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Recurrent GlioblastomaPhase 1NCT04477200

Mycophenolate Mofetil Combined With Radiation Therapy in Glioblastoma

A Phase 1 study testing Mycophenolate Mofetil, Radiation Therapy and Temozolomide in people with Recurrent Glioblastoma and Recurrent Gliosarcoma, run by University of Michigan Rogel Cancer Center at 1 site in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This is a phase 0/1 dose-escalation trial to determine the maximum tolerated dose of Mycophenolate Mofetil (MMF) when administered with radiation, in patients with glioblastoma or gliosarcoma. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Mycophenolate Mofetil, Radiation Therapy and Temozolomide
Could I receive a placebo?
No, everyone receives an active treatment
How many people
68 participants
Where
1 siteUnited States
Study dates
5 Aug 2020to 5 Nov 2027
Phase
Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Glioblastoma or gliosarcoma (recurrent or newly diagnosed).
  • Karnofsky Performance Status 60 or greater.
  • Phase 0: Candidate for clinically indicated re-resection or biopsy of glioblastoma or gliosarcoma per treating physician(s).
  • Phase 1, Recurrent: Candidate for clinically indicated re-irradiation of glioblastoma or gliosarcoma per treating physician(s) (No more than one prior course of radiation for GBM).
  • Phase 1, Newly Diagnosed: Candidate for upfront standard of care chemoradiation for glioblastoma or gliosarcoma per treating physician(s), to start no earlier than 14 days post- operatively from last definitive surgery for glioblastoma or gliosarcoma (if more than one surgery done. Ex. biopsy prior to resection).
  • ANC >=1,500 cells/mm^3 within 14 days prior to enrollment.
  • Patient (men and childbearing age women) agrees to the use of highly effective contraception during study participation and for at least 6 weeks for female patients and 90 days for male patients after final MMF administration.
  • Ability to understand and the willingness to sign a written informed consent.

Who cannot join

  • Lack of histopathological diagnosis of the tumor.
  • Gliomatosis cerebri pattern (tumor involving 3 or more lobes) of disease.
  • Leptomeningeal disease.
  • Use of bevacizumab within 8 weeks of study enrollment.
  • Known history of HIV.
  • Active hepatitis B or C infection.
Show all 23Show fewer
  • Active systemic or central nervous system (CNS) infection.
  • Grade 4 lymphopenia (if ALC <0.5, patient must be on Pneumocystis jirovecii prophylaxis).
  • Estimated CrCl < 25 ml/min.
  • History of organ transplantation.
  • Patients with known hypoxanthine-guanine phosphoribosyl-transferase deficiency.
  • Serious intercurrent disease.
  • History of allergic reaction or hypersensitivity to mycophenolate mofetil or mycophenolic acid or any component of the drug product; or medical contraindication for MMF per treating physician(s).
  • Known immunosuppressive condition from autoimmune disease, immune deficiency syndrome, or chronic immunosuppressive therapy.
  • Inability to undergo MRI brain with and without contrast.
  • Pregnant or lactating women.
  • Patients with known phenylketonuria.
  • Phase 0: Patients undergoing biopsy who are deemed unlikely to have sufficient tissue to spare for research purposes (e.g., those whose tumors are in an eloquent brain location where all tissue taken must be used for diagnostic purposes).
  • Phase I: Increase in steroid requirement within 7 days of study enrollment (stable or decreasing dose allowed).
  • Phase I, Recurrent: Radiation within 6 months prior to study enrollment.
  • Phase I, Recurrent: Surgery within 4 weeks of re-irradiation.
  • Phase I, Newly Diagnosed: History of hypersensitivity reactions to temozolomide or any other ingredients in temozolomide and dacarbazine.
  • Phase I, Newly Diagnosed: Prior chemotherapy or radiation therapy for glioblastoma or gliosarcoma.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Michigan Rogel Cancer Center

    Ann Arbor, Michigan, 48109

Other trials in United States

About this study

Official title: Phase 0/I Dose Escalation Study of Mycophenolate Mofetil Combined With Radiation Therapy in Glioblastoma

This is a phase 0/1 dose-escalation trial to determine the maximum tolerated dose of Mycophenolate Mofetil (MMF) when administered with radiation, in patients with glioblastoma or gliosarcoma.

Read the detailed description

The goal of the Phase 0 component is to determine if MMF achieves active concentrations in brain tumors. Eight participants in Phase 0 will receive MMF for one week before undergoing an already planned biopsy or re-resection (surgical removal) of glioblastoma or gliosarcoma (GBM/GS). A small portion of the tumor, removed as part of clinical care, will be used for testing in this study. Sixty additional participants will be enrolled in the Phase 1 component of the trial (30 with recurrent GBM/GS and 30 with newly diagnosed GBM/GS). The goal of the Phase 1 component is to find the dose of MMF that works best without causing severe side effects (the maximum tolerated dose) when combined with radiation in recurrent GBM/GS and with radiation and chemotherapy in newly diagnosed GBM/GS. Participants in Phase 0 who meet the eligibility criteria for the Phase 1 component may participate in both phases.

Being tested
Mycophenolate Mofetil, Radiation Therapy, Re-resection (as part of standard of care), Temozolomide
Keywords
recurrent Glioblastoma, recurrent Gliosarcoma, newly diagnosed Glioblastoma, newly diagnosed Gliosarcooma, Recurrent Astrocytoma, Grade IV, Newly Diagnosed Astrocytoma, Grade IV
Medical subject headings
Glioblastoma, Gliosarcoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Mycophenolate MofetilDrug

    Also called MMF

    500-2000mg orally twice daily, one week prior to re-resection (2 participants at each of 4 dose levels: 500mg, 1000mg, 1500mg and 2000mg)

  • Radiation TherapyRadiation

    Also called RT

    40.5 Gy in 15 fractions

  • Re-resection (as part of standard of care)Procedure or surgery

    Re-resection or biopsy of tumor as part of standard of care

  • TemozolomideDrug

    Also called TMZ

    Temozolomide capsules are an approved oral chemotherapeutic drug for the treatment of adult patients with newly diagnosed GBM/GS concomitantly with radiotherapy and then as adjuvant treatment. The dosing and timing of temozolomide therapy will be determined as per standard-of-care for the individual patient by the treating oncologist.

  • Mycophenolate MofetilDrug

    Also called MMF

    250-2000mg orally twice daily, one week prior to and concurrent with RT.

  • Mycophenolate MofetilDrug

    Also called MMF

    250-2000mg orally twice daily, one week prior to and concurrent with RT and cyclic chemotherapy with temozolomide.

  • Radiation TherapyRadiation

    Also called RT

    60 Gy in 30 fractions

Study groups in NCT04477200
Study groupRoleWhat they receive
Phase 0 - Recurrent glioblastoma (GBM) / gliosarcoma (GS)ExperimentalMycophenolate mofetil
Receives: Drug: Mycophenolate Mofetil; Procedure: Re-resection (as part of standard of care)
Phase 1 - Recurrent GBM / GSExperimentalMycophenolate mofetil; radiation therapy
Receives: Radiation: Radiation Therapy; Drug: Mycophenolate Mofetil
Phase 1 - Newly Diagnosed GBM / GSExperimentalMycophenolate mofetil; radiation therapy; temozolomide
Receives: Drug: Temozolomide; Drug: Mycophenolate Mofetil; Radiation: Radiation Therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Concentration of Mycophenolic Acid (MPA) in Tumor Tissue in Phase 0 Participants

    The concentration of MPA (the active metabolite of mycophenolate mofetil [MMF]) in tumor tissue, measured by mass spectrometry on a continuous scale after one week of MMF administration.

    This measure includes all phase 0 participants.

    Measured: At 1 week

  2. Number of Recurrent Phase 1 Participants Who Experience Dose-limiting Toxicities (DLTs) at Each Dose Level

    DLT will be defined based on the rate of drug related grade 3-5 adverse events experienced from the start of treatment with MMF and for up to 4 weeks after completion of MMF + radiation therapy (RT). Assessed using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.

    This measure includes only phase 1 participants with recurrent GBM/GS.

    Measured: Up to 28 days following completion of MMF + RT (up to ~9 weeks)

  3. Number of Newly Diagnosed Phase 1 Participants Who Experience Dose-limiting Toxicities (DLTs) at Each Dose Level -- DLT1 Period

    DLT will be defined based on the rate of drug related grade 3-5 adverse events experienced from the start of treatment with MMF and for up to 4 weeks after completion of MMF + RT + TMZ. Assessed using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.

    This measure includes only newly diagnosed phase 1 participants.

    Measured: Up to 28 days following completion of MMF + RT + TMZ (up to ~11 weeks)

  4. Number of Newly Diagnosed Phase 1 Participants Who Experience Dose-limiting Toxicities (DLTs) at Each Dose Level -- DLT2 Period

    DLT will be defined based on the rate of drug related grade 3-5 adverse events experienced during the first 2 cycles (8 weeks) of MMF with adjuvant TMZ. (The first cycle of MMF with adjuvant TMZ begins 28 days post-RT.) These will be assessed using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.

    This measure includes only newly diagnosed phase 1 participants.

    Measured: During the first 2 cycles (8 weeks) of MMF with adjuvant TMZ (up to ~19 weeks)

Secondary outcomes (7)
  1. Concentrations of Guanosine Triphosphate (GTP) in Tumor Tissue in Phase 0 Participants

    The concentrations of GTP in tumor tissue, measured by mass spectrometry on a continuous scale.

    This measure includes all phase 0 participants.

    Measured: After one week of MMF administration

  2. Adverse Events Associated With Treatment in All Phase 1 Participants

    Toxicities at each dose level will be tabulated, categorized by grade and attribution.

    This measure includes all phase 1 participants.

    Measured: Up to 28 days following completion of MMF + RT (up to ~9 weeks)

  3. Adverse Events Associated With Treatment in Newly Diagnosed Phase 1 Participants

    Toxicities at each dose level will be tabulated, categorized by grade and attribution.

    This measure includes only newly diagnosed phase 1 participants.

    Measured: Up to 28 days following completion of MMF with adjuvant temozolomide (up to ~15 months)

  4. Overall Response Rate in Phase 1 Participants With Recurrent GBM/GS

    Determined by modified Response Assessment for Neuro-Oncology (mRANO) criteria. The number and proportion of patients with progressive disease, stable disease, partial and complete response will be calculated for each dose level and overall.

    This measure includes only phase 1 participants with recurrent GBM/GS.

    Measured: Until study stops or death; up to approximately 3 years.

  5. Median Progression Free Survival (PFS) in Phase 1 Participants With Recurrent GBM/GS

    PFS defined as time from date of registration to the date of documented progressive disease, other disease related therapy or death. Determined by mRANO criteria.

    This measure includes only phase 1 participants with recurrent GBM/GS.

    Measured: Until study stops or death; up to approximately 3 years.

  6. Median Freedom From Local Progression (FFLP) in Phase 1 Participants With Recurrent GBM/GS

    FFLP defined as time from date of registration to the date of documented local progressive disease. Determined by mRANO criteria.

    This measure includes only phase 1 participants with recurrent GBM/GS.

    Measured: Until study stops or death; up to approximately 3 years.

  7. Median Overall Survival (OS) in Phase 1 Participants With Recurrent GBM/GS

    OS defined as time from date of registration to date of death or last follow up. Determined by Kaplan Meier method.

    This measure includes only phase 1 participants with recurrent GBM/GS.

    Measured: Until study stops or death; up to approximately 3 years.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Jul 2020
  2. Study start5 Aug 2020
  3. Primary completion6 Jan 2025
  4. Study completion5 Nov 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Model description
Phase 0 will include 8 participants; eligible participants from phase 0 may continue on to phase 1.
Masking
None (open label)
Enrolment
68 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04477200
Sponsor's protocol ID
UMCC 2019.192
Other IDs
HUM00175785, R37CA258346
Status last verified
Apr 2026
First submitted
14 Jul 2020
Last updated
14 May 2026
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Zhao G, Newbury P, Ishi Y, Chekalin E, Zeng B, Glicksberg BS, Wen A, Paithankar S, Sasaki T, Suri A, Nazarian J, Pacold ME, Brat DJ, Nicolaides T, Chen B, Hashizume R. Reversal of cancer gene expression identifies repurposed drugs for diffuse intrinsic pontine glioma. Acta Neuropathol Commun. 2022 Oct 23;10(1):150. doi: 10.1186/s40478-022-01463-z.

    PubMed 36274161

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Mycophenolate Mofetil, Radiation Therapy and Temozolomide in people with Recurrent Glioblastoma and Recurrent Gliosarcoma, run by University of Michigan Rogel Cancer Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 23 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 14 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 14 May 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Concentration of Mycophenolic Acid (MPA) in Tumor Tissue in Phase 0 Participants (time frame: At 1 week). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04477200, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 May 2026.

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