Table 5.
Selected ongoing trials with molecularly targeted treatments
| Molecular Target | Therapy | Phase | Design | Tumor Type | Trial |
|---|---|---|---|---|---|
| MDM2 | AMG-232 | Phase 0/I | • P53 wildtype status • Phase 0/I to measure concentrations in tumor in patients with recurrent GBM and of AMG 232 in combination with RT in patients with newly diagnosed GBM and unmethylated MGMT promoter |
Recurrent and newly diagnosed GBM | NCT03107780 |
| mTORC1/2 | Sapanisertib (MLN0128) | Phase 0 | • No selection • Phase 0 to evaluate tumor PK and PD effects |
Recurrent GBM | NCT02133183 |
| CDK4/6 | Abemaciclib | 0/II | • Patients with activation of CDK4/6 pathway and intact RB | Recurrent GBM | NCT02981940 |
| CDKs 1, 2, 7, and 9, JAK2 and FLT3 | Zotiraciclib (TG02) with metronomic TMZ | I/randomized phase II | • Phase I with metronomic TMZ followed by randomized phase II comparing zoltiraciclib = TMZ versus TMZ | Recurrent grade III glioma and GBM | NCT02942264 |
| CDKs 1, 2, 7 and 9, JAK2 and FLT3 | Zotiraciclib (TG02) with metronomic TMZ | I | • Zotiraciclib + RT for unmethylated MGMT patients • Zotiraciclib with TMZ for methylated MGMT patients • Zotiraciclib alone for recurrent patients |
Newly diagnosed and recurrent grade III glioma and GBM in elderly population | NCT03224104 |
| H3K27M mutation | ONC201 (dopamine receptor D2 inhibitor and ClpP agonist)212,213 | II | • H3K27M mutated gliomas • Non H3K27M mutated midline GBM |
Recurrent H3K27M mutated gliomas and other GBM | NCT02525692 NCT03295396 |
| Interleukin-4 (IL-4) receptor | MDNA55 | II | • Convection enhanced delivery of genetically engineered IL-4 linked to a modified version of the Pseudomonas aeruginosa exotoxin A | Recurrent GBM | NCT02858895 |
| HIF2α | PTC2977 | II | • No selection | Recurrent GBM | NCT02974738 |
| Proteasome | Marizomib | III | • No selection | Newly diagnosed GBM | NCT03345095 |
| Platform Trials | |||||
| Alk MDM2 SHH CDK4/6 mTOR | Alectinib Idasanutlin Vismodegib Palbociclib Temsirolimus | Phase II | • Umbrella trial N2M2/NOA-20 • Alk expression • P53wild-type/MDM2 high • SHH activation • CDK4/6 high or codeletion of CDKN2A/B • Phospho mTOR Ser 24448 |
Newly diagnosed GBM without MGMT hypermethylation, targeted treatment according to molecular profile | NCT03158389 |
| EGFR mTOR/DNA PK CDK4/6 | Neratinib CC115 Abemaciclib | Bayesian adaptive randomized phase II platform trial | INSIGhT Agnostic (assessment post hoc) | Newly diagnosed unmethylated GBM | NCT02977780 |
| Agnostic (assessment post hoc) | Multiple regimens (regorafenib) | Bayesian adaptive randomized phase II/III platform trial | GBM AGILE Multiple | Newly diagnosed and recurrent GBM | NCT03970447 |
Abbreviations: GBM, glioblastoma; HIF2α, hypoxia-inducible factor alpha; MDM2, mouse double minute 2; m, months; ORR, objective response rate; PD, pharmacodynamics; PK, pharmacokinetics; RB, retinoblastoma; SD, stable disease; SHH, sonic hedgehog.