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Transforming Glioblastoma Treatment: How a Phase III Trial Combining Lomustine, Temozolomide, and Tumor Treating Fields is Redefining Survival Outcomes in MGMT-Methylated IDHwt GBM Patients

region-ostergotland-logo

Industry

Academia

Challenge

Glioblastoma (GBM) patients with methylated MGMT promoters face poor survival rates, even with standard treatment. Existing trials had not evaluated combined LOM/TMZ therapy with Tumor Treating Fields (TTFields) in the IDH wildtype population.

Results

Region Östergötlan leveraged Collective Minds’ platform to streamline image sharing and decision-making across multiple trial sites—including international readers—in real time. For their Phase III multicenter trial evaluating a novel combination therapy for MGMT-methylated glioblastoma patients, the platform enabled instant transfer and review of imaging within 24 hours, ensuring rapid inclusion decisions. The system successfully supported the first patient evaluations, demonstrating both operational efficiency and clinical readiness across site boundaries.

Key Product

Research

www.regionostergotland.se/
48 mo.
Trial duration
7
Centers
3
READERS
24 hs
transfers, review and decision

Region Östergötlan -Linköping University Hospital

  • Karolinska Universitetssjukhuset
  • Oslo University Hospital
  • Aarhus University Hospital
  • St. Olavs University Hospital, Trondheim, Norway
  • Medical University of Graz
  • Haukeland Universitets sjukehus
  • Center for Cancer Treatment, Kristiansand
  • Sahlgrenska Universitetssjukhuset, Göteborg
  • Örebro University Hospital
  • Onkologkliniken Gävle sjukhus
  • Kliniska forskningsenheten (KFE)

Addressing Treatment Limitations in MGMT-Methylated Glioblastoma

Patients diagnosed with GBM (IDH wildtype) and a methylated MGMT promoter typically see limited benefit from standard chemoradiation using temozolomide alone. Despite modest improvements in median overall survival (14.6 months), further gains had plateaued. Prior trials exploring the addition of lomustine (LOM) showed promise, but did not include Tumor Treating Fields (TTFields)—a now-emerging standard in some healthcare systems. There was a critical need to assess whether integrating LOM/TMZ and TTFields could redefine first-line treatment outcomes.

Accelerating Global Clinical Trials with Real-Time Imaging Collaboration

As Region Östergötlan prepared to launch a prospective, randomized Phase III clinical trial targeting treatment gaps in MGMT-methylated glioblastoma, they needed a solution that could support fast, cross-border collaboration on imaging data. The team evaluated several technologies capable of transferring and reviewing imaging across multiple clinical sites. Ultimately, they selected Collective Minds’ platform due to its unique ability to connect multiple locations—including international readers—in real time and entirely online.

Once implemented, the system was put to the test as the first patients entered the screening cycle. When a patient arrived at one of the participating centers, their imaging data was instantly uploaded to the Collective Minds platform, where it was accessible to designated readers at other sites—many times even in other countries. A decision on trial inclusion had to be made within 24 hours, and the platform enabled fast, secure image transfers, efficient collaboration, and timely review. This made it possible to meet the strict protocol timelines from the very first cases.

The strongest feature of the Collective Minds platform in this project was the ability to instantly connect multiple sites and readers in real time—that’s essential in a trial where every hour counts.

These capabilities helped harmonize trial protocols across countries with different healthcare systems, while maintaining speed, quality, and compliance.

Transforming Glioblastoma Trial Operations and Enhancing Patient Outcomes

Since the adoption of Collective Minds’ platform, Region Östergötlan has successfully advanced through the initial phase of their multicenter clinical trial. The system enabled fast, cross-site image transfers and decision-making within the 24-hour window—crucial for enrolling eligible patients without delay. The first patient cycles confirmed the platform’s reliability, supporting rapid inclusion decisions and laying a strong operational foundation for the rest of the trial.

Though the study is ongoing (2023–2030), early-phase results and predictive modeling already show promising outcomes. Based on Phase II/III data trends, the projected median overall survival (mOS) stands at 48 months in the experimental arm compared to 31 months in the control arm—a substantial improvement in patient prognosis. Additionally, 200 patients have already been randomized from an initial 500-screened cohort, with 176 expected to be evaluable, underscoring the trial’s recruitment efficiency.

Collective Minds’ platform also contributed to broader operational success:

  • Seamless protocol harmonization across international sites with differing healthcare systems and TTFields availability.
  • Improved trial precision, with built-in tracking of neurocognition and quality of life, enhanced patient outcomes, including improved progression-free survival (PFS), lower brain radiation exposure, and better compliance through adaptive dosing.

“Integrating TTFields with LOM/TMZ could change the frontline standard of care for these patients globally.”

By enabling this level of speed, coordination, and clinical oversight, Collective Minds played a pivotal role in accelerating trial operations and helping the research team move one step closer to redefining treatment standards in neuro-oncology.