PHASE 2 Study of Entrectinib as a Single Agent in Upfront Therapy for Children <3 Years of Age With NTRK1/2/3 or ROS1-FUSED CNS Tumors (GLOBOTRK)
Summary
This clinical trial tests how well entrectinib works to treat patients less than 3 years of age with NTRK 1/2/3 or ROS1 fused, high grade glioma or other central nervous system (CNS) tumors.
Detailed description
PRIMARY OBJECTIVE * To determine the overall response rate of entrectinib when used as first line therapy in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused high-grade glioma (HGG) (Cohort 1). SECONDARY OBJECTIVES * To estimate the 2-year and 5-year progression free survival (PFS) and overall survival (OS) in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused HGG treated with entrectinib as first line therapy (Cohort 1). * To estimate the duration of response (DOR) in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused HGG treated with entrectinib as first line therapy (Cohort 1). * To evaluate the fraction of patients with NTRK1/2/3- or ROS1-fused HGG treated who have second surgeries and a gross-total resection after treatment with entrectinib is achieved, overall and by country and hospital (Cohort 1). * To describe the overall response rate of entrectinib when used as first line therapy in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG (Cohort 2). * To estimate the 2-year and 5-year PFS and OS in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG treated with entrectinib as first line therapy (Cohort 2). * To estimate the duration of response (DOR) in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG treated with entrectinib as first line therapy (Cohort 2). * To evaluate the fraction of patients with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG who have second surgeries and a gross-total resection after treatment with entrectinib is achieved, overall and by country and hospital (Cohort 2). * To describe toxicities experienced by patients younger than 3 years of age treated with entrectinib (Cohort 1 and 2). * To evaluate number of patients that are screened for the study and eligible versus enrolled and treated with entrectinib (Cohort 1 and 2). * To measure the time intervals (days) from time of initial diagnostic surgery to screening and enrollment in this study (Cohort 1 and 2). The trial will have 2 cohorts: Cohort 1: patients diagnosed with NTRK1/2/3- or ROS1-fused high-grade glioma (HGG) and Cohort 2: patients diagnosed with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG. Patients receive entrectinib enterally once daily (QD) on days 1-28 of each cycle. Treatment repeats every 28 days for up to 24 cycles in the absence of disease progression or unacceptable toxicity. Patients requiring bridging therapy prior to starting entrectinib may receive cyclophosphamide intravenously (IV) over 1 hour on day 1, etoposide IV over 1 hour on day 1 and 2, carboplatin IV over 1 hour on day 2, filgrastim subcutaneously (SC) or IV or pegfilgrastim SC on day 3. A gross total resection or significant debulking may become possible if a response to entrectinib is seen. If surgical resection is performed and a gross total resection is achieved, 24 cycles of entrectinib will be completed, including those before and after surgery. After treatment, patients will be followed for 5 years.
Arms & interventions
- DrugEntrectinib
Given orally (PO) or enterally
- DrugCyclophosphamide
Given intravenous (IV)
- DrugEtoposide
Given IV
- DrugCarboplatin
Given IV
- BiologicalG-CSF
Given subcutaneous (SQ) or IV
- BiologicalPegfilgrastim
Given SQ as part of recommended Bridging Therapy instead of G-CSF.
- ProcedureSurgery
A gross total resection or significant debulking may become possible if a response to entrectinib is seen.
Outcome measures
Primary
Overall response rate (ORR) (Cohort 1)
ORR is defined as the percentage of patients with either partial or complete response assessed at the protocol-defined evaluation timepoint. Overall response will be determined by the central imaging review based on the scheduled evaluations.
Time frame: After cycle 4 (each cycle is 28 days).
Secondary
Progression free survival (PFS) (Cohort 1)
Time frame: At 2 and 5 years
Overall survival (OS) (Cohort 1)
Time frame: At 2 and 5 years
Duration of response (DOR) (Cohort 1)
Time frame: Up to 5 years
Patients who have second surgeries (Cohort 1)
Time frame: Up to 5 years
Patients who undergo gross-total resection after treatment (Cohort 1)
Time frame: Up to 5 years
ORR (Cohort 2)
Time frame: After cycle 4 (each cycle is 28 days).
PFS (Cohort 2)
Time frame: At 2 and 5 years
OS (Cohort 2)
Time frame: At 2 and 5 years
DOR (Cohort 2)
Time frame: Up to 5 years
Patients who have second surgeries (Cohort 2)
Time frame: Up to 5 years
Patients who undergo gross-total resection after treatment (Cohort 2)
Time frame: Up to 5 years
Incidence of adverse events (Cohort 1 and 2)
Time frame: Up to 5 years
Number of patients screened versus enrolled and treated (Cohort 1 and 2)
Time frame: Up to 5 years
Time from initial diagnostic surgery to screening and enrollment (Cohort 1 and 2)
Time frame: Up to 5 years
Eligibility criteria
Study locations (1)
St. Jude Children's Research Hospital
Memphis, Tennessee, 38105
References
- Bagchi A, Chiang J, Pinto S, Dhanda S, Gajjar A. Infant-Type Hemispheric Gliomas: A Review of Clinical, Radiologic, Histopathologic, and Molecular Features. J Natl Compr Canc Netw. 2025 Nov;23(11):e257064. doi: 10.6004/jnccn.2025.7064.(PubMed)