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Phase III Study Comparing 2 Brain Conformational Radiotherapy in Combination With Chemotherapy in the Treatment of Glioblastoma (SPECTRO GLIO)

Primary Purpose

Glioblastoma

Status
Terminated
Phase
Phase 3
Locations
France
Study Type
Interventional
Intervention
Radiotherapy
Experimental arm
Sponsored by
Institut Claudius Regaud
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glioblastoma focused on measuring Glioblastoma, Radiotherapy, Intensity modulated radiation therapy (IMRT), Magnetic resonance spectroscopic imaging (MRSI)

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients must have unifocal glioblastoma (grade IV astrocytoma, WHO classification). The GBM can be:

    • Or resectable and the patient has received curative surgery
    • Or unresectable, and the largest tumor diameter (contrast enhancement) must be less than 5 cm on MRI
  2. In all cases, the diagnosis must be confirmed by a pathologist. In patients for whom surgery is not possible, the diagnosis is confirmed by a biopsy of tumor tissue.
  3. Methylation status of MGMT gene promoter is known
  4. Patients who have undergone resection should have received an MRI or a scan after surgery in order to visualize residual tumor. If not, the operative report must be available.
  5. Surgery or biopsy must have occurred 45 days before the start of radiotherapy.
  6. WHO ≤ 2
  7. Age ≥ 18 years
  8. Signed Consent collected before any specific procedure in the study
  9. Patient member in a national insurance scheme

Exclusion Criteria:

  1. Signs of hemorrhage on pre-radiotherapy MRI preventing a good spectrometric analysis
  2. Patient with multifocal glioblastoma
  3. Tumor located within 2 cm of the optic chiasm
  4. Patient with leptomeningeal metastases,
  5. patients prone to epileptic seizures despite treatment with anticonvulsant
  6. Patients who received other previous treatment for glioblastoma multiforme
  7. Abnormal haematological results at inclusion with:

    • Neutrophils < 1500/mm3
    • Blood-platelets < 100000/mm3
  8. Severe or chronic renal insufficiency (creatinin clearance ≤ 30 ml/min calculated using Cockroft-Gault's formula
  9. Patient unable to follow procedures, visits, examinations described in the study
  10. Any usual formal indication against imaging examinations (important claustrophobia, pace maker ...)
  11. Pregnant women or nursing mothers can not participate in the study. Women of childbearing age must have a negative pregnancy test within 72 hours prior to study entry
  12. Men and women of childbearing age must use effective contraception at study entry and throughout the study
  13. Any concomitant or previous malignant disease within 5 years prior to study entry
  14. Any prior systemic chemotherapy within 5 years prior to inclusion (for malignant disease in medical history)
  15. Any other medical conditions making the inclusion of the patient in the study inappropriate in the opinion of the investigator
  16. Patient under legal guardianship

Sites / Locations

  • Clinique Claude Bernard
  • Centre Jean Perrin
  • Centre Georges François Leclerc
  • Hospices Civils de Lyon (Hôpital Lyon Sud/Hôpital P. Wertheimer)
  • Centre Leon Berard
  • AP HM - Hôpital La Timone
  • Centre Val d'Aurelle
  • Institut de Cancerologie Lucien Neuwirth
  • Centre Paul Strauss
  • CHU de Strasbourg
  • Institut Claudius REGAUD
  • Centre Marie Curie

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Conventional arm

Experimental arm

Arm Description

3-dimensional conformal radiotherapy + Temozolomide

simultaneous-integrated boost with intensity-modulated radiotherapy guided by magnetic resonance spectroscopic imaging + Temozolomide

Outcomes

Primary Outcome Measures

Overall survival defined as the time from randomization to the date of death or date of last follow-up news (censured data)

Secondary Outcome Measures

Progression-free survival, defined as the time from randomization to the date of progression or death
Safety evaluated according to the classification of NCI CTCAE (Common Terminology Criteria for Adverse Events)V3.0

Full Information

First Posted
December 20, 2011
Last Updated
January 11, 2021
Sponsor
Institut Claudius Regaud
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1. Study Identification

Unique Protocol Identification Number
NCT01507506
Brief Title
Phase III Study Comparing 2 Brain Conformational Radiotherapy in Combination With Chemotherapy in the Treatment of Glioblastoma
Acronym
SPECTRO GLIO
Official Title
Phase III Randomized Study Comparing 2 Brain Conformational Radiotherapy in Combination With Chemotherapy in the Treatment of Glioblastoma : Standard 3D Conformational Radiotherapy Versus Intensity-modulated Radiotherapy With Simultaneous-integrated Boost Guided by Magnetic Resonance Spectroscopic Imaging
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Terminated
Study Start Date
March 15, 2011 (Actual)
Primary Completion Date
January 2, 2020 (Actual)
Study Completion Date
January 2, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institut Claudius Regaud

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a multi-institutional phase III clinical study of interventional type. The trial will include 220 patients with confirmed unifocal glioblastoma over a period of 3 years + 3 years of follow up. Patients with unifocal glioblastoma (diagnosis confirmed by histology on tumoral biopsy or surgical specimen) and who meet all eligibility criteria will be randomized in one chemoradiotherapy arm : Conventional arm: 3-dimensional conformational radiotherapy + Temozolomide Experimental arm : simultaneous-integrated boost with intensity-modulated radiotherapy guided by magnetic resonance spectroscopic imaging + Temozolomide The patient monitoring will be regular and standardized. The main objective of this study is to improve overall survival of patients treated in experimental group (with simultaneous integrated boost).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma
Keywords
Glioblastoma, Radiotherapy, Intensity modulated radiation therapy (IMRT), Magnetic resonance spectroscopic imaging (MRSI)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
180 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Conventional arm
Arm Type
Active Comparator
Arm Description
3-dimensional conformal radiotherapy + Temozolomide
Arm Title
Experimental arm
Arm Type
Experimental
Arm Description
simultaneous-integrated boost with intensity-modulated radiotherapy guided by magnetic resonance spectroscopic imaging + Temozolomide
Intervention Type
Radiation
Intervention Name(s)
Radiotherapy
Intervention Description
Conventional arm: 3D conformational radiotherapy (arm A): 60 Gy per fractions of 2 Gy in 30 sessions on the PTV1 (contrast enhancement + 2 cm) with a linear accelerator equipped with a portal imaging. + Chemotherapy (Drug) :treatment should be combined with temozolomide during and after radiotherapy in a conventional treatment Stupp (Stupp et al. 2005), ie : during radiotherapy : Temozolomide 75 mg/m2/day by oral route every day, post radiotherapy : 6 cycles of Temozolomide oral route : 150 mg/m2/day from D1 to D5 for the 1st cycle followed by 200 mg/m2/day from D28 to D32.
Intervention Type
Radiation
Intervention Name(s)
Experimental arm
Intervention Description
Conformational radiotherapy with simultaneous integrated boost by intensity modulation (Arm B): 60 Gy per fraction of 2 Gy in 30 sessions on the PTV1 (contrast enhancement + 2 cm) with concomitant daily superimposed boost on spectroscopic active region (PTV2) corresponding to the ratio Cho / NAA> 2 + 0.7 mm + contrast enhancement + 3mm. The PTV2 will receive a daily dose of 2.4 Gy for a cumulative dose of 72 Gy Only irradiation with simultaneous integrated boost are allowed + Chemotherapy (Drug) :treatment should be combined with temozolomide during and after radiotherapy in a conventional treatment Stupp (Stupp et al. 2005), ie : during radiotherapy : Temozolomide 75 mg/m2/day by oral route every day, post radiotherapy : 6 cycles of Temozolomide oral route : 150 mg/m2/day from D1 to D5 for the 1st cycle followed by 200 mg/m2/day from D28 to D32.
Primary Outcome Measure Information:
Title
Overall survival defined as the time from randomization to the date of death or date of last follow-up news (censured data)
Time Frame
8 years
Secondary Outcome Measure Information:
Title
Progression-free survival, defined as the time from randomization to the date of progression or death
Time Frame
8 years
Title
Safety evaluated according to the classification of NCI CTCAE (Common Terminology Criteria for Adverse Events)V3.0
Time Frame
8 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have unifocal glioblastoma (grade IV astrocytoma, WHO classification). The GBM can be: Or resectable and the patient has received curative surgery Or unresectable, and the largest tumor diameter (contrast enhancement) must be less than 5 cm on MRI In all cases, the diagnosis must be confirmed by a pathologist. In patients for whom surgery is not possible, the diagnosis is confirmed by a biopsy of tumor tissue. Methylation status of MGMT gene promoter is known Patients who have undergone resection should have received an MRI or a scan after surgery in order to visualize residual tumor. If not, the operative report must be available. Surgery or biopsy must have occurred 45 days before the start of radiotherapy. WHO ≤ 2 Age ≥ 18 years Signed Consent collected before any specific procedure in the study Patient member in a national insurance scheme Exclusion Criteria: Signs of hemorrhage on pre-radiotherapy MRI preventing a good spectrometric analysis Patient with multifocal glioblastoma Tumor located within 2 cm of the optic chiasm Patient with leptomeningeal metastases, patients prone to epileptic seizures despite treatment with anticonvulsant Patients who received other previous treatment for glioblastoma multiforme Abnormal haematological results at inclusion with: Neutrophils < 1500/mm3 Blood-platelets < 100000/mm3 Severe or chronic renal insufficiency (creatinin clearance ≤ 30 ml/min calculated using Cockroft-Gault's formula Patient unable to follow procedures, visits, examinations described in the study Any usual formal indication against imaging examinations (important claustrophobia, pace maker ...) Pregnant women or nursing mothers can not participate in the study. Women of childbearing age must have a negative pregnancy test within 72 hours prior to study entry Men and women of childbearing age must use effective contraception at study entry and throughout the study Any concomitant or previous malignant disease within 5 years prior to study entry Any prior systemic chemotherapy within 5 years prior to inclusion (for malignant disease in medical history) Any other medical conditions making the inclusion of the patient in the study inappropriate in the opinion of the investigator Patient under legal guardianship
Facility Information:
Facility Name
Clinique Claude Bernard
City
Albi
ZIP/Postal Code
81000
Country
France
Facility Name
Centre Jean Perrin
City
Clermont-ferrand
ZIP/Postal Code
63011
Country
France
Facility Name
Centre Georges François Leclerc
City
Dijon
ZIP/Postal Code
21000
Country
France
Facility Name
Hospices Civils de Lyon (Hôpital Lyon Sud/Hôpital P. Wertheimer)
City
Lyon
ZIP/Postal Code
69002
Country
France
Facility Name
Centre Leon Berard
City
Lyon
ZIP/Postal Code
69373
Country
France
Facility Name
AP HM - Hôpital La Timone
City
Marseille
ZIP/Postal Code
13385
Country
France
Facility Name
Centre Val d'Aurelle
City
Montpellier
ZIP/Postal Code
34298
Country
France
Facility Name
Institut de Cancerologie Lucien Neuwirth
City
Saint-Priest-En-Jarez
ZIP/Postal Code
42271
Country
France
Facility Name
Centre Paul Strauss
City
Strasbourg
ZIP/Postal Code
67065
Country
France
Facility Name
CHU de Strasbourg
City
Strasbourg
ZIP/Postal Code
67065
Country
France
Facility Name
Institut Claudius REGAUD
City
Toulouse
ZIP/Postal Code
31052
Country
France
Facility Name
Centre Marie Curie
City
Valence
ZIP/Postal Code
26953
Country
France

12. IPD Sharing Statement

Citations:
PubMed Identifier
30791889
Citation
Laprie A, Ken S, Filleron T, Lubrano V, Vieillevigne L, Tensaouti F, Catalaa I, Boetto S, Khalifa J, Attal J, Peyraga G, Gomez-Roca C, Uro-Coste E, Noel G, Truc G, Sunyach MP, Magne N, Charissoux M, Supiot S, Bernier V, Mounier M, Poublanc M, Fabre A, Delord JP, Cohen-Jonathan Moyal E. Dose-painting multicenter phase III trial in newly diagnosed glioblastoma: the SPECTRO-GLIO trial comparing arm A standard radiochemotherapy to arm B radiochemotherapy with simultaneous integrated boost guided by MR spectroscopic imaging. BMC Cancer. 2019 Feb 21;19(1):167. doi: 10.1186/s12885-019-5317-x.
Results Reference
derived
PubMed Identifier
26189058
Citation
Ken S, Deviers A, Filleron T, Catalaa I, Lotterie JA, Khalifa J, Lubrano V, Berry I, Peran P, Celsis P, Moyal EC, Laprie A. Voxel-based evidence of perfusion normalization in glioblastoma patients included in a phase I-II trial of radiotherapy/tipifarnib combination. J Neurooncol. 2015 Sep;124(3):465-73. doi: 10.1007/s11060-015-1860-8. Epub 2015 Jul 19.
Results Reference
derived

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Phase III Study Comparing 2 Brain Conformational Radiotherapy in Combination With Chemotherapy in the Treatment of Glioblastoma

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