Clinical trial • Phase III • Oncology

VORASIDENIB for Grade 2 glioma (oligodendroglioma or astrocytoma) — residual or recurrent, IDH1 or IDH2 mutation

Phase III trial of VORASIDENIB for Grade 2 glioma (oligodendroglioma or astrocytoma) — residual or recurrent, IDH1 or IDH2 mutation.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Grade 2 glioma (oligodendroglioma or astrocytoma) — residual or recurrent, IDH1 or IDH2 mutation
Trial Stage
Phase III
Drug Modality
Small molecule
Paediatric Trial
Yes

Key dates

Initial CTIS Submission Date
14-06-2024
First CTIS Authorization Date
15-07-2024

Trial design

Randomised, placebo (matched tablets) orally vs vorasidenib 40 mg qd (vorasidenib film-coated tablets; active arm: vorasidenib 40 mg qd, days 1–28 in 28-day cycles; placebo supplied as matched tablets administered orally).-controlled, crossover Phase III trial in France, Italy, Spain and others.

Randomised
Yes
Comparator
Placebo (matched tablets) orally vs vorasidenib 40 mg QD (vorasidenib film-coated tablets; active arm: vorasidenib 40 mg QD, Days 1–28 in 28-day cycles; placebo supplied as matched tablets administered orally).
Crossover
Yes
Biomarker Stratified
True (1p19q status; strata: co-deleted vs not co-deleted)
Target Sample Size
269
Trial Duration For Participant
1825

Stratification factors

  • Local 1p19q status (co-deleted vs not co-deleted)
  • Baseline tumor size per local assessment (longest diameter ≥2 cm vs <2 cm)

Eligibility

Recruits 269 paediatric patients.

Vulnerable Population
Vulnerable population selected: includes adolescents (minimum age 12 years). Age-appropriate consent/assent materials are provided (adolescent 12–17 ICFs and parental/guardian ICFs are available per country). Protocol uses LPPS for subjects <16 years and KPS for ≥16 years, indicating paediatric/adolescent-specific assessments and consent/assent handling.

Inclusion criteria

  • {"criterion_text":"- 1. Be at least 12 years of age and weigh at least 40 kg.\n- 2. Have Grade 2 oligodendroglioma or astrocytoma per WHO 2016 criteria.\n- 3. Have had at least 1 prior surgery for glioma (biopsy, sub-total resection, gross-total resection), with the most recent surgery having occurred at least 1 year (-1 month) and not more than 5 years (+3 months) before the date of randomization, and no other prior anticancer therapy, including chemotherapy and radiotherapy, and not be in need of immediate chemotherapy or radiotherapy in the opinion of the Investigator.\n- 4. Have confirmed IDH1 (IDH1 R132H/C/G/S/L mutation variants tested) or IDH2 (IDH2 R172K/M/W/S/G mutation variants tested) gene mutation status disease by central laboratory testing during the Prescreening period and available 1p19q status by local testing (eg, fluorescence in situ hybridization [FISH], comparative genomic hybridization [CGH] array, sequencing) using an accredited laboratory.\n- 5. Have MRI-evaluable, measurable, non-enhancing disease, as confirmed by the BIRC.\n- 6. Have a KPS score (for subjects ≥16 years of age) or LPPS score (for subjects <16 years of age) of ≥80%."}

Exclusion criteria

  • {"criterion_text":"- 1. Have had any prior anticancer therapy other than surgery (biopsy, sub-total resection, gross-total resection) for treatment of glioma including systemic chemotherapy, radiotherapy, vaccines, small-molecules, IDH inhibitors, investigational agents, laser ablation, etc.\n- 2. Have features assessed as high-risk by the Investigator, including brainstem involvement either as primary location or by tumor extension, clinically relevant functional or neurocognitive deficits due to the tumor in the opinion of the Investigator (deficits resulting from surgery are allowed), or uncontrolled seizures (defined as persistent seizures interfering with activities of daily life AND failed 3 lines of antiepileptic drug regimens including at least 1 combination regimen)."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Radiographic PFS as assessed by the BIRC per modified Response Assessment for Neuro-oncology for Low-Grade Gliomas [RANO-LGG]","definition_or_measurement_approach":"Radiographic progression-free survival assessed by the blinded independent review committee (BIRC) using the modified RANO-LGG criteria."}

Secondary endpoints

  • {"endpoint_text":"- 1. The key secondary endpoint is TTNI.","definition_or_measurement_approach":"Time to next intervention (TTNI) compared between vorasidenib and placebo."}
  • {"endpoint_text":"- 2.Other secondary efficacy endpoints are TGR, objective response, CR+PR, time to response, time to CR+PR, duration of response, duration of CR+PR, OS, FACT-BR scores, and PFS by investigator.","definition_or_measurement_approach":"Tumor growth rate (TGR) by volume per BIRC; objective response (CR+PR), time to response, time to CR+PR, duration of response/CR+PR assessed by BIRC and Investigator; overall survival (OS); health-related quality of life by FACT-Br; PFS per investigator assessment."}
  • {"endpoint_text":"- 3. Adverse events, serious adverse events (SAEs), and AEs leading to discontinuation or death, and severity of AEs","definition_or_measurement_approach":"Safety endpoints include incidence and severity of AEs, SAEs, and AEs leading to discontinuation or death (standard AE reporting)."}
  • {"endpoint_text":"- 4. Safety laboratory parameters, vital signs, 12-lead electrocardiograms (ECGs), evaluation of left ventricular ejection fraction (LVEF), Karnofsky Performance Scale (KPS)/Lansky Play-Performance Scale (LPPS), and concomitant medications.","definition_or_measurement_approach":"Clinical safety assessments including labs, vitals, ECGs, LVEF evaluation, performance scales (KPS/LPPS), and concomitant medication review."}
  • {"endpoint_text":"- 5. Serial or sparse blood sampling at specified time points for determination of plasma concentration-time profiles and PK parameters of vorasidenib and its circulating metabolite AGI-69460.","definition_or_measurement_approach":"Pharmacokinetic sampling (serial or sparse) to determine plasma concentration–time profiles and PK parameters for vorasidenib and metabolite AGI-69460."}

Recruitment

Planned Sample Size
269
Recruitment Window Months
98
Consent Approach
Informed consent obtained using country/language-specific main ICFs for adults. For adolescents (12–17) separate adolescent ICFs and parental/guardian ICFs are provided (documents available in multiple languages). ICFs and related materials available in English, French, Spanish, Italian, Dutch and German as per country-specific documentation.

Geography

Total Number Of Sites
16
Total Number Of Participants
71

France

Earliest CTIS Part Ii Submission Date
08-07-2024
Latest Decision Or Authorization Date
22-07-2024
Processing Time Days
14
Number Of Sites
3
Number Of Participants
32

Sites

Site Name
Hospices Civils De Lyon
Department Name
Service de Neurologie Vasculaire
Principal Investigator Name
François Ducray
Principal Investigator Email
francois.ducray@chu-lyon.fr
Contact Person Name
François Ducray
Contact Person Email
francois.ducray@chu-lyon.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Service de Neurologie 2- Batiment Mazarin
Principal Investigator Name
Mehdi Touat
Principal Investigator Email
mehdi.touat@gmail.com
Contact Person Name
Mehdi Touat
Contact Person Email
mehdi.touat@gmail.com
Site Name
Centre Hospitalier Regional De Marseille
Department Name
Neuro-Oncology
Principal Investigator Name
Olivier-Louis Chinot
Principal Investigator Email
olivier.chinot@ap-hm.fr
Contact Person Name
Olivier-Louis Chinot
Contact Person Email
olivier.chinot@ap-hm.fr

Italy

Earliest CTIS Part Ii Submission Date
08-07-2024
Latest Decision Or Authorization Date
22-07-2024
Processing Time Days
14
Number Of Sites
4
Number Of Participants
10

Sites

Site Name
Istituto Oncologico Veneto
Department Name
S.C. Oncologia 1
Principal Investigator Name
Giuseppe Lombardi
Principal Investigator Email
giuseppe.lombardi@iov.veneto.it
Contact Person Name
Giuseppe Lombardi
Site Name
Humanitas Mirasole S.p.A.
Department Name
U.O di Oncologia ed Ematologia
Principal Investigator Name
Matteo Simonelli
Principal Investigator Email
matteo.simonelli@hunimed.eu
Contact Person Name
Matteo Simonelli
Contact Person Email
matteo.simonelli@hunimed.eu
Site Name
Azienda Ospedaliera Universitaria Citta Della Salute E Della Scienza Di Torino
Department Name
SSD Neuro-oncologia Clinica
Principal Investigator Name
Alessia Pellerino
Principal Investigator Email
alessia.pellerino85@gmail.com
Contact Person Name
Alessia Pellerino
Contact Person Email
alessia.pellerino85@gmail.com
Site Name
Azienda Unita Sanitaria Locale Di Bologna
Department Name
UOC Oncologia del Sistema Nervoso
Principal Investigator Name
Enrico Franceschi
Principal Investigator Email
e.franceschi@isnb.it
Contact Person Name
Enrico Franceschi
Contact Person Email
e.franceschi@isnb.it

Spain

Earliest CTIS Part Ii Submission Date
08-07-2024
Latest Decision Or Authorization Date
17-07-2024
Processing Time Days
9
Number Of Sites
3
Number Of Participants
10

Sites

Site Name
Hospital Universitario 12 De Octubre
Department Name
Oncology
Principal Investigator Name
Juan Manuel Sepúlveda Sanchez
Principal Investigator Email
sepulvedasanchez@seom.org
Contact Person Name
Juan Manuel Sepúlveda Sanchez
Contact Person Email
sepulvedasanchez@seom.org
Site Name
Hospital Universitario Ramon Y Cajal
Department Name
Oncology
Principal Investigator Name
María Ángeles Vaz Salgado
Principal Investigator Email
mavaz4@gmail.com
Contact Person Name
María Ángeles Vaz Salgado
Contact Person Email
mavaz4@gmail.com
Site Name
Hospital Universitari Vall D Hebron
Department Name
Oncology
Principal Investigator Name
Maria Vieito Villar
Principal Investigator Email
mvieito@vhio.net
Contact Person Name
Maria Vieito Villar
Contact Person Email
mvieito@vhio.net

Netherlands

Earliest CTIS Part Ii Submission Date
08-07-2024
Latest Decision Or Authorization Date
15-07-2024
Processing Time Days
7
Number Of Sites
2
Number Of Participants
10

Sites

Site Name
Universitair Medisch Centrum Utrecht
Department Name
Dept. of Medical Oncology
Principal Investigator Name
Filip De Vos
Principal Investigator Email
f.devos@umcutrecht.nl
Contact Person Name
Filip De Vos
Contact Person Email
f.devos@umcutrecht.nl
Site Name
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Department Name
Neurology
Principal Investigator Name
Jacoline Bromberg
Principal Investigator Email
j.bromberg@erasmusmc.nl
Contact Person Name
Jacoline Bromberg
Contact Person Email
j.bromberg@erasmusmc.nl

Germany

Earliest CTIS Part Ii Submission Date
08-07-2024
Latest Decision Or Authorization Date
22-07-2024
Processing Time Days
14
Number Of Sites
4
Number Of Participants
9

Sites

Site Name
University Medical Center Hamburg-Eppendorf
Department Name
Klinik für Neurochirurgie
Principal Investigator Name
Frank Lennard Ricklefs
Principal Investigator Email
f.ricklefs@uke.de
Contact Person Name
Frank Lennard Ricklefs
Contact Person Email
f.ricklefs@uke.de
Site Name
Universitaetsklinikum Essen AöR
Department Name
Abteilung Klinische Neuroonkologie Klinik für Neurologie
Principal Investigator Name
Sied Kebir
Principal Investigator Email
Sied.Kebir@uk-essen.de
Contact Person Name
Sied Kebir
Contact Person Email
Sied.Kebir@uk-essen.de
Site Name
Universitaetsklinikum Heidelberg AöR
Department Name
Neurologische Klinik
Principal Investigator Name
Wolfgang Wick
Principal Investigator Email
Wolfgang.Wick@med.uni-heidelberg.de
Contact Person Name
Wolfgang Wick
Site Name
Universitat Heidelberg (Medizinische Fakultät Mannheim der Universität Heidelberg)
Department Name
Medizinische Fakultät Mannheim der Universität Heidelberg
Principal Investigator Name
Michael Platten
Principal Investigator Email
michael.platten@umm.de
Contact Person Name
Michael Platten
Contact Person Email
michael.platten@umm.de

Sponsor

Primary sponsor

Full Name
Institut De Recherches Internationales Servier IRIS
Organisation Type
Pharmaceutical company
Country Of Registered Address
France

Contract research organisations

Name
PPD Development LP
Responsibilities
SUSAR reporting, regulatory activities and multiple clinical trial support functions
Name
Ppd Inc.
Responsibilities
PK samples analysis
Name
Fortrea Inc.
Responsibilities
Statistical programming support for ADaM and TFL generation
Name
Endpoint Clinical Inc.
Responsibilities
IMP dispensation and inventory management, IVRS and treatment randomisation
Name
Almac Clinical Services LLC
Responsibilities
Packaging, labeling, QP release and distribution of the IMP

Third parties

  • {"country":"United States","full_name":"Life Technologies Clinical Services Lab Inc.","duties_or_roles":"Analysis of pre-screening tumor samples for confirmation of presence of IDH1 and/or IDH2 mutation","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Meeting Protocol Worldwide LP","duties_or_roles":"Planning and execution of US Investigator Meeting","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Xogene Services LLC","duties_or_roles":"Clinical data registry posting support","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Cogstate Inc.","duties_or_roles":"Provide ePRO tablets and Cogstate eSource Platform to administer the Cogstate Battery of Tests","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Fortrea Inc.","duties_or_roles":"Statistical programming support for generating ADaM and TFLs for planned and ad-hoc analysis","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Medidata Solutions Inc.","duties_or_roles":"URL, Project Support and EDC hosting services","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"Ppd Inc.","duties_or_roles":"PK samples analysis","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"PPD Development LP","duties_or_roles":"SUSAR Reporting and Regulatory Activities; other clinical supply and reporting responsibilities","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Endpoint Clinical Inc.","duties_or_roles":"IMP dispensation and inventory management, IVRS – treatment randomisation","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Drugdev Inc.","duties_or_roles":"Site Payments","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Clinical Ink Inc.","duties_or_roles":"Electronic platform for administration of questionnaires: EQ-5D-5L; PGI-C; FACT-Br","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Rxlogix Corp.","duties_or_roles":"Hosting and managed services provider of Argus Safety Database & PV Analytics Suite","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Medqia LLC","duties_or_roles":"Blinded Independent Review Committee (BIRC) for collection and central read of MRI scans","organisation_type":"Pharmaceutical company"}
  • {"country":"Belgium","full_name":"PPD Global Central Labs","duties_or_roles":"Coagulation, pregnancy testing (serum), support with lab kit supply and management of samples","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Almac Clinical Services LLC","duties_or_roles":"Packaging, labeling, QP release, and distribution of the IMP","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
S95032/AG-881
Active Substance
VORASIDENIB
Modality
Small molecule
Routes Of Administration
Oral
Route
Oral
Authorisation Status
MIA numbers provided: IMP12181/00001/ DE_NW_05_MIA_2020_0002 / UK MIA 20377
Starting Dose
40 mg
Dose Levels
10 mg; 40 mg
Frequency
Once daily (QD)
Maximum Dose
40 mg/day
Investigational Product Name
Placebo tablets to match S95032 drug product
Modality
Other
Routes Of Administration
Oral
Route
Oral
Dose Levels
Matched 10 mg and 40 mg tablet presentations

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