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抗分泌因子作为新诊断的异柠檬酸脱氢酶野生型胶质母细胞瘤的附加治疗:一项随机双盲安慰剂对照试验的研究方案

Antisecretory factor as add-on treatment for newly diagnosed glioblastoma, IDH wildtype: study protocol for a randomized double-blind placebo-controlled trial.

作者信息

Ehinger Erik, Darabi Anna, Visse Edward, Edvardsson Charlotte, Tomasevic Gregor, Cederberg David, Kinhult Sara, Rydelius Anna, Nilsson Christer, Belting Mattias, Bengzon Johan, Siesjö Peter

机构信息

Department of Neurosurgery, Skåne University Hospital, Lund, Sweden.

Glioma Immunotherapy Group, Section of Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden.

出版信息

Trials. 2025 Mar 13;26(1):86. doi: 10.1186/s13063-025-08792-z.

Abstract

BACKGROUND

Glioblastoma, IDH wildtype is the most common primary malignant brain tumor in adults. Despite best available treatment, prognosis remains poor. Current standard therapy consists of surgical tumor removal followed by radiotherapy and chemotherapy with the alkylating agent temozolomide. Antisecretory factor (AF), an endogenous protein, may potentiate the effect of temozolomide and alleviate cerebral edema. Salovum® is an egg-yolk powder enriched for AF and is classified as a medical food in the European Union. Salovum® has shown preliminary clinical effect on glioblastoma in a recent pilot study. Here, we aim to assess if add-on Salovum® to temozolomide therapy can improve outcomes in patients with newly diagnosed glioblastoma.

METHODS

This is a multi-center, double-blinded, randomized, placebo-controlled phase II-III clinical trial to investigate superiority of Salovum® over placebo as add-on treatment for glioblastoma during concomitant and adjuvant temozolomide therapy. Patients with newly diagnosed glioblastoma that are planned for temozolomide treatment are screened for eligibility and randomized to receive Salovum® (n = 150) or placebo (n = 150). An interim analysis will be performed after 80 included patients to guide whether to continue or terminate. Primary endpoint is 12-month overall survival. Secondary outcome is 24-month overall survival.

DISCUSSION

This study will likely produce high-grade evidence to support or reject Salovum® as add-on treatment for glioblastoma.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05669820 . Registered on January 3, 2023.

摘要

背景

异柠檬酸脱氢酶(IDH)野生型胶质母细胞瘤是成人中最常见的原发性恶性脑肿瘤。尽管采用了最佳可用治疗方法,但其预后仍然很差。目前的标准治疗包括手术切除肿瘤,随后进行放疗以及使用烷化剂替莫唑胺进行化疗。抗分泌因子(AF)是一种内源性蛋白质,可能会增强替莫唑胺的疗效并减轻脑水肿。Salovum®是一种富含AF的蛋黄粉,在欧盟被归类为医用食品。在最近的一项试点研究中,Salovum®已显示出对胶质母细胞瘤的初步临床疗效。在此,我们旨在评估在替莫唑胺治疗中添加Salovum®是否能改善新诊断胶质母细胞瘤患者的预后。

方法

这是一项多中心、双盲、随机、安慰剂对照的II-III期临床试验,旨在研究在同步和辅助替莫唑胺治疗期间,Salovum®作为胶质母细胞瘤附加治疗优于安慰剂的效果。计划接受替莫唑胺治疗的新诊断胶质母细胞瘤患者将接受资格筛查,并随机分为接受Salovum®(n = 150)或安慰剂(n = 150)。在纳入80例患者后将进行中期分析,以指导是否继续或终止试验。主要终点是12个月总生存率。次要结局是24个月总生存率。

讨论

本研究可能会产生高级别证据,以支持或拒绝将Salovum®作为胶质母细胞瘤的附加治疗。

试验注册

ClinicalTrials.gov NCT05669820。于2023年1月3日注册。

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