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Brief Title: DAY101 vs. Standard of Care Chemotherapy in Pediatric Patients With Low-Grade Glioma Requiring First-Line Systemic Therapy (LOGGIC/FIREFLY-2)
Official Title: LOGGIC/FIREFLY-2: A Phase 3, Randomized, International Multicenter Trial of DAY101 Monotherapy Versus Standard of Care Chemotherapy in Patients With Pediatric Low-Grade Glioma Harboring an Activating RAF Alteration Requiring First-Line Systemic Therapy
Study ID: NCT05566795
Brief Summary: This is a 2-arm, randomized, open-label, multicenter, global, Phase 3 trial to evaluate the efficacy, safety, and tolerability of tovorafenib monotherapy versus standard of care (SoC) chemotherapy in patients with pediatric low-grade glioma (LGG) harboring an activating rapidly accelerated fibrosarcoma (RAF) alteration requiring front-line systemic therapy.
Detailed Description: Approximately 400 treatment-naïve low-grade glioma patients will be randomized 1:1 to either tovorafenib (Arm 1) or an Investigator's choice of SoC chemotherapy (Arm 2). Arm 1 (tovorafenib): treatment cycles will repeat every 28 days in the absence of disease progression. Patients will continue tovorafenib until any of the following occurs: disease progression based on Response Assessment in Neuro-Oncology (RANO-LGG) criteria, unacceptable toxicity, withdrawal of consent to treatment, or end of study. Arm 2 (Investigator's Choice of SoC Chemotherapy): patients will receive one of 3 SoC chemotherapy options selected by the treating Investigator: Children's Oncology Group - Vincristine/Carboplatin (COG-V/C) regimen, International Society for Paediatric Oncology - Low-Grade Glioma Vincristine/Carboplatin (SIOPe-LGG-V/C) regimen, or vinblastine (VBL) regimen. The choice of SoC chemotherapy regimen will be selected prior to patient randomization. Treatment will continue until completion of therapy or until any of the following occurs: disease progression based on RANO-LGG criteria, unacceptable toxicity, withdrawal of consent to treatment, or end of study. Patients who discontinue treatment due to disease progression will have (1) radiographic evidence of progressive disease based on RANO-LGG, as determined by the Investigator and confirmed by the IRC, or (2) clinical progression based on RANO-LGG criteria determined by the Investigator. Investigators are encouraged to discuss cases of clinical progression and early radiographic progression without clinical symptom with the Sponsor Medical Monitor prior to treatment discontinuation or initiation of a different form of treatment for the malignancy. Patients may continue therapy beyond progressive disease
Minimum Age:
Eligible Ages: CHILD, ADULT
Sex: ALL
Healthy Volunteers: No
Children's of Alabama, Birmingham, Alabama, United States
Phoenix Children's Hospital, Phoenix, Arizona, United States
Children's Hospital Los Angeles, Los Angeles, California, United States
UCSF Benioff Children's Hospital, San Francisco, California, United States
Children's Hospital Colorado, Aurora, Colorado, United States
Children's National Medical Center, Washington, District of Columbia, United States
Arnold Palmer Hospital for Children, Orlando, Florida, United States
Children's Healthcare of Atlanta, Atlanta, Georgia, United States
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, United States
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
University of Michigan - - C.S. Mott Children's Hospital, Ann Arbor, Michigan, United States
St. Louis Children's Hospital, Saint Louis, Missouri, United States
New York University Langone Health, New York, New York, United States
University of Rochester, Rochester, New York, United States
Duke Cancer Institute, Durham, North Carolina, United States
University of Texas Southwestern Medical Center, Dallas, Texas, United States
Texas Children's Hospital, Houston, Texas, United States
Seattle Children's Hospital, Seattle, Washington, United States
Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
Perth Children's Hospital, Nedlands, , Australia
Women's and Children's Health Network, North Adelaide, , Australia
The Royal Children's Hospital - Children's Cancer Centre, Parkville, , Australia
Sydney Children's Hospital - Randwick, Randwick, , Australia
Children's Hospital at Westmead, Westmead, , Australia
Medizinische Universität Wien, Innsbruck, , Austria
Cliniques Universitaires Saint-Luc, Brussel, , Belgium
Universitair Ziekenhuis Gent, Ghent, , Belgium
Universitair Ziekenhuis Leuven - Campus Gasthuisberg, Leuven, , Belgium
Alberta Children's Hospital, Calgary, Alberta, Canada
British Columbia Children's Hospital, Vancouver, British Columbia, Canada
CHU Sainte-Justine, Montréal, Quebec, Canada
The Montreal Children's Hospital, Montréal, Quebec, Canada
Centre Hospitalier de l'Université Laval et Centre Mère-Enfant Soleil, Québec, , Canada
SickKids - The Hospital for Sick Children, Toronto, , Canada
Fakultní Nemocnice Brno - D?tská Nemocnice, Brno, , Czechia
Motol University Hospital, Prague, , Czechia
Aarhus Universitetshospital, Aarhus, Midtjylland, Denmark
Rigshospitalet, Copenhagen, , Denmark
Helsingin yliopistollinen sairaala (HUS), Helsinki, , Finland
Tampereen Yliopistollinen Sairaala, Tampere, , Finland
Centre Léon Bérard, Lyon, , France
Hôpital de la Timone, Marseille, , France
Institut Curie, Paris, , France
Gustave Roussy, Villejuif, , France
Universitätsklinikum Freiburg, Freiburg, Baden-Württemberg, Germany
Universitätsklinikum Augsburg, Augsburg, Bayern, Germany
Universitätsklinikum Würzburg, Würzburg, Bayern, Germany
Universitätsklinikum Frankfurt, Frankfurt, Hessen, Germany
Universitätsklinikum Leipzig, Leipzig, Sachsen, Germany
Charité Universitätsmedizin Berlin, Berlin, , Germany
Evangelische Klinikum Bethel (EvKB), Bielefeld, , Germany
Universitätsklinikum Hamburg-Eppendorf, Hamburg, , Germany
Universitätsklinikum Heidelberg, Heidelberg, , Germany
Universitätsklinikum Tübingen, Tübingen, , Germany
Universitätsklinikum Erlangen, Ulm, , Germany
Aghia Sofia General Children's Hospital, Athens, , Greece
Athens General Children's Hospital, Athens, , Greece
Semmelweis Egyetem Tűzoltó utcai II. Sz. Gyermekgyógyászati Kliniká, Budapest, , Hungary
Children's Health Ireland at Crumlin, Crumlin, Dublin, Ireland
Schneider Children's Medical Center of Israel, Petah tikva, , Israel
The Edmond and Lily Safra Children's Hospital, Ramat Gan, , Israel
Fondazione IRCCS - Istituto Nazionale dei Tumori, Milano, Milan, Italy
Ospedale Pediatrico Bambino Gesù, Roma, Rome, Italy
Ospedale Infantile Regina Margherita, Torino, Turin, Italy
Istituto Giannina Gaslini, Genova, , Italy
Azienda Ospedaliera di Rilievo Nazional Santobono Pausilipon, Napoli, , Italy
Azienda Ospedale Università di Padova, Padova, , Italy
Seoul National University Hospital, Seoul, , Korea, Republic of
Severance Hospital, Seoul, , Korea, Republic of
Prinses Maxima Centrum Kinderoncologie, Utrecht, , Netherlands
Starship Paediatric Blood & Cancer Center, Grafton, , New Zealand
Universitetssykehuset Nord-Norge - Tromsø, Tromsø, Troms, Norway
Oslo Universitetssykehus, Oslo, , Norway
SingHealth Group - KK Women's and Children's Hospital, Singapore, , Singapore
Univerzitetni Klinini Center Ljubljana, Ljubljana, , Slovenia
Hospital Universitario Cruces, Barakaldo, , Spain
Hospital Universitari Vall d'Hebrón, Barcelona, , Spain
Hospital Sant Joan de Déu Barcelona, Barcelona, , Spain
Hospital Infantil Universitario Niño Jesús, Madrid, , Spain
Hospital Universitario La Paz, Madrid, , Spain
Hospital Universitario Virgen del Rocío, Sevilla, , Spain
Hospital Universitari i Politècnic La Fe, Valencia, , Spain
Drottning Silvias barn- och ungdomssjukhus, Göteborg, , Sweden
Skånes Universitetssjukhus - Lund, Lund, , Sweden
Astrid Lindgrens Barnsjukhus Solna, Stockholm, , Sweden
Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, , Switzerland
Universitaets - Kinderspital Zürich, Zurich, , Switzerland
Leeds Teaching Hospital NHS Trust, Leeds, England, United Kingdom
The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England, United Kingdom
Great Ormond Street Hospital for Children, Oxford, England, United Kingdom
NHS Greater Glasgow and Clyde, Glasgow, Scotland, United Kingdom
The Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom
University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, , United Kingdom
Cambridge University Hospitals NHS Foundation Trust, Cambridge, , United Kingdom