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Not yet recruiting NCT07739017

OLIG2 Inhibitor CT-179 for Recurrent and Newly-diagnosed Glioblastoma

Phase I Interventional Recurrent Glioblastoma Newly Diagnosed MGMT Unmethylated Glioblastoma

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: CT-179.
Who it may be relevant to
Registry conditions: Recurrent Glioblastoma, Newly Diagnosed MGMT Unmethylated Glioblastoma. Basic parameters: 18 years — 75 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Australia
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Official title

A Phase 1, Two-Part, Accelerated Dose Titration Trial of CT-179 as Monotherapy in the Treatment of Recurrent Glioblastoma and in Combination With Radiation Therapy in the Treatment of Newly Diagnosed MGMT-Unmethylated Glioblastoma

Overview

This is a first-in-human Phase 1 two-part, open-label, multi-center, dose escalation study designed to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD) and maximum tolerated dose (MTD) of CT-179 in patients with recurrent glioblastoma and newly diagnosed MGMT-unmethylated glioblastoma who are eligible to receive radiation therapy following surgery, and to establish the recommended Phase 2 dose.

Detailed description

The OPAL trial is a Phase 1, multi-center, open-label study designed to evaluate the safety and tolerability of CT-179. CT-179 is an orally administered small molecule that modulates the oligodendrocyte transcription factor 2 (OLIG2). The study will enroll up to 54 adult patients with isocitrate dehydrogenase (IDH)-wild type Glioblastoma (GBM).

To evaluate the drug across different stages of the disease, the trial is structured into distinct treatment groups:

* Treatment Arm 1 (Recurrent GBM): In Treatment Arm 1, patients will receive a daily oral dose of CT-179 for a 28-day Dose-Limiting Toxicity (DLT) assessment period. Dose escalation begins at 0.65 mg/kg and may proceed up to 10.4 mg/kg across six planned cohorts. The first three cohorts will use an Accelerated Titration design (one patient per cohort) before reverting to a standard 3+3 dose-escalation design if specific moderate or dose-limiting toxicities are observed. * Treatment Arm 2 (Newly Diagnosed MGMT-Unmethylated GBM):

Enrollment in Arm 2 will only begin after the sixth cohort in Arm 1 successfully clears its 28-day DLT period. These patients will receive CT-179 for a one-week lead-in, followed by six weeks of CT-179 administered concurrently with standard radiation therapy (60 Gy). The DLT observation period for this arm lasts up to 12 weeks and uses a standard 3+3 dose-escalation design.

* Intra-Tumoral Drug Concentration (IDC) Sub-Study: Once the Maximum Tolerated Dose (MTD) is established in Arm 1, a sub-study will evaluate how well CT-179 penetrates tumor tissue. Patients will receive CT-179 for 7 to 14 days before their scheduled tumor resection so that intra-tumoral drug concentrations can be measured from the resected tissue. * Study Objectives: The primary objective across all cohorts is to determine the MTD and the Recommended Phase 2 Dose (RP2D) for CT-179. Secondary and exploratory measures include tracking pharmacokinetics (PK), assessing preliminary efficacy via Overall Response Rate (ORR) and Progression-Free Survival (PFS) using RANO 2.0 criteria, and evaluating changes in tumor metabolism via FET-PET imaging.

Interventions

  • Drug CT-179
    Daily administration of CT-179

Primary outcome measures

  • Determine Maximum Tolerated Dose (MTD) in TA1 in patients with rGBM [Time frame: From first dose of CT-179 through the end of the 28-day DLT assessment period (Day 28) for each cohort.]
  • Determine MTD/RP2D in TA2 in patients with newly diagnosed MGMT-unmethylated GBM [Time frame: From first dose of CT-179 through 4 weeks after completion of radiotherapy (up to 12 weeks).]
Secondary outcome measures (7)
  • Incidence of Adverse Events, graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0 [Time frame: From first dose of CT-179 through 28 days after the last dose of study treatment, assessed for up to 24 months.]
  • Pharmacokinetic parameters Tmax [Time frame: From first dose of CT-179 through the end of treatment, assessed for up to 24 months.]
  • Overall response rate (ORR) [Time frame: From first dose of CT-179 until documented disease progression or withdrawal, assessed for up to 24 months.]
  • Progression-Free Survival (PFS) [Time frame: From first dose of CT-179 to first documented disease progression, assessed for up to 24 months.]
  • Pharmacokinetic parameters Cmax [Time frame: From first dose of CT-179 through the end of treatment, assessed for up to 24 months.]
  • Pharmacokinetic parameters T1/2 [Time frame: From first dose of CT-179 through the end of treatment, assessed for up to 24 months.]
  • Pharmacokinetic parameters AUC [Time frame: From first dose of CT-179 through the end of treatment, assessed for up to 24 months.]

Eligibility criteria

Inclusion criteria

  • Male or female aged ≥ 18 years at the time of signing informed consent
  • Supratentorial, histologically confirmed diagnosis of primary GBM that meets the current diagnostic classification: 2021 WHO Classification of Tumors of the Central Nervous System
  • KPS score ≥ 70
  • Adequate organ function
  • Contraception during study participation, as applicable
  • Able to swallow tablets

Exclusion criteria

  • Treatment with an investigational agent within the last 30 days excluding 5- aminolevulinic acid (5-ALA)
  • Placement of Gliadel wafers or similar local therapy at time of surgery
  • Receive bevacizumab
  • Evidence of intracranial or intra-tumoral hemorrhage
  • Significant concomitant disorder or serious intercurrent illness
  • History of prior malignancy, except adequately treated non-melanoma skin cancer, carcinoma in-situ of the cervix, or disease-free for more than 5 years
  • Treatment for HIV, hepatitis B, or hepatitis C
  • Any gastrointestinal disorder that could result in reduced absorption of CT-179
  • Any psychiatric illness or social situation that would limit compliance with study requirements
  • Dose of dexamethasone higher than 4 mg/day within 1 week of the first dose of study medication

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Non-randomized
Model
Sequential
Masking
Open label
Primary purpose
Treatment

Study locations

Australia · 2 centers
  • Royal Brisbane and Women's Hospital — Herston
  • Austin Health — Heidelberg

Identifiers

NCT: NCT07739017 · CT-179-102

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗