Avelumab With Laser Interstitial Therapy for Recurrent Glioblastoma

Study Overview
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Brief Summary
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The purpose of the study is to characterize the safety and tolerability of avelumab in combination with Laser Interstitial Thermal Therapy (LITT) for blood barrier disruption in patients with recurrent glioblastoma.

Detailed Description
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This is an open label, non-randomized Phase I study of intravenous avelumab every 2 weeks to be administered after real-time MRI-guided LITT therapy for patients with a first recurrence of a glioblastoma. The primary objective of the study is to characterize the tolerability and safety profile of avelumab in combination with MRI guided LITT administered to patients diagnosed with recurrent GBM. Part A, the initial cohort of patients will be treated with intravenous avelumab alone. Part B, patients will receive avelumab in combination with MRI-guided LITT to characterize the tolerability and safety of the combined treatment.

Official Title
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Phase I Study of PD-L1 Inhibition With Avelumab and Laser Interstitial Thermal Therapy in Patients With Recurrent Glioblastoma

Conditions
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GBM, Glioblastoma

Intervention / Treatment
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* Drug: Avelumab
* Combination Product: MRI-guided LITT therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients must have histologically proven GBM from the initial resection. Patients must have a life expectancy > 16 weeks. Patients must have a Karnofsky performance status of ≥ 60 or ECOG 0 - 2 Patient's requirement for dexamethasone should be ≤ 4mg daily or a stable dose at enrollment. Patients must have adequate bone marrow, hepatic and renal function and hemoglobin and the test musts be performed within 14 days prior to study Day 1. Highly effective contraception for both male and female subjects if the risk of conception exists. Exclusion Criteria: Known history of autoimmune disorder except diabetes mellitus type 1, vitiligo or hypothyroidism only requiring hormone replacement Patients who have received any other therapeutic investigational agent within 30 days of enrollment with the exception of the personalized MTA vaccine (NCT03223103) that can be continued throughout the study. Patients who have received any other therapeutic investigational agent within 30 days of enrollment or prior Prior placement of intracavitary BCNU-impregnated wafers (Gliadel). Prior treatment with checkpoint inhibitors, CTL-4 antibody or other immunotherapy agents Presence of any other active malignancy or prior history of malignancy, except for: basal cell carcinoma of the skin, cervical carcinoma in situ, early stage prostate carcinoma not requiring active treatment. Prior organ transplantation, including allogeneic stem cell transplantation Significant acute or chronic infections including, among others: HIV, AIDS, HBV Pregnancy or lactation Contact site for full inclusion/exclusion list.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients with Recurrent Glioblastoma<br>Part A - Avelumab Part B - Avelumab + MRI-guided LITT therapy | Drug: Avelumab<br>* Avelumab will be administered intravenously every 2 weeks at a dose of 10 mg/kg for 2 cycles<br>Combination Product: MRI-guided LITT therapy<br>* (Part B) prior to receiving Avelumab 10 mg/kg every 2 weeks + LITT<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dose Limiting Toxicity level | Toxicity will be measured by severity of Adverse events with toxicity grading defined by Cancer Therapy Evaluation Program's (CTEP) v4.0 of National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) scale. | 4 weeks | 
| Objective response rate (ORR) | Tumor response to treatment with avelumab in combination with MRI-guided LITT administered to patients with recurrent GBM by estimation of the objective response rate (ORR) -classified according to the RANO Response Criteria (Proportion of Complete Response, Partial Response, Stable Disease and Progressive Disease) | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progression-free survival | The % of progression free survival at 6 months | 6 months | 
| Overall response rate | Overall response rate (proportion of partial and complete responses) will be evaluated according to Rano criteria. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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GBM, LITT, Laser Interstitial Thermal Therapy, Bavencio, immunotherapy