GBM AGILE: Global Adaptive Trial Master Protocol: An International, Seamless Phase II/III Response Adaptive Randomization Platform Trial Designed To Evaluate Multiple Regimens In Newly Diagnosed and Recurrent GBM
Summary
Glioblastoma (GBM) adaptive, global, innovative learning environment (GBM AGILE) is an international, seamless Phase II/III response adaptive randomization platform trial designed to evaluate multiple therapies in newly diagnosed (ND) and recurrent GBM. All institutions are enrolling Newly Diagnosed participants. Institutions also enrolling Recurrent participants are marked with an asterisk (\*).
Detailed description
Glioblastoma (GBM) adaptive, global, innovative learning environment (GBM AGILE) is an international, seamless Phase II/III response adaptive randomization platform trial designed to evaluate multiple therapies in newly diagnosed (ND) and recurrent GBM. Its goals are to identify effective therapies for glioblastoma and match effective therapies with patient subtypes. Bayesian response adaptive randomization is used within subtypes of the disease to assign participants to Arms based on their performance. The primary endpoint is overall survival (OS). GBM AGILE is designed to efficiently evaluate therapies. The trial will be conducted under a single Master Investigational New Drug Application/Clinical Trial Application and Master Protocol, allowing multiple drugs and drug combinations from different pharmaceutical companies to be evaluated simultaneously. The plan is to add experimental therapies as new information about promising new drugs are identified and remove therapies as they complete their evaluation.
Arms & interventions
- DrugTemozolomide
Dosage Form: Capsule for oral administration Strengths: 5 mg, 20 mg, 100 mg, 140 mg, 180 mg, or 250 mg
- DrugLomustine
Dosage Form: Capsule for oral administration Strength: 5 mg, 10 mg, 40 mg, and 100 mg
- DrugRegorafenib
Dosage Form: Tablet for oral administration Strength: 40 mg Standard Regimen: 160 mg orally (PO) every day (QD) for 3 weeks of every 4 week cycle (i.e., 3 weeks on, 1 week off)
- RadiationRadiation
60 Gy
- DrugPaxalisib
Dosage Form: Tablet for oral administration Strength: 15 mg Standard Regimen: 45 mg orally (PO) every day for 28 days for the first cycle. If tolerated, increase dose to 60 mg orally (PO) every day for 28 days for all subsequent cycles
- DrugVAL-083
Dosage Form: Infusion for intravenous administration Strength: 40 mg per vial Standard Regimen: 30 mg/m2 on Day 1, 2 and 3 of 21-day cycle. The drug is available in powder form. It is reconstituted with 5 mL of 0.9% Sodium Chloride for Injection, USP. This will produce a solution of 40 mg VAL-083 in 5 mL. The required volume of reconstituted VAL-083 for the patient is then calculated at the rate of 30 mg/m2. The corresponding volume is further diluted into 250 mL of 0.9% Sodium Chloride for Injection, USP, prior to intravenous administration.
- DrugVT1021
Dosage Form: Infusion for intravenous administration Strength: 10 mg/mL Standard Regimen Newly Diagnosed: Dose as confirmed through the dose finding phase, administered twice weekly (Mon and Thurs or Tues and Fri or Mon and Fri). Standard Regimen Recurrent: 12 mg/kg administered twice weekly (Mon and Thurs or Tues and Fri or Mon and Fri). The drug is available as a sterile solution of the acetate salt formulated with phosphate-buffered saline, mannitol, and 2.5% polysorbate 80. The required volume stock solution for the patient is calculated. The corresponding volume is diluted in 500 mL of either 0.9% saline or D5W, prior to intravenous administration.
- DrugTroriluzole
Dosage Form: Capsule for oral administration Strength: 100 mg Standard Regimen: Dose as confirmed through the dose finding phase orally BID.
- BiologicalADI-PEG 20
Dosage Form: Solution for intramuscular injection Strength: 11.5 ± 1.0 mg/ml Standard Regimen: For newly diagnosed patients, 36mg/m2. For recurrent disease patients, dose as confirmed through the dose finding phase intramuscularly once a week
- DrugAZD1390
Standard Regimen Newly Diagnosed: Given once daily on days of radiation and once daily for 14 consecutive days after completion of radiation.
- DrugTinostamustine
Dosage form: Reconstituted powder for intravenous administration Strength: 2mg/mL Standard Regimen: Dose as confirmed through the dose finding phase, on Day 1 of 21-day cycle for up to 12 cycles in the maintenance phase.
Outcome measures
Primary
Overall Survival (OS)
Overall survival is defined from the time of randomization to death from any cause. Patients still alive at the time of an analysis will be considered censored at their date of last contact.
Time frame: From date of randomization until the date of death from any cause, or until 12 months following last patient randomization (approximately 2 years), whichever comes first.
Secondary
Progression-free survival (PFS)
Time frame: From date of randomization to date of clinically determined progression or date of death from any cause, or until 12 months following last patient randomization (approximately 2 years), whichever comes first.
Tumor Response
Time frame: From initiation of study treatment to date of disease progression, or until 12 months following last patient randomization (approximately 2 years), whichever comes first.
Duration of Response (CR + PR)
Time frame: From date of response to date of clinically determined disease progression or date of death from any cause, or until 12 months following last patient randomization (approximately 2 years), whichever comes first.
Eligibility criteria
Study locations (42)
University of Alabama at Birmingham
Birmingham, Alabama, 35249
University of California, San Diego
La Jolla, California, 92093
Cedars Sinai - Samuel Oschin Comprehensive Cancer Institute
Los Angeles, California, 90048
University of California, Los Angeles
Los Angeles, California, 90095
St. Joseph Hospital
Orange, California, 92868
University of California, San Francisco
San Francisco, California, 94143
Stanford Cancer Center
Stanford, California, 94305
University of Colorado Denver
Aurora, Colorado, 80045
Yale Cancer Center / Smilow Cancer Hospital*
New Haven, Connecticut, 06511
Mayo Clinic Cancer Center
Jacksonville, Florida, 32224
Sylvester Comprehensive Cancer Center*
Miami, Florida, 33136
Moffitt Cancer Center
Tampa, Florida, 33612
Piedmont Atlanta Hospital
Atlanta, Georgia, 30309
Winship Cancer Institute of Emory University
Atlanta, Georgia, 30322
LSU Health Sciences Center - New Orleans
New Orleans, Louisiana, 70112
Massachusetts General Hospital
Boston, Massachusetts, 02114
Dana Farber Cancer Institute
Boston, Massachusetts, 02115
Henry Ford Health System
Detroit, Michigan, 48202
Allina Health Systems/Abbott Northwestern Hospital
Minneapolis, Minnesota, 55407
Mayo Clinic Cancer Center - Rochester
Rochester, Minnesota, 55905
University of Mississippi Medical Center
Jackson, Mississippi, 39213
Washington University School of Medicine - Siteman Cancer Center
St Louis, Missouri, 63110
Perlmutter Cancer Center, NYU Langone Health
New York, New York, 10016
Icahn School of Medicine at Mount Sinai
New York, New York, 10029
Columbia University Medical Center
New York, New York, 10032
Memorial Sloan Kettering Cancer Center*
New York, New York, 10065
Duke University Medical Center
Durham, North Carolina, 27710
Comprehensive Cancer Center of Wake Forest*
Winston-Salem, North Carolina, 272157
University Hospitals Cleveland Medical Center*
Cleveland, Ohio, 44106
Cleveland Clinic
Cleveland, Ohio, 44195
Ohio State University Cancer Center
Columbus, Ohio, 43210
University of Pennsylvania - Perelman Center for Advanced Medicine
Philadelphia, Pennsylvania, 19104
Allegheny General Hospital
Pittsburgh, Pennsylvania, 15212
University of Pittsburgh Medical Center - Hillman Cancer Center
Pittsburgh, Pennsylvania, 15232
Medical University of South Carolina - Hollings Cancer Center
Charleston, South Carolina, 29425
Texas Oncology - Austin
Austin, Texas, 78705
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
University of Texas - MD Anderson Cancer Center
Houston, Texas, 77030
University of Utah - Huntsman Cancer Institute
Salt Lake City, Utah, 84112
University of Virginia Health
Charlottesville, Virginia, 22908
University of Washington Medical Center
Seattle, Washington, 98101
Froedtert Hospital/Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
References
- Wen PY, Berry DA, Buxton MB, Colman H, de Groot J, Lim M, Mellinghoff I, Perry JR, Weller M, Blondin NA, Butt OH, Damek DM, de la Fuente MI, Drappatz J, Dunbar E, Giglio P, Hyddmark EV, Iwamoto F, Jaeckle KA, Kim L, Kling HM, Lee EQ, Mantica M, Mikkelsen T, Nabors B, Newton HB, Olson JJ, Schiff D, Walbert T, Weathers SP, Cloughesy T, Lassman AB; GBM AGILE Regorafenib Study Group. Evaluation of Regorafenib in Newly Diagnosed and Recurrent Glioblastoma: GBM AGILE Phase II/III Bayesian Randomized Platform Trial. J Clin Oncol. 2026 Apr 14:JCO2501137. doi: 10.1200/JCO-25-01137. Online ahead of print.(PubMed)
- Chen JJ, Vincent MY, Shepard D, Peereboom D, Mahalingam D, Battiste J, Patel MR, Juric D, Wen PY, Bullock A, Selfridge JE, Pant S, Liu J, Li W, Fyfe S, Wang S, Zota V, Mahoney J, Watnick RS, Cieslewicz M, Watnick J. Phase 1 dose expansion and biomarker study assessing first-in-class tumor microenvironment modulator VT1021 in patients with advanced solid tumors. Commun Med (Lond). 2024 May 21;4(1):95. doi: 10.1038/s43856-024-00520-z.(PubMed)