Neoantigen-Pulsed Autologous Dendritic Cell Vaccine Combined With Temozolomide for Newly Diagnosed Glioblastoma

An Open-Label, Multicenter, Randomized Phase II Study to Evaluate the Efficacy and Safety of Personalized Dendritic Cell Vaccine ZSNeo-DC1.1 in Combination With Temozolomide as Adjuvant Therapy in Patients With Newly Diagnosed Glioblastoma After Surgery and Concurrent Chemoradiotherapy

This is a multicenter, open-label, randomized Phase II clinical study designed to evaluate the efficacy and safety of a personalized dendritic cell (DC) vaccine, ZSNeo-DC1.1, in combination with temozolomide (TMZ) as adjuvant therapy in patients with newly diagnosed glioblastoma (GBM).

Eligible patients with histologically confirmed, IDH1/IDH2 wild-type newly diagnosed glioblastoma who have undergone tumor debulking surgery followed by standard concurrent chemoradiotherapy will be enrolled. After confirmation of tumor neoantigens and eligibility, patients will be randomized in a 1:1 ratio to receive either ZSNeo-DC1.1 in combination with TMZ or TMZ alone.

The primary objective is to evaluate progression-free survival (PFS) as assessed by an Independent Radiological Review Committee (IRRC) according to RANO 2.0 criteria. Secondary objectives include overall survival (OS), survival rates, tumor response outcomes, and safety. Exploratory objectives include assessment of antigen-specific T-cell immune responses induced by ZSNeo-DC1.1.

Inclusion Criteria:

Participants must meet all the following criteria to be eligible:

Inclusion Criteria

1. Age 18 to 75 years, inclusive
2. Histologically confirmed newly diagnosed glioblastoma (WHO grade IV)
3. Molecular diagnosis of IDH1/IDH2 wild-type
4. Completion of tumor debulking surgery followed by standard concurrent chemoradiotherapy
5. Karnofsky Performance Status (KPS) score of 50 to 100
6. Adequate hematologic, hepatic, renal, and coagulation function
7. Availability of sufficient tumor tissue and blood samples for neoantigen identification
8. Adequate venous access for PBMC collection
9. Life expectancy greater than 3 months
10. Willingness to use effective contraception during study treatment and for 3 months thereafter
11. Ability to understand and willingness to sign written informed consent

Exclusion Criteria:

Exclusion Criteria:

Subjects meeting any of the following criteria are ineligible:

1. Not suitable for standard temozolomide-based chemoradiotherapy
2. Prior participation in another interventional clinical trial within 4 weeks before randomization
3. Prior implantation of carmustine wafers within 6 months
4. Known hypersensitivity to temozolomide or dacarbazine
5. Active autoimmune disease or requirement for systemic immunosuppressive therapy
6. Active infection including HIV, active hepatitis B or C, or syphilis
7. Use of systemic immunosuppressive therapy within 30 days before randomization
8. Uncontrolled cardiovascular, metabolic, or systemic disease
9. Pregnancy or breastfeeding
10. Any condition that, in the investigator's judgment, would interfere with study participation or interpretation of results