High Grade Meningioma
Conditions
Brief summary
This is a randomized, controlled, open-label, multicenter, Phase III clinical study designed to compare the efficacy and safety of SYHA1813 versus treatment of investigators' choice in patients with recurrent or progressive high-grade meningioma not amenable to local therapy.
Detailed description
Approximately136 participants with recurrent or progressive high-grade meningioma who have received surgical resection and radiotherapy will be enrolled and randomized 1:1 to receive either SYHA1813 (experimental group) or investigators' choice (control group) treatment. The primary endpoint is progression-free survival (PFS) assessed by blinded Independent Review Committee (BIRC) using the Response Assessment in Neuro-Oncology Working Group (RANO criteria) for meningioma.
Interventions
SYHA1813 20mg QD
Investigator's Choice Treatment:bevacizumab, temozolomide or hydroxyurea
Sponsors
Study design
Intervention model description
This is a randomized, controlled, open-label, multicenter, Phase III clinical trial. Participants with recurrent or progressive high-grade meningioma (WHO Grade II and III) who have received surgical resection and radiotherapy and are not eligible for local therapy judged by investigator will be randomized 1:1 to receive either SYHA1813 (experimental group) or investigators' choice (control group) treatment.
Eligibility
Inclusion criteria
* 1\. Aged \>= 18 years. * 2\. Histologically confirmed WHO grade II/III meningioma (WHO CNS 5th) that is progressive or recurrent. * 3\. Individuals must have received surgery and radiation therapy. * 4\. There is at least one measurable intracranial tumor lesion in the baseline period (RANO-meningioma). * 5\. KPS≥60. * 6\. The expected survival time is \>=3 months. * 7\. The organ function level and related laboratory indicators must meet requirement. * 8\. Agree to use reliable and effective methods of contraception during the study treatment period and for at least 3 months after the last study treatment.
Exclusion criteria
* 1\. Individuals who are known to have severe allergic reaction to the study drug or any other ingredients/excipients in the formulation. * 2\. Meets one of the following conditions: patients with brainstem involvement or extracranial metastasis; patients with severe brain herniation or at risk of brain herniation. * 3\. History of other malignant tumors within 3 years or concurrent active malignant tumors. * 4\. The toxic reactions of previous anti-tumor treatments have not yet recovered to ≤ Grade 1. * 5\. Have used potent inhibitors or inducers of CYP3A4, CYP2C19 or CYP1A2 within the 14 days prior to randomization or are still requiring continued use of such agents. * 6\. Individuals currently receiving warfarin or other oral anticoagulants (excluding those who use low-dose anticoagulants to maintain patency of central venous access or prevent deep vein thrombosis). * 7\. Individuals who are unable to undergo enhanced MRI (such as those with pacemakers, metal dentures, claustrophobia, contrast agent allergies, etc.). * 8\. Individuals with evidence or medical history of bleeding tendency within 2 months prior to randomization. * 9\. Individuals with urine protein ≥ 2+, and 24-hour quantitative urine protein ≥ 1.0 g/24 h upon testing. * 10\. History of acquired immunodeficiency syndrome or HIV antibody positivity in the past; Active hepatitis C; Active hepatitis B. * 11\. Individuals with poorly healing wounds or ulcers, or fractures that require treatment or exhibit poor healing. * 12\. Within 14 days prior to randomization, there were severe chronic or active infections (including tuberculosis infections) that required intravenous injection of antibacterial, antifungal or antiviral therapy. * 13\. Individuals with cardiovascular and cerebrovascular diseases of significant clinical significance. * 14\. Have undergone surgery of major vital organs within 28 days prior to randomization (excluding puncture biopsy). * 15\. Individuals with swallowing difficulties or known medication absorption disorders. * 16\. Pregnant or lactating women. * 17\. Any other conditions that may interfere with the participant's adherence to study procedures, compromise the participant's best interests in participating in the study, or affect study results.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Progression-Free Survival (PFS) as Assessed by RANO Criteria and Evaluated by BIRC | Up to approximately 4 years |
Secondary
| Measure | Time frame |
|---|---|
| PFS as Assessed by RANO Criteria and Evaluated by investigators | Up to approximately 4 years |
| Overall Survival (OS) | Up to approximately 4 years |
| Overall Survival Rate at 12 Months (OS-12) | Up to approximately 4 years |
| Progression Free Survival Rate at 6 Months (PFS-6) as Assessed by RANO Criteria | Up to approximately 4 years |
| Objective Response Rate (ORR) as Assessed by RANO Criteria | Up to approximately 4 years |
| Disease Control Rate (DCR) as Assessed by RANO Criteria | Up to approximately 4 years |
| Frequency and severity of TEAEs and SAEs | Up to approximately 4 years |
| Cmax of SYHA1813 | Cycles 1, 2, 3 |
| Tmax of SYHA1813 | Cycles 1, 2, 3 |
| AUClast of SYHA1813 | Cycles 1, 2, 3 |
| AUCinf of SYHA1813 | Cycles 1, 2, 3 |
| t1/2 of SYHA1813 | Cycles 1, 2, 3 |