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Brief Title: LAM561 With RT and TMZ for Adults With Glioblastoma
Official Title: A Randomized, Double-blind, Placebo-controlled Adjuvant Trial in Newly Diagnosed Primary Glioblastoma Subjects to Assess the Efficacy and Safety of LAM561 in Combination With Radiotherapy and Temozolomide Standard of Care Treatment.
Study ID: NCT04250922
Brief Summary: The proposed Phase IIB/III randomized, double-blind, placebo-controlled trial in subjects with newly diagnosed primary glioblastoma multiforme (ndGBM) aims to compare the efficacy and safety of LAM561 versus placebo, given with standard of care (SoC) therapy of radiation therapy plus temozolomide (TMZ), followed by an adjuvant treatment of 6 month period of TMZ and then LAM561 or placebo in monotherapy.
Detailed Description: This is a randomized, double-blind, placebo-controlled, 2 parallel arms (1:1 ratio), adjuvant trial to assess the efficacy of LAM561 versus placebo in patients with newly diagnosed, IDH1 wildtype, GBM. In all arms, patients will receive the SoC and will be randomized to receive either placebo or LAM561 dose. The study is planned to enrol 140 patients. The primary endpoints of the study are PFS (for CMA) and OS (for FMA) as assessed after observing at least 66 PFS events and at least 90 OS events, respectively. It is expected that the analysis for PFS will be performed 1-2 years earlier than the analysis for OS. An IDMC (Independent Data Monitoring Committee) meeting took place to assess the trial's futility and safety data from the start of the trial until September 2023. The IDMC had open access to the data without blinding; after analysis IDMC concluded that there were no concerns that would necessitate stopping the study for ethical reasons or safety issues that could adversely affect patients due to taking the medication, so the study is continuing as normal with no changes. After 45 events for PFS are observed, a formal interim analysis will be performed and the data reviewed by an Independent Data Monitoring Committee (IDMC) or may be activated by the IDMC 12 months after the inclusion of the last patient if follow up is sufficient to identify an overall PFS or OS significant deviation from the literature. After reviewing the interim results, the iDMC will make recommendations regarding: the sample size and the continuation of the trial overall. Further, the sample size and events will be re-estimated to ensure that the statistical power is maintained given the estimated treatment effect at interim analysis. The events/sample size increase will be based on the considerations of the success probability. For that purpose, based on the conditional power, the interim results will be classified into the following zones: favourable, unfavourable or promising. If the interim results fall in the promising zone, then it is planned to increase the total number of events both for PFS and OS by up to 50%, with up to 99 events for PFS and up to 135 events for OS. The total sample size will also be increased to up to 210 patients to ensure the desired number of events within a realistic time. If the interim results are favourable or unfavourable, the study size will remain as initially planned with 66 events for PFS and 90 for OS, collected from 140 patients. The IDMC committee experts met in February 2024 after 45 PFS events occurred in the trial. Unblinded medical and clinical statistical data from 103 patients were evaluated to assess the efficacy - progression free survival (tumour growth or clinical deterioration) - of LAM561. The IDMC confirmed that, at the current level of evidence, after evaluating the Conditional Power of the unblinded results, no futility has been identified and recommends continuation of the study without modification.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Institut Cancerologie de L'Ouest (ICO), Angers, , France
Centre Eugène Marquis (CEM), Rennes, , France
Gustave Roussy University Hospital, Rennes, , France
Institut universitaire du cancer, Toulouse, , France
Reaserch Fund of the Hadassah Medical Organization, Jerusalem, , Israel
Istituto Oncologico Veneto IRCCS, Padova, Veneto, Italy
Istituto Nazionale Neurologico Carlo Besta, Milan, , Italy
Istituto Nazionale Tumori "Regina Elena", Roma, , Italy
University of Turin, Turin, , Italy
Hospital Universitario Reina Sofía, Córdoba, Andalucía, Spain
Hospital Universitario Virgen del Rocío, Sevilla, Andalucía, Spain
Hospital Universitari i Politécnic La Fe., Valencia, Comunidad Valenciana, Spain
Hospital Clinic, Barcelona, , Spain
Hospital del Mar, Barcelona, , Spain
Hospital Vall d'Hebron, Barcelona, , Spain
Hospital Clínico San Carlos, Madrid, , Spain
Hospital Universitario 12 De Octubre, Madrid, , Spain
Hospital Parc Tauli, Sabadell, , Spain
Freeman Hospital's Northern Centre of Cancer Care, Newcastle, Newcastle Upon Tyne, United Kingdom
University Hospitals Birmingham NHS Foundation Trust - New Queen Elizabeth Hospital, Birmingham, , United Kingdom
Cambridge university hospital, Cambridge, , United Kingdom
The Royal Marsden Hospital, London, , United Kingdom