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A Study of Bevacizumab (Avastin) in Combination With Temozolomide (TMZ) and Radiotherapy in Paediatric and Adolescent Participants With High-Grade Glioma

Primary Purpose

High Grade Glioma

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Bevacizumab
Radiotherapy
Temozolomide (TMZ)
Sponsored by
Hoffmann-La Roche
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for High Grade Glioma

Eligibility Criteria

6 Months - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria - Main cohort :

  • Paediatric participants, aged >= 3 years and < 18 years
  • Written informed consent obtained from the participant/parents or legally acceptable representative
  • Newly diagnosed localised, supratentorial or infratentorial cerebellar or peduncular, WHO Grade III or IV gliomas
  • Local histological diagnosis confirmed by a designated central reference neuropathologist
  • Availability of the baseline magnetic resonance imaging (MRI) performed according to imaging guidelines
  • Able to commence trial treatment not before 4 weeks after cranial surgery and no later than 6 weeks following the last major surgery
  • Adequate bone marrow, coagulation, liver, and renal function

Young Participant Cohort

  • Written informed consent obtained from parents or legal representative
  • Age at enrollment: from >= 6 months to < 3 years of age
  • Progressive or relapsed metastatic or localised, supra- or infratentorial, non-brain stem WHO Grade III or IV glioma (local pathology confirmation made either at initial diagnosis or at relapse)
  • Availability of a baseline MRI performed according to imaging guidelines
  • Adequate organ function (bone marrow, coagulation, liver, kidney)

Exclusion Criteria - Main cohort:

  • Metastatic HGG defined as evidence of neuraxis dissemination by MRI or positive cerebrospinal fluid (CSF) cytology
  • WHO-defined Gliomatosis cerebri (multifocal HGG)
  • Any disease or condition that contraindicates the use of the study medication/treatment or places the patient at an unacceptable risk of experiencing treatment-related complications
  • Radiological evidence of surgically related intracranial bleeding
  • Prior diagnosis of a malignancy and disease-free for 5 years
  • Prior systemic anti-cancer therapy
  • Previous cranial irradiation

Young Participant Cohort

  • WHO-defined Gliomatosis cerebri (multifocal HGG)
  • Newly diagnosed HGG below the age of 3 years
  • Relapsed HGG below the age of 6 months or above the age of 3 years regardless of the age at first onset
  • Indication for concomitant cranial irradiation, regardless of age
  • Any disease or condition that contraindicates the use of the study medication/treatment or places the child at an unacceptable risk of experiencing treatment-related complications
  • Any specific contraindication to MRI

Sites / Locations

  • The Children's Hospital at Westmead
  • Lady Cilento Children's Hospital; Oncology Services Group, Level 12b
  • Kepler Universitätskliniken GmbH - Med Campus IV.
  • Medizinische Universität Wien
  • UZ Leuven Gasthuisberg
  • Alberta Children'S Hospital
  • Hospital For Sick Children
  • Fakultni nemocnice Brno; 2. detska klinika, pracoviste Detska nemocnice
  • Fakultni Nemocnice V Motole, S.P.
  • Skejby Sygehus - Aarhus University Hospital; CF Center, Børneafdeling A
  • Rigshospitalet; Onkologisk Klinik
  • Centre Hospitalier d'Angers; Service de cancérologie pédiatrique
  • CHU ESTAING; Centre Regional de Cancérologie et Thérapie Cellulaire Pédiatrique (CRCTCP)
  • Centre Oscar Lambret; Service de Pediatrie
  • Centre Leon Berard
  • Hopital Timone Enfants; Onco Pediatrie
  • Hopital Lenval; Service Hématologie Infantile
  • Institut Curie - Centre de Lutte Contre le Cancer (CLCC) de Paris; Service d Oncologie Pediatrique
  • CHRU de Rennes - Hôpital Sud- Service d'Hématologie Pédiatrique
  • Hopital Nord;Consult Pediatrie
  • Hôpital Hautepierre
  • Hopital Des Enfants; Service d Hemato-Oncologie
  • CHRU de Tours - Centre de Pédiatrie Clocheville; Service d'Oncopédiatrie
  • Hopital Brabois Enfants
  • Institut Gustave Roussy; Service Pediatrique
  • Semmelweis University, 2nd Dept of Pediatrics Neurooncology Unit
  • Azienda Ospedaliera Universitaria Policlinico Sant'Orsola Malpigh
  • Istituto Giannina Gaslini-Ospedale Pediatrico IRCCS; U.O.S. Neuroncologia
  • Fondazione IRCCS Istituto Nazionale dei Tumori
  • Azienda Ospedaliera di Padova
  • UMC St Radboud
  • Erasmus Mc/Sophia's Childrens Hospital; Dept. of Pediatric Oncology
  • Instytut Pomnik-Centrum Zdrowia Dziecka; Klinika Onkologii
  • Hospital Sant Joan De Deu
  • Hospital Universitari Vall d'Hebron
  • Hospital Universitario La Fe
  • Sahlgrenska Universitetssjukhuset, Östra Sjukhus; Drottning Silvias Barnsjukhus
  • Universitetssjukhuset Linköping; Barn och Ungdomskliniken
  • Skånes Universitetssjukhus
  • Karolinska Universitetssjukhuset, Solna; Astrid Lindgrens Barnsjukhus, Barcanceravdelningen
  • Birmingham Childrens Hospital; Oncology Dept
  • Bristol Royal Hospital for Children; Paediatric Haematology, Oncology, BMT
  • Addenbrookes Hospital; Paediatric Oncology Ward C2
  • Royal Hospital for Sick Children
  • Leeds General Infirmary; Ward 35
  • Alder Hey Children's NHS Foundation Trust
  • University College London NHS Foundation Trust
  • Great Ormond Street Hospital; Dept. Of Pediatric Oncology
  • Royal Manchester Childrens Hospital
  • Newcastle University & The Newcastle upon Tyne Hospitals NHS Foundation Trust
  • Queens Medical Centre
  • Southampton General Hospital
  • Royal Marsden Hospital; Pediatric Unit

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Bevacizumab + TMZ Young Patient Cohort (YPC)

Main Cohort: Chemoradiation + Bevacizumab + TMZ

Main Cohort: Chemoradiation + TMZ

Arm Description

Participants aged greater than or equal to (>/=) 6 months and less than (<) 3 years will receive 10 milligrams per kilogram (mg/kg) Bevacizumab every 2 weeks and 150 to 200 milligrams per meter squared (mg/m^2) of TMZ daily on Days 1-5 of each cycle. TMZ will be given at a dose of 150 mg/m^2 on Days 1-5 of cycle 1 and then escalated to 200 mg/m^2 on days 1-5 from cycle 2 onwards depending on the tolerance during the 1st cycle.

Participants will receive a total dose of 54 Grey (Gy) units delivered in 30 daily fractions of 1.8 Gy over 6 weeks with 75 mg/m^2 TMZ daily for up to 49 days followed by a treatment break of approximately 4 weeks. The treatment break will be followed by an adjuvant treatment phase where participants will receive 150 to 200 mg/m^2 of TMZ daily on Days 1-5 of each cycle. TMZ will be given at a dose of 150 mg/m^2 on Days 1-5 of cycle 1 and then escalated to 200 mg/m^2 on days 1-5 from cycle 2 onwards depending on the tolerance during the 1st cycle. Bevacizumab will be given concomitantly at a dose of 10 mg/kg every 2 weeks throughout the entire treatment period.

Participants will receive a total dose of 54 Gy units delivered in 30 daily fractions of 1.8 Gy over 6 weeks with 75 mg/m^2 TMZ daily for up to 49 days followed by a treatment break of approximately 4 weeks. The treatment break will be followed by an adjuvant treatment phase where participants will receive 150 to 200 mg/m^2 of TMZ daily on Days 1-5 of each cycle. TMZ will be given at a dose of 150 mg/m^2 on Days 1-5 of cycle 1 and then escalated to 200 mg/m^2 on days 1-5 from cycle 2 onwards depending on the tolerance during the 1st cycle.

Outcomes

Primary Outcome Measures

Event-Free Survival (EFS) as Assessed by the Central Radiology Review Committee (CRRC)
EFS was defined as the time from randomisation to the earliest occurrence of any of the following: tumor progression, tumor recurrence, second primary non- HGG malignancy or death attributable to any cause. Tumor assessments were conducted using magnetic resonance imaging (MRI) and reviewed by the site-independent CRRC using Response Assessment in Neuro-Oncology (RANO) criteria. Tumor progression was defined as clear clinical progression or >/= 25% increase in the sum of the products of perpendicular diameters of the contrast enhancing lesions compared with the smallest tumor measurement obtained either at baseline (if no decrease was observed) or best response and with the subject on stable or increasing doses of corticosteroids. Tumor recurrence was defined as recurrence after tumor was completely resected (no disease present at baseline). EFS was estimated using the Kaplan-Meier method.

Secondary Outcome Measures

Overall Survival
Overall Survival was defined as the time of diagnosis to the date of death due to any cause. Overall Survival was estimated using the Kaplan-Meier method.
Percentage of Participants With 1-Year Survival
1-year survival was estimated using the Kaplan-Meier method.
Percentage of Participants With EFS as Determined by the CRRC at 6 Months
EFS was defined as the time from randomisation to the earliest occurrence of any of the following: tumor progression, tumor recurrence, second primary non- HGG malignancy or death attributable to any cause. Tumor assessments were conducted using MRI and reviewed by the site-independent CRRC using RANO criteria. Tumor progression was defined as clear clinical progression or >/= 25% increase in the sum of the products of perpendicular diameters of the contrast enhancing lesions compared with the smallest tumor measurement obtained either at baseline (if no decrease was observed) or best response and with the subject on stable or increasing doses of corticosteroids. Tumor recurrence was defined as recurrence after tumor was completely resected (no disease present at baseline). EFS was estimated using the Kaplan-Meier method.
Percentage of Participants With EFS as Determined by the CRRC at 1 Year
EFS was defined as the time from randomisation to the earliest occurrence of any of the following: tumor progression, tumor recurrence, second primary non- HGG malignancy or death attributable to any cause. Tumor assessments were conducted using MRI and reviewed by the site-independent CRRC using RANO criteria. Tumor progression was defined as clear clinical progression or >/= 25% increase in the sum of the products of perpendicular diameters of the contrast enhancing lesions compared with the smallest tumor measurement obtained either at baseline (if no decrease was observed) or best response and with the subject on stable or increasing doses of corticosteroids. Tumor recurrence was defined as recurrence after tumor was completely resected (no disease present at baseline). EFS was estimated using the Kaplan-Meier method.
EFS as Assessed by the Investigator
EFS was defined as the time from randomisation to the earliest occurrence of any of the following: tumor progression, tumor recurrence, second primary non-HGG malignancy or death attributable to any cause. Tumor assessments were conducted using MRI and reviewed by the investigator using RANO criteria. Tumor progression was defined as clear clinical progression or >/= 25% increase in the sum of the products of perpendicular diameters of the contrast enhancing lesions compared with the smallest tumor measurement obtained either at baseline (if no decrease was observed) or best response and with the participant on stable or increasing doses of corticosteroids. Tumor recurrence was defined as recurrence after tumor was completely resected (no disease present at baseline). EFS was estimated using the Kaplan-Meier method.
Objective Response Rate (ORR)
ORR was defined as the percentage of participants with a complete response (CR) or partial response (PR) determined on two consecutive occasions >/= 4 weeks apart. Tumor assessments were conducted using MRI and reviewed by the site-independent CRRC using RANO criteria. The following were needed to qualify as CR: complete disappearance of all measurable enhancing lesions sustained for at least 4 weeks by MRI, no steroids above physiological levels, clinical status stable or improved compared to baseline. The following were needed to qualify as PR: ≥ 50% decrease from baseline in the sum of products of perpendicular diameters of all measurable enhancing lesions sustained for at least 4 weeks by MRI, steroid dose not increased compared to baseline, clinical status stable or improved compared to baseline.
Concordance Between Structural Versus Multimodal Imaging for CRRC-Assessed Event-Free Survival
Concordance is presented as the percentage of participants with concordance between assessments. EFS concordance was defined as event Structural assessment and Diffusion Perfusion assessment occurs within 28 days or no event Structural and no Diffusion Perfusion.
Health Status as Measured by the Health Utility Index (HUI)
HUI is a preference-based, multi-attitude, health-related instrument specifically developed for use with children. HUI consists of eight attributes of health status: vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain. Each attribute had 5 or 6 levels varying from highly impaired to normal. Each of the eight health dimensions was tested separately and a composite score ranging between 1 (perfect health) and 0 (death) was obtained for participants aged 5 years or older.
Neurological Psychological Function as Measured by the Wechsler Scale
The Wechsler Intelligence Scale for Children version IV (WISC-IV) was used to generate a full scale intelligence quotient (IQ) which represents a child's general intellectual ability. The average IQ score is 100, with lower scores representing lower intellectual ability.
Percentage of Participants Who Completed >/= 90% of Planned Radiotherapy and TMZ Administrations
Percentage of Participants With a Treatment Delay or Discontinuation
Number of Radiotherapy Dose Administrations in the Concurrent Phase
Number of doses were assessed for the concurrent phase, which is the treatment period after the initial treatment phase and including the subsequent treatment break of approximately 4 weeks.
Number of Dose Administrations of TMZ and Bevacizumab in the Concurrent Phase
Number of doses were assessed for the concurrent phase, which is the treatment period after the initial treatment phase and including the subsequent treatment break of approximately 4 weeks.
Percentage of Participants With an Adverse Event (AE)
An AE was defined as any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.

Full Information

First Posted
July 7, 2011
Last Updated
July 23, 2020
Sponsor
Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT01390948
Brief Title
A Study of Bevacizumab (Avastin) in Combination With Temozolomide (TMZ) and Radiotherapy in Paediatric and Adolescent Participants With High-Grade Glioma
Official Title
A Phase II Open-Label, Randomized, Multi-Centre Comparative Study Of Bevacizumab-Based Therapy In Paediatric Patients With Newly Diagnosed Supratentorial, Infratentorial Cerebellar, or Peduncular High-Grade Glioma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2020
Overall Recruitment Status
Completed
Study Start Date
October 18, 2011 (Actual)
Primary Completion Date
February 5, 2016 (Actual)
Study Completion Date
January 29, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This randomized, open-label, multicenter, 2-arm study will investigate the efficacy, safety, tolerability and pharmacokinetics of bevacizumab when added to postoperative radiotherapy with concomitant and adjuvant TMZ as compared to postoperative radiotherapy with concomitant and adjuvant TMZ alone in paediatric participants with newly diagnosed histologically confirmed World Health Organization (WHO) Grade III or IV localized supratentorial or infratentorial cerebellar or peduncular high grade glioma (HGG). Participants will be randomly assigned to one of two treatment arms. Upon approval by the Health Authorities/Ethics Committees in the participating countries, an additional young participant cohort (YPC) (children >/= 6 months and < 3 years of age with progressive or relapsed metastatic or localized, supra- or infratentorial, non-brain stem WHO Grade III or IV HGG) was included in the study. Children in the YPC will receive bevacizumab and TMZ without radiation therapy. The anticipated time on study treatment is over 1 year.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
High Grade Glioma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
124 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bevacizumab + TMZ Young Patient Cohort (YPC)
Arm Type
Experimental
Arm Description
Participants aged greater than or equal to (>/=) 6 months and less than (<) 3 years will receive 10 milligrams per kilogram (mg/kg) Bevacizumab every 2 weeks and 150 to 200 milligrams per meter squared (mg/m^2) of TMZ daily on Days 1-5 of each cycle. TMZ will be given at a dose of 150 mg/m^2 on Days 1-5 of cycle 1 and then escalated to 200 mg/m^2 on days 1-5 from cycle 2 onwards depending on the tolerance during the 1st cycle.
Arm Title
Main Cohort: Chemoradiation + Bevacizumab + TMZ
Arm Type
Experimental
Arm Description
Participants will receive a total dose of 54 Grey (Gy) units delivered in 30 daily fractions of 1.8 Gy over 6 weeks with 75 mg/m^2 TMZ daily for up to 49 days followed by a treatment break of approximately 4 weeks. The treatment break will be followed by an adjuvant treatment phase where participants will receive 150 to 200 mg/m^2 of TMZ daily on Days 1-5 of each cycle. TMZ will be given at a dose of 150 mg/m^2 on Days 1-5 of cycle 1 and then escalated to 200 mg/m^2 on days 1-5 from cycle 2 onwards depending on the tolerance during the 1st cycle. Bevacizumab will be given concomitantly at a dose of 10 mg/kg every 2 weeks throughout the entire treatment period.
Arm Title
Main Cohort: Chemoradiation + TMZ
Arm Type
Active Comparator
Arm Description
Participants will receive a total dose of 54 Gy units delivered in 30 daily fractions of 1.8 Gy over 6 weeks with 75 mg/m^2 TMZ daily for up to 49 days followed by a treatment break of approximately 4 weeks. The treatment break will be followed by an adjuvant treatment phase where participants will receive 150 to 200 mg/m^2 of TMZ daily on Days 1-5 of each cycle. TMZ will be given at a dose of 150 mg/m^2 on Days 1-5 of cycle 1 and then escalated to 200 mg/m^2 on days 1-5 from cycle 2 onwards depending on the tolerance during the 1st cycle.
Intervention Type
Drug
Intervention Name(s)
Bevacizumab
Other Intervention Name(s)
Avastin
Intervention Description
10 milligrams per kilogram every 2 weeks during the study for up to 12 cycles, each cycle length of 28 days
Intervention Type
Radiation
Intervention Name(s)
Radiotherapy
Intervention Description
Total dose of 54 Grey (Gy) units delivered in 30 daily fractions of 1.8 Gy over 6 weeks during the chemoradiation phase.
Intervention Type
Drug
Intervention Name(s)
Temozolomide (TMZ)
Intervention Description
75 milligrams per square meter (mg/m^2) daily continuous starting concomitantly with the first radiation fraction and ending with the last radiation fraction for a maximum number of treatment days = 49 days. During the TMZ adjuvant treatment phase and for participants from YPC: TMZ (150 to 200 mg/m^2/day) x 12 cycles, 1st cycle 150 mg/m^2/days 1-5, escalated to 200 mg/m^2 on Days 1-5 from Cycle 2 onwards depending on the tolerance during the 1st cycle. Cycle length = 28 days.
Primary Outcome Measure Information:
Title
Event-Free Survival (EFS) as Assessed by the Central Radiology Review Committee (CRRC)
Description
EFS was defined as the time from randomisation to the earliest occurrence of any of the following: tumor progression, tumor recurrence, second primary non- HGG malignancy or death attributable to any cause. Tumor assessments were conducted using magnetic resonance imaging (MRI) and reviewed by the site-independent CRRC using Response Assessment in Neuro-Oncology (RANO) criteria. Tumor progression was defined as clear clinical progression or >/= 25% increase in the sum of the products of perpendicular diameters of the contrast enhancing lesions compared with the smallest tumor measurement obtained either at baseline (if no decrease was observed) or best response and with the subject on stable or increasing doses of corticosteroids. Tumor recurrence was defined as recurrence after tumor was completely resected (no disease present at baseline). EFS was estimated using the Kaplan-Meier method.
Time Frame
From the time of randomization to the date of any defined event (up to 12 months)
Secondary Outcome Measure Information:
Title
Overall Survival
Description
Overall Survival was defined as the time of diagnosis to the date of death due to any cause. Overall Survival was estimated using the Kaplan-Meier method.
Time Frame
From the time of randomization to the date of death (up to approximately 60 months)
Title
Percentage of Participants With 1-Year Survival
Description
1-year survival was estimated using the Kaplan-Meier method.
Time Frame
1 year after end of treatment
Title
Percentage of Participants With EFS as Determined by the CRRC at 6 Months
Description
EFS was defined as the time from randomisation to the earliest occurrence of any of the following: tumor progression, tumor recurrence, second primary non- HGG malignancy or death attributable to any cause. Tumor assessments were conducted using MRI and reviewed by the site-independent CRRC using RANO criteria. Tumor progression was defined as clear clinical progression or >/= 25% increase in the sum of the products of perpendicular diameters of the contrast enhancing lesions compared with the smallest tumor measurement obtained either at baseline (if no decrease was observed) or best response and with the subject on stable or increasing doses of corticosteroids. Tumor recurrence was defined as recurrence after tumor was completely resected (no disease present at baseline). EFS was estimated using the Kaplan-Meier method.
Time Frame
6 months
Title
Percentage of Participants With EFS as Determined by the CRRC at 1 Year
Description
EFS was defined as the time from randomisation to the earliest occurrence of any of the following: tumor progression, tumor recurrence, second primary non- HGG malignancy or death attributable to any cause. Tumor assessments were conducted using MRI and reviewed by the site-independent CRRC using RANO criteria. Tumor progression was defined as clear clinical progression or >/= 25% increase in the sum of the products of perpendicular diameters of the contrast enhancing lesions compared with the smallest tumor measurement obtained either at baseline (if no decrease was observed) or best response and with the subject on stable or increasing doses of corticosteroids. Tumor recurrence was defined as recurrence after tumor was completely resected (no disease present at baseline). EFS was estimated using the Kaplan-Meier method.
Time Frame
1 year
Title
EFS as Assessed by the Investigator
Description
EFS was defined as the time from randomisation to the earliest occurrence of any of the following: tumor progression, tumor recurrence, second primary non-HGG malignancy or death attributable to any cause. Tumor assessments were conducted using MRI and reviewed by the investigator using RANO criteria. Tumor progression was defined as clear clinical progression or >/= 25% increase in the sum of the products of perpendicular diameters of the contrast enhancing lesions compared with the smallest tumor measurement obtained either at baseline (if no decrease was observed) or best response and with the participant on stable or increasing doses of corticosteroids. Tumor recurrence was defined as recurrence after tumor was completely resected (no disease present at baseline). EFS was estimated using the Kaplan-Meier method.
Time Frame
From the time of randomization to the date of any defined event (up to 12 months)
Title
Objective Response Rate (ORR)
Description
ORR was defined as the percentage of participants with a complete response (CR) or partial response (PR) determined on two consecutive occasions >/= 4 weeks apart. Tumor assessments were conducted using MRI and reviewed by the site-independent CRRC using RANO criteria. The following were needed to qualify as CR: complete disappearance of all measurable enhancing lesions sustained for at least 4 weeks by MRI, no steroids above physiological levels, clinical status stable or improved compared to baseline. The following were needed to qualify as PR: ≥ 50% decrease from baseline in the sum of products of perpendicular diameters of all measurable enhancing lesions sustained for at least 4 weeks by MRI, steroid dose not increased compared to baseline, clinical status stable or improved compared to baseline.
Time Frame
From the time of randomization to the date of any defined event (up to 12 months)
Title
Concordance Between Structural Versus Multimodal Imaging for CRRC-Assessed Event-Free Survival
Description
Concordance is presented as the percentage of participants with concordance between assessments. EFS concordance was defined as event Structural assessment and Diffusion Perfusion assessment occurs within 28 days or no event Structural and no Diffusion Perfusion.
Time Frame
Up to 12 months
Title
Health Status as Measured by the Health Utility Index (HUI)
Description
HUI is a preference-based, multi-attitude, health-related instrument specifically developed for use with children. HUI consists of eight attributes of health status: vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain. Each attribute had 5 or 6 levels varying from highly impaired to normal. Each of the eight health dimensions was tested separately and a composite score ranging between 1 (perfect health) and 0 (death) was obtained for participants aged 5 years or older.
Time Frame
Baseline, Cycle 6 of the adjuvant phase, end of treatment (approximately 58 weeks post-baseline), and yearly during the follow-up period (maximum 5 years in follow-up)
Title
Neurological Psychological Function as Measured by the Wechsler Scale
Description
The Wechsler Intelligence Scale for Children version IV (WISC-IV) was used to generate a full scale intelligence quotient (IQ) which represents a child's general intellectual ability. The average IQ score is 100, with lower scores representing lower intellectual ability.
Time Frame
End of treatment (approximately 58 weeks post-baseline)
Title
Percentage of Participants Who Completed >/= 90% of Planned Radiotherapy and TMZ Administrations
Time Frame
From the time of randomization of the first participant to the date of clinical cutoff (approximately 60 months)
Title
Percentage of Participants With a Treatment Delay or Discontinuation
Time Frame
From the time of randomization of the first participant to the date of clinical cutoff (approximately 60 months)
Title
Number of Radiotherapy Dose Administrations in the Concurrent Phase
Description
Number of doses were assessed for the concurrent phase, which is the treatment period after the initial treatment phase and including the subsequent treatment break of approximately 4 weeks.
Time Frame
Beginning of the concurrent phase to end of treatment break (10 weeks)
Title
Number of Dose Administrations of TMZ and Bevacizumab in the Concurrent Phase
Description
Number of doses were assessed for the concurrent phase, which is the treatment period after the initial treatment phase and including the subsequent treatment break of approximately 4 weeks.
Time Frame
Beginning of the concurrent phase to end of treatment break (10 weeks)
Title
Percentage of Participants With an Adverse Event (AE)
Description
An AE was defined as any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.
Time Frame
From the time of randomization of the first participant to the date of clinical cutoff (approximately 60 months)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Months
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria - Main cohort : Paediatric participants, aged >= 3 years and < 18 years Written informed consent obtained from the participant/parents or legally acceptable representative Newly diagnosed localised, supratentorial or infratentorial cerebellar or peduncular, WHO Grade III or IV gliomas Local histological diagnosis confirmed by a designated central reference neuropathologist Availability of the baseline magnetic resonance imaging (MRI) performed according to imaging guidelines Able to commence trial treatment not before 4 weeks after cranial surgery and no later than 6 weeks following the last major surgery Adequate bone marrow, coagulation, liver, and renal function Young Participant Cohort Written informed consent obtained from parents or legal representative Age at enrollment: from >= 6 months to < 3 years of age Progressive or relapsed metastatic or localised, supra- or infratentorial, non-brain stem WHO Grade III or IV glioma (local pathology confirmation made either at initial diagnosis or at relapse) Availability of a baseline MRI performed according to imaging guidelines Adequate organ function (bone marrow, coagulation, liver, kidney) Exclusion Criteria - Main cohort: Metastatic HGG defined as evidence of neuraxis dissemination by MRI or positive cerebrospinal fluid (CSF) cytology WHO-defined Gliomatosis cerebri (multifocal HGG) Any disease or condition that contraindicates the use of the study medication/treatment or places the patient at an unacceptable risk of experiencing treatment-related complications Radiological evidence of surgically related intracranial bleeding Prior diagnosis of a malignancy and disease-free for 5 years Prior systemic anti-cancer therapy Previous cranial irradiation Young Participant Cohort WHO-defined Gliomatosis cerebri (multifocal HGG) Newly diagnosed HGG below the age of 3 years Relapsed HGG below the age of 6 months or above the age of 3 years regardless of the age at first onset Indication for concomitant cranial irradiation, regardless of age Any disease or condition that contraindicates the use of the study medication/treatment or places the child at an unacceptable risk of experiencing treatment-related complications Any specific contraindication to MRI
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
Facility Information:
Facility Name
The Children's Hospital at Westmead
City
Westmead
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
Lady Cilento Children's Hospital; Oncology Services Group, Level 12b
City
South Brisbane
State/Province
Queensland
ZIP/Postal Code
QLD 4101
Country
Australia
Facility Name
Kepler Universitätskliniken GmbH - Med Campus IV.
City
Linz
ZIP/Postal Code
4020
Country
Austria
Facility Name
Medizinische Universität Wien
City
Wien
ZIP/Postal Code
1090
Country
Austria
Facility Name
UZ Leuven Gasthuisberg
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
Facility Name
Alberta Children'S Hospital
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T3B 6A8
Country
Canada
Facility Name
Hospital For Sick Children
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1X8
Country
Canada
Facility Name
Fakultni nemocnice Brno; 2. detska klinika, pracoviste Detska nemocnice
City
Brno
ZIP/Postal Code
62500
Country
Czechia
Facility Name
Fakultni Nemocnice V Motole, S.P.
City
Prague
ZIP/Postal Code
15060
Country
Czechia
Facility Name
Skejby Sygehus - Aarhus University Hospital; CF Center, Børneafdeling A
City
Aarhus N
ZIP/Postal Code
8200
Country
Denmark
Facility Name
Rigshospitalet; Onkologisk Klinik
City
København Ø
ZIP/Postal Code
2100
Country
Denmark
Facility Name
Centre Hospitalier d'Angers; Service de cancérologie pédiatrique
City
Angers
ZIP/Postal Code
49033
Country
France
Facility Name
CHU ESTAING; Centre Regional de Cancérologie et Thérapie Cellulaire Pédiatrique (CRCTCP)
City
Clermont Ferrand
ZIP/Postal Code
63003
Country
France
Facility Name
Centre Oscar Lambret; Service de Pediatrie
City
Lille
ZIP/Postal Code
59020
Country
France
Facility Name
Centre Leon Berard
City
Lyon
ZIP/Postal Code
69008
Country
France
Facility Name
Hopital Timone Enfants; Onco Pediatrie
City
Marseille
ZIP/Postal Code
13385
Country
France
Facility Name
Hopital Lenval; Service Hématologie Infantile
City
Nice
ZIP/Postal Code
06200
Country
France
Facility Name
Institut Curie - Centre de Lutte Contre le Cancer (CLCC) de Paris; Service d Oncologie Pediatrique
City
Paris
ZIP/Postal Code
75248
Country
France
Facility Name
CHRU de Rennes - Hôpital Sud- Service d'Hématologie Pédiatrique
City
Rennes
ZIP/Postal Code
35056
Country
France
Facility Name
Hopital Nord;Consult Pediatrie
City
St Priest En Jarez
ZIP/Postal Code
42777
Country
France
Facility Name
Hôpital Hautepierre
City
Strasbourg
ZIP/Postal Code
67200
Country
France
Facility Name
Hopital Des Enfants; Service d Hemato-Oncologie
City
Toulouse
ZIP/Postal Code
31059
Country
France
Facility Name
CHRU de Tours - Centre de Pédiatrie Clocheville; Service d'Oncopédiatrie
City
Tours
ZIP/Postal Code
37044
Country
France
Facility Name
Hopital Brabois Enfants
City
Vandoeuvre-les-Nancy cedex
ZIP/Postal Code
54511
Country
France
Facility Name
Institut Gustave Roussy; Service Pediatrique
City
Villejuif
ZIP/Postal Code
94805
Country
France
Facility Name
Semmelweis University, 2nd Dept of Pediatrics Neurooncology Unit
City
Budapest
ZIP/Postal Code
1094
Country
Hungary
Facility Name
Azienda Ospedaliera Universitaria Policlinico Sant'Orsola Malpigh
City
Bologna
State/Province
Emilia-Romagna
ZIP/Postal Code
40138
Country
Italy
Facility Name
Istituto Giannina Gaslini-Ospedale Pediatrico IRCCS; U.O.S. Neuroncologia
City
Genova
State/Province
Liguria
ZIP/Postal Code
16147
Country
Italy
Facility Name
Fondazione IRCCS Istituto Nazionale dei Tumori
City
Milano
State/Province
Lombardia
ZIP/Postal Code
20133
Country
Italy
Facility Name
Azienda Ospedaliera di Padova
City
Padova
State/Province
Veneto
ZIP/Postal Code
35128
Country
Italy
Facility Name
UMC St Radboud
City
Nijmegen
ZIP/Postal Code
6525 GA
Country
Netherlands
Facility Name
Erasmus Mc/Sophia's Childrens Hospital; Dept. of Pediatric Oncology
City
Rotterdam
ZIP/Postal Code
3015 GJ
Country
Netherlands
Facility Name
Instytut Pomnik-Centrum Zdrowia Dziecka; Klinika Onkologii
City
Warsaw
ZIP/Postal Code
04-746
Country
Poland
Facility Name
Hospital Sant Joan De Deu
City
Esplugues De Llobregas
State/Province
Barcelona
ZIP/Postal Code
08950
Country
Spain
Facility Name
Hospital Universitari Vall d'Hebron
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Hospital Universitario La Fe
City
Valencia
ZIP/Postal Code
46014
Country
Spain
Facility Name
Sahlgrenska Universitetssjukhuset, Östra Sjukhus; Drottning Silvias Barnsjukhus
City
Göteborg
ZIP/Postal Code
416 85
Country
Sweden
Facility Name
Universitetssjukhuset Linköping; Barn och Ungdomskliniken
City
Linkoeping
ZIP/Postal Code
581 85
Country
Sweden
Facility Name
Skånes Universitetssjukhus
City
Lund
ZIP/Postal Code
221 85
Country
Sweden
Facility Name
Karolinska Universitetssjukhuset, Solna; Astrid Lindgrens Barnsjukhus, Barcanceravdelningen
City
Solna
ZIP/Postal Code
171 76
Country
Sweden
Facility Name
Birmingham Childrens Hospital; Oncology Dept
City
Birmingham
ZIP/Postal Code
B4 6NH
Country
United Kingdom
Facility Name
Bristol Royal Hospital for Children; Paediatric Haematology, Oncology, BMT
City
Bristol
ZIP/Postal Code
BS2 8BJ
Country
United Kingdom
Facility Name
Addenbrookes Hospital; Paediatric Oncology Ward C2
City
Cambridge
ZIP/Postal Code
CB2 0QQ
Country
United Kingdom
Facility Name
Royal Hospital for Sick Children
City
Edinburgh
ZIP/Postal Code
EH91LF
Country
United Kingdom
Facility Name
Leeds General Infirmary; Ward 35
City
Leeds
ZIP/Postal Code
LS1 3EX
Country
United Kingdom
Facility Name
Alder Hey Children's NHS Foundation Trust
City
Liverpool
ZIP/Postal Code
L12 2AP
Country
United Kingdom
Facility Name
University College London NHS Foundation Trust
City
London
ZIP/Postal Code
NW1 2PG
Country
United Kingdom
Facility Name
Great Ormond Street Hospital; Dept. Of Pediatric Oncology
City
London
ZIP/Postal Code
WC1N 3JH
Country
United Kingdom
Facility Name
Royal Manchester Childrens Hospital
City
Manchester
ZIP/Postal Code
M13 9WL
Country
United Kingdom
Facility Name
Newcastle University & The Newcastle upon Tyne Hospitals NHS Foundation Trust
City
Newcastle upon Tyne
ZIP/Postal Code
NE1 4LP
Country
United Kingdom
Facility Name
Queens Medical Centre
City
Nottingham
ZIP/Postal Code
NG7 2UH
Country
United Kingdom
Facility Name
Southampton General Hospital
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Facility Name
Royal Marsden Hospital; Pediatric Unit
City
Surrey
ZIP/Postal Code
SM2 5PT
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
35412366
Citation
Rodriguez D, Calmon R, Aliaga ES, Warren D, Warmuth-Metz M, Jones C, Mackay A, Varlet P, Le Deley MC, Hargrave D, Canete A, Massimino M, Azizi AA, Saran F, Zahlmann G, Garcia J, Vassal G, Grill J, Peet A, Dineen RA, Morgan PS, Jaspan T. MRI and Molecular Characterization of Pediatric High-Grade Midline Thalamic Gliomas: The HERBY Phase II Trial. Radiology. 2022 Jul;304(1):174-182. doi: 10.1148/radiol.211464. Epub 2022 Apr 12.
Results Reference
derived
PubMed Identifier
31419298
Citation
Varlet P, Le Teuff G, Le Deley MC, Giangaspero F, Haberler C, Jacques TS, Figarella-Branger D, Pietsch T, Andreiuolo F, Deroulers C, Jaspan T, Jones C, Grill J. WHO grade has no prognostic value in the pediatric high-grade glioma included in the HERBY trial. Neuro Oncol. 2020 Jan 11;22(1):116-127. doi: 10.1093/neuonc/noz142.
Results Reference
derived
PubMed Identifier
30819765
Citation
Rodriguez D, Chambers T, Warmuth-Metz M, Aliaga ES, Warren D, Calmon R, Hargrave D, Garcia J, Vassal G, Grill J, Zahlmann G, Morgan PS, Jaspan T. Evaluation of the Implementation of the Response Assessment in Neuro-Oncology Criteria in the HERBY Trial of Pediatric Patients with Newly Diagnosed High-Grade Gliomas. AJNR Am J Neuroradiol. 2019 Mar;40(3):568-575. doi: 10.3174/ajnr.A5982. Epub 2019 Feb 28.
Results Reference
derived
PubMed Identifier
29763623
Citation
Mackay A, Burford A, Molinari V, Jones DTW, Izquierdo E, Brouwer-Visser J, Giangaspero F, Haberler C, Pietsch T, Jacques TS, Figarella-Branger D, Rodriguez D, Morgan PS, Raman P, Waanders AJ, Resnick AC, Massimino M, Garre ML, Smith H, Capper D, Pfister SM, Wurdinger T, Tam R, Garcia J, Thakur MD, Vassal G, Grill J, Jaspan T, Varlet P, Jones C. Molecular, Pathological, Radiological, and Immune Profiling of Non-brainstem Pediatric High-Grade Glioma from the HERBY Phase II Randomized Trial. Cancer Cell. 2018 May 14;33(5):829-842.e5. doi: 10.1016/j.ccell.2018.04.004.
Results Reference
derived
PubMed Identifier
29412784
Citation
Grill J, Massimino M, Bouffet E, Azizi AA, McCowage G, Canete A, Saran F, Le Deley MC, Varlet P, Morgan PS, Jaspan T, Jones C, Giangaspero F, Smith H, Garcia J, Elze MC, Rousseau RF, Abrey L, Hargrave D, Vassal G. Phase II, Open-Label, Randomized, Multicenter Trial (HERBY) of Bevacizumab in Pediatric Patients With Newly Diagnosed High-Grade Glioma. J Clin Oncol. 2018 Apr 1;36(10):951-958. doi: 10.1200/JCO.2017.76.0611. Epub 2018 Feb 7.
Results Reference
derived

Learn more about this trial

A Study of Bevacizumab (Avastin) in Combination With Temozolomide (TMZ) and Radiotherapy in Paediatric and Adolescent Participants With High-Grade Glioma

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