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GlioblastomaPhase 3INTRAGO-IINCT02685605

Intraoperative Radiotherapy in Newly Diagnosed Glioblastoma Multiforme

A Phase 3 study testing Standard surgery, Intraoperative radiotherapy and Radiochemotherapy in people with Glioblastoma, run by Universitätsmedizin Mannheim at 19 sites in 8 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

INTRAGO II resembles a multicentric, prospective, randomized, 2-arm, open-label clinical phase III trial which tests if the median progression-free survival (PFS) of patients with newly diagnosed glioblastoma multiforme (GBM) can be improved by the addition of intraoperative radiotherapy (IORT) to standard… Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Glioblastoma
What is being tested?
Standard surgery, Intraoperative radiotherapy and Radiochemotherapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
314 participants
Where
19 sitesin 8 countries
Study dates
9 Dec 2016to Jun 2026
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18 and ≤ 80 years
  • Karnofsky Performance Score (KPS) ≥ 60%
  • Supratentorial T1-Gd enhancing lesion(s) amenable to total resection
  • Legal capacity and ability of subject to understand character and individual consequences of the clinical trial
  • Patient's written IC obtained at least 24h prior to surgery
  • For women with childbearing potential: adequate contraception
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  • Patients must have adequate organ functions
  • Bone marrow function:
  • Platelets ≥ 75.000/μL
  • WBC ≥ 3.000/μL
  • Hemoglobin ≥ 10.0 g/dL
  • Liver Function:
  • ASAT and ALAT ≤ 3.0 times ULN
  • ALP ≤ 2.5 times ULN
  • Total Serum Bilirubin < 1.5 times ULN
  • Renal Function:
  • Serum Creatinine ≤ 1.5 times ULN
  • IORT must be technically feasible
  • Histology supports diagnosis of GBM

Who cannot join

  • Multicentric disease (e.g. in both hemispheres) or non-resectable satellite lesions
  • Previous cranial radiation therapy
  • Cytostatic therapy / chemotherapy for cancer within the past 5 years
  • History of cancers or other comorbidities that limit life expectancy to less than five years
  • Previous therapy with anti-angiogenic substances (such as bevacizumab)
  • Technical impossibility to use MRI or known allergies against MRI and/or CT contrast agents
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  • Participation in other clinical trials testing cancer-derived investigational agents/procedures.
  • Pregnant or breast feeding patients
  • Fertile patients refusing to use safe contraceptive methods during the study
  • Active egress of fluids from a ventricular defect
  • In-field risk organs and/or IORT dose >8 Gy to any risk organ

Trial locations and contacts

19 sites in 8 countries.

19 sites in 8 countries

Germany7 sites
  • University Hospital Augsburg

    Augsburg, 86156

  • Charité - Universitätsmedizin

    Berlin, 13353

  • St. Georg Hospital

    Leipzig

  • University Hospital Mannheim

    Mannheim, 68167

  • Technical University of Munich (TUM), Department of Radiation Oncology

    Munich, 81675

  • Klinikum Stuttgart

    Stuttgart, 70174

  • Helios University Hospital Wuppertal

    Wuppertal, 42283

Other trials in Germany

United States5 sites
  • Long Island Jewish Medical Center, North Shore University Hospital

    Lake Success, New York, 11042

  • Stritch School of Medicine Loyola University

    Maywood, Illinois, 60153

  • West Virginia University

    Morgantown, West Virginia, 26506-9260

  • Lenox Hill Hospital, Hofstra Northwell School of Medicine

    New York, New York, 10028

  • Barrow Neurological Institute (SJHMC)

    Phoenix, Arizona, 85013

Other trials in United States

Spain2 sites
  • Catalan Institute of Oncology (ICO)

    Barcelona, 08908

  • Hospital Reina Sofia

    Córdoba

Other trials in Spain

Brazil1 site
  • Hospital Alemão Oswaldo Cruz

    São Paulo, 01323-020

Other trials in Brazil

Canada1 site
  • Montreal Neurological Institute and Hospital

    Montreal, Quebec, H3A 2B4

Other trials in Canada

China1 site
  • Beijing Tian Tan Hospital, Capital Medical University

    Beijing, 100050

Other trials in China

South Korea1 site
  • Gangnam Severance Hospital, Yonsei University College of Medicine

    Seoul, 06273

Other trials in South Korea

United Kingdom1 site
  • The London Clinic

    London, W1G 6BW

Other trials in United Kingdom

About this study

Official title: A Multicenter Randomized Phase III Trial on INTraoperative RAdiotherapy in Newly Diagnosed GliOblastoma Multiforme (INTRAGO II)

INTRAGO II resembles a multicentric, prospective, randomized, 2-arm, open-label clinical phase III trial which tests if the median progression-free survival (PFS) of patients with newly diagnosed glioblastoma multiforme (GBM) can be improved by the addition of intraoperative radiotherapy (IORT) to standard radiochemotherapy.

Conditions
Glioblastoma
Being tested
Standard surgery, Intraoperative radiotherapy, Radiochemotherapy, Temozolomide
Keywords
Glioblastoma, Intraoperative Radiotherapy, Radiotherapy Dose Escalation
Medical subject headings
Glioblastoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Standard surgeryProcedure or surgery

  • Intraoperative radiotherapyRadiation

    Also called IORT

    Dose to applicator surface: 20-30 Gy; Carl Zeiss INTRABEAM System. IORT with a surface dose of 30 Gy is recommended.Should the proximity to any risk structure not allow to apply 30 Gy, a dose reduction by up to 10 Gy (resulting in a surface dose of 20 Gy) is allowed.

  • RadiochemotherapyRadiation

    EBRT to 60 Gy plus 75 mg/m2/d temozolomide

  • TemozolomideDrug

    Adjuvant chemotherapy with 150-200 mg/m2/d temozolomide per cycle (5/28 days).

Study groups in NCT02685605
Study groupRoleWhat they receive
Experimental Arm (A)ExperimentalStandard surgery plus intraoperative radiotherapy (20-30 Gy) followed by radiochemotherapy (EBRT: 60 Gy, 75 mg/m2/d temozolomide) and adjuvant chemotherapy with 150-200 mg/m2/d temozolomide per cycle (5/28 days).
Receives: Procedure: Standard surgery; Radiation: Intraoperative radiotherapy; Radiation: Radiochemotherapy; Drug: Temozolomide
Control Arm (B)Active comparatorStandard surgery followed by radiochemotherapy (EBRT: 60 Gy, 75 mg/m2/d temozolomide) and adjuvant chemotherapy with 150-200 mg/m2/d temozolomide per cycle (5/28 days).
Receives: Procedure: Standard surgery; Radiation: Radiochemotherapy; Drug: Temozolomide

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Median Progression-Free Survival

    Determined according to modified Response Assessment in Neuro-Oncology (RANO) criteria and serial perfusion imaging

    Measured: 24 Months

Secondary outcomes (15)
  1. Median Overall Survival

    Measured: 24 Months

  2. PFS within a 1-2 cm margin around the cavity

    Determined by serial contrast-enhanced MRI scans using modified RANO criteria and serial perfusion imaging

    Measured: 24 Months

  3. OS with respect to Age

    Median overall survival of patients <65 vs. ≥ 65 years

    Measured: 24 Months

  4. PFS with respect to Age

    Progression-free survival of patients <65 vs. ≥ 65 years; determined according to modified RANO criteria and serial perfusion imaging

    Measured: 24 Months

  5. OS with respect to KPS

    Median overall survival of patients with KPS 80-100% vs. 60-70%

    Measured: 24 Months

  6. PFS with respect to KPS

    Progression-free survival of patients with KPS 80-100% vs. 60-70%; determined according to modified RANO criteria and serial perfusion imaging

    Measured: 24 Months

  7. OS with respect to thickness of anticipated T1-Gd-enhancing (remaining) tumor margin

    Thickness of anticipated T1-Gd-enhancing (remaining) tumor margin as per the discretion of the surgeon (margin ≥0.5 cm or multiple spots of residual tumor within the cavity vs. <0.5 cm)

    Measured: 24 Months

  8. PFS with respect to thickness of anticipated T1-Gd-enhancing (remaining) tumor margin

    Thickness of anticipated T1-Gd-enhancing (remaining) tumor margin as per the discretion of the surgeon (margin ≥0.5 cm or multiple spots of residual tumor within the cavity vs. <0.5 cm); determined according to modified RANO criteria and serial perfusion imaging

    Measured: 24 Months

  9. OS with respect to extent of resection

    Early postoperative MRI scans must be used to determine the extent of resection (EoR). The EoR is given as sum of all maximum diameters of residual lesions in cm. OS will be calculated for the following groups:

    • Max Diameter group 0: 0 cm (no residual tumor)
    • Max Diameter group 1: >0 to ≤1.5 cm (cumulative if multiple residual lesions)
    • Max Diameter group 2: >1.5 cm (cumulative if multiple residual lesions)

    Measured: 24 Months

  10. PFS with respect to extent of resection

    Early postoperative MRI scans must be used to determine the extent of resection (EoR). The EoR is given as sum of all maximum diameters of residual lesions in cm. PFS will be determined according to modified RANO criteria and serial perfusion imaging for the following groups:

    • Max Diameter group 0: 0 cm (no residual tumor)
    • Max Diameter group 1: >0 to ≤1.5 cm (cumulative if multiple residual lesions)
    • Max Diameter group 2: >1.5 cm (cumulative if multiple residual lesions)

    Measured: 24 Months

  11. OS with respect to MGMT promoter methylation status

    OS in patients with promoter methylation vs. no promoter methylation

    Measured: 24 Months

  12. PFS with respect to MGMT promoter methylation status

    PFS in patients with promoter methylation vs. no promoter methylation; determined according to modified RANO criteria and serial perfusion imaging

    Measured: 24 Months

  13. Quality of Life (QoL) questionnaire

    Assessed by European Organization for Research and Treatment (EORTC)- Quality of Life Questionnaires (QLQ C30/BN20)

    Measured: 24 Months

  14. Activities of daily living (ADL), assessed using the Barthel Index (Mahoney & Barthel, 1965).

    Change in functional outcomes as measured by BI from its baseline value.

    Measured: 24 Months

  15. Radiation-related (acute / early delayed / late) neurotoxicity

    Assessed by regular neurological examinations and serial MRI scans

    Measured: 24 Months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Feb 2016 (estimated)
  2. Study start9 Dec 2016
  3. Primary completionNov 2025 (estimated)
  4. Study completionJun 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
314 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02685605
Sponsor's protocol ID
INTRAGO-II
Other IDs
ARO-2016-1, AG-NRO-03
Acronym
INTRAGO-II
Status last verified
Oct 2025
First submitted
5 Feb 2016
Last updated
14 Oct 2025
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Giordano FA, Brehmer S, Abo-Madyan Y, Welzel G, Sperk E, Keller A, Schneider F, Clausen S, Herskind C, Schmiedek P, Wenz F. INTRAGO: intraoperative radiotherapy in glioblastoma multiforme-a phase I/II dose escalation study. BMC Cancer. 2014 Dec 22;14:992. doi: 10.1186/1471-2407-14-992.

    PubMed 25535398
  • Sarria GR, Sperk E, Han X, Sarria GJ, Wenz F, Brehmer S, Fu B, Min S, Zhang H, Qin S, Qiu X, Hanggi D, Abo-Madyan Y, Martinez D, Cabrera C, Giordano FA. Intraoperative radiotherapy for glioblastoma: an international pooled analysis. Radiother Oncol. 2020 Jan;142:162-167. doi: 10.1016/j.radonc.2019.09.023. Epub 2019 Oct 16.

    PubMed 31629553
  • Ayala Alvarez DS, Watson PGF, Popovic M, Heng VJ, Evans MDC, Panet-Raymond V, Seuntjens J. Evaluation of Dosimetry Formalisms in Intraoperative Radiation Therapy of Glioblastoma. Int J Radiat Oncol Biol Phys. 2023 Nov 1;117(3):763-773. doi: 10.1016/j.ijrobp.2023.04.031. Epub 2023 May 5.

    PubMed 37150259
  • Cifarelli CP, Jacobson GM. Intraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors. Front Oncol. 2021 Nov 11;11:768168. doi: 10.3389/fonc.2021.768168. eCollection 2021.

    PubMed 34858846
  • Sarria GR, Smalec Z, Muedder T, Holz JA, Scafa D, Koch D, Garbe S, Schneider M, Hamed M, Vatter H, Herrlinger U, Giordano FA, Schmeel LC. Dosimetric Comparison of Upfront Boosting With Stereotactic Radiosurgery Versus Intraoperative Radiotherapy for Glioblastoma. Front Oncol. 2021 Oct 28;11:759873. doi: 10.3389/fonc.2021.759873. eCollection 2021.

    PubMed 34778080
  • Giordano FA, Ganslandt O, Munter MW, Combs SE, Diehl C, Meyer B, Herrlinger U, Schneider M, Kahl KH, Shiban E, Goenka A, Schulder M, Lucas A, Plans G, Brehmer S, Ruder AM, Garcia-Cabezas S, Solivera J, Cifarelli CP, Wenz F, Sarria GR, Pope WB, Layer JP, Tsien CI, Petrecca K; INTRAGO-II Study Group. Dose escalation with intraoperative radiotherapy in newly diagnosed glioblastoma (INTRAGO-II): an open-label, multicentre, randomised, controlled, phase 3 trial. Lancet Oncol. 2026 Jul;27(7):864-878. doi: 10.1016/S1470-2045(26)00235-4.

    PubMed 42372746
  • Giordano FA, Brehmer S, Murle B, Welzel G, Sperk E, Keller A, Abo-Madyan Y, Scherzinger E, Clausen S, Schneider F, Herskind C, Glas M, Seiz-Rosenhagen M, Groden C, Hanggi D, Schmiedek P, Emami B, Souhami L, Petrecca K, Wenz F. Intraoperative Radiotherapy in Newly Diagnosed Glioblastoma (INTRAGO): An Open-Label, Dose-Escalation Phase I/II Trial. Neurosurgery. 2019 Jan 1;84(1):41-49. doi: 10.1093/neuros/nyy018.

    PubMed 29528443

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Standard surgery, Intraoperative radiotherapy and Radiochemotherapy in people with Glioblastoma, run by Universitätsmedizin Mannheim at 19 sites in 8 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 19 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 14 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in Germany, United States, Spain, Brazil, Canada and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Median Progression-Free Survival (time frame: 24 Months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02685605, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Oct 2025.

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