Recurrent glioblastoma (GBM) is a disease with high unmet clinical need. The standard of care for patients with GBM includes surgery, radiotherapy and chemotherapy. Despite this aggressive treatment, the overall median survival of patients with GBM remains at 15-20 months. In more than 95% of cases, tumor recurrence is observed within 2 cm to 3 cm of the resection cavity within 4-7 months after initial treatments. One of the main causes of recurrence is the inability of chemotherapies to enter the brain from the systemic circulation due to the blood-brain barrier (BBB). The BBB is unique to cerebral blood vessels and blocks most drugs from entering the brain in sufficient concentrations. The SonoCloud-9 (SC9) System delivers ultrasound to locally and transiently increase the permeability of the BBB to allow the passage of drugs into the cerebral parenchyma. The SC9 is dimensioned to cover the resection area and surrounding tissues in patients with recurrent GBM. The large sonicated volume covered by the SC9 device allows for broad BBB disruption and should allow for carboplatin chemotherapy to penetrate the surrounding tumor infiltrative area. By enhancing drug concentrations, it is hypothesized that further disease progression will be prevented.
This will be an open-label, Phase 1/2a, multicenter, single-arm, interventional trial that will first evaluate the dose limiting toxicity (DLT) of escalating numbers of ultrasound beams at constant acoustic pressure using a standard escalation (Phase 1) and then confirm the safety and efficacy of BBB opening (Phase 2a expansion).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
38
Escalating numbers of ultrasound beams at constant acoustic pressure
Dose of carboplatin infusion is AUC4-6
Northwestern University
Chicago, Illinois, United States
MD Anderson Cancer Center
Houston, Texas, United States
CHU
Angers, France
Hôpital Neurologique Pierre Wertheimer
Bron, France
Hôpital de La Timone
Marseille, France
Hôpital de la Pitié-Salpêtrière
Paris, France
Dose limiting toxicity (DLT) of number of activated ultrasound beams
DLT will be evaluated using imaging (MRI) and clinical examination, as CTCAE that occurs within 2 weeks of the first sonication and that does not respond to optimal medical management (including steroids) within 7 days.
Time frame: 15 days after the first sonication treatment
Blood-Brain Barrier (BBB) opening
BBB opening will be evaluated by contrast-enhanced T1w magnetic resonance imaging (MRI)
Time frame: At the end of the first three sonication treatments (treatment occurs every 4 weeks)
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