EORTC 1709/CCTG CE.8: A phase III trial of marizomib in combination with temozolomide-based radiochemotherapy versus temozolomide-based radiochemotherapy alone in patients with newly diagnosed glioblastoma.

Authors

Patrick Roth

Patrick Roth

Department of Neurology, University Hospital Zürich, Zürich, Switzerland

Patrick Roth , Thierry Gorlia , Jaap C. Reijneveld , Filip Yves Francine Leon De Vos , Ahmed Idbaih , Jean-Sebastien Frenel , Emilie Le Rhun , José Manuel Sepulveda Sánchez , James R. Perry , Laura Masucci , Pierre Freres , Hal W. Hirte , Clemens Seidel , Anna Maria Elisabeth Walenkamp , Frederic Dhermain , Martin J. Van Den Bent , Christopher J. O'Callaghan , Maureen Vanlancker , Warren P. Mason , Michael Weller

Organizations

Department of Neurology, University Hospital Zürich, Zürich, Switzerland, EORTC Headquarters, Brussels, Belgium, Department of Neurology, VU University Medical Center, Amsterdam, Netherlands, University Medical Center Utrecht, Division of Medical Oncology, Utrecht, Netherlands, Inserm U 1127, Cnrs Umr 7225, Sorbonne Universités, UPMC Univ Paris 06 Umr S 1127, Institut Du Cerveau Et De La Moelle Épinière, ICM, Paris, France, GINECO & Institut de Cancerologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France, Lille University Hospital, Lille, France, H. U. 12 de Octubre, Madrid, Spain, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, CHUM-Hopital Notre-Dame, Montreal, QC, Canada, CHU Liege, Liege, Belgium, McMaster University Juravinski Cancer Centre, Hamilton, ON, Canada, Universitätsklinikum Leipzig, Leipzig, Germany, Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands, Gustave Roussy Cancer Centre, Villejuif Cedex, PA, France, Erasmus MC Cancer Institute, Rotterdam, Netherlands, Queen's University, Canadian Cancer Trials Group, Kingston, ON, Canada, EORTC, Brussels, Belgium, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, Laboratory of Molecular Neuro-Oncology, Department of Neurology, and Neuroscience Center Zürich, University Hospital and University of Zürich, Zürich, Switzerland

Research Funding

Pharmaceutical/Biotech Company
Celgene / BMS

Background: Patients with newly diagnosed glioblastoma receive postoperative standard therapy with radiotherapy (RT), and concomitant and up to six cycles of maintenance temozolomide (TMZ) chemotherapy (TMZ/RT→TMZ). Marizomib is a novel, irreversible and brain-penetrant pan-proteasome inhibitor with encouraging findings in preclinical models and early-stage clinical trials for patients with newly diagnosed and recurrent glioblastoma. Therefore, a phase 3 trial was designed to explore the activity of marizomib in addition to TMZ/RT→TMZ. ClinicalTrials.gov Identifier: NCT03345095 Methods: EORTC 1709/CCTG CE.8 is a multicenter, randomized, controlled, open label phase 3 superiority trial. Eligibility criteria included histologically confirmed newly diagnosed glioblastoma and a Karnofsky performance status (KPS) > 70. Eligible patients were stratified for institution, age, KPS as well as extent of surgery, and centrally randomized in a 1:1 ratio. The primary objective of this study is to compare overall survival (OS) in patients receiving marizomib in addition to standard treatment with patients receiving standard treatment only. Secondary endpoints include progression-free survival (PFS), safety, neurocognitive function, and quality of life. Results: The study was opened at 49 EORTC sites in Europe, 23 CCTG sites in Canada, and 8 sites in the US. Patient enrolment started in June 2018 and was close to completion at the time of a planned interim analysis in September 2020. A total of 749 patients (of the planned 750) were randomized when the IDMC recommended to discontinue enrollment. Age, KPS and extent of resection were well balanced between the 2 study arms. No difference in median OS was observed between the standard arm (15.9 months) and the marizomib arm (15.7 months; HR = 0.99). Median PFS was 6.1 vs. 6.2 months (HR = 1.02). Patients in the marizomib group had more often grade 3/4 treatment-emergent adverse events (TEAE) compared to the standard therapy group (42.6% vs. 20.5%), including ataxia, hallucinations and headache. Conclusions: The addition of marizomib to standard radiochemotherapy did not improve OS or PFS in patients with newly diagnosed glioblastoma. Final survival analyses including determination of MGMT promoter methylation status and analyses of other secondary endpoints are ongoing. Clinical trial information: NCT03345095

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Primary CNS Tumors–Glioma

Clinical Trial Registration Number

NCT03345095

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 2004)

DOI

10.1200/JCO.2021.39.15_suppl.2004

Abstract #

2004

Abstract Disclosures

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