. 2025 Mar 7;7(1):vdaf056.

doi: 10.1093/noajnl/vdaf056. eCollection 2025 Jan-Dec.

Personalized targeted glioblastoma therapies by ex vivo drug screening: Study protocol of the Advanced brain Tumor TheRApy Clinical Trial (ATTRACT)

Anna Sophie Berghoff¹, Maximilian J Mair¹, Zoltán Spiró^{2

1}, Calvin Abdel Malak¹, Amin El-Heliebi³, Franziska Eckert⁴, Julia Furtner⁵, Franz König⁶, Annette Leibetseder^{7

8}, Martha Nowosielski⁹, Stefan Oberndorfer¹⁰, Barbara Prietl², Josef Pichler⁸, Thomas R Pieber², Sabine Spiegl-Kreinecker^{11

12}, Tadeja Urbanic Purkart^{13

2}, Adelheid Wöhrer^{14

15}, Georg Widhalm¹⁶, Matthias Preusser¹; ATTRACT study group

Collaborators, Affiliations

Collaborators

ATTRACT study group:
Julia Bandres Meriz, Christian Baumgartner, Luzia Berchtold, Anna Sophie Berghoff, Bernadette Calabek-Wohinz, Mario Dorostkar, Franziska Eckert, Julian Elbischger, Amin El-Heliebi, Christian Enzinger, Joakim Franz, Elisabeth Freydl, Christian Freyschlag, Julia Furtner-Srajer, Astrid Grams, Andreas Gruber, Johannes Hainfellner, Nora Harbusch, Daniela Hauk-Csar, Thomas Hauska, Laurin Herbsthofer, Flemming Hermsmeyer, Johanna Heugenhauser, Isolde Höllmüller, Sarah Iglseder, Aysegül Ilhan-Mutlu, Silvia Katzmayr, Johannes Kerschbaumer, Barbara Kiesel, Franz König, Annette Leibetseder, Marlene Leoni, Daniela Loetsch, Kariem Mahdy, Maximilian Mair, Calvin Abdel Malak, Franz Marhold, Karin Mattersdorfer, Patrizia Moser, Winfried Neuhaus, Meinhard Nevinny, Christa Nöhammer, Martha Nowosielski, Monika Oberhuber, Stefan Oberndorfer, Josef Pichler, Thomas Pieber, Theo Pirich, Matthias Preusser, Barbara Prietl, Hannah Puhr, Philip-Rudolph Rauch, Alina Riedl, Karl Rössler, Florian Scheichel, Maria Schmook, Camillo Sherif, Sara Silvaieh, Sabine Spiegl-Kreinecker, Stefanie Stanzer, Angelika Starzer, Günther Stockhammer, Tadeja Urbanic Purkart, Serge Weis, Sabine Weiss, Georg Widhalm, Adelheid Woehrer, Stefan Wolfsberger, Margret Zinnegger, Iris Zinterl

Affiliations

¹ Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
² Precision Medicine Technologies, CBmed GmbH, Graz, Austria.
³ Gottfried Schatz Research Center, Division of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria.
⁴ Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria.
⁵ Research Center for Medical Image Analysis and Artificial Intelligence, Faculty of Medicine and Dentistry, Danube Private University, Krems an der Donau, Austria.
⁶ Center For Medical Data Sciences, Medical University of Vienna, Vienna, Austria.
⁷ Department of Neurology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria.
⁸ Department of Internal Medicine and Neurooncology, Kepler University Hospital Linz, Neuromed Campus, Linz, Austria.
⁹ Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
¹⁰ Clinical Division of Neurology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria.
¹¹ Clinical Research Institute for Neurosciences, Johannes Kepler University and Kepler University Hospital Linz, Linz, Austria.
¹² Department of Neurosurgery, Johannes Kepler University, Linz, Kepler University Hospital Linz, Linz, Austria.
¹³ Department of Neurology, Division of General Neurology, Medical University of Graz, Graz, Austria.
¹⁴ Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria.
¹⁵ Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria.
¹⁶ Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.

PMID: 40351832
PMCID: PMC12063086
DOI: 10.1093/noajnl/vdaf056

Personalized targeted glioblastoma therapies by ex vivo drug screening: Study protocol of the Advanced brain Tumor TheRApy Clinical Trial (ATTRACT)

Anna Sophie Berghoff et al. Neurooncol Adv. 2025.

. 2025 Mar 7;7(1):vdaf056.

doi: 10.1093/noajnl/vdaf056. eCollection 2025 Jan-Dec.

Authors

Collaborators

ATTRACT study group:
Julia Bandres Meriz, Christian Baumgartner, Luzia Berchtold, Anna Sophie Berghoff, Bernadette Calabek-Wohinz, Mario Dorostkar, Franziska Eckert, Julian Elbischger, Amin El-Heliebi, Christian Enzinger, Joakim Franz, Elisabeth Freydl, Christian Freyschlag, Julia Furtner-Srajer, Astrid Grams, Andreas Gruber, Johannes Hainfellner, Nora Harbusch, Daniela Hauk-Csar, Thomas Hauska, Laurin Herbsthofer, Flemming Hermsmeyer, Johanna Heugenhauser, Isolde Höllmüller, Sarah Iglseder, Aysegül Ilhan-Mutlu, Silvia Katzmayr, Johannes Kerschbaumer, Barbara Kiesel, Franz König, Annette Leibetseder, Marlene Leoni, Daniela Loetsch, Kariem Mahdy, Maximilian Mair, Calvin Abdel Malak, Franz Marhold, Karin Mattersdorfer, Patrizia Moser, Winfried Neuhaus, Meinhard Nevinny, Christa Nöhammer, Martha Nowosielski, Monika Oberhuber, Stefan Oberndorfer, Josef Pichler, Thomas Pieber, Theo Pirich, Matthias Preusser, Barbara Prietl, Hannah Puhr, Philip-Rudolph Rauch, Alina Riedl, Karl Rössler, Florian Scheichel, Maria Schmook, Camillo Sherif, Sara Silvaieh, Sabine Spiegl-Kreinecker, Stefanie Stanzer, Angelika Starzer, Günther Stockhammer, Tadeja Urbanic Purkart, Serge Weis, Sabine Weiss, Georg Widhalm, Adelheid Woehrer, Stefan Wolfsberger, Margret Zinnegger, Iris Zinterl

Affiliations

¹ Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
² Precision Medicine Technologies, CBmed GmbH, Graz, Austria.
³ Gottfried Schatz Research Center, Division of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria.
⁴ Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria.
⁵ Research Center for Medical Image Analysis and Artificial Intelligence, Faculty of Medicine and Dentistry, Danube Private University, Krems an der Donau, Austria.
⁶ Center For Medical Data Sciences, Medical University of Vienna, Vienna, Austria.
⁷ Department of Neurology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria.
⁸ Department of Internal Medicine and Neurooncology, Kepler University Hospital Linz, Neuromed Campus, Linz, Austria.
⁹ Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
¹⁰ Clinical Division of Neurology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria.
¹¹ Clinical Research Institute for Neurosciences, Johannes Kepler University and Kepler University Hospital Linz, Linz, Austria.
¹² Department of Neurosurgery, Johannes Kepler University, Linz, Kepler University Hospital Linz, Linz, Austria.
¹³ Department of Neurology, Division of General Neurology, Medical University of Graz, Graz, Austria.
¹⁴ Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria.
¹⁵ Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria.
¹⁶ Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.

PMID: 40351832
PMCID: PMC12063086
DOI: 10.1093/noajnl/vdaf056

Abstract

Background: Novel approaches to guide personalized treatment in glioblastoma are urgently needed. Given the poor predictive value of genetic biomarkers in glioblastoma, we are conducting a prospective clinical trial to investigate the novel approach of cultivated patient-derived tumor cells (PDCs) for ex vivo drug screening.

Methods: In this randomized phase 2 study, we are testing the ability of PDC-based ex vivo drug screening to formulate a personalized recommendation for maintenance treatment in patients with newly diagnosed glioblastoma with unmethylated MGMT promoter after combined radio-chemotherapy. Based on overall survival as the primary endpoint, we plan to include 240 patients (120 per group) to show with a power of 80% that we can increase the median survival from 12 to 17 months (hazard ratio 0.7). Patients will be randomized 1:1 to either the standard group (no drug screening) or the intervention group (drug screening and personalized recommendation for maintenance treatment). In the intervention group, automated drug screening will be performed on PDCs with 28 drugs used for the treatment of solid tumors and hematological malignancies. Based on the cytotoxic activity of these drugs, as quantified by relative viability based on adenosine triphosphate levels, a molecular tumor board will recommend a personalized treatment regimen.

Results: The first patient was enrolled in July 2024. Interim analysis of the ATTRACT study (NCT06512311) is expected in late 2027, and final results in 2030.

Trial registration: The ATTRACT trial is registered under the ID NCT06512311 (https://clinicaltrials.gov/study/NCT06512311).

Keywords: ATTRACT; drug screening; glioblastoma; patient-derived tumor cells; personalized medicine.

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Figures

**Figure 1.**
Overall design of the clinical study

See this image and copyright information in PMC

References

1. Ostrom QT, Patil N, Cioffi G, et al.CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2013-2017. Neuro-Oncology. 2020;24(Suppl5):1214–1214. - PMC - PubMed
1. Stupp R, Mason WP, van den Bent MJ, et al.; European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352(10):987–996. - PubMed
1. Horbinski CM, Nabors LB.. NCCN Guidelines for central nervous system cancers: updates in the treatment of adult patients with glioma. J Natl Compr Canc Netw. 2023;21(5.5):583–586.
1. Weller M, van den Bent M, Preusser M, et al.EANO guidelines on the diagnosis and treatment of diffuse gliomas of adulthood. Nat Rev Clin Oncol. 2021;18:170–186. - PMC - PubMed
1. Annavarapu S, Gogate A, Pham T, et al.Treatment patterns and outcomes for patients with newly diagnosed glioblastoma multiforme: a retrospective cohort study. CNS Oncol 2021;10(3):CNS76. - PMC - PubMed

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Personalized targeted glioblastoma therapies by ex vivo drug screening: Study protocol of the Advanced brain Tumor TheRApy Clinical Trial (ATTRACT)

Collaborators

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Personalized targeted glioblastoma therapies by ex vivo drug screening: Study protocol of the Advanced brain Tumor TheRApy Clinical Trial (ATTRACT)

Authors

Collaborators

Affiliations

Abstract

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References

Associated data

LinkOut - more resources

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Medical

Research Materials