Infant-Type Hemispheric Gliomas: A Review of Clinical, Radiologic, Histopathologic, and Molecular Features.
Aditi Bagchi, Jason Chiang, Soniya Pinto...
https://pubmed.ncbi.nlm.nih.gov/41213248/Actively Recruiting
Led by Nationwide Children's Hospital · Updated on 2026-03-18
15
Participants Needed
21
Research Sites
521 weeks
Total Duration
This research aims to evaluate disease status in children newly diagnosed with high-grade glioma that have a TRK fusion. It is a pilot study focusing on children up to 21 years old, assessing disease control and survival rates. The study also examines the safety of larotrectinib given with chemotherapy or after focal radiation therapy in this group. Participants will receive larotrectinib orally twice daily at a dose based on body surface area, in 28-day cycles. After 2 cycles of larotrectinib alone, patients showing a complete or continued complete response will continue larotrectinib as maintenance therapy for up to 12 cycles, with possible extension to 24 cycles if beneficial. Those with partial response or stable disease may receive additional chemotherapy or focal radiation depending on age and clinical factors. A surgical cohort will receive larotrectinib for 3-5 days before surgery followed by larotrectinib treatment. During the study, participants will be closely monitored for disease control using imaging and for safety by tracking side effects and adverse events. Researchers will measure drug levels in blood and tumor tissue in the surgical group. The main outcomes include disease control after 2 cycles and treatment-related side effects, with survival rates assessed over time. Participation involves regular visits, treatment cycles, and follow-up evaluations for up to several years.
CONDITIONS
A Pilot Study of Larotrectinib for Newly-Diagnosed High-Grade Glioma With NTRK Fusion
K
Kelsey H Troyer, PhD
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Nationwide Children's Hospital
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Larotrectinib-Based Therapy (Trial) | Current Standard Care |
|---|---|---|
| What it is | An investigational regimen using larotrectinib for children and young adults with newly diagnosed high-grade glioma (including diffuse intrinsic pontine glioma) confirmed to have an NTRK fusion. The regimen includes pre-surgical dosing in the surgical cohort, monotherapy cycles, and may combine with chemotherapy backbone based on feasibility and molecular profile. | The usual approach for similar patients includes maximal safe tumor resection when feasible, followed by radiation therapy and chemotherapy. Standard protocols are generally adapted from high-grade glioma guidelines for children and young adults. |
| Role in trial | Investigational treatment approach for NTRK fusion-positive pediatric high-grade glioma, evaluated for feasibility, disease control, and safety. | Not assigned within this trial. Provided for context as the externally established standard regimen for similar patients with high-grade glioma. |
| Primary use | Targeted inhibition of TRK fusion proteins in tumors with confirmed NTRK gene fusion, aiming to control disease and assess feasibility in new diagnoses. | Multimodal treatment intended to maximize tumor control and prolong survival, with approaches tailored to patient age, disease site, and tumor characteristics. |
| How it is given or performed | Oral larotrectinib administered for initial cycles, sometimes started prior to surgery (in the surgical cohort), with or without additional chemotherapy backbone based on specific case details. Surgical resection is also performed for eligible cases. | Maximal safe tumor resection is pursued when feasible, followed by fractionated radiation therapy. Chemotherapy regimens are customized based on patient factors and tumor features, using agents supported by pediatric high-grade glioma protocols. |
| Evidence status | Currently studied in this early-phase clinical trial; published disease control or survival data in newly diagnosed pediatric high-grade glioma with NTRK fusion remains immature or incomplete, pending results. | Supported by long-term published experience and expert reviews as the established approach for children and young adults with high-grade glioma, though outcomes, especially for DIPG, remain poor with standard protocols. |
| Important limitations | Investigational use in newly diagnosed setting; safety, efficacy, and longer-term outcomes are not yet established. Small sample size and single-arm design may limit generalizability. | Despite being the current standard, outcomes with multimodal therapy can be poor, particularly for diffuse intrinsic pontine glioma and tumors with aggressive molecular features. Treatment-related toxicity remains a challenge. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Initial 2 cycles of 28 days each, followed by up to 12 cycles maintenance and possible extension up to 24 cycles
Participants receive larotrectinib monotherapy twice daily orally on a 28-day cycle for 2 cycles, followed by disease evaluation. Those with continued complete or complete response continue larotrectinib monotherapy maintenance for up to 12 cycles, with possible extension to 24 cycles if benefiting clinically. Participants with partial response or stable disease may receive larotrectinib combined with chemotherapy or undergo focal radiation therapy depending on age and other factors.
2 cycles (each 28 days) followed by additional cycles depending on response and treatment plan
Duration - 3 to 5 days pre-surgery plus subsequent treatment cycles
Participants in the surgical cohort receive larotrectinib orally twice daily for 3 to 5 days prior to definitive tumor resection surgery, followed by larotrectinib monotherapy treatment cycles as described in the treatment stage.
1 pre-surgery visit plus treatment visits post-surgery
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NON_RANDOMIZED
Model
SINGLE_GROUP
Primary Purpose
TREATMENT
Number of Arms
2
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Aditi Bagchi, Jason Chiang, Soniya Pinto...
https://pubmed.ncbi.nlm.nih.gov/41213248/Nationwide Children's Hospital
Lead Sponsor