AzTrials
AzTrials

GlioblastomaPhase 3RE-GENDNCT02761070

Bevacizumab Alone Versus Dose-dense Temozolomide Followed by Bevacizumab for Recurrent Glioblastoma, Phase III

A Phase 3 study testing Temozolomide and Bevacizumab in people with Glioblastoma and Recurrence, run by Kyorin University at 37 sites in Japan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The aim of this Phase III study is to evaluate the superiority of dose-dense temozolomide (ddTMZ) followed by bevacizumab at ddTMZ failure for glioblastoma at first recurrence or progression, comparing to bevacizumab alone. Read more about this study

Who is it for?
Ages 20 to 75 years
Conditions the study is for
Glioblastoma, Recurrence, Progression
What is being tested?
Temozolomide and Bevacizumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
146 participants
Where
37 sitesJapan
Study dates
11 Jul 2016to 17 Apr 2025
Phase
Phase 3
Are there results?
None posted in the registry

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 20 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically proven diagnosis of glioblastoma (including giant cell glioblastoma and gliosarcoma) by WHO2007 criteria.
  • For patients who did not undergo surgery for recurrent disease; pre-registration contrast MRI should confirm; (i)progressive or recurrent glioblastoma; (ii)no evidence of acute or subacute cerebral hemorrhage at enrolment; (iii)presence of a measurable lesion.
  • For patients who underwent surgery for recurrent disease; (i)progressive or recurrent glioblastoma must be confirmed on contrast MRI before reoperation; (ii)glioblastoma or anaplastic astrocytoma must be histologically identified in the tissue resected at reoperation; (iii)presence of measurable lesions is not mandatory on pre-registration contrast MRI (more than 4 days after reoperation); (iv)no MRI evidence of aggravating cerebral hemorrhage.
  • No evidence of tumors in the cerebellum, brain stem, optic nerve, olfactory nerve, and pituitary gland.
  • No evidence of meningeal dissemination or gliomatosis cerebri.
  • Prior treatment for newly-diagnosed glioblastoma (or diffuse astrocytoma (Grade II) or anaplastic astrocytoma (Grade III)) with postoperative TMZ administered concomitantly with radiotherapy (>=54 Gy for <=69 years old; >=30 Gy for >=70 years old) and at least for two cycles (5/28d) as an adjuvant treatment have been given.
Show all 16Show fewer
  • No history of prior treatment with stereotactic radiotherapy (ex. Gamma-knife/Cyberknife), proton beam irradiation, neutron capture therapy, and chemotherapies except standard dose TMZ and immunotherapy (vaccines, immune checkpoint inhibitors, antibodies etc.), bevacizumab (12 weeks or more after termination of prior upfront bevacizumab use) that were combined with TMZ, and intraoperative placement of carmustine wafers, for glioblastoma (including diffuse astrocytoma (Grade II) and anaplastic astrocytoma (Grade III) at onset) diagnosed with WHO2007 criteria.
  • Time periods required from the last day of the prior treatment indicated at registration.
  • ①Peptide vaccination, immune checkpoint inhibitors, antibodies: 4 weeks.
  • ②Bevacizumab: 12 weeks.
  • More than 90 days after completion of radiotherapy. For those who underwent reoperation, between 21 and 28 days postoperatively.
  • Age between 20 and 75 years at enrolment.
  • Karnofsky Performance Status >= 60 within 14 days before enrolment.
  • No prior treatment with chemotherapy, molecular targeted therapy, or radiotherapy to head and neck area for other malignancies.
  • Adequate organ function.
  • Written informed consent.

Who cannot join

  • Synchronous or metachronous (within 5 years) malignancy, except for carcinoma in situ or mucosal tumors curatively treated with local therapy
  • Active infection requiring systemic therapy
  • Body temperature >= 38 degrees Celsius at registration
  • Women during pregnancy, possible pregnancy, within 28 days after delivery, or breast-feeding
  • Psychosis or with psychotic symptom
  • Continuous systemic use of immunosuppressant except for steroid
Show all 19Show fewer
  • Uncontrolled diabetes mellitus
  • Unstable angina within 3 weeks, with a history of myocardial infarction within 6 months, or New York Heart Association (NYHA) class II or greater congestive heart failure
  • Inadequately controlled hypertension (cannot be controlled to a systolic pressure of >= 150 mmHg and a diastolic pressure of >= 100 mmHg)
  • History of symptomatic cerebrovascular disorder (including subarachnoid hemorrhage, cerebral infarction and transient ischemic attack) within 6 months or history of vascular disorder requiring intervention (including venous/arterial thrombosis or embolism and aortic aneurysm) within 6 moths
  • History of grade >= 2 hemoptysis within 28 days
  • History of hemorrhagic tendency (e.g., coagulation disorder) or any grade >= 3 hemorrhage within 28 days
  • History of gastrointestinal perforation, fistula, abdominal abscess or uncontrolled peptic ulcer within 6 months
  • Interstitial pneumonia, pulmonary fibrosis, or severe lung emphysema
  • Severe non-healing wound or traumatic fracture at enrolment
  • Hypersensitivity to Chinese Hamster Ovary-derived drugs or other recombinant antibodies
  • Gadolinium allergy
  • Positive HIV antibody
  • Positive Hepatitis B (HB)s antigen

Trial locations and contacts

37 sites in 1 country.

37 sites in 1 country

Japan37 sites
  • Tokyo Medical And Dental University, Medical Hospital

    Bunkyō-Ku, Tokyo, 113-8519

  • Chiba University Hospital

    Chiba, Chiba, 260-8677

  • University of Yamanashi

    Chuo-shi, Yamanashi, 400-8510

  • Kusyu University Graduate School of Medical Sciences

    Fukuoka, 812-8582

  • Saitama Medical University International Medical Center

    Hidaka, Saitama, 350-1298

  • Kansai Medical University

    Hirakata, Osaka, 573-1191

  • Hirosaki University School of Medicine

    Hirosaki, Aomori, 036-8563

  • Hiroshima University Hospital

    Hiroshima, 734-8551

  • Kagoshima University Graduate School of Medical and Dental Sciences

    Kagoshima, 890-8520

  • Kitasato University School of Medicine

    Kanagawa, 252-0374

  • Kobe University Hospital

    Kobe, Hyōgo, 650-0017

  • Kumamoto University Hospital

    Kumamoto, Kumamoto, 860-8556

  • Kurume University Hospital

    Kurume-shi, Fukuoka, 830-0011

  • Kyoto University Graduate School of Medicine

    Kyoto, 606-8507

  • Iwate Medical University

    Morioka, Iwate, 020-8505

  • Nagasaki University Hospital

    Nagasaki, Nagasaki, 852-8501

  • Nagoya University Hospital

    Nagoya, Aichi-ken, 466-8560

  • Niigata University Medical & Dental Hospital

    Niigata, Niigata, 951-8520

  • Okayama University Hospital

    Okayama, Okayama-ken, 700-8558

  • Osaka International Cancer Institute

    Osaka, 541-8567

  • Saga University Hospital

    Saga, Saga-ken, 849-8501

  • Sapporo Medical University Hospital

    Sapporo, Hokkaido, 060-8543

  • Nakamura Memorial Hospital

    Sapporo, 060-8570

  • Hokkaido University Graduate School of Medicine

    Sapporo, 060-8648

  • Tohoku University Graduate School of Medicine

    Sendai, Miyagi, 980-8574

  • Dokkyo Medical University

    Shimotsuge, Tochigi, 321-0293

  • Ehime University Graduate School of Medicine

    Shizukawa, Ehime, 791-0295

  • Shizuoka Canser Center Hospital

    Shizuoka, 411-8777

  • Osaka University Graduate School of Medicine

    Suita, Osaka, 565-0871

  • National Cancer Center Hospital

    Tokyo, 104-0045

  • The University of Tokyo Hospital

    Tokyo, 113-8655

  • Keio University Hospital

    Tokyo, 160-8582

  • Nihon University School of Medicine Itabashi Hospital

    Tokyo, 173-0032

  • Kyorin University Faculty of Medicine, Department of Neurosurgery

    Tokyo, 181-8611

  • Fujita Health University Hospital

    Toyoake, Aichi-ken, 470-1192

  • University of Tsukuba Hospital

    Tsukuba, Ibaraki, 305-8576

  • Yamagata University Hospital

    Yamagata, Yamagata, 990-9585

Other trials in Japan

About this study

Official title: A Multicenter Randomized Phase III Study for Recurrent Glioblastoma Comparing Bevacizumab Alone With Dose-dense Temozolomide Followed by Bevacizumab (JCOG1308C, RE-GEND-pIII)

The aim of this Phase III study is to evaluate the superiority of dose-dense temozolomide (ddTMZ) followed by bevacizumab at ddTMZ failure for glioblastoma at first recurrence or progression, comparing to bevacizumab alone.

Read the detailed description

Glioblastoma (GBM), the most frequent malignant primary brain tumor, has yet been incurable despite recent progress on its standard of care using TMZ as the main trunk of initial therapy in the newly diagnosed setting. One of the main reasons accounting for the dismal prognosis would attribute to lack of active therapeutic regimens at recurrence.

Bevacizumab, a humanized monoclonal antibody against cardinal angiogenic factor vascular endothelial growth factor (VEGF), has recently shown efficacy for recurrent GBM, and has been approved in Japan, thereby being a standard care for recurrent GBM. Since there is no effective drugs or regimens developed at bevacizumab failure, insertion of another active drug prior to bevacizumab induction would enhance survival time for patients with recurrent GBM.

In Japan, there are currently only few chemotherapeutic agents approved and available for GBM. Among them rechallenge with alternating dosing of TMZ have shown certain efficacy with acceptable toxicities for patients with TMZ-pretreated recurrent GBM, thus being a good candidate for the regimen used prior to bevacizumab at recurrence.

The present proposal of sequential administration of dose dense TMZ (7/14d) followed by bevacizumab wishes to define a new standard of care for recurrent disease and hopes to identify the subgroups of patients with progressive or recurrent glioblastoma that respond particularly well to dose-dense temozolomide regimens.

This study is carried out as a JCOG Brain Tumor Study Group multicenter randomized phase III trial under approval by Advanced Medical Care B system, Ministry of Health, Labour and Welfare, Japan.

Keywords
glioblastoma, recurrent, dose-dense temozolomide, bevacizumab
Medical subject headings
Glioblastoma, Recurrence, Disease Progression

What participants receive

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

Study groups in NCT02761070
Study groupRoleWhat they receive
Bevacizumab (BEV) aloneActive comparatorBevacizumab 10 mg/kg, day 1 div, every 2 weeks
Receives: Drug: Bevacizumab
Dose Dense Temozolomide Followed by BEVExperimentalTemozolomide (120 mg/m2, po, 7 days on/7 days off, every 2 weeks per cycle) up to 48 cycles. The dose will be escalated to 150 mg/m2 at 3rd cycle if the defined conditions are met throughout the first 2 cycles. At recurrence or progression, bevacizumab alone(10 mg/kg, day 1 div, every 2 weeks)
Receives: Drug: Temozolomide; Drug: Bevacizumab

What is being measured

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

  1. Overall survival

    Overall survival will be measured from registration until death for any reason. If the patient is alive at last follow-up, the patient will be censored at the last time of confirmation of survival.

    Measured: Time to event. Up to 2 years from the last patient in.

Secondary outcomes (11)
  1. Progression-free survival (PFS)

    Progression free will be measured from registration until the first occurrence of progression or death.

    Measured: Time to event. Up to 2 years from the last patient in.

  2. 6-month progression-free survival (6m-PFS)

    Number of patients without progression at 6 months from registration divided by number of all registered

    Measured: 6 months from registration

  3. Complete response rate

    Complete response rate is defined as the rate of complete response after chemotherapy in cases with measurable lesions through completion/termination of the protocol treatment.

    Measured: Through study completion, an average of 1 year

  4. Response rate

    Response rate is defined as the rate of complete response/partial response after chemotherapy in cases with measurable lesions through completion/termination of the protocol treatment.

    Measured: Through study completion, an average of 1 year

  5. Adverse events

    Each adverse event must be graded as the worst grade observed during the entire treatment period of each treatment protocol according to Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4.0) up to 1 year.

    Measured: Up to 1 year after completion/termination of the protocol treatment.

  6. Serious adverse events

    Each serious adverse event must be recorded according to CTCAE v4.0 up to 1 year.

    Measured: Up to 1 year after completion/termination of the protocol treatment.

  7. Progression-free survival (PFS) from bevacizumab (BEV) initiation

    Progression free from BEV initiation will be measured from the day of initiation of BEV until the first occurrence of progression or death.

    Measured: Time to event from initiation of BEV. Up to 2 years from the last patient in.

  8. 6-month progression-free survival (6m-PFS) after initiation of bevacizumab (BEV) (Experimental Arm Only)

    Number of patients without progression at 6 months from the day of initiation of BEV divided by number of all second-line (BEV) treated in Experimental Arm

    Measured: 6 months from initiation of BEV

  9. Overall survival after initiation of bevacizumab (BEV)

    Overall survival from the day of initiation of BEV until death for any reason. If the patient is alive at last follow-up, the patient will be censored at the last time of confirmation of survival.

    Measured: Time to event from initiation of BEV. Up to 2 years from the last patient in.

  10. MMSE non-deterioration rate

    The MMSE (Mini Mental Status Examination) non-deterioration rate is calculated from the number of patients who underwent baseline MMSE evaluation prior to initiation of protocol treatment as a denominator and the number of those whose MMSE score (normal (30-24), mild decrease (23-20), intermediate decrease (19-10), severe decrease (9-0)) at 16 weeks improved or maintained from that at baseline as a numerator among all eligible patients.

    Measured: MMSE non-deterioration rates will be calculated at 8 and 24 weeks after initiation of protocol treatment

  11. KPS non-deterioration rate

    The KPS non-deterioration rate is calculated from the number of patients whose KPS was recorded prior to initiation of protocol treatment as a denominator and the number of those whose KPS score at 16 weeks improved or maintained from that at baseline as a numerator among all eligible patients. In case KPS is not recorded, it is considered as deterioration.

    Measured: KPS non-deterioration rates will be calculated at 8 and 24 weeks after initiation of protocol treatment

Timeline

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

  1. First posted4 May 2016 (estimated)
  2. Study start11 Jul 2016
  3. Primary completion17 Apr 2025
  4. Study completion17 Apr 2025

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
146 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02761070
Sponsor's protocol ID
JCOG1308C
Acronym
RE-GEND
Status last verified
Aug 2026
First submitted
28 Apr 2016
Last updated
7 Aug 2026
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Temozolomide and Bevacizumab in people with Glioblastoma and Recurrence, run by Kyorin University at 37 sites in Japan.

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 16 inclusion and 19 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: finished, as of the sponsor's last update on 7 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 37 sites in Japan. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Overall survival (time frame: Time to event. Up to 2 years from the last patient in.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 7 Aug 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in