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RecruitingInterventionalPhase 2/Phase 3

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

NCT ID: NCT03970447Sponsor: Global Coalition for Adaptive ResearchLast updated: 2026-06-12

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

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Newly Diagnosed Inclusion Criteria: * Age ≥ 18 years. * Histologically confirmed Grade IV GBM, inclusive of gliosarcoma (WHO criteria; IDH wild-type by immunohistochemistry \[IHC\] or sequencing for IDH) established following either a surgical resection or biopsy. An MRI scan with the required imaging sequences performed within 21 days prior to randomization preferably. The post-operative MRI scan performed within 96 hours of surgery or the MRI scan performed for radiation therapy planning may serve as the MRI scan performed during screening if all required imaging sequences were obtained. * Karnofsky performance status ≥ 60% performed within a 14-day window prior to randomization. * Availability of tumor tissue representative of GBM from definitive surgery or biopsy. Recurrent Inclusion Criteria: * Age ≥ 18 years. * Histologically confirmed Grade IV GBM, inclusive of gliosarcoma (WHO criteria; IDH wild-type by immunohistochemistry \[IHC\] or sequencing for IDH) at first or second recurrence after initial standard, control or experimental therapy that includes at a minimum radiation therapy (RT). * Evidence of recurrent disease demonstrated by disease progression using slightly modified Response Assessment in Neuro-Oncology (RANO) criteria. * Two scans to confirm progression are required: at least 1 scan at the time of progression and 1 scan prior to the time of progression. * Karnofsky performance status ≥ 70% performed within a 14-day window prior to randomization. * Availability of tumor tissue representative of GBM from initial definitive surgery and/or, recurrent surgery, if performed. Newly Diagnosed Exclusion Criteria: * Received any prior treatment for glioma including: a. Prior prolifeprospan 20 with carmustine wafer. b. Prior intracerebral, intratumoral, or cerebral spinal fluid (CSF) agent. c. Prior radiation treatment for GBM or lower-grade glioma. d. Prior chemotherapy or immunotherapy for GBM or lower-grade glioma. Receiving additional, concurrent, active therapy for GBM outside of the trial. * Extensive leptomeningeal disease. * QTc \> 470 msec * History of another malignancy in the previous 2 years, with a disease-free interval of \< 2 years. Patients with prior history of in situ cancer or basal or squamous cell skin cancer are eligible. Recurrent Exclusion Criteria: * Early disease progression prior to 3 months (12 weeks) from the completion of RT. * More than 2 prior lines for chemotherapy administration. (NOTE: In the 1st line adjuvant setting, combination of temozolomide (TMZ) with an experimental agent, is considered one line of chemotherapy.) * Received any prior treatment with lomustine, agents part of any of the experimental arms, and bevacizumab or other vascular endothelial growth factor (VEGF) or VEGF receptor-mediated targeted agent. * Any prior treatment with prolifeprospan 20 with carmustine wafer. * Any prior treatment with an intracerebral agent. * Receiving additional, concurrent, active therapy for GBM outside of the trial * Extensive leptomeningeal disease. * QTc \> 470 msec * History of another malignancy in the previous 2 years, with a disease-free interval of \< 2 years. Patients with prior history of in situ cancer or basal or squamous cell skin cancer are eligible.

Study locations (42)

University of Alabama at Birmingham

Birmingham, Alabama, 35249

Recruiting
Thiru Pillay · Contact
Yantong (Lily) Liu · Contact
Louis B Nabors, MD · Principal Investigator

University of California, San Diego

La Jolla, California, 92093

Recruiting
David Piccioni, MD, PhD · Principal Investigator

Cedars Sinai - Samuel Oschin Comprehensive Cancer Institute

Los Angeles, California, 90048

Recruiting
Jethro Hu, MD · Principal Investigator

University of California, Los Angeles

Los Angeles, California, 90095

Recruiting
Phioanh Nghiemphu, MD · Principal Investigator

St. Joseph Hospital

Orange, California, 92868

Recruiting
Lars Anker, MD · Principal Investigator

University of California, San Francisco

San Francisco, California, 94143

Recruiting
UCSF Neuro Onc New Patient Coordinator · Contact
Nicholas Butowski, MD · Principal Investigator

Stanford Cancer Center

Stanford, California, 94305

Completed

University of Colorado Denver

Aurora, Colorado, 80045

Recruiting
Denise Damek, MD · Principal Investigator

Yale Cancer Center / Smilow Cancer Hospital*

New Haven, Connecticut, 06511

Recruiting
Amy L. Rodriguez · Contact
Nicholas Blondin, MD · Principal Investigator

Mayo Clinic Cancer Center

Jacksonville, Florida, 32224

Completed

Sylvester Comprehensive Cancer Center*

Miami, Florida, 33136

Recruiting
Leonela Wright · Contact
Macarena I De La Fuente, MD · Principal Investigator

Moffitt Cancer Center

Tampa, Florida, 33612

Recruiting
Patrick Grogan, MD · Principal Investigator

Piedmont Atlanta Hospital

Atlanta, Georgia, 30309

Recruiting
Takiyyah Hamiliton · Contact
Erin Dunbar, MD · Principal Investigator

Winship Cancer Institute of Emory University

Atlanta, Georgia, 30322

Completed

LSU Health Sciences Center - New Orleans

New Orleans, Louisiana, 70112

Completed

Massachusetts General Hospital

Boston, Massachusetts, 02114

Recruiting
Lauren Hibyan · Contact
Marie Aste · Contact
Patrick Wen, MD · Principal Investigator

Dana Farber Cancer Institute

Boston, Massachusetts, 02115

Recruiting
Patrick Wen, MD · Principal Investigator

Henry Ford Health System

Detroit, Michigan, 48202

Completed

Allina Health Systems/Abbott Northwestern Hospital

Minneapolis, Minnesota, 55407

Recruiting
Andrea Wasilewski, MD · Principal Investigator

Mayo Clinic Cancer Center - Rochester

Rochester, Minnesota, 55905

Completed

University of Mississippi Medical Center

Jackson, Mississippi, 39213

Completed

Washington University School of Medicine - Siteman Cancer Center

St Louis, Missouri, 63110

Completed

Perlmutter Cancer Center, NYU Langone Health

New York, New York, 10016

Recruiting
Ewelina Rakoczy, Rachel Kim · Contact
Jonathan Yang, MD, PhD · Principal Investigator

Icahn School of Medicine at Mount Sinai

New York, New York, 10029

Recruiting
Disha Jain · Contact
Lyndon Kim, MD · Principal Investigator

Columbia University Medical Center

New York, New York, 10032

Recruiting
Andrew Lassman, MD · Principal Investigator

Memorial Sloan Kettering Cancer Center*

New York, New York, 10065

Recruiting
Kerina Yang · Contact
Nancy Keith · Contact
Ingo Mellinghoff, MD · Principal Investigator

Duke University Medical Center

Durham, North Carolina, 27710

Recruiting
Erin Severance · Contact
Katherine Peters, MD, PhD · Principal Investigator

Comprehensive Cancer Center of Wake Forest*

Winston-Salem, North Carolina, 272157

Recruiting
Glenn Lesser, MD · Principal Investigator

University Hospitals Cleveland Medical Center*

Cleveland, Ohio, 44106

Recruiting
Carmen Gray · Contact
Herbert Newton, MD · Principal Investigator

Cleveland Clinic

Cleveland, Ohio, 44195

Recruiting
Rachel Hufsey · Contact
Kathy Robinson · Contact
Mina Lobbous, MD · Principal Investigator

Ohio State University Cancer Center

Columbus, Ohio, 43210

Active Not Recruiting

University of Pennsylvania - Perelman Center for Advanced Medicine

Philadelphia, Pennsylvania, 19104

Recruiting
Leah Coghlan · Contact
Arati Desai, MD · Principal Investigator

Allegheny General Hospital

Pittsburgh, Pennsylvania, 15212

Completed

University of Pittsburgh Medical Center - Hillman Cancer Center

Pittsburgh, Pennsylvania, 15232

Recruiting
Theo Estep · Contact
Jan Drappatz, MD · Principal Investigator

Medical University of South Carolina - Hollings Cancer Center

Charleston, South Carolina, 29425

Recruiting
HCC Clinical Trials Office · Contact
Scott Lindhorst, MD · Principal Investigator

Texas Oncology - Austin

Austin, Texas, 78705

Active Not Recruiting

University of Texas Southwestern Medical Center

Dallas, Texas, 75390

Active Not Recruiting

University of Texas - MD Anderson Cancer Center

Houston, Texas, 77030

Recruiting
Evguenia Gachimova, RN · Contact
Shiao-Pei Weathers, MD · Principal Investigator

University of Utah - Huntsman Cancer Institute

Salt Lake City, Utah, 84112

Recruiting
Howard Colman, MD, PhD · Principal Investigator

University of Virginia Health

Charlottesville, Virginia, 22908

Recruiting
CJ Woodburn · Contact
David Schiff, MD · Principal Investigator

University of Washington Medical Center

Seattle, Washington, 98101

Active Not Recruiting

Froedtert Hospital/Medical College of Wisconsin

Milwaukee, Wisconsin, 53226

Active Not Recruiting

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)
A Trial to Evaluate Multiple Regimens in Newly Diagnosed and Recurrent Glioblastoma | Cancerify