Why are we doing this research?
The purpose of this study is to measure the benefit of adding abemaciclib to the chemotherapy, temozolomide, for newly diagnosed high-grade glioma following radiotherapy.
Your participation could last approximately 11 months and possibly longer depending upon how you and your tumor respond.
I3Y-MC-JPEH: A Randomized, Open-Label, Phase 2 Study Evaluating Abemaciclib in Combination With Temozolomide Compared to Temozolomide Monotherapy in Children and Young Adults With Newly Diagnosed High-Grade Glioma Following Radiotherapy.
Who can participate?
Inclusion Criteria:
- Biopsy proven high-grade glioma (HGG) as defined by 2016 World Health Organization (WHO) Classification Criteria, Grade 3-4 including:
- Anaplastic astrocytoma
- Anaplastic ganglioglioma
- Anaplastic oligodendroglioma.
- Anaplastic pleomorphic xanthoastrocytoma,
- Glioblastoma
OR as defined by the 2021 WHO Classification Criteria as molecularly characterized:
- Non-pontine diffuse midline glioma, H3 K27-altered,
- Diffuse hemispheric glioma, H3 G34-mutant
- Diffuse pediatric HGG, H3/IDH-wildtype
- Infant-type hemispheric glioma
- High-grade astrocytoma with piloid features
- High-grade pleomorphic xanthoastrocytoma
- IDH-mutant diffuse glioma with homozygous cyclin- dependent kinase inhibitor 2A/B (CDKN2A/B) deletion,
- IDH-mutant and 1p/19q co-deleted oligodendroglioma
- IDH-mutant astrocytoma with homozygous CDKN2A/B deletion
- Contraceptive use should be consistent with local regulations for participants in clinical studies.
- Radiotherapy initiated within 6 weeks (+1 week) of diagnosis and administered over 6 weeks (±1 week). Participants <3 years of age, considered not suitable for radiotherapy may be eligible.
- Minimum of 4 weeks between completion of radiation and Cycle 1 Day 1 (C1D1).
- Maximum of 8 weeks between completion of radiation and C1D1. Exceptional circumstances can be discussed with the medical monitor.
- Acute effects of prior therapies must be Grade ≤1 unless deemed clinically insignificant by the investigator.
- Adequate hematologic and organ function ≤7 days prior to C1D1
- Life expectancy of ≥8 weeks and deemed likely to complete at least 1 cycle of treatment.
- A performance score of ≥60 using:
- Lansky scale for participants <16 years
- Karnofsky scale for participants ≥16 years
- Able to swallow and/or have a gastric/nasogastric tube.
- Any current systemic steroid use dose must be stable or decreasing at least 7 days prior to C1D1.
- Able and willing to adhere to study procedures, including frequent blood draws and MRI.
- At least 28 days since any major surgery, laparoscopic procedure, or a significant traumatic injury.
- Has a body surface area (BSA) of ≥0.2 m2.
Exclusion Criteria:
Participants are excluded if any of the following apply:
- Diffuse Intrinsic Pontine Glioma (DIPG) or diffuse midline glioma located in the pons.
- Recurrent or refractory HGG including any recurrence/progression during/after radiotherapy.
- Secondary HGG, defined as a previously treated low-grade glioma that now meets high- grade criteria, or that resulted from a previously treated malignancy.
- Have known pathogenic somatic mutations appropriate for an anaplastic lymphoma kinase (ALK), B-rapidly accelerated fibrosarcoma (BRAF), or neurotrophic tyrosine receptor kinase (NTRK ) inhibitor, in regions where these therapies are available and deemed appropriate by the investigator.
- Prior HGG treatment (including bevacizumab), except for surgery and radiotherapy (with or without concomitant temozolomide).
- Current enrollment in another trial deemed incompatible with this study.
- Treatment with an investigational product within the last 30 days or 5 half-lives (whichever is longer).
- Prior malignancy within the previous 3 years that, per the investigator and the medical monitor, may affect interpretation of study results.
- A preexisting medical condition(s) that, per the investigator, would preclude study participation.
- Any serious, active, systemic infection requiring IV antibiotic, antifungal, or antiviral therapy, including acute hepatitis B or C, or Human Immunodeficiency Virus at C1D1.
- Intolerability or hypersensitivity such as urticaria, anaphylaxis, toxic necrolysis, and/or Stevens-Johnson syndrome to temozolomide, and/or abemaciclib, their excipients, or dacarbazine.
- Received a live virus vaccine within 28 days of C1D1.
- Pregnant, breastfeeding, or intend to become pregnant during the study.