A Randomized, Open-label, Multicentric, Two-arm Pivotal Trial of SonoCloud-9 Combined With Carboplatin (CBDCA) vs Standard of Care Lomustine (CCNU) or Temozolomide (TMZ) in Patients Undergoing Planned Resection for First Recurrence Glioblastoma.
Summary
The brain is protected from any toxic or inflammatory molecule by the blood-brain barrier (BBB). This physical barrier is located at the level of the blood vessel walls. Because of these barrier properties, the blood vessels are also impermeable to the passage of therapeutic molecules from the blood to the brain. The development of effective treatments against glioblastoma is thus limited due to the BBB that prevents most drugs injected in the bloodstream from getting into brain tissue where the tumour is seated. The SonoCloud-9 (SC9) is an investigational device using ultrasound technology and specially developed to open the BBB in the area of and surrounding the tumour. The transient opening of the BBB allows more drugs to reach the brain tumour tissue. Carboplatin is a chemotherapy that is approved to treat different cancer types alone or in combination with other drugs, and has been used in the treatment of glioblastoma. Despite its proven efficacy in the laboratory on glioblastoma cells, carboplatin does not readily cross the BBB in humans. A clinical trial has shown that in combination with the SonoCloud-9, more carboplatin can reach the brain tumour tissue. The objective of the proposed trial is to show that the association - carboplatin with the SonoCloud-9 - will increase efficacy of the drug in patients with recurrent glioblastoma.
Arms & interventions
- DeviceSonoCloud-9 (SC9)
Implantation of SC9 device and repeat activation at constant acoustic pressure
- DrugCarboplatin
Dose of carboplatin AUC 5 mg/ml.min-1 calculated using Calvert's formula: Dose (mg) = target AUC (mg/mL x minute) x \[glomerular filtration rate (GFR) mL/minute + 25\].
- DrugLomustine
Dosed and administered per labelling.
- DrugTemozolomide
Dosed and administered per labelling.
Outcome measures
Primary
Overall survival (OS)
Survival status will be collected during the treatment period, for up to 7 months (short-term follow-up) and then every 3 months as standard of care follow-up (long-term follow-up) until participant's 'End of Study', defined as end of survival follow-up period, death, withdrawal of consent for the collection of data, or 'lost to follow-up' (whichever comes first).
Time frame: Up to 24 months
Secondary
Tumor Growth Rate
Time frame: Up to week 24
Progression Free Survival (PFS)
Time frame: Up to 24 months
Overall survival at 12 months (OS12)
Time frame: 12 months
Overall survival at 18 months (OS18)
Time frame: 18 months
Progression-free survival at 6 months (PFS6)
Time frame: 6 months
Eligibility criteria
Study locations (19)
Mayo Clinic Arizona
Phoenix, Arizona, 805054
University of California, San Francisco
San Francisco, California, 94143
UCHealth
Aurora, Colorado, 80011
Mayo Clinic of Jacksonville Florida
Jacksonville, Florida, 32224
Miami Cancer Institute
Miami, Florida, 33176
Moffitt Cancer Center
Tampa, Florida, 33612
Winship Cancer Institute at Emory University
Atlanta, Georgia, 30322
Northwestern University
Chicago, Illinois, 60611
Indiana University Health
Indianapolis, Indiana, 46202
John Hopkins University
Baltimore, Maryland, 21287
Mayo Clinic Rochester
Rochester, Minnesota, 55905
Weill Cornell Medicine
New York, New York, 10021
NewYork-Presbyterian / Columbia University Irving Medical Center
New York, New York, 10032
Lennox Hill Hospital
New York, New York, 10075
University of North Carolina
Chapel Hill, North Carolina, 27516
Penn State Health Milton S. Hershey Medical Center
Hershey, Pennsylvania, 17033
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
University of Texas Houston Health Science Center
Houston, Texas, 77030
University of Utah, Hunstman Cancer Institute
Salt Lake City, Utah, 84112
References
- Carpentier A, Canney M, Vignot A, Reina V, Beccaria K, Horodyckid C, Karachi C, Leclercq D, Lafon C, Chapelon JY, Capelle L, Cornu P, Sanson M, Hoang-Xuan K, Delattre JY, Idbaih A. Clinical trial of blood-brain barrier disruption by pulsed ultrasound. Sci Transl Med. 2016 Jun 15;8(343):343re2. doi: 10.1126/scitranslmed.aaf6086.(PubMed)
- Sonabend AM, Gould A, Amidei C, Ward R, Schmidt KA, Zhang DY, Gomez C, Bebawy JF, Liu BP, Bouchoux G, Desseaux C, Helenowski IB, Lukas RV, Dixit K, Kumthekar P, Arrieta VA, Lesniak MS, Carpentier A, Zhang H, Muzzio M, Canney M, Stupp R. Repeated blood-brain barrier opening with an implantable ultrasound device for delivery of albumin-bound paclitaxel in patients with recurrent glioblastoma: a phase 1 trial. Lancet Oncol. 2023 May;24(5):509-522. doi: 10.1016/S1470-2045(23)00112-2.(PubMed)