Skip to content

Cediranib in Combination With Lomustine Chemotherapy in Recurrent Glioblastoma

A Phase III, Randomised, Parallel Group, Multi-Centre Study in Recurrent Glioblastoma Patients to Compare the Efficacy of Cediranib [RECENTIN™, AZD2171] Monotherapy and the Combination of Cediranib With Lomustine to the Efficacy of Lomustine Alone

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00777153
Acronym
REGAL
Enrollment
423
Registered
2008-10-22
Start date
2008-10-31
Completion date
2016-09-30
Last updated
2016-12-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Recurrent Glioblastoma

Keywords

Cancer, Tumour, Advanced Solid Tumour, GBM, Glioblastoma

Brief summary

The purpose of this study is to see how effective cediranib is in treating a brain tumour called recurrent glioblastoma. Two drugs are being tested in this study. Lomustine is an approved oral chemotherapy that belongs to the class of drugs called alkylating agents. Cediranib is a new drug that has not yet been approved for this disease. This study will compare the use of lomustine with cediranib, cediranib alone or lomustine with placebo (inactive substance) to see whether the combination or cediranib alone will be more effective than the chemotherapy alone (lomustine) in preventing the growth of cancer cells.

Interventions

DRUGCediranib

30 mg/day, oral, until progression

DRUGLomustine Chemotherapy

110 mg/m2 / Q6W, oral, until progression

Oral, until progression

Sponsors

AstraZeneca
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No

Inclusion criteria

* Confirmation of recurrent glioblastoma * Life expectancy ≥ 12 weeks * Received only one prior systemic chemotherapy regimen and this regimen must contain temozolomide

Exclusion criteria

* Patients on enzyme-inducing anti-epileptic drugs within 3 weeks prior to randomisation * Poorly controlled hypertension * Previous anti-angiogenesis (eg bevacizumab, sorafenib, sunitinib) therapy

Design outcomes

Primary

MeasureTime frameDescription
Progression Free Survival (PFS)Baseline at 6 weeks and then every 6 weeks to discontinuationFor patients with measurable disease at entry (at least one lesion that has a shortest diameter ≥10 mm at baseline on 2 axial slices), PFS will be defined as the earliest time that: 1. The sum of the products of the largest perpendicular diameters of contrast enhancement for all lesions has increased by a greater than or equal to 25% in comparison to the nadir scan as long as the shortest diameter is ≥15 mm. If the dose of steroids has been reduced within the 10 days prior to the scan being conducted, progression will be based on a follow-up scan performed after the dose of steroids has been stabilized for 10 days. 2. The patient has died from any cause. 3. A new lesion is detected that is outside the original tumor volume and has a shortest diameter ≥10 mm.

Secondary

MeasureTime frameDescription
Overall Survival (OS)Baseline through to date of death up to 25th April 2010Number of months from randomisation to the date of death from any cause
Response RateBaseline at 6 weeks and then every 6 weeks to discontinuationAn individual visit response of PR was defined as a greater than or equal to 50% reduction in the sum of the products of the largest perpendicular diameters of contrast enhancement for all lesions compared to baseline as long as the steroid dose has not been increased within the previous 10 days and no new lesions are present. An individual visit response of CR was defined as the complete disappearance of all tumor on MRI scan.
Alive and Progression Free Rate at 6 Months (APF6)6 MonthsProportion of patients alive and progression free at 6 months (based on central review) as estimated from Kaplan-Meier techniques. Values are percentages.
Daily Steroid DoseBaseline to the date of first documented progression or date of death or study discontinuation, whichever came first, assed up to 2014-April-25The mean steroid dosage prior to treatment will be considered as the patient's baseline. The percent change in average daily steroid dosage from baseline is calculated by following formula: PC = (md - bm)/bm\*100; where PC is the percent change in average daily steroid dosage from baseline; md the mean daily steroid dosage recorded from the first day of therapy to progression; and bm the baseline mean.
Steroid Free DaysBaseline to the date of first documented progression or date of death or study discontinuation, whichever came first, assessed up to 2014-April-25Number of days known not to have used any steroids prior to progression

Countries

Australia, Austria, Belgium, Canada, Czechia, France, Germany, Netherlands, United Kingdom, United States

Participant flow

Recruitment details

423 patients were enrolled in to the study but did not start the study. They did not go on to be randomized.

Pre-assignment details

Randomised=Full Analysis Set (ITT): Cediranib 30 mg=131, Cediranib 20 mg + Lomustine=129, Placebo + Lomustine=65; ITT with measurable disease at baseline (based on site review): Cediranib 30 mg=115, Cediranib 20 mg + Lomustine=112, Placebo + Lomustine=55; Safety Set: Cediranib 30 mg=128, Cediranib 20 mg + Lomustine=123, Placebo + Lomustine=64

Participants by arm

ArmCount
Cediranib 30mg
Cediranib 30mg/Day
131
Cediranib 20mg + Lomustine 110mg
Cediranib 20mg/Day + Lomustine 110mg/m2/Day
129
Lomustine 110mg
Lomustine 110mg/m2/Day + Placebo cediranib
65
Total325

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyDeath857333
Overall StudyIncorrect enrol/elig crit not fulfilled151
Overall StudyLost to Follow-up110
Overall StudyWithdrawal by Subject343

Baseline characteristics

CharacteristicCediranib 30mgCediranib 20mg + Lomustine 110mgLomustine 110mgTotal
Age, Continuous53.4 years
STANDARD_DEVIATION 11.81
53.7 years
STANDARD_DEVIATION 10.78
52.0 years
STANDARD_DEVIATION 13.09
53.3 years
STANDARD_DEVIATION 11.67
Gender
Female
46 Participants44 Participants24 Participants114 Participants
Gender
Male
85 Participants85 Participants41 Participants211 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
124 / 128120 / 12361 / 64
serious
Total, serious adverse events
55 / 12845 / 12326 / 64

Outcome results

Primary

Progression Free Survival (PFS)

For patients with measurable disease at entry (at least one lesion that has a shortest diameter ≥10 mm at baseline on 2 axial slices), PFS will be defined as the earliest time that: 1. The sum of the products of the largest perpendicular diameters of contrast enhancement for all lesions has increased by a greater than or equal to 25% in comparison to the nadir scan as long as the shortest diameter is ≥15 mm. If the dose of steroids has been reduced within the 10 days prior to the scan being conducted, progression will be based on a follow-up scan performed after the dose of steroids has been stabilized for 10 days. 2. The patient has died from any cause. 3. A new lesion is detected that is outside the original tumor volume and has a shortest diameter ≥10 mm.

Time frame: Baseline at 6 weeks and then every 6 weeks to discontinuation

ArmMeasureValue (MEDIAN)
Cediranib 30mgProgression Free Survival (PFS)92 Days
Cediranib 20mg+ Lomustine 110mgProgression Free Survival (PFS)125 Days
Lomustine 110mgProgression Free Survival (PFS)82 Days
Secondary

Alive and Progression Free Rate at 6 Months (APF6)

Proportion of patients alive and progression free at 6 months (based on central review) as estimated from Kaplan-Meier techniques. Values are percentages.

Time frame: 6 Months

ArmMeasureValue (NUMBER)
Cediranib 30mgAlive and Progression Free Rate at 6 Months (APF6)16.2 % of patients alive and progression free
Cediranib 20mg+ Lomustine 110mgAlive and Progression Free Rate at 6 Months (APF6)34.5 % of patients alive and progression free
Lomustine 110mgAlive and Progression Free Rate at 6 Months (APF6)24.5 % of patients alive and progression free
Secondary

Daily Steroid Dose

The mean steroid dosage prior to treatment will be considered as the patient's baseline. The percent change in average daily steroid dosage from baseline is calculated by following formula: PC = (md - bm)/bm\*100; where PC is the percent change in average daily steroid dosage from baseline; md the mean daily steroid dosage recorded from the first day of therapy to progression; and bm the baseline mean.

Time frame: Baseline to the date of first documented progression or date of death or study discontinuation, whichever came first, assed up to 2014-April-25

ArmMeasureValue (NUMBER)
Cediranib 30mgDaily Steroid Dose-17.6 percentage of change
Cediranib 20mg+ Lomustine 110mgDaily Steroid Dose-1.8 percentage of change
Lomustine 110mgDaily Steroid Dose36.6 percentage of change
Secondary

Overall Survival (OS)

Number of months from randomisation to the date of death from any cause

Time frame: Baseline through to date of death up to 25th April 2010

ArmMeasureValue (MEDIAN)
Cediranib 30mgOverall Survival (OS)8.0 Months
Cediranib 20mg+ Lomustine 110mgOverall Survival (OS)9.4 Months
Lomustine 110mgOverall Survival (OS)9.8 Months
Secondary

Response Rate

An individual visit response of PR was defined as a greater than or equal to 50% reduction in the sum of the products of the largest perpendicular diameters of contrast enhancement for all lesions compared to baseline as long as the steroid dose has not been increased within the previous 10 days and no new lesions are present. An individual visit response of CR was defined as the complete disappearance of all tumor on MRI scan.

Time frame: Baseline at 6 weeks and then every 6 weeks to discontinuation

Population: Patients are only included in the analysis if they have measurable disease at baseline based on central.

ArmMeasureValue (NUMBER)
Cediranib 30mgResponse Rate18 Participants
Cediranib 20mg+ Lomustine 110mgResponse Rate21 Participants
Lomustine 110mgResponse Rate5 Participants
Secondary

Steroid Free Days

Number of days known not to have used any steroids prior to progression

Time frame: Baseline to the date of first documented progression or date of death or study discontinuation, whichever came first, assessed up to 2014-April-25

ArmMeasureValue (MEAN)Dispersion
Cediranib 30mgSteroid Free Days75.8 DaysStandard Deviation 110.1
Cediranib 20mg+ Lomustine 110mgSteroid Free Days74.8 DaysStandard Deviation 91.7
Lomustine 110mgSteroid Free Days92.3 DaysStandard Deviation 122

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026