The BIOMEDE 2.0 study is the second stage of the BIOMEDE multi-arm, multistage rolling programme (adaptive platform protocol). It is a multicenter, randomized, open-label, controlled phase-3 trial evaluating efficacy of ONC201 in comparison with everolimus (primary objective based on internal comparison) and subsequently to historical controls. Two treatment groups will be compared. A switch between treatment groups is allowed after confirmation of the disease progression (real-time central review blinded to the treatment arm allocation). Study treatment will be continued until centrally confirmed disease progression (either radiologically or histologically), unacceptable toxicity or consent withdrawal. The final conclusion of the trial will be successful for ONC201, if ONC201 is found significantly superior to everolimus in terms of centrally-reviewed PFS (Progression-free survival) from randomization (internal comparison) either overall, considering ND-DMG and DIPG-patients together, or in the subgroup of ND-DMG patients alone. In other cases, Everolimus will remain the standard arm unless it appears associated with an excess of toxicity compared to ONC201 which could then be discussed as a new standard.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
433
Tablets of 2.5 mg or 10 mg. The prescribed dose is 5 mg/m²/day, orally, once daily. Dose will be capped at 10 mg once daily.
Capsules of 125mg. The prescribed dose is 375mg/m², orally, once daily at Day 1 and Day 2 of each week. Dose will be capped at 625 mg per dose.
All patients will be treated with 30 conventional single daily fractions of 1.8 Gy to a total of 54 Gy over a planned period of 6 weeks. Dose may be increased up to 60 Gy for adult patients with supratentorial ND-DMG. The clinical target volume will include all the areas of abnormality on T2/FLAIR sequences with a 1-cm margin. Radiotherapy will have to start within a maximum of 4 weeks for DIPG, up to 6 weeks for other DMG H3K28-altered (ND-DMG), after the biopsy or last surgery. The study medication will be started at Day 1 (+3 days max) of radiotherapy. Reirradiation is permitted only at disease progression according to local practice. In case of metastatic disease or intramedullary tumors, patients can be included in the study. In this situation, radiotherapy will have to start within a maximum of 4 weeks for DIPG, up to 6 weeks for other DMG H3K28-altered (ND-DMG), after the biopsy or last surgery while targeted treatment will start at the end of the irradiation.
Aarhus Universitetshospital Skejby
Aarhus, Denmark
RECRUITINGRigshospitalet
Copenhagen, Denmark
RECRUITINGH.C. Andersen Children's Hospital, Odense Universitetshospital
Odense, Denmark
RECRUITINGGustave Roussy
Villejuif, Val de Marne, France
Progression-free survival
Defined as the time between date of randomization and unequivocal clinical, cytological or radiological progression confirmed by central review, or death whatever the cause.
Time frame: Until 2 years after inclusion of the last patient
Overall survival (for all the comparisons to historical controls)
Defined from the date of radiological diagnosis to the date of death from any cause.
Time frame: Until 5 years after randomization of the last patient
Overall survival (for the internal comparison between randomized groups)
Defined from the date of randomization to the date of death from any cause.
Time frame: Until 5 years after randomization of the last patient
Progression-free survival after first progression
It will also be computed from the date of progression to the date of subsequent progression or death from any cause, in order to describe the outcome after progression.
Time frame: Until 5 years after randomization of the last patient
Complication rate of the diagnostic biopsy-based procedure
Time frame: Until 5 years after randomization of the last patient
Severity of the complications (including prolongation of the hospital stay) of the diagnostic biopsy-based procedure
Time frame: Until 5 years after randomization of the last patient
Duration of the complications (including delay for starting treatment) of the diagnostic biopsy-base procedure
Time frame: Until 5 years after randomization of the last patient
Safety profile of the drugs
Using the NCI-CTC v5.0 criteria, during radiotherapy and during the entire duration of the administration of the drug, considering all adverse events except adverse events unequivocally related to the disease (pseudo)-progression.
Time frame: Until 5 years after randomization of the last patient
Relative benefit/risk ratio of ONC201 compared to everolimus
It will be assessed using the Q-TWiST approach (Quality-adjusted time without symptoms of disease or adverse event) evaluated from survival times (overall survival and progression-free survival) and adverse events data (date of occurrence of grade 3+ adverse event).
Time frame: Until 5 years after randomization of the last patient
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
CHU d'Amiens-Picardie Site Sud
Amiens, France
RECRUITINGInstitut de Cancérologie de l'Ouest (ICO) - Site Paul Papin
Angers, France
RECRUITINGCHU d'Angers - Bâtiment Robert Debré
Angers, France
RECRUITINGCHU Besançon - Hôpital Jean Minjoz
Besançon, France
RECRUITINGCHU de Bordeaux - Groupe hospitalier Saint André - Hôpital Saint André
Bordeaux, France
RECRUITINGCHU de Bordeaux - Groupe hospitalier Pellegrin - Hôpital des enfants
Bordeaux, France
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