Trials & Research

NUTMEG

Trial status: Completed

Last updated: 12 September, 2025

Protocol title

A Randomised Phase II Study of NivolUmab and TeMozolomide vs Temozolomide alone in newly diagnosed Elderly patients with Glioblastoma

Purpose of the study

This Phase II, open-label, randomized study (NUTMEG; ACTRN12617000267358) compares standard radiotherapy combined with temozolomide against the same regimen plus nivolumab, in elderly patients (≥70, or 65–69 if standard radiotherapy isn’t feasible) with newly diagnosed glioblastoma. The primary endpoint is overall survival, while secondary outcomes include 6-month progression-free survival, adverse events (per CTCAE v4.03), quality of life (EORTC QLQ-C30, BN-20, EQ-5D-5L), neurological function (NANO Scale), and correlation of RANO with immune-related RANO

Intervention

Control Arm: All patients will receive radiotherapy (40Gy/ 15 fractions, weekdays over 21 days) concurrently with temozolomide (TMZ) tablets 75mg/m2 daily for 21 days.

Experimental Arm: After a 4 week break the experimental group will receive nivolumab intravenous infusions (240 mg days 1 and 15 every 28 days for cycles 1-4; then 480 mg day 1 every 28 days for cycles 5-6) with concurrent adjuvant temozolomide tablets days 1-5, every 28 days) for 6 cycles. TMZ will be dosed at 150mg/m2 for the first cycle. If well tolerated TMZ is then given at 200mg/m2 for cycles 2 - 6.

Study Chair

Professor Mustafa Khasraw

Coordinating Centre

NHMRC Clinical Trials Centre
Locked Bag 77
Camperdown
NSW, 1450
Australia
Email: nutmeg.study@sydney.edu.au

Design

Phase II, multi-centre, open-label, parallel-arm

Cancer Type

Glioblastoma

Publications

  • NUTMEG: A randomized phase II study of nivolumab and temozolomide versus temozolomide alone in newly diagnosed older patients with glioblastoma , Mustafa Khasraw, Kerrie McDonald, Sonia Yip, Roel Verhaak, Amy Heimberger, Merryn Hall, Lauren Fisher, Elizabeth Barnes, Mark Rosenthal, Craig Gedye, Elizabeth Hovey, Benjamin Ellingson, John Simes, Annette Tognela, Eng-Siew Koh, Hui Gan, Michael Back, Zarnie Lwin, RBTT-07. https://doi.org/10.1093/noajnl/vdad124
Trials & Research