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AstrocytomaPhase 2TUVASTRATNCT07417761

Tuvusertib in Astrocytoma With ATRX Mutation

A Phase 2 study testing Tuvusertib in people with Astrocytoma, run by Grupo Español de Investigación en Neurooncología at 10 sites in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The TUVASTRAT study is a phase 2, non-randomized, two.cohort, CRS clinical trial of tuvusertib in patients with first recurrence of IDH1/2-mutated, ATRX-mutated and p53-mutated astrocytoma (Grade 2-4 from WHO classification). The mutational status of IDH (required for diagnosis) is also required. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Astrocytoma
What is being tested?
Tuvusertib
Could I receive a placebo?
No, everyone receives an active treatment
How many people
56 participants
Where
10 sitesSpain
Study dates
19 Dec 2025to Sep 2028
Phase
Phase 2
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent approved by the Independent Ethics Committee (IEC), prior to the performance of any trial activities.
  • Patients, males and females, ≥ 18 years of age at the time of signing the informed consent.
  • Patients with Karnofsky performance status (KPS) index > 60% (Appendix 5).
  • Diagnosis of Grade 2-4 astrocytoma, IDH-mutated according to the 2021 WHO classification.
  • Patients must have confirmed ATRX mutation (IHC or NGS sequencing) and p53 mutation (NGS sequencing). Evaluation of CDKN2A also is required by FISH or NGS.
  • Patients must have progressive disease and evaluable disease according to RANO 2.0 criteria. All patients should have MRI contrast enhancement disease.
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  • Patients must have undergone previous standard treatment with radiotherapy and chemotherapy (procarbazine, lomustine and vincristine [PCV] or temozolomide [TMZ]).
  • Stable corticosteroid doses during the 2 weeks previous to the first dose of tuvusertib, maximum dose of dexamethasone 4 mg/day or equivalent.
  • Adequate hematologic, hepatic and renal function as follows:
  • Platelet count ≥ 100,000/mm3,
  • Hemoglobin ≥ 9.0 g/dL,
  • Absolute neutrophil count ≥ 1,500/μL with no growth factor treatment within the last 14 days,
  • Total bilirubin level ≤ 1.5 × upper limit of normal (ULN) (if Gilbert's Syndrome may have total bilirubin > 1.5 × ULN),
  • Aspartate aminotransferase (AST) level ≤ 3 × ULN, and an alanine aminotransferase (ALT) level ≤ 3 × ULN.
  • Serum creatinine ≤ 1.5 × ULN. If serum creatinine is > 1.5 × ULN, creatinine clearance needs to be ≥ 50 mL/min, as estimated by Cockcroft-Gault
  • Contraceptive use by males or females will be consistent with local regulations on contraception methods for those participating in clinical studies.
  • Patients able to take oral medications.
  • Willingness and ability of patients to comply with the protocol for the duration of the study including undergoing treatment as well as availability for scheduled visits and examinations including follow-up.

Who cannot join

  • Patients with radiographic recurrence without contrast enhancement by MRI.
  • Leptomeningeal dissemination and/or extracranial metastases.
  • Patients who received more than 1 previous systemic line of treatment for astrocytoma.
  • Patients who received previous treatment with bevacizumab.
  • Persistence of AEs related to any prior treatments that have not recovered to Grade ≤ 1 unless AEs are clinically nonsignificant (e.g. alopecia) and/or stable on supportive therapy in the opinion of the Investigator.
  • No prior ATR inhibitor and/or CHK1 inhibitor.
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  • Concurrent treatment with a non permitted drug/intervention:
  • Prohibited concomitant medication, as listed in Section 7.8.
  • Anticancer treatment within 30 days or 5 half-lives, whichever is shorter, prior to Day 1 of study intervention (6 weeks for nitrosoureas or mitomycin C).
  • Prior palliative radiotherapy to metastatic lesion(s) is permitted provided it was completed ≥ 12 weeks prior to study intervention administration and participants have recovered from all related radiotherapy toxicities to Grade ≤ 1.
  • Another investigational drug within 30 days or 5 half-lives, whichever is shorter, prior to start of tuvusertib administration.
  • Increasing dose of corticoids.
  • Received hematopoietic growth factor (e.g., granulocyte colony-stimulating factor, erythropoietin) within 14 days prior to the first dose of tuvusertib.
  • Significant cardiac disease:
  • Unstable angina, myocardial infarction, congestive heart failure ≥ stage II) or a coronary revascularization procedure within 180 days of study entry.
  • Calculated QTc average (using the Fridericia correction calculation) of > 450 msec for males and > 470 msec for females.
  • Uncontrolled hypertension.
  • Active and/or uncontrolled infection. The following exceptions apply:
  • Participants with HIV infection are eligible if they are on effective antiretroviral therapy with undetectable viral load within 6 months, provided there is no expected drug-drug interaction
  • Participants with evidence of chronic HBV infection are eligible if the HBV viral load is undetectable on suppressive therapy (if indicated), and if they have ALT, AST, and total bilirubin levels < ULN, and provided there is no expected drug-drug interaction
  • Participants with a history of HCV infection are eligible if they have been treated and cured. For participants with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load, and if they have ALT, AST, and total bilirubin levels < ULN.
  • 11. Treatment with live or live attenuated vaccine within 30 days of dosing.
  • 12. Known hypersensitivity to the components of tuvusertib.
  • 13. Major surgery (as deemed by the Investigator) for any reason, except diagnostic biopsy, within 4 weeks of the study intervention and/or if the patient has not fully recovered from the surgery within 4 weeks of the study intervention.

Trial locations and contacts

10 sites in 1 country. Contact the study team or a site near you to ask about taking part.

GEINO Secretary contact

0034934344412

secretaria@geino.es

10 sites in 1 country

Spain10 sites, 10 recruiting
  • Hospital Universitario de Cruces

    Barakaldo, Bizkaia, 48903

    Responsible person Designated by the Sponsor, 0034934344412, investigacion@mfar.net

    Principal investigator Designated by the Sponsor, MD

    Recruiting
  • Hospital Universitario Vall d'Hebron

    Barcelona, Barcelona, 08035

    Responsible person Designated by the Sponsor, 0034934344412, investigacion@mfar.net

    Principal investigator Designated by the Sponsor, MD

    Recruiting
  • Hospital Clinic de Barcelona

    Barcelona, Barcelona, 08036

    Responsible person Designated by the Sponsor, 0034934344412, investigacion@mfar.net

    Principal investigator Designated by the Sponsor, MD

    Recruiting
  • Hospital Universitario Virgen de las Nieves

    Granada, Granada, 18014

    Responsible person Designated by the Sponsor, 0034934344412, investigacion@mfar.net

    Principal investigator Designated by the Sponsor, MD

    Recruiting
  • Hospital Universitario Ramón y Cajal

    Madrid, Madrid, 28034

    Responsible person Designated by the Sponsor, 0034934344412, Investigacion@mfar.net

    Principal investigator Designated by the Sponsor, MD

    Recruiting
  • Hospital Universitario Son Espases

    Palma de Mallorca, Balearic Islands, 07120

    Responsible person Designated by the Sponsor, 0034934344412, investigacion@mfar.net

    Principal investigator Designated by the Sponsor, MD

    Recruiting
  • Hospital Clínico Universitario de Salamanca

    Salamanca, Salamanca, 37007

    Resposible person Designated by the Sponsor, 0034934344412, investigacion@mfar.net

    Principal investigator Designated by the Sponsor, MD

    Not yet recruiting
  • Hospital Universitario Virgen del Rocío

    Seville, Sevilla, 41013

    Responsible person Designated by the Sponsor, 0034934344412, investigacion@mfar.net

    Principal investigator Designated by the Sponsor, MD

    Recruiting
  • Hospital Clínico Universitario de Valencia - INCLIVA

    Valencia, Valencia, 46010

    Responsible person Designated by the Sponsor, 0034934344412, investigacion@mfar.net

    Principal investigator Designated by the Sponsor, MD

    Recruiting
  • Hospital Álvaro Cunqueiro

    Vigo, Pontevedra, 36312

    Responsible person Designated by the Sponsor, 0034934344412, investigacion@mfar.net

    Principal investigator Designated by the Sponsor, MD

    Recruiting

Other trials in Spain

About this study

Official title: Efficacy of Tuvusertib in Recurrent IDH Mutant Astrocytoma With ATRX Mutation, a Phase II Prospective Trial.

The TUVASTRAT study is a phase 2, non-randomized, two.cohort, CRS clinical trial of tuvusertib in patients with first recurrence of IDH1/2-mutated, ATRX-mutated and p53-mutated astrocytoma (Grade 2-4 from WHO classification). The mutational status of IDH (required for diagnosis) is also required. CDKN2A and ATRX will be also determined locally as per standard of care.

All enrolled patients should have received first-line chemotherapy and have reported a contrast enhanced PD. Eligible patients are enrolled in two cohorts depending on their eligibility to undergo rescue surgery:

Read more
  • Cohort A: First recurrence of IDH1/2-mutated, ATRX-mutated astrocytoma NOT eligible for rescue surgery.
  • Cohort B: First recurrence of IDH1/2-mutated, ATRX-mutated astrocytoma candidates to rescue surgery.

The primary hypothesis is that treatment with tuvusertib, an ATR inhibitor, will improve the efficacy outcomes and increase the 6-months PFS rate from 45% reported by the standard therapies up to 65% in patients with recurrent IDH-mutated astrocytomas with ATRX mutation.

Clinic visits will occur every 3 weeks ±3 days. Tumor assessments by MRI according to RANO 2.0 criteria will be performed at baseline, and every 12 weeks +/-2 weeks (Q12W) until PD, patient withdrawal, start of new treatment line or death. This schedule must be maintained regardless of any delays in dosing. After the first suspect of progression, we recommend a second MRI at 4-8 weeks to confirm the progression, except if there is clinical progression. The MRI imaging will be assessed by PI and central radiologists.

The trial includes the assessment of safety (AEs, comorbidities) throughout the study period at every visit, the collection of health-related patient reported outcomes through validated questionnaires at baseline, coincident with the tumor assessments and at the safety visit. Neurologic / neurocognitive status will be assessed through validated tests administered by the physicians. Additionally, ATRX, IDH, P53 and CDK2A mutations will be centrally reviewed in tumor biopsies or archival tumor tissue obtained as close as possible to the baseline. PKs will be determined in sparse peripheral blood samples during the treatment phase.

The study includes a data safety monitoring committee (DSMC) to regularly review safety and efficacy. The DSMC will review efficacy and safety at least yearly and more frequently if deemed necessary.

Conditions
Astrocytoma
Being tested
Tuvusertib
Keywords
Tuvusertib, Astrocytoma, IDH mutated, ATRX mutated
Medical subject headings
Astrocytoma

What participants receive

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

  • TuvusertibDrug

    All patients will receive tuvusertib at the recommended dose (for) expansion (RDE) of 180 mg daily (QD) during 2 weeks on and 1 week off.

Study groups in NCT07417761
Study groupRoleWhat they receive
Tuvusertib treatmentExperimentalTUVASTRAT is a study including patients with first recurrence of IDH1/2-mutated, ATRX-mutated and p53-mutated astrocytoma (Grade 2-4 from world health organization [WHO] classification). All enrolled patients should have received first-line chemotherapy as per standard clinical practice and have evidence of tumor progression with contrast enhancement. Patients included will be of the following two subgroups: Cohort A: First recurrence of IDH1/2-mutated, ATRX-mutated astrocytoma NOT eligible for rescue surgery. Cohort B: First recurrence of IDH1/2-mutated, ATRX-mutated astrocytoma candidates to rescue surgery.
Receives: Drug: Tuvusertib

What is being measured

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

  1. 6-months progression-free survival (PFS) rate

    defined as the proportion of patients alive and free of progression according to RANO 2.0 estimated by Kaplan-Meier.

    Measured: At 6 months after the first dose of tuvusertib

Secondary outcomes (12)
  1. Objective response (ORR)

    defined as the percentage of patients who have achieved complete response (CR), or partial response (PR) as their best response throughout the study locally assessed by investigators and by central radiologists by magnetic resonance imaging (MRI) following RANO criteria v2.0

    Measured: Throughout the study period, approximately an average of 2 year

  2. Progression-free survival (PFS)

    defined as the time from the first tuvusertib dosing date until the first documentation of disease progression or death from any cause, whichever occurs first. This endpoint will be locally assessed by investigators by magnetic resonance imaging (MRI) following RANO criteria v2.0. The median estimated by kaplan-Meier will be reported.

    Measured: Throughout the study period, approximately an average of 2 year

  3. Overall survival (OS)

    defined as the time from the first tuvusertib dosing date to the date of death from any cause. The median estimated by kaplan-Meier will be reported.

    Measured: Throughout the study period, approximately an average of 2 year

  4. Time to Next Intervention (TTNI)

    defined as the time from the first tuvusertib dosing date to the initiation of the first subsequent anticancer therapy (surgery, radiotherapy, chemotherapy or any antitumoral systemic treatment)

    Measured: Throughout the study period, approximately an average of 2 year

  5. Neurocognitive function changes by Hopkins Verbal Learning Test-Revised (HVLT-R)

    Patients are assessed by means of validated neurocognition tests: Hopkins Verbal Learning Test-Revised (HVLT-R). A numerical value is attributed to each patient in baseline and the changes of that in subsequent assessments will be calculated as percentage decrease / increase. Here we report the number of patients experiencing an increase (better) or decrease (worse) in their neurocognitive function throughout the study.

    Measured: Throughout the study period, approximately an average of 2 year

  6. Neurocognitive function changes by Trail Making Test (TMT-A and TMT-B)

    Patients are assessed by means of validated neurocognition tests: Trail Making Test (TMT-A and TMT-B). A numerical value is attributed to each patient in baseline and the changes of that in subsequent assessments will be calculated as percentage decrease / increase. Here we report the number of patients experiencing an increase (better) or decrease (worse) in their neurocognitive function throughout the study.

    Measured: Throughout the study period, approximately an average of 2 year

  7. Neurocognitive function changes by , Controlled Oral Word Association Test (COWA)

    Patients are assessed by means of validated neurocognition tests: Controlled Oral Word Association Test (COWA). A numerical value is attributed to each patient in baseline and the changes of that in subsequent assessments will be calculated as percentage decrease / increase. Here we report the number of patients experiencing an increase (better) or decrease (worse) in their neurocognitive function throughout the study.

    Measured: Throughout the study period, approximately an average of 2 year

  8. Neurologic status changes by Mini Mental Test

    Patients are assessed by means of validated Neurologic Assessment in Mini Mental tests. A numerical value is attributed to each patient in baseline and the changes of that in subsequent assessments will be calculated as percentage decrease / increase. Here we report the number of patients experiencing an increase (better) or decrease (worse) in their neurologic status throughout the study.

    Measured: Throughout the study period, approximately an average of 2 year

  9. Neurologic status changes by Neuro-Oncology Test

    Patients are assessed by means of validated Neurologic Assessment in Neuro-Oncology Test (NANO). A numerical value is attributed to each patient in baseline and the changes of that in subsequent assessments will be calculated as percentage decrease / increase. Here we report the number of patients experiencing an increase (better) or decrease (worse) in their neurologic status throughout the study.

    Measured: Throughout the study period, approximately an average of 2 year

  10. Functional status changes

    Patients are assessed by means of Barthel test and Karnofsky performance status (KPS) scale. A numerical value is attributed to each patient in baseline and the changes of that in subsequent assessments will be calculated as percentage decrease / increase. Here we report the number of patients experiencing an increase (better) or decrease (worse) in their functional status throughout the study.

    Measured: Throughout the study period, approximately an average of 2 year

  11. Treatment compliance

    Number of patients who experience tuvusertib dose delays and interruptions due to toxicities

    Measured: Throughout the study period, approximately an average of 2 year

  12. Global quality of life (QoL) changes

    assessed through the national cancer institute (NCI) - patient reported outcomes (PRO) -Common terminology Criteria for Adverse Events (CTCAE) Custom Survey questionnaire, and the Patient Global Impression of Change (PGIC) questionnaire. A numerical value is attributed to each patient in baseline and the changes of that in subsequent assessments will be calculated as percentage decrease / increase. Here we ONLY report the number of patients experiencing an increase (better) or decrease (worse) in their global QoL Score, being an unique measure or endpoint.

    The global value is to be reported, no more than one outcome.

    Measured: Throughout the study period, approximately an average of 2 year

Timeline

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

  1. First posted18 Feb 2026
  2. Study start19 Dec 2025
  3. Primary completionSep 2028 (estimated)
  4. Study completionSep 2028 (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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
56 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07417761
Sponsor's protocol ID
GEINO-2401
Other IDs
2025-521843-19-00, 2025
Acronym
TUVASTRAT
Status last verified
Feb 2026
First submitted
2 Jan 2026
Last updated
2 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Tuvusertib in people with Astrocytoma, run by Grupo Español de Investigación en Neurooncología at 10 sites in Spain.

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 18 inclusion and 24 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: looking for participants now, as of the sponsor's last update on 2 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 10 sites in Spain. 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 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?

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?

Contact GEINO Secretary (0034934344412, secretaria@geino.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

6-months progression-free survival (PFS) rate (time frame: At 6 months after the first dose of tuvusertib). 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 2 Apr 2026.

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