Clinical trial • Phase II/III • Oncology

IDROXIOLEIC ACID for Glioblastoma (newly diagnosed)

Phase II/III trial of IDROXIOLEIC ACID for Glioblastoma (newly diagnosed).

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Glioblastoma (newly diagnosed)
Trial Stage
Phase II/III
Drug Modality
Small molecule
Orphan Drug
Yes

Key dates

Initial CTIS Submission Date
28-02-2024
First CTIS Authorization Date
15-03-2024

Trial design

Randomised, placebo (matching 2-ohoa) in combination with radiotherapy and temozolomide (temodal). temozolomide products (temodal) are included as standard of care (product entries list dose units mg/m2 with maxdailydoseamount 75 and maxtotaldoseamount 200); specific dosing schedule not detailed in ctis summary.-controlled, adaptive Phase II/III trial across 16 sites in Spain, France, Italy.

Randomised
Yes
Comparator
Placebo (matching 2-OHOA) in combination with radiotherapy and temozolomide (Temodal). Temozolomide products (Temodal) are included as standard of care (product entries list dose units mg/m2 with maxDailyDoseAmount 75 and maxTotalDoseAmount 200); specific dosing schedule not detailed in CTIS summary.
Adaptive
True, adaptive elements include sample size re-estimation to detect a large range of treatment effect integrated into the study design and an optional responder-subgroup detection/characterisation function (as described in main objective).
Target Sample Size
106

Eligibility

Recruits 106 Vulnerable population flag set to true in CTIS record. Informed consent: "Written informed consent, signed and dated" is required and subjects must be able to understand and follow instructions. No details on assent or proxy consent are provided in the available CTIS texts or documents..

Pregnancy Exclusion
Female subjects with a childbearing potential must have a negative pregnancy test within one week before inclusion in the trial. Those female and male subjects admitted in the study must use a reliable method of contraception, for female subjects during the study period up until 32 days after last study treatment (in Germany, patients who use an efficient method of hormonal contraception during the study period must continue to use this for minimum of six months after their last dose of temozolomide) and for male subjects up until 92 days after last study administration. Women must be: • Either of NOT childbearing potential: postmenopausal (≥ 60 years of age, or < 60 years of age and amenorrhoea for 12 months in the absence of chemotherapy, tamoxifen, toremifene, or ovarian suppression with follicle-stimulating hormone (FSH) above 40 U/L and oestradiol below 30 ng/L, or if taking tamoxifen or toremifene, and age < 60 years, then FSH and oestradiol in the postmenopausal range), permanently sterilized (e.g., tubal occlusion, hysterectomy, bilateral salpingectomy), or otherwise incapable of pregnancy • Or of childbearing potential and practicing a highly effective method of birth control consistent with local regulations (if any/where applicable) regarding the use of birth control methods for subjects participating in clinical studies: e.g., established use of oral, injected or implanted hormonal methods of contraception; placement of an intrauterine device or intrauterine system; male partner sterilization (the vasectomized partner should be the sole partner for that subject). A man who is sexually active and has not had a vasectomy must agree to use a barrier method of birth control e.g., either condom or partner with occlusive cap (diaphragm or cervical/vault caps).
Vulnerable Population
Vulnerable population flag set to true in CTIS record. Informed consent: "Written informed consent, signed and dated" is required and subjects must be able to understand and follow instructions. No details on assent or proxy consent are provided in the available CTIS texts or documents.

Inclusion criteria

  • {"criterion_text":"- 1. Written informed consent, signed and dated\n- 2. Subjects who are able to understand and follow instructions during the trial\n- 3. Age ≥18 and ≤75\n- 4. Subjects with newly histologically confirmed intracranial malignant glioma (glioblastoma WHO Grade IV) that is IDH1 wildtype (local assessment)\n- 5. Ability to swallow and retain oral medication\n- 6. Centrally obtained MGMT promoter methylation status\n- 7. Subjects who underwent total or partial / incomplete resection and with the appropriate quantity of tumour tissue releasable for eligibility.\n- 8. Karnofsky Performance Score (KPS) > 50 %\n- 9. Female subjects with a childbearing potential must have a negative pregnancy test within one week before inclusion in the trial. Those female and male subjects admitted in the study must use a reliable method of contraception, for female subjects during the study period up until 32 days after last study treatment (in Germany, patients who use an efficient method of hormonal contraception during the study period must continue to use this for minimum of six months after their last dose of temozolomide) and for male subjects up until 92 days after last study administration. Women must be: • Either of NOT childbearing potential: postmenopausal (≥ 60 years of age, or < 60 years of age and amenorrhoea for 12 months in the absence of chemotherapy, tamoxifen, toremifene, or ovarian suppression with follicle-stimulating hormone (FSH) above 40 U/L and oestradiol below 30 ng/L, or if taking tamoxifen or toremifene, and age < 60 years, then FSH and oestradiol in the postmenopausal range), permanently sterilized (e.g., tubal occlusion, hysterectomy, bilateral salpingectomy), or otherwise incapable of pregnancy • Or of childbearing potential and practicing a highly effective method of birth control consistent with local regulations (if any/where applicable) regarding the use of birth control methods for subjects participating in clinical studies: e.g., established use of oral, injected or implanted hormonal methods of contraception; placement of an intrauterine device or intrauterine system; male partner sterilization (the vasectomized partner should be the sole partner for that subject).\n- 10. A man who is sexually active and has not had a vasectomy must agree to use a barrier method of birth control e.g., either condom or partner with occlusive cap (diaphragm or cervical/vault caps).\n- 11. Adequate bone marrow function including: Absolute neutrophil count (ANC) ≥1,500/mm3 or ≥1.5 x 109/L; Platelets ≥ 100,000/mm3 or ≥100 x 109/L; Haemoglobin ≥ 9 g/dL (may have been transfused).\n- 12. Adequate hepatic function defined by a total bilirubin level ≤ 1.5 × the upper limit of normal range (ULN), an aspartate aminotransferase (AST), level ≤ 2.5 × ULN, and an alanine aminotransferase (ALT) level ≤ 2.5 × ULN or, for subjects with documented metastatic disease to the liver, AST and ALT levels ≤ 5 × ULN. Subjects with documented Gilbert disease are allowed if total bilirubin ≤ 3 x ULN\n- 13. Adequate renal function defined by an estimated creatinine clearance ≥ 30 mL/min according to the Cockcroft-Gault formula"}

Exclusion criteria

  • {"criterion_text":"- 1. Known hypersensitivity to any component of the investigational product.\n- 2. Any other investigational drug within the preceding 30 days. Prior, concomitant, or planned concomitant treatment with anti-neoplastic aim including (but not limited) to NovoTumor Treatment Fields (Novo TTF), bevacizumab, intratumoural or intracavitary anti-neoplastic therapy (e.g Gliadel wafers), or other experimental therapeutics intended to treat the tumour.\n- 3. Subjects who underwent \"only biopsy\" resection\n- 4. Anticancer therapy within 4 weeks of study entry (6 weeks for mitomycin and nitrosoureas)\n- 5. Other major surgery within the preceding 30 days\n- 6. Allergy, hypersensitivity or other intolerability to temozolomide and its excipients, patients with hypersensitivity to dacarbazine and patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.\n- 7. Unable to undergo MRI\n- 8. Presenting with diffuse midline gliomas or multifocal GBM (distant from the flare or contralateral) or rapid progression between early postsurgery MRI and pre-radiotherapy MRI\n- 9. Uncontrolled or significant cardiovascular disease\n- 10. A history of uncontrolled hyperlipidaemia and/or the need for concurrent lipid lowering therapy\n- 11. Need for warfarin, phenytoin or sulphonylureas (glibenclamide, glimepiride, glipizide, glyburide or nateglanide)\n- 12. Past medical history of uncontrolled clinically significant active or chronic gastrointestinal disorders (for example, Crohn's disease, celiac disease, untreated stomach ulcers, etc) and gastro-inflammatory pathologies\n- 13. Uncontrolled diabetes mellitus, with glycated haemoglobin (HbA1c) levels at the screening visit of ≥7.5%\n- 14. Cardiac disease, defined specifically as either a. Mean resting corrected QT interval (QTc) > 470 msec (for women) and > 450 ms (for men) obtained from 3 consecutive ECGs b. Any clinically important abnormalities in rhythm, conduction or morphology of resting ECG (example, complete left bundle branch block, third degree heart block) c. Any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as heart failure, hypokalaemia, potential for Torsades de Pointes, congenital long QT syndrome, family history of long QT syndrome or unexplained sudden death under 40 years of age\n- 15. Previous malignancies within the last three years other than ndGBM, except successfully treated squamous cell carcinoma of the skin, superficial bladder cancer, and in situ carcinoma of the cervix\n\nAdditional information regarding concomitant medications. Based on data in vitro, 2-OHOA is a potent inhibitor of CYP2C9. Subjects on warfarin, phenytoin and various oral hypoglycaemics are excluded (see above). Where concomitant use of other products metabolized by CYP2C9 is unavoidable, caution must be exercised and subjects should be closely monitored as appropriate."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- • PFS according to RANO criteria evaluated after at least 66 PFS events occur. Occurrence of disease progression to calculate PFS will be determined first by the investigator based on local evaluation of images and other clinical information. Progression will be confirmed by an adjudication/imaging committee.\n- • Overall Survival evaluated after at least 90 OS events are observed.","definition_or_measurement_approach":"Progression-Free Survival (PFS) assessed according to Response Assessment in Neuro-Oncology (RANO) criteria; progression initially determined by investigator local image assessment and other clinical information and subsequently confirmed by an adjudication/imaging committee. Overall Survival (OS) measured as time to death; evaluated after observation of at least 90 OS events."}

Secondary endpoints

  • {"endpoint_text":"- • Changes in neurological function, based on Neurologic Assessment in Neuro-Oncology (NANO) criteria\n- • To evaluate additional measures of efficacy including: o Time to Progression (TTP) (as assessed using RANO criteria)\n- • HRQoL assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, EORTC-QLQ C30, version 3.0 and brain cancer specific QLQ-BN20.","definition_or_measurement_approach":"Neurological function changes assessed by NANO criteria. Time to Progression (TTP) assessed using RANO criteria. Health-related quality of life (HRQoL) assessed using EORTC QLQ-C30 v3.0 and QLQ-BN20 instruments."}

Other endpoints

  • {"endpoint_text":"- • To characterize the safety and tolerability of 2-OHOA in combination with RT and TMZ.\n- • To characterize the pharmacokinetics (PK) and pharmacodynamics (PD) of 2-OHOA in combination with RT and TMZ.\n- • To explore further the mechanism of action (MoA) of 2-OHOA.","definition_or_measurement_approach":"Safety and tolerability characterized by collection of adverse events, laboratory assessments and clinical evaluations per protocol. PK and PD characterised by appropriate blood sampling and assays as defined in protocol. Mechanism of action explored via predefined exploratory biomarker and mechanistic analyses (refer to protocol for specifics)."}

Recruitment

Planned Sample Size
106
Recruitment Window Months
72
Consent Approach
Written informed consent required: "Written informed consent, signed and dated". Participants must be able to understand and follow instructions. Subject information and informed consent forms available in multiple languages (documents listed include ICFs in Italian and Spanish and a main ICF document). No assent or proxy consent procedures are described in the available CTIS summary.

Geography

Total Number Of Sites
16
Total Number Of Participants
106

Spain

Earliest CTIS Part Ii Submission Date
21-02-2024
Latest Decision Or Authorization Date
26-06-2025
Processing Time Days
491
Number Of Sites
9
Number Of Participants
62

Sites

Site Name
Hospital Del Mar
Department Name
Neuro-Oncology
Contact Person Name
Maria Martinez Garcia
Site Name
Hospital Clinico San Carlos
Department Name
Oncology
Contact Person Name
Pedro Perez-Segura
Contact Person Email
pperez.hcsc@salud.madrid.org
Site Name
Hospital Universitari Vall D Hebron
Department Name
Oncology
Contact Person Name
Maria Vieito Villar
Contact Person Email
mvieito@vhio.net
Site Name
University Hospital Virgen Del Rocio S.L.
Department Name
Oncology
Contact Person Name
Miriam Alonso Garcia
Contact Person Email
miriamag3@hotmail.com
Site Name
Hospital Universitario Y Politecnico La Fe
Department Name
Oncology
Contact Person Name
Regina Girones Sarrio
Contact Person Email
girones_reg@gva.es
Site Name
Parc Tauli Hospital Universitari
Department Name
Medicine
Contact Person Name
Julia Giner Joaquin
Contact Person Email
jginer@tauli.cat
Site Name
Hospital Universitario 12 De Octubre
Department Name
Neuro-Oncology
Contact Person Name
Juan Sepulveda
Contact Person Email
jmsepulveda76@gmail.com
Site Name
Hospital General Universitario Reina Sofia
Department Name
Radiotherapy Oncology
Contact Person Name
Sonia Garcia Cabezas
Contact Person Email
songar1@gmail.com
Site Name
Hospital Clinic De Barcelona
Department Name
Oncology
Contact Person Name
Estela Pineda Losada
Contact Person Email
epineda@clinic.cat

France

Earliest CTIS Part Ii Submission Date
21-02-2024
Latest Decision Or Authorization Date
25-10-2024
Processing Time Days
247
Number Of Sites
3
Number Of Participants
28

Sites

Site Name
Institut Gustave Roussy
Department Name
Medecine - Committee 040
Contact Person Name
Frédéric Dhermain
Site Name
Institut Universitaire Du Cancer Toulouse-Oncopole
Department Name
Radiotherapy
Contact Person Name
Elizabeth Cohen-Jonathan Moyal
Site Name
Centre De Lutte Contre Le Cancer Eugene Marquis
Department Name
Medical Oncology
Contact Person Name
Elodie Vauleon
Contact Person Email
e.vauleon@rennes.unicancer.fr

Italy

Earliest CTIS Part Ii Submission Date
21-02-2024
Latest Decision Or Authorization Date
24-10-2024
Processing Time Days
246
Number Of Sites
4
Number Of Participants
16

Sites

Site Name
Azienda Ospedaliera Universitaria Citta Della Salute E Della Scienza Di Torino
Department Name
Neuro-Oncology
Contact Person Name
Veronica Villani
Contact Person Email
veronica.villani@ifo.it
Site Name
I.F.O. Istituti Fisioterapici Ospitalieri
Department Name
Pathophysiology and Transplantation
Contact Person Name
Francesco Di Meco
Site Name
IRCCS Foundation Istituto Neurologico Carlo Besta
Department Name
Oncology 1
Contact Person Name
Giuseppe Lombardi
Site Name
Istituto Oncologico Veneto
Department Name
Neuro-Oncology-Neuroscience
Contact Person Name
Alessia Pellerino
Contact Person Email
alessia.pellerino@unito.it

Sponsor

Primary sponsor

Full Name
Laminar Pharmaceuticals S.A.
Organisation Type
Pharmaceutical company
Country Of Registered Address
Spain

Contract research organisations

Name
Fortrea Inc.
Responsibilities
sponsorDuties codes: 1,10,11,12,2,5,6,7,8,9
Name
Venn Life Sciences Biometry Services
Responsibilities
sponsorDuties codes: 3 (biometry/statistics)
Name
Qualitecfarma Regulatory & Business Strategies S.L.
Responsibilities
sponsorDuties codes: 15 (Susar reporting)

Third parties

  • {"country":"United Kingdom","full_name":"University College London","duties_or_roles":"sponsorDuties codes: 4","organisation_type":"Educational Institution"}
  • {"country":"United States","full_name":"Fortrea Inc.","duties_or_roles":"sponsorDuties codes: 1,10,11,12,2,5,6,7,8,9","organisation_type":"Pharmaceutical company"}
  • {"country":"Spain","full_name":"Qualitecfarma Regulatory & Business Strategies S.L.","duties_or_roles":"sponsorDuties codes: 15 (Susar reporting)","organisation_type":"Pharmaceutical company"}
  • {"country":"France","full_name":"Centre De Lutte Contre Le Cancer Eugene Marquis","duties_or_roles":"sponsorDuties codes: 4","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"France","full_name":"Venn Life Sciences Biometry Services","duties_or_roles":"sponsorDuties codes: 3","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
2-Hydroxyoleic acid sodium salt (Milynvo; 2-OHOA; LAM561)
Active Substance
IDROXIOLEIC ACID
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
prodAuthStatus: 1; euMpNumber PRD8181177; no marketing authorisation number listed
Orphan Designation
Yes
Maximum Dose
12 g (maxDailyDoseAmount 12, doseUom: g)
Investigational Product Name
Temozolomide (Temodal hard capsules - multiple strengths listed)
Active Substance
TEMOZOLOMIDE
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
Marketing authorisations listed for Temodal products (marketingAuthNumber examples: EU/1/98/096/021 etc; prodAuthStatus: 2)
Orphan Designation
Yes
Maximum Dose
75 mg/m2 daily (maxDailyDoseAmount 75, doseUom: mg/m2); maxTotalDoseAmount listed 200 mg/m2
Investigational Product Name
Placebo
Modality
Other
Authorisation Status
Not applicable / not a medicinal active product
Combination Treatment
Yes

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