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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03763422
Additional trial details provided through ANZCTR are available at the end of this record.
Registration number
NCT03763422
Ethics application status
Date submitted
13/11/2018
Date registered
4/12/2018
Date last updated
1/02/2022
Titles & IDs
Public title
Trial in Low Grade Glioma Patients: Wait or Treat
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Scientific title
IDH Mutated 1p/19q Intact Lower Grade Glioma Following Resection: Wait Or Treat? IWOT - a Phase III Study
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Secondary ID [1]
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EORTC-BTG-1635
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Universal Trial Number (UTN)
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Trial acronym
IWOT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Low-grade Glioma
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Temozolomide
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Phase III
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Wait or Treat
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Condition category
Condition code
Cancer
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Brain
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Temozolomide
Treatment: Other - Radiotherapy
Treatment: Surgery - Surgery
Experimental: Early Treatment arm - Radiotherapy + Temozolomide
Active comparator: Active surveillance arm - Treatment as per local practice
Treatment: Drugs: Temozolomide
Oral Administration of Temozolomide
Treatment: Other: Radiotherapy
50.4 Gy in 28 fractions over 6 weeks
Treatment: Surgery: Surgery
Surgery
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Treatment: Other
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Intervention code [3]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Next intervention free survival (FIFS)
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Assessment method [1]
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Timepoint [1]
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From the date of randomization until initiation of second treatment or death whichever occurs first assessed up to 11.5 years as of first patient in (FPI)
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Secondary outcome [1]
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First intervention free survival (FIFS)
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Assessment method [1]
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Timepoint [1]
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from the date of randomization until initiation of preferably RT/TMZ or any other first therapeutic intervention (second surgery, RT, chemotherapy) or death (any cause) whichever occurs first assessed up to 11.5 years as of first patient in
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Secondary outcome [2]
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Progression Free Survival (PFS)
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Assessment method [2]
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Timepoint [2]
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From the date of randomization until the date of first objective progression or the date of patient's death whichever occurs first assessed up to 11.5 years as of first patient in
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Secondary outcome [3]
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Overall Survival
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Assessment method [3]
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Timepoint [3]
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From the date of randomization up to the date of death up to 1 year after first progression or start of second treatment in early treatment arm or first treatment in active surveillance arm assessed up to 11.5 years as of first patient in
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Secondary outcome [4]
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Seizure activity
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Assessment method [4]
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Seizure activity will be evaluated by the IWOT Seizure Control Composite Score Index completed by patients with an additional answer from the local investigator.
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Timepoint [4]
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The IWOT Seizure Control Composite Score Index can be completed up to 4 weeks before or after the planned assessment. A time window of 8 weeks is therefore available for each assessment. Assessed up to 11.5 years after FPI
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Secondary outcome [5]
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Safety profile: CTCAE
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Assessment method [5]
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This study will use the International Common Terminology Criteria for Adverse Events (CTCAE), version 5.0, for adverse event reporting.
Hematological toxicity will be assessed on the basis of blood counts. The nadir count will be assessed for each cycle of TMZ therapy, and graded according to CTCAE.
Non-hematological acute side effects will be assessed and reported separately for each cycle of TMZ therapy, and graded according to the Common Terminology Criteria for Adverse Events version 5.0.
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Timepoint [5]
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The collection period will start from randomization and up to start of second treatment for patients in the early treatment arm and from randomization to first treatment, for patients in active surveillance arm. Assessed up to 11.5 years after FPI
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Secondary outcome [6]
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Translational research
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Assessment method [6]
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The main objectives of TR are the assessment of markers that can identify patients in whom an active surveillance policy is not recommended or who are at risk to develop delayed complications is important. Furthermore, identification of predictive factors that could guide when to start RT and chemotherapy would aid the implementation of an active surveillance approach in clinical practice.
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Timepoint [6]
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tissue and blood at randomization and new tissue at repeated surgical interventions if patient consented for translational research.Assessed up to 11.5 years after FPI
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Secondary outcome [7]
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HRQoL related to seizures
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Assessment method [7]
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A seizure specific questionnaire will be used. The Seizure Control Composite Score Index is self-reported 7-item questionnaire developed to assess seizures frequency and severity.
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Timepoint [7]
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From randomization until progression assessed up to 11.5 years as of FPI
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Eligibility
Key inclusion criteria
* Histologically WHO grade II (diffuse) or III (anaplastic) astrocytoma, IDHmt without 1p/19q co-deletion (local diagnosis)
* Time since diagnostic surgery or first resection = 6 months
* No need for immediate radiotherapy followed by chemotherapy
* Having seizures only, without functional deficits due to the tumor (but the presence of functional deficits due to the resection is allowed)
* Patients for whom by local judgment an active surveillance policy is a realistic management alternative
* The patient is at least 18 years of age on day of signing informed consent
* WHO PS 0-2
* Adequate hematological, renal, and hepatic function, as follows:
* Absolute neutrophil count = 1.5 x 10*9/L
* Platelets = 100 × 10*9/L
* Serum creatinine = 1.5 times upper limit of laboratory normal (ULN)
* Total serum bilirubin = 1.5 × ULN
* AST and ALT = 2.5 × ULN
* Alkaline phosphatase of = 2.5 × ULN
* Presence of at least one paraffin block from the initial diagnosis for pathology review and translational research. If a representative formalin-fixed, paraffin-embedded (FFPE) block is not available, the collection of optimally 36, minimally 24 x 5 µm, unstained slides is required.
* At the time of randomization presence only of a non-enhancing tumor on T1 weighted contrast enhanced MR images; some faint non-nodular enhancement or enhancement that can be ascribed to the surgical resection or peri-operative ischemia is allowed. Preoperative enhancement is allowed provided this area is resected as shown on postoperative imaging
* Ability to take oral medication
* Women of child bearing potential (WOCBP) must have a negative serum or urine pregnancy test done within 72 hours prior to randomization
* Patients of childbearing / reproductive potential must agree to use adequate birth control measures, as defined by the investigator, during RT and TMZ treatment and for at least 6 months after the last TMZ cycle. A highly effective method of birth control is defined as those which result in low failure rate (i.e., less than 1 percent per year) when used consistently and correctly
* Women who are breast feeding must agree to discontinue nursing prior to the first dose of study treatment and until 6 months after the last study treatment
* Male patients should be advised not to father a child and not to donate sperm up to 6 months after receiving the last dose of TMZ, and to seek advice on cryoconservation of sperm prior to treatment start
* Ability to understand the requirements of the study, provide written informed consent and authorization of use and disclosure of protected health information, and agree to abide by the study restrictions and return for the required assessments
* Before patient registration/randomization, written informed consent must be given according to ICH/GCP, and national/local regulations
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Presence of signs of increased intracranial pressure after surgery
* Requirement of steroids for control of tumor symptoms
* Presence of uncontrolled seizures after surgery, defined as having both:
* persistent seizures interfering with everyday life activities AND
* failed three lines of anti-epileptic drug regimen, including at least one combination regimen
* Presence of contra-indications for radiotherapy
* Hypersensitivity to dacarbazine (DTIC), to the active substance or to any of the excipients used for TMZ capsules
* Prior chemotherapy, or prior radiotherapy to the brain
* Pregnancy or breastfeeding
* Known HIV, chronic hepatitis B, or hepatitis C infection
* Inability to take oral medication (e.g., frequent vomiting, partial bowel obstruction)
* Concurrent severe or uncontrolled medical disease (e.g., active systemic infection, diabetes, hypertension, coronary artery disease, psychiatric disorder) that, in the opinion of the investigator, would compromise the safety of the patient or compromise the ability of the patient to complete the study
* Prior or second invasive malignancy, except non-melanoma skin cancer, completely resected cervical or prostate cancer (with PSA of less than or equal to 0.1 ng/mL). Other cancers for which the subject has completed potentially curative treatment more than 3 years prior to study entry are allowed
* Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/03/2020
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
29/12/2021
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Sample size
Target
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Accrual to date
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Final
19
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Recruitment in Australia
Recruitment state(s)
Brisbane, QLDNSW,SA,TAS,VIC,West-Australi
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Recruitment hospital [1]
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Princess Alexandra Hospital - University of Queensland - Woolloongabba
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Recruitment hospital [2]
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Prince of Wales Hospital - Randwick - Sydney
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Recruitment hospital [3]
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Westmead Hospital - Crown Princess Mary Cancer Centre - Westmead
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Recruitment hospital [4]
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Illawarra Cancer Care Centre - Wollongong Hospital - Wollongong
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Recruitment hospital [5]
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Royal Adelaide Hospital - Adelaide
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Recruitment hospital [6]
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Royal Hobart Hospital - Hobart
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Recruitment hospital [7]
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Monash Medical Centre - Clayton
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Recruitment hospital [8]
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St Vincent's Hospital - Fitzroy (Melbourne)
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Recruitment hospital [9]
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Austin Hospital - Heidelberg
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Recruitment hospital [10]
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment postcode(s) [1]
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4102 - Woolloongabba
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Recruitment postcode(s) [2]
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2031 - Randwick - Sydney
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Recruitment postcode(s) [3]
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2145 - Westmead
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Recruitment postcode(s) [4]
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2500 - Wollongong
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Recruitment postcode(s) [5]
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5000 - Adelaide
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Recruitment postcode(s) [6]
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7000 - Hobart
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Recruitment postcode(s) [7]
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3168 - Clayton
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Recruitment postcode(s) [8]
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3065 - Fitzroy (Melbourne)
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Recruitment postcode(s) [9]
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3084 - Heidelberg
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Recruitment postcode(s) [10]
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6009 - Nedlands
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Recruitment outside Australia
Country [1]
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Austria
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State/province [1]
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Vienna
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Belgium
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Aalst
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Belgium
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Wilrijk
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Denmark
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State/province [4]
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Aarhus
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France
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Bron
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France
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Lille
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Country [7]
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France
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Marseille
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France
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Paris
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France
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Strasbourg
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Italy
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Bologna
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Italy
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Firenze
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Italy
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Meldola
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Italy
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Milano
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Italy
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Padova
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Italy
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Torino
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Netherlands
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Eindhoven
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Netherlands
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Leiden
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Netherlands
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Leidschendam
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Maastricht
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Rotterdam
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Tilburg
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Utrecht
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Spain
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Barcelona
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Spain
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Madrid
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Spain
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Valencia
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Switzerland
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Bellinzona
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Switzerland
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Lausanne
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Switzerland
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Zürich
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United Kingdom
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Scotland
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United Kingdom
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Edinburgh
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United Kingdom
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Wirral
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Funding & Sponsors
Primary sponsor type
Other
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Name
European Organisation for Research and Treatment of Cancer - EORTC
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Address
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Other collaborator category [1]
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Other
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Name [1]
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Cooperative Trials Group for Neuro-Oncology (COGNO)
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The 1635-EORTC-BTG study - Wait or Treat - concerns patients that represent a clinically favorable group of patients with IDHmutated astrocytoma (oligo-symptomatic), without a need for immediate post-operative treatment. It will establish whether early adjuvant treatment with radiotherapy and adjuvant temozolomide in resected IDHmutated astrocytoma will improve outcome, and whether benefits of early treatment outweigh potential side-effects of that, such as deterioration in neurocognitive function or Quality of Live, seizure activity and Patient Reported outcome compared to active surveillance.
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Trial website
https://clinicaltrials.gov/study/NCT03763422
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Martin Van den Bent
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Address
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EORTC Study Coordinator
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Phone
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Fax
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Email
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Contact person for public queries
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Address
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Phone
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Fax
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Email
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03763422
Additional trial details provided through ANZCTR
Accrual to date
Recruiting in Australia
Recruitment state(s)
NSW,QLD,SA,TAS,WA,VIC
Funding & Sponsors
Funding source category [1]
45
Government body
Name [1]
45
Cancer Australia
Address [1]
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Level 14, 300 Elizabeth Street Sydney NSW 2000
Country [1]
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Australia
Funding source category [2]
47
Charities/Societies/Foundations
Name [2]
47
Mark Hughes Foundation
Address [2]
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PO Box 417 Hamilton NSW 2303
Country [2]
47
Australia
Primary sponsor
University
Primary sponsor name
The University of Sydney
Primary sponsor address
NHMRC Clinical Trials Centre,
University of Sydney
Lifehouse Level 6
119–143 Missenden Road,
Camperdown NSW 2050
Primary sponsor country
Australia
Other collaborator category [1]
44
Other Collaborative groups
Name [1]
44
Cooperative Trials Group for Neuro-Oncology (COGNO)
Address [1]
44
NHMRC Clinical Trials Centre Lifehouse Building, Level 6 119-143 Missenden Road Camperdown NSW 2050 Australia
Country [1]
44
Australia
Other collaborator category [2]
46
Other Collaborative groups
Name [2]
46
European Organisation for Research and Treatment for Cancer (EORTC)
Address [2]
46
Avenue E Mounierlaan 83/11 B-1200 Brussels Belgium
Country [2]
46
Belgium
Ethics approval
Ethics application status
Approved
Ethics committee name [1]
22
SLHD Ethics Review Committee RPAH Zone
Address [1]
22
RPAH Medical Centre Suite 210A, 100 Carillon Avenue NEWTOWN NSW 2042
Country [1]
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Australia
Date submitted for ethics approval [1]
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25/01/2021
Approval date [1]
22
27/04/2021
Ethics approval number [1]
22
Public notes
Contacts
Principal investigator
Title
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A/Prof
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Name
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Mark Pinkham
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Address
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Building 1 Ground Floor, Princess Alexandra Hospital 199 Ipswich Road Woolloongabba QLD 4102
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Country
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Australia
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Phone
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07 3176 7853
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Fax
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(07) 3176 1983
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Email
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[email protected]
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Contact person for public queries
Title
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Ms
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Name
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Trial Coordinator
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Address
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Level 6, Chris O'Brien Lifehouse 119-143 Missenden Road Camperdown NSW 1450
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Australia
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Phone
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(02) 9562 5000
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Fax
210
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(02) 9562 5094
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Email
210
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[email protected]
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Contact person for scientific queries
Title
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A/Prof
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Name
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Mark Pinkham
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Address
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Building 1 Ground Floor, Princess Alexandra Hospital 199 Ipswich Road Woolloongabba QLD 4102
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Country
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Australia
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Phone
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07 3176 7853
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Fax
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(07) 3176 1983
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Email
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[email protected]
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