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Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Study protocol

Adjuvant stereotactic fractionated radiotherapy to the resection cavity in recurrent glioblastoma – the GlioCave study (NOA 17 – ARO 2016/3 – DKTK ROG trial)

Authors: Christoph Straube, Hagen Scherb, Jens Gempt, Jan Kirschke, Claus Zimmer, Friederike Schmidt-Graf, Bernhard Meyer, Stephanie E. Combs

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

Glioblastoma relapses in the vast majority of cases within 1 year. Maximum safe resection of the recurrent glioblastoma can be offered in some cases. Re-irradiation has been established for the treatment of recurrent glioblastoma, too. In both cases, adjuvant treatment, mostly using temozolomide, can improve PFS and OS after these interventions. However, combining gross tumor resection and adjuvant re-radiotherapy to the resection cavity has not been tested so far.

Methods/Design

In the multicenter two-armed randomized Phase II GlioCave Study, fractionated stereotactic radiotherapy to the resection cavity, after gross tumor resection of recurrent glioblastoma, will be compared to observation. Depending on the size of the target volume, a total dose of 46 Gy in 2 Gy per fraction or a total dose if 36 Gy in 3 Gy per fraction will be applied. Progression free survival will be the primary endpoint of the study.

Discussion

Adjuvant treatment after gross tumor resection of recurrent glioblastoma is currently deemed to be limited to chemotherapy. However, re-irradiation has proven safety and tolerability in the treatment of macroscopic disease. Performing re-irradiation as an adjuvant measure after gross tumor resection has not been tested so far. The GlioCave Study will investigate the efficacy and the safety profile of this approach.

Trial registration

The trial was prospectively registered at clinicaltrials.gov (NCT02715297, registration date February 29th, 2016). The protocol presented hereby refers to the version 1.2 of the protocol (January 11th, 2017).
Literature
3.
go back to reference Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJB, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J, Janzer RC, Ludwin SK, Gorlia T, Allgeier A, Lacombe D, Cairncross JG, Eisenhauer E, Mirimanoff RO. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352:987–96. https://doi.org/10.1056/NEJMoa043330.CrossRefPubMed Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJB, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J, Janzer RC, Ludwin SK, Gorlia T, Allgeier A, Lacombe D, Cairncross JG, Eisenhauer E, Mirimanoff RO. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352:987–96. https://​doi.​org/​10.​1056/​NEJMoa043330.CrossRefPubMed
5.
go back to reference Lai A, Tran A, Nghiemphu PL, Pope WB, Solis OE, Selch M, Filka E, Yong WH, Mischel PS, Liau LM, Phuphanich S, Black K, Peak S, Green RM, Spier CE, Kolevska T, Polikoff J, Fehrenbacher L, Elashoff R, Cloughesy T. Phase II study of bevacizumab plus temozolomide during and after radiation therapy for patients with newly diagnosed glioblastoma multiforme. J Clin Oncol. 2011;29:142–8. https://doi.org/10.1200/JCO.2010.30.2729.CrossRefPubMed Lai A, Tran A, Nghiemphu PL, Pope WB, Solis OE, Selch M, Filka E, Yong WH, Mischel PS, Liau LM, Phuphanich S, Black K, Peak S, Green RM, Spier CE, Kolevska T, Polikoff J, Fehrenbacher L, Elashoff R, Cloughesy T. Phase II study of bevacizumab plus temozolomide during and after radiation therapy for patients with newly diagnosed glioblastoma multiforme. J Clin Oncol. 2011;29:142–8. https://​doi.​org/​10.​1200/​JCO.​2010.​30.​2729.CrossRefPubMed
6.
go back to reference Wen PY, Chang SM, Lamborn KR, Kuhn JG, Norden AD, Cloughesy TF, Robins HI, Lieberman FS, Gilbert MR, Mehta MP, Drappatz J, Groves MD, Santagata S, Ligon AH, Yung WKA, Wright JJ, Dancey J, Aldape KD, Prados MD, Ligon KL. Phase I/II study of erlotinib and temsirolimus for patients with recurrent malignant gliomas: north American brain tumor consortium trial 04-02. Neuro-Oncology. 2014;16:567–78. https://doi.org/10.1093/neuonc/not247.CrossRefPubMedPubMedCentral Wen PY, Chang SM, Lamborn KR, Kuhn JG, Norden AD, Cloughesy TF, Robins HI, Lieberman FS, Gilbert MR, Mehta MP, Drappatz J, Groves MD, Santagata S, Ligon AH, Yung WKA, Wright JJ, Dancey J, Aldape KD, Prados MD, Ligon KL. Phase I/II study of erlotinib and temsirolimus for patients with recurrent malignant gliomas: north American brain tumor consortium trial 04-02. Neuro-Oncology. 2014;16:567–78. https://​doi.​org/​10.​1093/​neuonc/​not247.CrossRefPubMedPubMedCentral
7.
go back to reference Chakravarti A, Wang M, Robins HI, Lautenschlaeger T, Curran WJ, Brachman DG, Schultz CJ, Choucair A, Dolled-Filhart M, Christiansen J, Gustavson M, Molinaro A, Mischel P, Dicker AP, Bredel M, Mehta M. RTOG 0211: a phase 1/2 study of radiation therapy with concurrent gefitinib for newly diagnosed glioblastoma patients. Int. J. Radiat. Oncol. Biol. Phys. 2013;85:1206–11. https://doi.org/10.1016/j.ijrobp.2012.10.008.CrossRefPubMed Chakravarti A, Wang M, Robins HI, Lautenschlaeger T, Curran WJ, Brachman DG, Schultz CJ, Choucair A, Dolled-Filhart M, Christiansen J, Gustavson M, Molinaro A, Mischel P, Dicker AP, Bredel M, Mehta M. RTOG 0211: a phase 1/2 study of radiation therapy with concurrent gefitinib for newly diagnosed glioblastoma patients. Int. J. Radiat. Oncol. Biol. Phys. 2013;85:1206–11. https://​doi.​org/​10.​1016/​j.​ijrobp.​2012.​10.​008.CrossRefPubMed
8.
go back to reference Friday BB, Anderson SK, Buckner J, Yu C, Giannini C, Geoffroy F, Schwerkoske J, Mazurczak M, Gross H, Pajon E, Jaeckle K, Galanis E. Phase II trial of vorinostat in combination with bortezomib in recurrent glioblastoma: a north central cancer treatment group study. Neuro-Oncology. 2012;14:215–21. https://doi.org/10.1093/neuonc/nor198.CrossRefPubMed Friday BB, Anderson SK, Buckner J, Yu C, Giannini C, Geoffroy F, Schwerkoske J, Mazurczak M, Gross H, Pajon E, Jaeckle K, Galanis E. Phase II trial of vorinostat in combination with bortezomib in recurrent glioblastoma: a north central cancer treatment group study. Neuro-Oncology. 2012;14:215–21. https://​doi.​org/​10.​1093/​neuonc/​nor198.CrossRefPubMed
19.
go back to reference Gobitti C, Borsatti E, Arcicasa M, Roncadin M, Franchin G, Minatel E, Skrap M, Zanotti B, Tuniz F, Cimitan M, Capra E, Drigo A, Trovò MG. Treatment of recurrent high-grade gliomas with GliaSite brachytherapy: a prospective mono-institutional Italian experience. Tumori. 2011;97:614–9. https://doi.org/10.1700/989.10721.PubMed Gobitti C, Borsatti E, Arcicasa M, Roncadin M, Franchin G, Minatel E, Skrap M, Zanotti B, Tuniz F, Cimitan M, Capra E, Drigo A, Trovò MG. Treatment of recurrent high-grade gliomas with GliaSite brachytherapy: a prospective mono-institutional Italian experience. Tumori. 2011;97:614–9. https://​doi.​org/​10.​1700/​989.​10721.PubMed
21.
23.
27.
go back to reference Halligan JB, Stelzer KJ, Rostomily RC, Spence AM, Griffin TW, Berger MS. Operation and permanent low activity 125I Brachytherapy for recurrent high-grade astrocytomas. Int J Radioation Oncology Biol Phys. 1996;35:541–7.CrossRef Halligan JB, Stelzer KJ, Rostomily RC, Spence AM, Griffin TW, Berger MS. Operation and permanent low activity 125I Brachytherapy for recurrent high-grade astrocytomas. Int J Radioation Oncology Biol Phys. 1996;35:541–7.CrossRef
29.
go back to reference Wen PY, Macdonald DR, Reardon DA, Cloughesy TF, Sorensen AG, Galanis E, DeGroot J, Wick W, Gilbert MR, Lassman AB, Tsien C, Mikkelsen T, Wong ET, Chamberlain MC, Stupp R, Lamborn KR, Vogelbaum MA, Van Den Bent MJ, Chang SM. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol. 2010;28:1963–72. https://doi.org/10.1200/JCO.2009.26.3541.CrossRefPubMed Wen PY, Macdonald DR, Reardon DA, Cloughesy TF, Sorensen AG, Galanis E, DeGroot J, Wick W, Gilbert MR, Lassman AB, Tsien C, Mikkelsen T, Wong ET, Chamberlain MC, Stupp R, Lamborn KR, Vogelbaum MA, Van Den Bent MJ, Chang SM. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol. 2010;28:1963–72. https://​doi.​org/​10.​1200/​JCO.​2009.​26.​3541.CrossRefPubMed
30.
go back to reference Macdonald DR, Cascino TL, Schold SCJ, Cairncross JG. Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol. 1990;8:1277–80.CrossRefPubMed Macdonald DR, Cascino TL, Schold SCJ, Cairncross JG. Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol. 1990;8:1277–80.CrossRefPubMed
32.
go back to reference Gray R, Manola J, Saxman S, Wright J, Dutcher J, Atkins M, Carducci M, See W, Sweeney C, Liu G, Stein M, Dreicer R, Wilding G, DiPaola RS. Phase II clinical trial design: methods in translational research from the genitourinary Committee at the Eastern Cooperative Oncology Group. Clin Cancer Res. 2006;12:1966–9. https://doi.org/10.1158/1078-0432.CCR-05-1136.CrossRefPubMed Gray R, Manola J, Saxman S, Wright J, Dutcher J, Atkins M, Carducci M, See W, Sweeney C, Liu G, Stein M, Dreicer R, Wilding G, DiPaola RS. Phase II clinical trial design: methods in translational research from the genitourinary Committee at the Eastern Cooperative Oncology Group. Clin Cancer Res. 2006;12:1966–9. https://​doi.​org/​10.​1158/​1078-0432.​CCR-05-1136.CrossRefPubMed
Metadata
Title
Adjuvant stereotactic fractionated radiotherapy to the resection cavity in recurrent glioblastoma – the GlioCave study (NOA 17 – ARO 2016/3 – DKTK ROG trial)
Authors
Christoph Straube
Hagen Scherb
Jens Gempt
Jan Kirschke
Claus Zimmer
Friederike Schmidt-Graf
Bernhard Meyer
Stephanie E. Combs
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3928-7

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