About this trial

Previous evidence has indicated that resection for recurrent glioblastoma might benefit the prognosis of these patients in terms of overall survival. However, the demonstrated safety profile of this approach is contradictory in the literature and the specific benefits in distinct clinical and molecular patient subgroups remains ill-defined. The aim of this study, therefore, is to compare the effects of resection and best oncological treatment for recurrent glioblastoma as a whole and in clinically important subgroups.

This study is an international, multicenter, prospective observational cohort study. Recurrent glioblastoma patients will undergo tumor resection or best oncological treatment at a 1:1 ratio as decided by the tumor board. Primary endpoints are: 1) proportion of patients with NIHSS (National Institute of Health Stroke Scale) deterioration at 6 weeks after surgery and 2) overall survival. Secondary endpoints are: 1) progression-free survival (PFS), 2) NIHSS deterioration at 3 months and 6 months after surgery, 3) health-related quality of life (HRQoL) at 6 weeks, 3 months, and 6 months after surgery, and 4) frequency and severity of Serious Adverse Events (SAEs) in each arm. Estimated total duration of the study is 5 years. Patient inclusion is 4 years, follow-up is 1 year.

The study has been approved by the Medical Ethics Committee (METC Zuid-West Holland/Erasmus Medical Center; MEC-2020-0812). The results will be published in peer-reviewed academic journals and disseminated to patient organisations and media.

Eligibility criteria

Qualifiers

Age ≥18 years and ≤90 years

Tumor recurrence according to the RANO criteria of a previously diagnosed glioblastoma based on the WHO 2021 classification for glioma

The tumor is suitable for resection (according to neurosurgeon)

Written informed consent

Disqualifiers

Tumors of the cerebellum, brainstem, or midline

Medical reasons precluding MRI (e.g., pacemaker)

Inability to give written informed consent

Secondary high-grade glioma due to malignant transformation from low-grade glioma

Trial design

Treatments tested in this trial

  • Re-resection
  • Temozolomide
  • Lomustine
  • Re-irradiation
  • Experimental therapy
  • Best supportive care

Treatment groups

464 Participants
are divided into 2 treatment groups

Locations

8
Belgium
University Hospital Leuven Leuven Belgium
Germany
University Hospital Heidelberg Heidelberg Germany
Technical University Munich Munich Germany
Netherlands
Erasmus MC3015 CE, RotterdamSouth Holland, Netherlands

Sponsors and collaborators

Jasper Gerritsen

Lead sponsor

Erasmus Medical Center

Sponsor institution

Haaglanden Medical Centre

Collaborator

Universitaire Ziekenhuizen KU Leuven

Collaborator

University Hospital Heidelberg

Collaborator

Technical University of Munich

Collaborator

Insel Gruppe AG, University Hospital Bern

Collaborator

Massachusetts General Hospital

Collaborator

University of California, San Francisco

Collaborator