History of Changes for Study: NCT05902169
Sonocloud-9 in Association With Carboplatin Versus Standard-of-Care Chemotherapies (CCNU or TMZ) in Recurrent GBM (SONOBIRD)
Latest version (submitted January 30, 2024) on
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Study Record Versions
Version A B Submitted Date Changes
1 June 5, 2023 None (earliest Version on record)
2 January 5, 2024 Recruitment Status, Study Status, Contacts/Locations and Oversight
3 January 30, 2024 Study Status and Contacts/Locations
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Study NCT05902169
Submitted Date:  January 5, 2024 (v2)

Open or close this module Study Identification
Unique Protocol ID: SC9-GBM-03
Brief Title: Sonocloud-9 in Association With Carboplatin Versus Standard-of-Care Chemotherapies (CCNU or TMZ) in Recurrent GBM (SONOBIRD)
Official Title: A Randomized, Open-label, Multicentric, Two-arm Pivotal Trial of SonoCloud-9 Combined With Carboplatin (CBDCA) vs Standard of Care Lomustine (CCNU) or Temozolomide (TMZ) in Patients Undergoing Planned Resection for First Recurrence Glioblastoma.
Secondary IDs: 2023-505829-14-00 [EU CT Number]
Open or close this module Study Status
Record Verification: June 2023
Overall Status: Recruiting
Study Start: January 22, 2024
Primary Completion: January 28, 2028 [Anticipated]
Study Completion: June 30, 2028 [Anticipated]
First Submitted: June 5, 2023
First Submitted that
Met QC Criteria:
June 5, 2023
First Posted: June 13, 2023 [Actual]
Last Update Submitted that
Met QC Criteria:
January 5, 2024
Last Update Posted: January 8, 2024 [Actual]
Open or close this module Sponsor/Collaborators
Sponsor: CarThera
Responsible Party: Sponsor
Open or close this module Oversight
U.S. FDA-regulated Drug: Yes
U.S. FDA-regulated Device: No
Data Monitoring: Yes
Open or close this module Study Description
Brief Summary: The brain is protected from any toxic or inflammatory molecule by the blood-brain barrier (BBB). This physical barrier is located at the level of the blood vessel walls. Because of these barrier properties, the blood vessels are also impermeable to the passage of therapeutic molecules from the blood to the brain. The development of effective treatments against glioblastoma is thus limited due to the BBB that prevents most drugs injected in the bloodstream from getting into brain tissue where the tumour is seated. The SonoCloud-9 (SC9) is an investigational device using ultrasound technology and specially developed to open the BBB in the area of and surrounding the tumour. The transient opening of the BBB allows more drugs to reach the brain tumour tissue. Carboplatin is a chemotherapy that is approved to treat different cancer types alone or in combination with other drugs, and has been used in the treatment of glioblastoma. Despite its proven efficacy in the laboratory on glioblastoma cells, carboplatin does not readily cross the BBB in humans. A clinical trial has shown that in combination with the SonoCloud-9, more carboplatin can reach the brain tumour tissue. The objective of the proposed trial is to show that the association - carboplatin with the SonoCloud-9 - will increase efficacy of the drug in patients with recurrent glioblastoma.
Detailed Description:
Open or close this module Conditions
Conditions: Glioblastoma
Recurrent Glioblastoma
Keywords: carboplatin
blood-brain barrier
Low Intensity Pulsed Ultrasound (LIPU)
Open or close this module Study Design
Study Type: Interventional
Primary Purpose: Treatment
Study Phase: Phase 3
Interventional Study Model: Parallel Assignment
Number of Arms: 2
Masking: None (Open Label)
Allocation: Randomized
Enrollment: 560 [Anticipated]
Open or close this module Arms and Interventions
Arms Assigned Interventions
Experimental: Experimental Arm: SonoCloud-9 Ultrasound + Carboplatin
The SonoCloud-9 (SC9) device will be implanted in the skull bone window upon completion of tumor resection and routine craniotomy. Carboplatin (CBDCA) will be administered intravenously prior to sonication. The CBDCA/SC9 treatment will be repeated every 3 weeks (depending on patient's tolerability) until disease progression or as clinically indicated. Administration of up to 7 cycles is planned.
Device: SonoCloud-9 (SC9)
Implantation of SC9 device and repeat activation at constant acoustic pressure
Drug: Carboplatin

Dose of carboplatin AUC 5 mg/ml.min-1 calculated using Calvert's formula:

Dose (mg) = target AUC (mg/mL x minute) x [glomerular filtration rate (GFR) mL/minute + 25].

Other Names:
  • CycloButane DiCarboxylic Acid (CBDCA)
Active Comparator: Control Arm: SoC single agent chemotherapy TMZ or CCNU

Standard of Care (SoC) treatment with either temozolomide (TMZ) or lomustine (CCNU).

Standard TMZ chemotherapy as a single oral dose every 4 weeks for up to 6 cycles.

Standard CCNU chemotherapy as a single oral dose every 6 weeks for up to 4 cycles.

Drug: Lomustine
Dosed and administered per labelling.
Other Names:
  • 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU)
Drug: Temozolomide
Dosed and administered per labelling.
Other Names:
  • Temodal
Open or close this module Outcome Measures
Primary Outcome Measures:
1. Overall survival (OS)
[ Time Frame: Up to 24 months ]

Survival status will be collected during the treatment period, for up to 7 months (short-term follow-up) and then every 3 months as standard of care follow-up (long-term follow-up) until participant's 'End of Study', defined as end of survival follow-up period, death, withdrawal of consent for the collection of data, or 'lost to follow-up' (whichever comes first).
Secondary Outcome Measures:
1. Tumor Growth Rate
[ Time Frame: Up to week 24 ]

Tumor Growth Rate will be determined by measuring hyperintense tumor volume using T1w contrast-enhancing tumor-related region from post-surgery MRI baseline to unequivocal progression MRI (i.e., suspected radiologic progression confirmed by repeat scan).
2. Progression Free Survival (PFS)
[ Time Frame: Up to 24 months ]

Defined as the time from date of randomization to the earlier of the following events: unequivocal tumor progression as determined by IRC per RANO criteria or death due to any cause.
3. Overall survival at 12 months (OS12)
[ Time Frame: 12 months ]

Defined as the proportion of participants alive at 12 months
4. Overall survival at 18 months (OS18)
[ Time Frame: 18 months ]

Defined as the proportion of participants alive at 18 months
5. Progression-free survival at 6 months (PFS6)
[ Time Frame: 6 months ]

Defined as the proportion of participants without disease progression or death due to any cause at 6 months.
Other Outcome Measures:
1. Safety and Tolerability
[ Time Frame: Up to week 24 ]

Frequency and severity of adverse events scored according to the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0, from surgery to End-of-Trial Intervention visit
Open or close this module Eligibility
Minimum Age: 18 Years
Maximum Age:
Sex: All
Gender Based:
Accepts Healthy Volunteers: No

Inclusion Criteria:

  1. Histologically proven glioblastoma (WHO criteria 2021), absence of IDH mutation demonstrated by negative IDH1 R132H staining on Immunohistochemistry.
  2. Patient must have received prior first line therapy that must have contained both:
    1. Prior surgery or biopsy and standard fractionated radiotherapy (1.8-2 Gy/fraction, >56 Gy<66 Gy) or hypofractionated radiotherapy (15 x 2.66 Gy or similar regimen)
    2. One line of maintenance chemotherapy and/or immune- or biological therapy, (with or without Tumor-Treating Fields)
  3. First, unequivocal disease progression with
    1. measurable tumor (>100 mm2 or 1 cm3, based on RANO criteria) documented (e.g., increase of 25% in tumor diameter) on MRI performed within 14 days of inclusion and,
    2. interval of a minimum of 12 weeks since the completion of prior radiotherapy, unless there is a new lesion outside the radiation field or unequivocal evidence of viable tumor on histopathological sampling
  4. Patient is candidate for craniotomy and at least 50% resection of enhancing region
  5. Maximal enhancing tumor diameter prior to inclusion ≤ 5 cm on T1w. (In case of planned lobectomy, post operative peritumoral brain or residual size ≤5 cm)
  6. WHO performance status ≤ 2 (equivalent to Karnofsky Performance Status (KPS) ≥ 70)
  7. Age ≥ 18 years
  8. Participant must be recovered from acute toxic effects (<grade 2) of all prior anticancer therapy. Interval since last therapy to presumed date of surgery of at least:
    1. ≥ 4 weeks or 5 half-lives (whichever is shorter) for
      • Cytotoxic
      • Other small chemical entity (e.g., targeted therapy)
      • For biologics (e.g., antibodies, except bevacizumab)
    2. ≥ 6 weeks of prior bevacizumab
  9. Adequate hematologic, hepatic, and renal laboratory values within 14 days of inclusion i.e.:
    1. Hemoglobin ≥ 10 g/dL, platelets ≥ 100,000/mm3, neutrophils ≥ 1500/mm3.
    2. Liver function test with ≤ grade 1 alterations, except if due to antiepileptic drug therapy or isolated increased bilirubin due to Gilbert syndrome
    3. Estimated glomerular filtration rate (eGFR) of at least 60 mL/min/1.73 m2 using Cockcroft Gault formula
  10. Patient able to understand clinical trial information and willing to provide signed and informed consent
  11. Patient of childbearing potential must have a negative pregnancy test within 14 days of inclusion and must agree to use a medically-acceptable method of birth control during the treatment period and, if randomized in the experimental arm, for at least 1 month after the last cycle of carboplatin
  12. A male patient must agree to use condoms during the treatment period and, if randomized in the experimental arm, for at least 3 months after the last cycle of carboplatin; the patient must also refrain from donating sperm during this period.
  13. Patient must be a beneficiary of a health plan that covers routine patient care costs. Patient must be a beneficiary of or affiliated with a social security scheme (according to country-specific requirements)

Non-Inclusion Criteria:

  1. Multifocal enhancing tumor on T1w (unless all localized in a 5 cm diameter area)
  2. Posterior fossa tumor
  3. Known BRAF/ NTKR mutated patients
  4. Patient at risk of surgery site infection (e.g., 2 or more previous craniotomies/neurosurgery within the last 3 months, poor skin condition, and/or previously infected surgical field, or any other condition that is of increased infectious risk in the opinion of the neurosurgeon)
  5. Patient treated at high, stable -or average- dose of corticosteroids (≥ 6 mg/day dexamethasone or equivalent) in the 7 days prior to inclusion. Patients on dexamethasone for reasons other than mass effect may still be enrolled.
  6. Contra-indication to carboplatin, CCNU or TMZ
  7. Known history of hypersensitivity reactions to perflutren lipid microsphere components or to any of the inactive ingredients in ultrasound resonator
  8. Patient has received bevacizumab for other reasons (such as tumor progression) than treating edema
  9. Peripheral neuropathy or neuropathy ≥ grade 2
  10. Uncontrolled epilepsy or evidence of intracranial pressure
  11. Patient with known intracranial aneurism or having presented intra-tumor significant spontaneous hemorrhage
  12. Patient with unremovable coils, clips, shunts, intravascular stents, and/or wafer, or reservoirs
  13. Patient with medical need to be on continued anti-platelet aggregation therapy and/or anticoagulation. Patients for whom anticoagulation/platelet aggregation can be temporarily interrupted may be eligible after discussion and prior authorization by the sponsor.
  14. Patient receiving enzyme-inducing antiepileptic drugs (namely phenytoin, carbamazepine and derivatives, phenobarbital), unless switched on another antiepileptic regimen
  15. History of other malignancy within 3 years prior to study start with the exception of adequately treated basal cell carcinoma, squamous cell carcinoma, non-melanomatous skin cancer or carcinoma in situ of the uterine cervix
  16. Patient with known or suspected active or chronic infections
  17. Patient with known significant cardiac disease, known to have right-to-left shunts, severe pulmonary hypertension (pulmonary artery pressure > 90 mm Hg), uncontrolled systemic hypertension, or acute respiratory distress syndrome
  18. Known sensitivity/allergy to gadolinium, or other intravascular contrast agents
  19. Patient with impaired thermo-regulation or temperature sensation
  20. Pregnant, or breastfeeding patient
  21. Any other serious patient medical or psychological condition that may interfere with adequate and safe delivery of treatment and care (e.g., positive human immunodeficiency virus [HIV] status, potential blood-borne infections,…), circumstance (e.g., sinus opening during surgery), psychological, morphological characteristics (e.g., skin characteristics, bone thickness), or any pre-existing comorbidities that in the investigator's opinion may prevent the implantation of the device, may impair the ability of the patient to receive treatment with SonoCloud-9 or may be confounding for evaluation of the clinical trial endpoints
  22. Patients under guardianship, curatorship, under legal protection or deprived of liberty by an administrative or judicial decision

Exclusion Criterion:

Occurrence of any major medical illnesses or impairments that in the Investigator's opinion may hampered the ability of the patient to receive treatment with SonoCloud-9 or may be confounding for evaluation of the clinical endpoints.

Open or close this module Contacts/Locations
Central Contact Person: Carole Desseaux
Telephone: +33 472 626 268
Locations: United States, Illinois
Northwestern University
[Not yet recruiting]
Chicago, Illinois, United States, 60611
Contact:Contact: Adam Sonabend, MD
Universitair Ziekenhuis Leuven
[Not yet recruiting]
Leuven, Belgium
Contact:Contact: Steven De Vleeshouwer, MD
Hôpital Neurologique Pierre Wertheimer
Bron, France
Contact:Contact: François Ducray, MD
Hôpital de La Timone
[Not yet recruiting]
Marseille, France
Contact:Contact: Olivier Chinot, MD
Hôpital de la Pitié-Salpêtrière
[Not yet recruiting]
Paris, France
Contact:Contact: Ahmed Idbaih, MD
Neurochirurgie uniklinik Köln
[Not yet recruiting]
Köln, Germany
Contact:Contact: Roland Goldbrunner, MD
Istituto Oncologico Veneto
[Not yet recruiting]
Padua, Italy
Contact:Contact: Giuseppe Lombardi, MD
Hospital Universitario 12 de Octubre
[Not yet recruiting]
Madrid, Spain
Contact:Contact: Angel Perez-Nunez, MD
Open or close this module IPDSharing
Plan to Share IPD: No
Open or close this module References
Citations: Carpentier A, Canney M, Vignot A, Reina V, Beccaria K, Horodyckid C, Karachi C, Leclercq D, Lafon C, Chapelon JY, Capelle L, Cornu P, Sanson M, Hoang-Xuan K, Delattre JY, Idbaih A. Clinical trial of blood-brain barrier disruption by pulsed ultrasound. Sci Transl Med. 2016 Jun 15;8(343):343re2. doi: 10.1126/scitranslmed.aaf6086. PubMed 27306666
Sonabend AM, Gould A, Amidei C, Ward R, Schmidt KA, Zhang DY, Gomez C, Bebawy JF, Liu BP, Bouchoux G, Desseaux C, Helenowski IB, Lukas RV, Dixit K, Kumthekar P, Arrieta VA, Lesniak MS, Carpentier A, Zhang H, Muzzio M, Canney M, Stupp R. Repeated blood-brain barrier opening with an implantable ultrasound device for delivery of albumin-bound paclitaxel in patients with recurrent glioblastoma: a phase 1 trial. Lancet Oncol. 2023 May;24(5):509-522. doi: 10.1016/S1470-2045(23)00112-2. PubMed 37142373
Links: Description: CARTHERA
Available IPD/Information:

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