday-Friday) fractions of 2 Gy each; to start within 4 weeks of surgery (diagnostic and/or resection) Temozolomide Dose: 75 mg/m2 daily during radiotherapy; 150-200 mg/m2 for 5 days every 4 weeks (1 cycle) x 6 cycles during maintenance period Route of Administration: oral or intravenous |
|
| Placebo plus Radiotherapy and Temozolomide | Placebo Comparator | Placebo Dose: 36 mg/m2 given weekly Route of Administration: Intramuscular (IM) Radiotherapy Dose: 60 Gy in 30 daily (Monday-Friday) fractions of 2 Gy each; to start within 4 weeks of surgery (diagnostic and/or resection) Temozolomide Dose: 75 mg/m2 daily during radiotherapy; 150-200 mg/m2 for 5 days every 4 weeks (1 cycle) x 6 cycles during maintenance period Route of Administration: oral or intravenous |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ADI-PEG 20 | Drug | Investigational Medicine |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival (OS) | In the ADI-PEG 20 treated arm compared to the placebo arm, and determine if predefined patient subtypes or associated biomarkers uniquely benefit from the treatment | Through study completion, 2.5 year anticipated |
| Measure | Description | Time Frame |
|---|---|---|
| Progression-free survival (PFS) | PFS will be reported as the time subject experience from the start of treatment to disease progression or death, measured in month. | Through study completion, 2.5 year anticipated |
| Duration of response (DOR) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kuo-Chen Wei, M.D. | Chang Gung Memorial Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chonnam National University Hwasun Hospital | Hwasun-gun | Jeollanam-do | 58128 | South Korea | ||
| Seoul National University Hospital |
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| ID | Term |
|---|---|
| D005909 | Glioblastoma |
| ID | Term |
|---|---|
| D001254 | Astrocytoma |
| D005910 | Glioma |
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
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| ID | Term |
|---|---|
| C512527 | ADI PEG20 |
| D000077204 | Temozolomide |
| ID | Term |
|---|---|
| D003606 | Dacarbazine |
| D014226 | Triazenes |
| D009930 | Organic Chemicals |
| D007093 | Imidazoles |
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| Temozolomide |
| Drug |
Radiotherapy and TMZ are standard front-line therapy for newly diagnosed GBM. |
|
| Placebo | Drug | Investigational Medicine |
|
DOR is reported as the time from when the tumor begins to respond to treatment (first occurrence of CR or PR) until disease progression or deterioration occurs (diagnosis of disease progression), measured in month.
| Through study completion, 2.5 year anticipated |
| Tumor response rate | Response rate is usually measured in percentage (%). It represents the proportion of subjects whose tumors achieve partial or complete response among those who received treatment. | Through study completion, 2.5 year anticipated |
| Safety and tolerability of ADI-PEG 20 | Safety and tolerability in the ADI-PEG 20 treated arm compared to the placebo arm. Incidence of Treatment-Emergent Adverse Events from first dose to time of progression or death. The severity of all AEs will be assessed according to the NCI CTCAE Scale version 5. | Through study completion, 2.5 year anticipated |
| Pharmacokinetics of ADI-PEG 20 | ADI-PEG 20 Plasma Concentrations are measured over time, samples are collected before the dosing, and on week 0, 1, 2, 4, 6, 8, 10, 12, 16, 20, 24, 28 and 32, then every 4 weeks until week 52 or End of treatment visit. | Up to week 52 or End of treatment visit |
| Pharmacodynamics of ADI-PEG 20 | Citrulline and Arginine plasma concentrations are measured over time, samples are collected before the dosing, and on week 0, 1, 2, 4, 6, 8, 10, 12, 16, 20, 24, 28 and 32, then every 4 weeks until week 52 or End of treatment visit. | Up to week 52 or End of treatment visit |
| Immunogenicity of ADI-PEG 20 | Antibodies for ADI-PEG 20, Anti-PEG antibodies are measured in plasma over time, samples are collected before the dosing, and on week 0, 1, 2, 4, 6, 8, 10, 12, 13, 16, 20, 24, then once a month for three months, followed by once every three months until week 52 or End of treatment visit. | Up to week 52 or End of treatment visit |
| Seoul |
| Jongno-gu |
| 03080 |
| South Korea |
| Seoul St. Mary's Hospital, The Catholic University of Korea | Seoul | Seocho-gu | 06591 | South Korea |
| Severance Hospital Yonsei University | Seoul | Seodaemun-gu | 03722 | South Korea |
| Seoul National University Bundang Hospital | Gyeonggi-do | Seongnam | 13620 | South Korea |
| Chang Gung-Medical Foundation-Keelung (CGMF-KL) | Keelung | Anle Dist | 204201 | Taiwan |
| Chang Gung Memorial Hospital, Linkou Branch | Taoyuan | Guishan Dist | 333423 | Taiwan |
| Chang Gung Medical Foundation-Kaohsiung | Kaohsiung City | Niaosong Dist | 833401 | Taiwan |
| Mackay Memorial Hospital-Tamsui Branch | New Taipei City | Tamsui Dist | 251404 | Taiwan |
| National Taiwan University Hospital | Taipei | Zhongzheng Dist | 100229 | Taiwan |
| D009373 |
| Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |
| D001393 |
| Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |