Intraoperative Radiotherapy in Newly Diagnosed Glioblastoma Multiforme

NCT ID: NCT02685605

Last Updated: 2025-10-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

314 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-09

Study Completion Date

2026-06-30

Brief Summary

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INTRAGO II resembles a multicentric, prospective, randomized, 2-arm, open-label clinical phase III trial which tests if the median progression-free survival (PFS) of patients with newly diagnosed glioblastoma multiforme (GBM) can be improved by the addition of intraoperative radiotherapy (IORT) to standard radiochemotherapy.

Detailed Description

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Conditions

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Glioblastoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Experimental Arm (A)

Standard surgery plus intraoperative radiotherapy (20-30 Gy) followed by radiochemotherapy (EBRT: 60 Gy, 75 mg/m2/d temozolomide) and adjuvant chemotherapy with 150-200 mg/m2/d temozolomide per cycle (5/28 days).

Group Type EXPERIMENTAL

Standard surgery

Intervention Type PROCEDURE

Intraoperative radiotherapy

Intervention Type RADIATION

Dose to applicator surface: 20-30 Gy; Carl Zeiss INTRABEAM System. IORT with a surface dose of 30 Gy is recommended.Should the proximity to any risk structure not allow to apply 30 Gy, a dose reduction by up to 10 Gy (resulting in a surface dose of 20 Gy) is allowed.

Radiochemotherapy

Intervention Type RADIATION

EBRT to 60 Gy plus 75 mg/m2/d temozolomide

Temozolomide

Intervention Type DRUG

Adjuvant chemotherapy with 150-200 mg/m2/d temozolomide per cycle (5/28 days).

Control Arm (B)

Standard surgery followed by radiochemotherapy (EBRT: 60 Gy, 75 mg/m2/d temozolomide) and adjuvant chemotherapy with 150-200 mg/m2/d temozolomide per cycle (5/28 days).

Group Type ACTIVE_COMPARATOR

Standard surgery

Intervention Type PROCEDURE

Radiochemotherapy

Intervention Type RADIATION

EBRT to 60 Gy plus 75 mg/m2/d temozolomide

Temozolomide

Intervention Type DRUG

Adjuvant chemotherapy with 150-200 mg/m2/d temozolomide per cycle (5/28 days).

Interventions

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Standard surgery

Intervention Type PROCEDURE

Intraoperative radiotherapy

Dose to applicator surface: 20-30 Gy; Carl Zeiss INTRABEAM System. IORT with a surface dose of 30 Gy is recommended.Should the proximity to any risk structure not allow to apply 30 Gy, a dose reduction by up to 10 Gy (resulting in a surface dose of 20 Gy) is allowed.

Intervention Type RADIATION

Radiochemotherapy

EBRT to 60 Gy plus 75 mg/m2/d temozolomide

Intervention Type RADIATION

Temozolomide

Adjuvant chemotherapy with 150-200 mg/m2/d temozolomide per cycle (5/28 days).

Intervention Type DRUG

Other Intervention Names

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IORT

Eligibility Criteria

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Inclusion Criteria

1. Age ≥18 and ≤ 80 years
2. Karnofsky Performance Score (KPS) ≥ 60%
3. Supratentorial T1-Gd enhancing lesion(s) amenable to total resection
4. Legal capacity and ability of subject to understand character and individual consequences of the clinical trial
5. Patient's written IC obtained at least 24h prior to surgery
6. For women with childbearing potential: adequate contraception
7. Patients must have adequate organ functions

Bone marrow function:
* Platelets ≥ 75.000/μL
* WBC ≥ 3.000/μL
* Hemoglobin ≥ 10.0 g/dL

Liver Function:
* ASAT and ALAT ≤ 3.0 times ULN
* ALP ≤ 2.5 times ULN
* Total Serum Bilirubin \< 1.5 times ULN

Renal Function:
* Serum Creatinine ≤ 1.5 times ULN

8. IORT must be technically feasible
9. Histology supports diagnosis of GBM

Exclusion Criteria

1. Multicentric disease (e.g. in both hemispheres) or non-resectable satellite lesions
2. Previous cranial radiation therapy
3. Cytostatic therapy / chemotherapy for cancer within the past 5 years
4. History of cancers or other comorbidities that limit life expectancy to less than five years
5. Previous therapy with anti-angiogenic substances (such as bevacizumab)
6. Technical impossibility to use MRI or known allergies against MRI and/or CT contrast agents
7. Participation in other clinical trials testing cancer-derived investigational agents/procedures.
8. Pregnant or breast feeding patients
9. Fertile patients refusing to use safe contraceptive methods during the study

10. Active egress of fluids from a ventricular defect
11. In-field risk organs and/or IORT dose \>8 Gy to any risk organ
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Carl Zeiss Meditec AG

INDUSTRY

Sponsor Role collaborator

University of California, Los Angeles

OTHER

Sponsor Role collaborator

Universitätsmedizin Mannheim

OTHER

Sponsor Role lead

Responsible Party

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Frank A. Giordano

PI (Chair)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Frank A. Giordano, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Germany

Kevin Petrecca, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Neurosurgery, Montréal Neurological, Institute and Hospital, Montréal, Canada

Locations

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Barrow Neurological Institute (SJHMC)

Phoenix, Arizona, United States

Site Status

Stritch School of Medicine Loyola University

Maywood, Illinois, United States

Site Status

Long Island Jewish Medical Center, North Shore University Hospital

Lake Success, New York, United States

Site Status

Lenox Hill Hospital, Hofstra Northwell School of Medicine

New York, New York, United States

Site Status

West Virginia University

Morgantown, West Virginia, United States

Site Status

Hospital Alemão Oswaldo Cruz

São Paulo, , Brazil

Site Status

Montreal Neurological Institute and Hospital

Montreal, Quebec, Canada

Site Status

Beijing Tian Tan Hospital, Capital Medical University

Beijing, , China

Site Status

University Hospital Augsburg

Augsburg, , Germany

Site Status

Charité - Universitätsmedizin

Berlin, , Germany

Site Status

St. Georg Hospital

Leipzig, , Germany

Site Status

University Hospital Mannheim

Mannheim, , Germany

Site Status

Technical University of Munich (TUM), Department of Radiation Oncology

Munich, , Germany

Site Status

Klinikum Stuttgart

Stuttgart, , Germany

Site Status

Helios University Hospital Wuppertal

Wuppertal, , Germany

Site Status

Gangnam Severance Hospital, Yonsei University College of Medicine

Seoul, , South Korea

Site Status

Catalan Institute of Oncology (ICO)

Barcelona, , Spain

Site Status

Hospital Reina Sofia

Córdoba, , Spain

Site Status

The London Clinic

London, , United Kingdom

Site Status

Countries

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United States Brazil Canada China Germany South Korea Spain United Kingdom

References

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Giordano FA, Brehmer S, Abo-Madyan Y, Welzel G, Sperk E, Keller A, Schneider F, Clausen S, Herskind C, Schmiedek P, Wenz F. INTRAGO: intraoperative radiotherapy in glioblastoma multiforme-a phase I/II dose escalation study. BMC Cancer. 2014 Dec 22;14:992. doi: 10.1186/1471-2407-14-992.

Reference Type BACKGROUND
PMID: 25535398 (View on PubMed)

Sarria GR, Sperk E, Han X, Sarria GJ, Wenz F, Brehmer S, Fu B, Min S, Zhang H, Qin S, Qiu X, Hanggi D, Abo-Madyan Y, Martinez D, Cabrera C, Giordano FA. Intraoperative radiotherapy for glioblastoma: an international pooled analysis. Radiother Oncol. 2020 Jan;142:162-167. doi: 10.1016/j.radonc.2019.09.023. Epub 2019 Oct 16.

Reference Type BACKGROUND
PMID: 31629553 (View on PubMed)

Ayala Alvarez DS, Watson PGF, Popovic M, Heng VJ, Evans MDC, Panet-Raymond V, Seuntjens J. Evaluation of Dosimetry Formalisms in Intraoperative Radiation Therapy of Glioblastoma. Int J Radiat Oncol Biol Phys. 2023 Nov 1;117(3):763-773. doi: 10.1016/j.ijrobp.2023.04.031. Epub 2023 May 5.

Reference Type BACKGROUND
PMID: 37150259 (View on PubMed)

Cifarelli CP, Jacobson GM. Intraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors. Front Oncol. 2021 Nov 11;11:768168. doi: 10.3389/fonc.2021.768168. eCollection 2021.

Reference Type BACKGROUND
PMID: 34858846 (View on PubMed)

Sarria GR, Smalec Z, Muedder T, Holz JA, Scafa D, Koch D, Garbe S, Schneider M, Hamed M, Vatter H, Herrlinger U, Giordano FA, Schmeel LC. Dosimetric Comparison of Upfront Boosting With Stereotactic Radiosurgery Versus Intraoperative Radiotherapy for Glioblastoma. Front Oncol. 2021 Oct 28;11:759873. doi: 10.3389/fonc.2021.759873. eCollection 2021.

Reference Type BACKGROUND
PMID: 34778080 (View on PubMed)

Giordano FA, Brehmer S, Murle B, Welzel G, Sperk E, Keller A, Abo-Madyan Y, Scherzinger E, Clausen S, Schneider F, Herskind C, Glas M, Seiz-Rosenhagen M, Groden C, Hanggi D, Schmiedek P, Emami B, Souhami L, Petrecca K, Wenz F. Intraoperative Radiotherapy in Newly Diagnosed Glioblastoma (INTRAGO): An Open-Label, Dose-Escalation Phase I/II Trial. Neurosurgery. 2019 Jan 1;84(1):41-49. doi: 10.1093/neuros/nyy018.

Reference Type DERIVED
PMID: 29528443 (View on PubMed)

Other Identifiers

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ARO-2016-1

Identifier Type: OTHER

Identifier Source: secondary_id

AG-NRO-03

Identifier Type: OTHER

Identifier Source: secondary_id

INTRAGO-II

Identifier Type: -

Identifier Source: org_study_id

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