RecruitingPhase 2NCT06816927

Trial of Glioblastoma Immunotherapy Advancement With Nivolumab and Relatlimab

A Multi-Center, Randomized, Phase 2 Trial of Glioblastoma Immunotherapy Advancement With Nivolumab and Relatlimab (GIANT)


Sponsor

Duke University

Enrollment

92 participants

Start Date

Nov 28, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

GIANT is an open-label, multi-center, randomized, perioperative (neoadjuvant followed by adjuvant), phase 2 trial with a safety lead-in phase to investigate the feasibility, safety and tolerability, and establish the biological activity of nivolumab with or without relatlimab in patients with isocitrate dehydrogenase (IDH) wildtype newly diagnosed glioblastoma (ndGBM).


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study, called TITAN, is testing a combination of two immunotherapy drugs — nivolumab and relatlimab — given before and/or after surgery for newly diagnosed glioblastoma (GBM), the most aggressive type of brain tumor. These drugs work by releasing the brakes on the immune system so it can better attack cancer cells. The goal is to see if this combination improves outcomes compared to standard treatment. **You may be eligible if...** - You are 18 or older - You have a suspected or confirmed new diagnosis of glioblastoma based on brain imaging or prior biopsy - You have not yet received radiation or chemotherapy for your brain tumor - Your neurosurgeon believes surgery is needed and appropriate - You are willing to undergo surgery and provide tumor tissue for research **You may NOT be eligible if...** - You have already received radiation or systemic therapy for your brain tumor - You have a serious autoimmune condition or are on immunosuppressive drugs - You are pregnant Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGNivolumab

For Neoadjuvant treatment, on both Arms 1 and 2, all 92 patients will receive single dose of 480 mg by IV infusion on Day 1 followed by surgery. Post-resection, in Part 1 Adjuvant treatment, all patients will receive two doses of 480 mg of nivolumab by IV infusion on Days 1 and 29. In Part 2 Adjuvant Treatment of Nivolumab dosing will continue for up to 12 cycles. Each cycle is 28 Days long.

DRUGRelatlimab

For Neoadjuvant treatment, only on Arm 2, 69 patients will receive a single dose of 480 mg of nivolumab and 480 mg of relatimab by IV infusions on Day 1 followed by surgery. Post resection in Part 1 Adjuvant treatment, all patients will receive two doses of 480 mg of nivolumab and relatlimab by IV infusion on Days 1 and 29. In Part 2 Adjuvant Treatment of Relatimab dosing will continue for up to 12 cycles. Each cycle is 28 Days long.

DRUGTMZ

All patients in safety lead-in, Arm 1 and Arm 2 post resection in Part 1 Adjuvant Treatment setting will receive 75 mg/m2 TMZ from Day 1 to Day 42 orally. In Part 2 Adjuvant Treatment of TMZ dosing with TMZ will continue for up to 6 cycles with 150 mg/m2 for cycle 3 and escalating to 200 mg/m2 for cycles 4 to 8 day 1 to 5 for these 6 cycles.

RADIATIONRadiation Therapy

All patients in safety lead-in, Arm 1 and Arm 2 post resection in Part 1 Adjuvant Treatment will receive External Beam Radiation 2 Gy/day (60 Gy in total) Once daily, 5 days per week, for 6 weeks Starting on Day 1


Locations(1)

Duke University

Durham, North Carolina, United States

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NCT06816927


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