A Clinical Trial Evaluating the Efficacy of Valganciclovir in Glioblastoma Patients

  • STATUS
    Recruiting
  • End date
    Aug 31, 2024
  • participants needed
    220
  • sponsor
    Cecilia Soderberg-Naucler
Updated on 22 September 2021
temozolomide

Summary

This study is a multicenter randomized double-blinded controlled phase 2 study evaluating the efficacy and safety of the anti-CMV drug valganciclovir vs placebo as add-on therapy in patients with glioblastoma. Valganciclovir is approved for treatment of cytomegalovirus (CMV) infections, but may also have anti-tumoral effects. Current evidence imply that most glioblastomas are CMV positive and that the virus can affect tumor aggressiveness.

Description

Adult patients will either be randomized to standard treatment (temozolomide and radiation therapy) + placebo tablets or to standard treatment + valganciclovir. Patients are randomized using 1 to 1 distribution of the patients between the treatment groups and are stratified according to methylation status of the MGMT promoter; equal proportion of patients are included in each group. A maximum of 30% of patients with methylated MGMT promoter are allowed into the study (to harmonise with current data used for statistical power calculation), as MGMT promotor methylation status is prognostic for patient survival. Patients must enter the study within 10 weeks after surgery.

Full dose treatment with 900mgs of Valganciclovir is given twice daily for 6 weeks, thereafter 900 mgs daily during 98 weeks (total treatment of 24 months). Valganciclovir is available in 450 mg tablets. The dose of Valganciclovir will be adjusted according to renal function.

This study will be performed in compliance with the protocol, ICH-GCP, the declaration of Helsinki and applicable Swedish regulatory requirements.

The study discontinuation criteria are as follows:

  • Withdrawal of consent
  • An adverse event which requires discontinuation of the trial medication or results in
  • inability to continue to comply with trial procedures
  • Disease progression which results in inability to continue to comply with trial
  • procedures
  • Major Protocol deviations
  • Exclusion criteria met

Details
Condition Glioblastoma multiforme, glioblastoma, Glioblastoma Multiforme
Treatment Placebo Oral Tablet, Radiotherapy 60 Gy, Valganciclovir Tablets, Temozolomide 120 mg
Clinical Study IdentifierNCT04116411
SponsorCecilia Soderberg-Naucler
Last Modified on22 September 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Patients aged 18 years or older
Patients with newly diagnosed glioblastoma, IDH 1 wt, WHO grade IV
Radical resection
Concomitant treatment with temozolomide and radiation therapy
MGMT promoter methylation status
Patients with at least KPS 70 , ECOG/WHO 2
Patients providing written informed consent
Patients cooperative and able to complete all the assessment procedures
Females of child-bearing age must have a negative pregnancy test at screening (all premenopausal women, or in case when menstrual status can not be ascertained in women under the age of 55). Female patient must agree to utilize a highly efficient birth control method throughout the study period (Pearl index <1, e.g: oral contraception with gestagens, transdermal contraceptives, implants, injectables, intrauterine devices, bilateral tubal occlusion, sexual abstinence or vasectomised partner). The birth control method must be used at least 30 days after treatment end. Pregnancy testing should be performed at monthly intervals due to high teratogenic potential of valganciclovir. Men are recommended to use condoms with female partners during, and for at least 90 days following treatment with Valganciclovir
Patients must be enrolled within 10 weeks after surgery

Exclusion Criteria

Patients allergic to, or who do not tolerate Valganciclovir, aciclovir or valaciclovir treatment
Patients with decreased cognitive function (below 24 in MMSE test)
Pregnant or lactating females
Patients not signing informed consent
Patient is simultaneously participating in another experimental drug therapy trial
Neutrophil count < 1,5 cells/ 109/L
Platelet count < 150 cells/ 109/L
HGB < 80 g/L
Abnormal renal function (GFR < 30)
Secondary glioblastoma, or glioblastoma IDH1 mutated
Unfit for any other reason judged by investigator
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