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GlioblastomaPhase 1/2GLIOSTARNCT04573192

A Study to Evaluate Safety and Efficacy of L19TNF Plus Lomustine in Patients With Glioblastoma at First Progression

A Phase 1/2 study testing L19TNF and Lomustine in people with Glioblastoma, run by Philogen S.p.A. at 15 sites in 4 countries.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

Glioblastomas are the most common and most aggressive primary brain tumors in adults. The prognosis is poor despite multimodal therapy with surgery, radiotherapy and chemotherapy. Therefore, novel treatments are urgently needed. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Glioblastoma
What is being tested?
L19TNF and Lomustine
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
142 participants
Where
15 sitesin 4 countries
Study dates
19 Feb 2021to Dec 2025
Phase
Phase 1/2
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female, age ≥18.
  • Patients with histologically confirmed glioblastoma at unequivocal first recurrence or progression according to RANO criteria.
  • MGMT promotor methylation status known
  • IDH wildtype.
  • Patients may have undergone surgery for recurrence.
  • For operated patients: The histological report must document glioblastoma recurrence and a new MRI will need to be done at 3-5 weeks after surgery (directly before study treatment start). Study treatment will need to start minimum 4 weeks to maximum 6 weeks after surgery.
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  • Karnofsky Performance Status (KPS) ≥ 70%.
  • Documented negative test for HIV-HBV-HCV. For HBV serology, the determination of HBsAg and anti-HBcAg Ab is required. In patients with serology documenting previous exposure to HBV, negative serum HBV-DNA is required. For HCV, HCV-RNA or HCV antibody test is required. Subjects with a positive test for HCV antibody but no detection of HCV-RNA indicating no current infection are eligible.
  • Female patients: female patients must be either documented not Women Of Childbearing Potential (WOCBP)* or must have a negative pregnancy test within 14 days of starting treatment. Additionally WOCBP must agree to use, from the screening to 6 months following the last study drug administration, highly effective contraception methods, as defined by the "Recommendations for contraception and pregnancy testing in clinical trials" issued by the Head of Medicine Agencies' Clinical Trial Facilitation Group (www.hma.eu/ctfg.html) and which include, for instance, progesterone-only or combined (estrogen- and progesterone-containing) hormonal contraception associated with inhibition of ovulation, intrauterine devices, intrauterine hormone-releasing systems, bilateral tubal occlusion or vasectomized partner.
  • Male patients: male subjects able to father children must agree to use two acceptable methods of contraception throughout the study (e.g. condom with spermicidal gel). Double-barrier contraception is required.
  • Personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study.
  • Willingness and ability to comply with the scheduled visits, treatment plan, laboratory tests and other study procedures.
  • Women of childbearing potential are defined as females who have experienced menarche, are not postmenopausal (12 months with no menses without an alternative medical cause) and are not permanently sterilized (e.g., tubal occlusion, hysterectomy, bilateral oophorectomy, or bilateral salpingectomy).

Who cannot join

  • Prior treatment for glioblastoma at recurrence, except surgery.
  • Surgical resection or biopsy of glioma within 4 weeks of the start of study treatment.
  • Inability to undergo contrast-enhanced MRI.
  • Prior treatment with lomustine.
  • Known history of allergy to TNF or lomustine, any excipient in the study medication or any other intravenously administered human proteins/peptides/antibodies.
  • Absolute neutrophil count (ANC) < 1.5 x 10^9/L; platelets < 100 x 10^9/L or haemoglobin (Hb) < 9.0 g/dl.
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  • Chronically impaired renal function as indicated by creatinine clearance < 60 mL/min or serum creatinine > 1.5 ULN.
  • Inadequate liver function (ALT, AST, ALP ≥ 2.5 x ULN or total bilirubin ≥ 2.0 x ULN).
  • INR > 1.5 ULN.
  • Any severe concomitant condition which makes it undesirable for the patient to participate in the study or which could jeopardize compliance with the protocol, in the opinion of the investigator.
  • Active or history of autoimmune disease that might deteriorate when receiving an immuno-stimulatory agent, in the judgement of the investigator.
  • History within the last year of cerebrovascular disease and/or acute or subacute coronary syndromes including myocardial infarction, unstable or severe stable angina pectoris.
  • Heart insufficiency (> Grade II, New York Heart Association (NYHA) criteria).
  • Clinically significant cardiac arrhythmias or requiring permanent medication.
  • LVEF <55% or any other abnormalities observed during baseline ECG and echocardiogram investigations that are considered as clinically significant by the investigator. Subjects with current or a history of QT/QTc prolongation are excluded.
  • Uncontrolled hypertension.
  • Known arterial aneurism at high risk of rupture.
  • Ischemic peripheral vascular disease (Grade IIb-IV according to Leriche-Fontaine classification).
  • Medically documented history of or active major depressive episode, bipolar disorder (I or II), obsessive-compulsive disorder, schizophrenia, a history of suicidal attempt or ideation, or homicidal ideation (e.g. risk of doing harm to self or others), or patients with active severe personality disorders.
  • Anxiety ≥ CTCAE Grade 3.
  • Severe diabetic retinopathy such as severe non-proliferative retinopathy and proliferative retinopathy.
  • Major trauma including major surgery (such as abdominal/cardiac/thoracic surgery) within 4 weeks of administration of study treatment.
  • Known history of tuberculosis.
  • Pregnancy or breast feeding.
  • Requirement of chronic administration of high dose corticosteroids or other immunosuppressant drugs. Subjects must have been either off corticosteroids, or on a stable or decreasing dose ≤ 4 mg daily dexamethasone (or equivalent) for 7 days prior to start of treatment. Limited or occasional use of corticosteroids to treat or prevent acute adverse reactions is not considered an exclusion criterion.
  • Presence of active and uncontrolled infections or other severe concurrent disease, which, in the opinion of the investigator, would place the patient at undue risk or interfere with the study.
  • Concurrent malignancies unless the patient has been disease-free without intervention for at least 2 years.
  • Growth factors or immunomodulatory agents within 7 days prior to the administration of study treatment.
  • Serious, non-healing wound, ulcer, or bone fracture.
  • Anticoagulation therapy with P2Y12 antagonists (e.g., clopidogrel, ticagrelor) and vitamin K antagonists (e.g., phenprocoumon, warfarin).
  • Requirement of concurrent use of other anti-cancer treatments or agents other than study medication.
  • Any live vaccination within 4 weeks prior to treatment or plan to receive live vaccination during the study.

Trial locations and contacts

15 sites in 4 countries.

Teresa Hemmerle, PhD contact

+390577017816

regulatory@philogen.com

Marco Taras contact

regulatory@philogen.com

15 sites in 4 countries

Italy5 sites, 5 recruiting
  • Azienda USL di Bologna IRCCS delle Scienze Neurologiche di Bologna

    Bologna

    Enrico Franceschi

    Recruiting
  • Fondazione IRCCS Istituto Neurologico Carlo Besta

    Milan

    Antonio Silvani

    Recruiting
  • Istituto Oncologico Veneto IRCCS

    Padova

    Giuseppe Lombardi

    Recruiting
  • Azienda Ospedaliero-Universitaria Senese Policlinico Le Scotte

    Siena

    Anna Maria Di Giacomo

    Not yet recruiting
  • AOU Città della Salute e della Scienza di Torino

    Torino

    Alessia Pellerino

    Not yet recruiting

Other trials in Italy

Germany4 sites, 4 recruiting
  • University Hospital Bonn

    Bonn

    Ulrich Herrlinger

    Recruiting
  • University Hospital Köln

    Cologne

    Norbert Galldiks

    Not yet recruiting
  • Klinikum rechts der Isar

    München

    Meike Mitsdörffer

    Recruiting
  • Universitatsklinikum Tubingen

    Tübingen

    Ghazaleh Tabatabai

    Recruiting

Other trials in Germany

France3 sites, 3 recruiting
  • Hôpital Neurologique Pierre Wertheimer

    Bron

    François Ducray

    Not yet recruiting
  • Hôpital Saint Louis

    Paris

    Stefania Cuzzubbo

    Not yet recruiting
  • Sorbonne University, AP-HP, Paris brain institute

    Paris

    Ahmed Idbaih

    Not yet recruiting

Other trials in France

Switzerland3 sites, 3 recruiting
  • Inselspital Universitätsklinik für Medizinische Onkologie Bern

    Bern

    Marc Wehrli

    Recruiting
  • Centre Hospitalier Universitaire Vaudois (CHUV)

    Lausanne

    Andreas Hottinger

    Recruiting
  • Universitatspital Zurich - Klinik fur Neurologie & Hirntumorzentrum

    Zurich, CH-8091

    Tobias Weiss, MD, +41 44 255 11 11

    Recruiting

Other trials in Switzerland

About this study

Official title: A Study to Evaluate the Safety and Efficacy of the Tumor-targeting Human Antibody-cytokine Fusion Protein L19TNF Plus Lomustine in Patients With Glioblastoma at First Progression

Glioblastomas are the most common and most aggressive primary brain tumors in adults. The prognosis is poor despite multimodal therapy with surgery, radiotherapy and chemotherapy. Therefore, novel treatments are urgently needed.

L19TNF is a fully human fusion protein consisting of human tumor necrosis factor (TNF)-α fused to the L19 antibody in scFv format, specific to the extra-domain B of fibronectin. TNF not only induces apoptosis or necrosis in certain target cells, but also exerts inflammation and immunity. L19TNF selectively delivers TNF to the tumor site to spare normal tissues from undesired toxicity. Preclinical experiments with L19TNF have demonstrated tumor growth retardation in various mouse tumor models including models of glioma.

Conditions
Glioblastoma
Being tested
L19TNF, Lomustine
Medical subject headings
Glioblastoma

What participants receive

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

  • L19TNFDrug

    Also called onfekafusp alfa

    Cohort 1: 10 µg /kg L19TNF i.v. plus 90 mg/m2 lomustine Cohort 2: 10 µg /kg L19TNF i.v. plus 110 mg/m2 lomustine Cohort 3: 13 µg /kg L19TNF i.v. plus 110 mg/m2 lomustine

  • LomustineDrug

    Cohort 1: 10 µg /kg L19TNF i.v. plus 90 mg/m2 lomustine Cohort 2: 10 µg /kg L19TNF i.v. plus 110 mg/m2 lomustine Cohort 3: 13 µg /kg L19TNF i.v. plus 110 mg/m2 lomustine

Study groups in NCT04573192
Study groupRoleWhat they receive
Phase 1 part: Dose FindingExperimentalPhase I part: Dose Finding Patients will be treated in cohorts according to a traditional 3+3 design with lomustine on Day 1 and L19TNF on Days 1, 3 and 5, and on Days 22, 24 and 26, of a 42-days cycle at different dose levels. The RD will be confirmed following a traditional 3+3 design. Cohort 1: 10 µg /kg L19TNF i.v. plus 90 mg/m2 lomustine Cohort 2: 10 µg /kg L19TNF i.v. plus 110 mg/m2 lomustine Cohort 3: 13 µg /kg L19TNF i.v. plus 110 mg/m2 lomustine The dose of 13 ug/kg L19TNF will be declared the RD in case none of three or not more than one out of 6 patients experienced a DLT. Dose limiting toxicity will be assessed during the dose-escalation from Day 1 through Day 42 after the first administration of lomustine and study drug (Cycle 1). Not more than 2 patients might be treated simultaneously in Cycle 1.
Receives: Drug: L19TNF; Drug: Lomustine
Phase II part: Signal SeekingExperimental118 Patients will be randomized 1:1 and treated with either lomustine on day 1 and L19TNF on Days 1, 3 and 5, and on Days 22, 24, and 26 of a 42-days cycle at the RD established in the phase I part of the study or with lomustine on day 1 of a 42-days cycle. * Treatment Arm 1: L19TNF plus Lomustine * Treatment Arm 2: Lomustine
Receives: Drug: L19TNF; Drug: Lomustine

What is being measured

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

  1. For Phase 1: DLT

    Occurrence of dose limiting toxicity (DLT) assessed by frequency and grade of adverse events (AE) according to CTCAE v.5.0.

    Measured: For Cohort 1 to Cohort 3 from Day 1 to Day 42 after the first administration of lomustine and study drug (Cycle 1)

  2. For Phase 2: Overall Survival

    Overall survival (OS) rate

    Measured: From beginning of treatment to 12 months

Secondary outcomes (6)
  1. PFS

    Progression-free survival (PFS) based on iRANO criteria and a standardized MRI protocol will be assessed for all enrolled subjects.

    Measured: From the date of enrollment to the date of progression or death for any cause, whichever came first, assessed up to 52 weeks

  2. PFS-rate at 6 months

    Progression-free survival (PFS) based on iRANO criteria and a standardized MRI protocol will be assessed for all enrolled subjects

    Measured: From the date of enrollment to the date of progression or death for any cause, whichever came first, assessed up to 6 months

  3. OS-rate at 12 months

    Measured: From beginning of treatment to 12 months

  4. Adverse Events (AE)

    Safety of administration of L19TNF, through an assessed by Common Toxicity Criteria (version 5.0, CTCAE)

    Measured: Throughout study completion for each patient, a maximum of 52 weeks for each patient

  5. Serious Adverse Events (AE)

    Safety of administration of L19TNF, assessed by Common Toxicity Criteria (version 5.0, CTCAE)

    Measured: Throughout study completion for each patient, a maximum of 52 weeks for each patient

  6. Safety (DILI)

    Evaluation of possible Drug Induce Liver Injury, caused by L19TNF, assessed by Common Toxicity Criteria (version 5.0, CTCAE)

    Measured: Throughout study completion for each patient, a maximum of 52 weeks for each patient

Timeline

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

  1. First posted5 Oct 2020
  2. Study start19 Feb 2021
  3. Primary completionMar 2025 (estimated)
  4. Study completionDec 2025 (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 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Open label phase I/II study in subjects with glioblastoma at first progression.
Masking
None (open label)
Enrolment
142 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04573192
Sponsor's protocol ID
PH-L19TNFCCNU-02/20
Acronym
GLIOSTAR
Status last verified
Apr 2024
First submitted
25 Sep 2020
Last updated
8 Apr 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Look T, Puca E, Buhler M, Kirschenbaum D, De Luca R, Stucchi R, Ravazza D, Di Nitto C, Roth P, Katzenelenbogen Y, Weiner A, Rindlisbacher L, Becher B, Amit I, Weller M, Neri D, Hemmerle T, Weiss T. Targeted delivery of tumor necrosis factor in combination with CCNU induces a T cell-dependent regression of glioblastoma. Sci Transl Med. 2023 May 24;15(697):eadf2281. doi: 10.1126/scitranslmed.adf2281. Epub 2023 May 24.

    PubMed 37224228

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing L19TNF and Lomustine in people with Glioblastoma, run by Philogen S.p.A. at 15 sites in 4 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 13 inclusion and 32 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: status not confirmed, as of the sponsor's last update on 8 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in Italy, Germany, France, Switzerland. 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 combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

Results are not available in the source record.

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

Contact Teresa Hemmerle, PhD (+390577017816, regulatory@philogen.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

For Phase 1: DLT (time frame: For Cohort 1 to Cohort 3 from Day 1 to Day 42 after the first administration of lomustine and study drug (Cycle 1)). The study lists 2 primary outcomes in all. 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 NCT04573192, which also lists 1 linked publication.

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 8 Apr 2024.

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