Radiotherapy in IDH Mutated Glioma: Evaluation of Late Outcomes

Study Purpose

Rationale: Standard postoperative treatment of isocitrate dehydrogenase 1/2 mutated grade 2 and 3 glioma (IDHmG) consists of radiotherapy and chemotherapy. The improving prognosis of these patients leads towards more emphasis on the long-term effects of treatment. Specifically radiotherapy has been implicated in the development of delayed neurocognitive deterioration. The impact of modern radiotherapy techniques (such as intensity modulated radiotherapy, volumetric modulated radiotherapy and proton beam therapy) and chemotherapy on general toxicity, late neurocognitive outcomes and imaging changes is currently unclear. Objectives:

  • - To report treatment outcomes and radiation-induced toxicity from a prospective, multicentre observational cohort of IDHmG patients treated with radiotherapy and chemotherapy, - To integrate radiotherapeutic dose distributions, imaging changes and neuropsychological outcome in IDHmG.
  • - To evaluate the Dutch selection criteria for proton therapy applied to IDHmG based on the outcomes collected in this observational study.
  • - To assess the impact of proton and photon therapy on health-related quality of life (HRQoL) and health-related economics (HR-E) in IDHmG patients.
  • - To collect genetic material for future translational research into the interaction between germline DNA, prognosis and radiation-induced toxicity.
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: This project is a multicentre, observational cohort of patients undergoing radiotherapy and chemotherapy for IDHmG. The protocol closely follows the local guidelines for clinical follow-up. Specific to the study are extra questionnaires and specific imaging acquired during scheduled MRI's. Routine neuropsychological investigation is standard of care in Erasmus Medical Center (Erasmus MC), but not in all participating centers. We feel the additional burden of participation in this study to be low.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Observational
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Histologically confirmed glioma, World Health Organisation (WHO) grade 2 or 3, IDH mutated.
  • - Indication for standard treatment with radiotherapy and chemotherapy.
For WHO grade 2 tumors 50.4 Gy relative biological equivalent (RBE) in 28 fractions. For WHO grade 3 tumors 59.4 Gy (RBE) in 33 fractions.
  • - Ability to comply with the protocol, including neuropsychological testing and imaging.
  • - Ability to understand the requirements of the study and to give written informed consent, as determined by the treating physician.
  • - Written informed consent.

Exclusion Criteria:

  • - Any prior chemotherapy for IDHmG.
This includes upfront postoperative chemotherapy.
  • - Any prior cranial radiotherapy, including but not limited to radiotherapy for IDHmG.
  • - Prior invasive malignancy, except non-melanoma skin cancer, completely resected cervical or prostate cancer (with current prostate specific antigen (PSA) of less than or equal to 0.1 ng/mL).
  • - Extensive white matter disease visible on pre-therapy imaging (Fazekas grade ≥2) - Contra-indication for magnetic resonance (MR) imaging (i.e. metal implants, claustrophobia) - Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule in the participating hospitals.
  • - Any other serious medical condition that could interfere with follow-up.
- Severe aphasia or language barrier interfering with assessing endpoints (i.e. completion of questionnaires or neurocognitive performance)

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT04304300
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Erasmus Medical Center
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

N/A
Principal Investigator Affiliation N/A
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other, Industry
Overall Status Recruiting
Countries Netherlands
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Astrocytoma, Grade II, Astrocytoma, Grade III, Oligodendroglioma, Oligodendroglioma, Anaplastic
Arms & Interventions

Arms

: Study group

Glioma, IDH mutated, grade 2 and 3

Interventions

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

International Sites

Erasmus MC, Rotterdam, Zuid Holland, Netherlands

Status

Recruiting

Address

Erasmus MC

Rotterdam, Zuid Holland, 3015 CE

Site Contact

Alejandra Mendez Romero, MD PhD

[email protected]

+31 (0)10 7035829

Amsterdam UMC, Amsterdam, Netherlands

Status

Not yet recruiting

Address

Amsterdam UMC

Amsterdam, , 1081 HV

Site Contact

Frank Lagerwaard, MD, PhD

[email protected]

20 4440436 #+31

HollandPTC, Delft, Netherlands

Status

Recruiting

Address

HollandPTC

Delft, , 2629 JH

Site Contact

Marco van Vulpen, Prof. MD

[email protected]

88 5018800 #+31

Leiden University Medical Center, Leiden, Netherlands

Status

Not yet recruiting

Address

Leiden University Medical Center

Leiden, , 2333 ZA

Site Contact

Ida Coremans, MD, PhD

[email protected]

071 5263525

Haaglanden Medical Center, Leidschendam, Netherlands

Status

Not yet recruiting

Address

Haaglanden Medical Center

Leidschendam, , 2262BA

Site Contact

Ruud Wiggenraad, MD, PhD

[email protected]

88 979 2071 #+31

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