Actively Recruiting
Improvement of Functional Outcome for Patients With Newly Diagnosed Grade 2 or 3 Glioma With Co-deletion of 1p19q - IMPROVE CODEL the NOA-18 Trial
Led by University Hospital Heidelberg · Updated on 2026-02-03
406
Participants Needed
19
Research Sites
N/A
Total Duration
On this page
Sponsors
U
University Hospital Heidelberg
Lead Sponsor
U
Universitätsmedizin Mannheim
Collaborating Sponsor
AI-Summary
What this Trial Is About
Researchers are investigating treatments for oligodendrogliomas, a type of brain tumor classified by specific genetic markers including mutations in isocitrate dehydrogenase IDH and co-deletion of chromosomes 1p19q. This trial focuses on adults with newly diagnosed grade 2 or 3 gliomas, aiming to improve survival without loss of brain function, cognition, or quality of life. The study compares two treatment approaches to determine the best timing and combination of chemotherapy and radiotherapy. Participants are randomly assigned to receive either standard chemoradiation with procarbazine, CCNU lomustine, and vincristine PCV combined with radiotherapy, or an experimental approach starting with chemotherapy using lomustine and temozolomide CETEG followed by radiotherapy and PCV at tumor progression. Radiotherapy is delivered over about 5 to 6 weeks, with doses adjusted for tumor grade. Chemotherapy cycles last 6 weeks and include specified doses of oral and intravenous drugs. During the study, participants undergo regular magnetic resonance imaging MRI scans every three months, neurological assessments, quality of life questionnaires, and cognitive testing annually. The main outcome measured is qualified overall survival, which tracks survival without significant cognitive or functional decline. The study lasts up to 10 years, with ongoing monitoring of tumor progression, treatment response, and patient wellbeing. Safety and side effects are carefully assessed throughout the trial.
CONDITIONS
Brief Title
A Clinical Study to Improve Brain Function and Quality of Life of Patients With Newly Diagnosed Brain Tumors (Gliomas).
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Histologically confirmed, newly diagnosed CNS WHO grade 2 or 3 glioma
- Tumor has IDH mutation and 1p/19q co-deletion confirmed by appropriate testing
- Biopsy or resection performed with sufficient tissue for molecular analysis
- Age 18 years or older
- Karnofsky Performance Status of 60% or higher
- Life expectancy longer than 6 months
- Availability of tissue and blood samples for biomarker research
- MRI within 72 hours after surgery following guidelines
- Surgery site fully healed
- Time from surgery between 2 weeks and 3 months without prior radio- or chemotherapy
- Willing and able to complete regular neurocognitive and quality of life assessments
- Indication for postsurgical chemotherapy or toxic therapy
- Written informed consent provided
- For females with reproductive potential: negative pregnancy test before screening and agreement to use contraception during and 7 months after treatment or postmenopausal for at least 2 years
- Male participants willing to use contraception
You will not qualify if you...
- Participation in other ongoing interventional clinical trials
- Unable to undergo MRI
- Abnormal laboratory values in hematology, liver, or kidney function above grade 2 CTCAE
- Active infections like tuberculosis, HIV, Hepatitis B or C, or others posing risk to staff
- Prior anti-cancer therapy except surgery
- Immunosuppression unrelated to cancer treatment
- Other malignancies within last 5 years except certain skin cancers unless disease-free for 5 years
- Significant medical conditions that interfere with study or medication absorption
- Psychological, social, or geographical issues that could affect compliance
- Pregnancy or breastfeeding
- Known allergies to study drugs or their components
- Prolonged QTc interval over 500 ms
- Restricted medications for study drugs
- Liver disease or hepatitis as defined
- Blood clotting disorders or thrombocytopenia
- Autoimmune diseases except stable hypothyroidism and type I diabetes on stable treatment
- Recent live vaccinations
- Neuromuscular diseases like Charcot-Marie-Tooth syndrome
- Chronic constipation or subileus
- Combination treatment with mitomycin
- Hypersensitivity to dacarbazine
- Certain hereditary digestive disorders or allergies related to study drugs
Research Team
W
Wolfgang Wick, Prof. Dr.
A
Antje Wick, PD Dr.
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