ClinicalTrials.gg
Not yet recruitingNCT07788677TARLAGLIAUpdated Nov 12, 2026

Tarlatamab Treatment Before and After Surgery in Surgically Resectable Recurrent High-grade Glioma: a Window of Opportunity Study (TARLAGLIA Study)

A Phase 1 interventional study of Tarlatamab in High-Grade Glioma (HGG), sponsored by Vall d'Hebron Institute of Oncology. Not yet recruiting at 1 site in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-12.

Sponsored by Vall d'Hebron Institute of Oncology · Phase 1, Interventional, and Treatment

Updated Nov 12, 2026Start date movedGo to Updates ↓
Phase
Phase 1
Study type
Interventional
Enrollment
10
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 46 studies in Glioma with a site in Spain — 14 open to participants now, 21 under way, 2 of them phase 3. Glioma · Spain.

Planned enrollment
36th of 38
10 · median 60
Started
2027
the only one that year
Phase 1
8 of 46
2 open now
Primary completion
2029-05
later than 17 of 20 live
Registered
43rd of 46
by date

Among the 46 studies in Glioma with a site in Spain, this one is the 36th largest by planned enrollment of the 38 interventional ones that give a count, is the only one that started in 2027, is one of 8 in phase 1, reaches primary completion later than 17 of the 20 other live ones, and was the 43rd registered.

Glioma

1,452 studies on the registry are indexed under Glioma; 349 are open to participants now.

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Open to participants now

14 of the 46 studies in Glioma with a site in Spain are open now. Recruiting first, the newest first:

8 more — sign in →

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A study can be open while its sites in Spain have not opened yet or have stopped. Only those recruiting at a site in Spain →

Who these studies take

Of the 267 Glioma studies recruiting now, 164 (61%) set no upper age limit and 57 (21%) stop at 75 or younger; 63 take children under 18; 15 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

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02

Study summary

This is a single-arm, window-of-opportunity clinical study evaluating tarlatamab administered before and after surgery in adult participants with surgically resectable recurrent DLL3-positive high-grade glioma. The study is designed to assess the feasibility and safety of neoadjuvant tarlatamab treatment prior to planned tumor resection, as well as the safety and tolerability of postoperative adjuvant tarlatamab.

Eligible participants will have histologically confirmed recurrent high-grade glioma with DLL3-positive tumor expression and will be candidates for neurosurgical resection in whom surgery can be safely delayed to allow neoadjuvant treatment. Participants will receive tarlatamab intravenously using a step-up dosing regimen during the neoadjuvant phase, followed by planned surgical resection after a washout period. After recovery from surgery, participants will restart tarlatamab with step-up dosing and continue adjuvant treatment every 2 weeks for up to 6 cycles.

The primary objective is to evaluate the feasibility and safety of neoadjuvant tarlatamab, including the number of participants able to complete the dose-limiting toxicity evaluation period and undergo planned surgery without experiencing a dose-limiting toxicity. Safety assessments will include adverse events graded according to CTCAE v5.0, as well as cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome graded according to ASTCT criteria.

Secondary objectives include assessment of antitumor activity using RANO and iRANO criteria, progression-free survival, 12-month overall survival, quality of life using EORTC QLQ-C30 and EORTC QLQ-BN20 questionnaires, and the incidence, severity, and type of treatment-emergent adverse events during the adjuvant treatment period.

03

Conditions studied

  • High-Grade Glioma (HGG)

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04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age ≥18 years.
  2. Ability to provide written .
  3. confirmed diagnosis of DLL3 positive high-grade glioma (HGG).
  4. Candidate for neurosurgical resection of HGG, either in the category of supramaximal contrast-enhancing (CE) resection (class 1), maximal CE resection (class 2), or submaximal CE resection (class 3), according to the RANO resect group classification system for extent of resection (EOR).
  5. Surgery can be safely delayed for a minimum of 2 weeks following the Day 15 (D15) administration of study immunotherapy.
  6. (ECOG) performance status (PS) of 0 or 1.
  7. Adequate organ function, defined as follows:

    a. Hematological function: i. ≥ 1.5 x 109/L ii. count ≥ 100 x 109/L iii. ≥ 9 g/dL (90 g/L) b. Coagulation function: i. (PT)/international normalized ratio (INR) and partial thromboplastin time (PTT) or activated partial thromboplastin time (APTT) ≤ 1.5 x institutional (ULN) except for patients receiving anticoagulation, who must be on a stable dose of anticoagulant therapy for 6 weeks prior to study entry.

    c. Renal function: i. Estimated (eGFR) based on Modification of Diet in Renal Disease (MDRD) calculation > 30 mL/min/1.73 m2.

    d. Hepatic function: i. (AST) and alanine aminotransferase (ALT) \< 3 x ULN (or \< 5 x ULN for patients with liver involvement).

    ii. total (TBL) \< 1.5 x ULN (or \< 2 x ULN for patients with liver involvement), except for patients with Gilbert's disease.

    e. Pulmonary function i. No oxygen supplementation. f. Cardiac function i. cardiac >/= 50%, no pericardial effusion as determined by an echocardiogram (ECHO) or multigated acquisition (MUGA) scan, and no clinically significant (ECG) finding.

  8. For women of : negative pregnancy test at screening.
  9. Willingness to use highly effective during treatment during treatment and for at least 60 days after the last dose of tarlatamab,

Exclusion criteria

Exclusion Criteria:

  1. Candidate for only (class 4), according to the RANO resect group classification system for EOR.
  2. Ongoing treatment at a dose >4 mg dexamethasone equivalents daily.
  3. Active disease that has required systemic treatment in the past 2 years (including disease-modifying agents, corticosteroids, or drugs).

    Note: Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement for adrenal or pituitary insufficiency) is permitted.

  4. Known history of (HIV) infection (HIV-1/2 antibodies).
  5. Known active virus infection (hepatitis B surface antigen reactive).
  6. Known active virus infection (HCV RNA qualitative positive).
  7. Receipt of a or live-attenuated vaccine within 30 days before the first dose of study treatment.
  8. Prior within the past 3 years, except: except basal cell carcinoma or scaly skin, cervical carcinoma in situ adequately treated or other tumors treated curatively without recurrence for 3 or more years,
  9. Pregnant or lactating women.
Terms in these criteria, in plain language(25)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
10 participants (estimated)

Study arms

  • Experimental
    Recurrent high-grade glioma with DDL-3 positive tumor expression, as assessed by IHC.

    Participants with surgically resectable recurrent DLL3-positive high-grade glioma will receive neoadjuvant tarlatamab prior to planned surgery, followed by adjuvant tarlatamab after surgery. In the neoadjuvant phase, tarlatamab will be administered intravenously using a step-up regimen of 1 mg on Cycle 1 Day 1, followed by 10 mg on Days 8 and 15. Surgery will be performed after a 2-week washout period following the Day 15 dose. Approximately 3 weeks after surgery, tarlatamab will be restarted with step-up dosing of 1 mg on Day 1, followed by 10 mg on Days 8 and 15, then continued at 10 mg intravenously every 2 weeks for up to 6 cycles, with each cycle defined as 4 weeks.

    Biological: Tarlatamab

Interventions

  • BiologicalTarlatamab

    Tarlatamab will be administered by intravenous infusion using a step-up dosing regimen. During the neoadjuvant phase, participants will receive 1 mg on Cycle 1 Day 1, followed by 10 mg on Cycle 1 Day 8 and Day 15. Surgery will be performed after a 2-week washout period following the Day 15 dose. Postoperatively, tarlatamab will be restarted approximately 3 weeks after surgery using step-up dosing with 1 mg on Day 1, followed by 10 mg on Day 8 and Day 15. Thereafter, participants will receive tarlatamab 10 mg intravenously every 2 weeks for up to 6 cycles. Each treatment cycle is defined as 4 weeks. Tarlatamab will be administered as a 60-minute intravenous infusion, followed by a slow bolus flush.

06

What researchers measure

Primary outcomes

  1. Number of Participants Completing the DLT Evaluation Period and Undergoing Planned Surgery Without a DLT

    Number of participants who complete the protocol-defined DLT evaluation period and undergo the planned surgical resection without experiencing a DLT. A participant will be counted only if all criteria are met. DLTs are defined according to protocol-specified criteria.

    Time frame: From first neoadjuvant tarlatamab dose through the postoperative safety assessment 7 days after surgery; Cycle 1 is 4 weeks, with dosing on Days 1, 8, and 15 and surgery approximately 2 weeks after Day 15.

  2. Number of Participants With Treatment-Emergent Adverse Events

    Number of participants with at least one treatment-emergent adverse event (TEAE). AEs will be coded using MedDRA and severity graded according to NCI CTCAE v5.0, except CRS and ICANS, which will be graded according to ASTCT consensus criteria.

    Time frame: From first study intervention through 60 days after cessation of study intervention.

  3. Number of Participants With Treatment-Related Adverse Events

    Number of participants with at least one adverse event assessed as related to study intervention. AEs will be coded using MedDRA and severity graded according to NCI CTCAE v5.0, except CRS and ICANS, which will be graded according to ASTCT consensus criteria.

    Time frame: From first study intervention through 60 days after cessation of study intervention.

  4. Incidence of all treatment-emergent adverse events and treatment-related adverse events.

    Number and percentage of participants experiencing treatment-emergent adverse events (TEAEs) and treatment-related adverse events during the study. Events will be summarized by incidence, type, severity, seriousness, and relationship to tarlatamab.

    Time frame: From first study intervention through 60 days after cessation of study intervention.

  5. Number of Participants With Cytokine Release Syndrome by Maximum ASTCT Grade

    Number of participants with cytokine release syndrome (CRS), categorized according to the maximum CRS grade experienced during the assessment period using the ASTCT consensus grading criteria.

    Time frame: From first study intervention through 60 days after cessation of study intervention.

  6. Number of Participants With ICANS by Maximum ASTCT Grade

    Number of participants with immune effector cell-associated neurotoxicity syndrome (ICANS), categorized according to the maximum ICANS grade experienced during the assessment period using the ASTCT consensus grading criteria.

    Time frame: From first study intervention through 60 days after cessation of study intervention.

Secondary outcomes

  1. Response rate according to RANO and iRANO criteria.

    Percentage of participants achieving a complete response (CR) or partial response (PR) according to RANO and iRANO criteria, as assessed by the investigator using serial MRI examinations.

    Time frame: From treatment initiation; MRI at baseline, pre-surgery, and every 8 weeks thereafter until end of treatment or disease progression, assessed up to approximately 7 months.

  2. Progression-free survival (PFS)

    Progression-free survival (PFS) is defined as the time from treatment initiation to the first documented disease progression according to RANO/iRANO criteria or death from any cause, whichever occurs first.

    Time frame: From treatment initiation to the first documented disease progression per RANO/iRANO criteria or death from any cause, whichever occurs first, assessed up to 24 months.

  3. Overall survival (OS)

    Overall survival (OS) is defined as the time from treatment initiation to death from any cause. Participants alive at the time of analysis will be censored at the last date they were known to be alive.

    Time frame: From treatment initiation until death from any cause, assessed up to 12 months.

  4. EORTC QLQ-C30 questionnaires.

    Assessment of health-related quality of life using the 30-item EORTC QLQ-C30 questionnaire. Scores will be calculated according to the published EORTC scoring guidelines to assess global health status, functioning, and cancer-related symptoms.

    Time frame: Baseline, after surgery, and every 3 months thereafter through end of treatment or disease progression.

  5. EORTC QLQ-BN20 questionnaires

    Assessment of brain tumor-specific symptoms and functioning using the 20-item EORTC QLQ-BN20 questionnaire. Scores will be calculated according to the published EORTC scoring guidelines to assess brain tumor-related symptoms and functional impairment.

    Time frame: Baseline, after surgery, and every 3 months thereafter through end of treatment or disease progression.

  6. Incidence, severity (graded per CTCAE v5.0 and ASTCT criteria for CRS and ICANS), and type of treatment-emergent adverse events occurring during the adjuvant treatment period.

    Assessment of treatment-emergent adverse events during adjuvant tarlatamab treatment. Events will be summarized by incidence, type, and severity. Severity will be graded using CTCAE v5.0, except CRS and ICANS, which will be graded using ASTCT criteria.

    Time frame: From first postoperative adjuvant tarlatamab dose through 60 days after completion of adjuvant treatment; up to 6 cycles (each cycle is 4 weeks), for an estimated total of approximately 33 weeks.

07

Study locations

1 site
08

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Oct 2027; primary completion for May 2029, 19 months later.

Of 166 non-industry phase 1 interventional studies under Glioma, half reached primary completion within 59 months of starting (the median), counting those still running; a quarter within 36 and three quarters within 87. This study's planned 19 months is below that.

Counting every sponsor, half of 213 studies reached it within 59 months; a quarter within 36 and three quarters within 88.

Start moved once since we started tracking on Sep 25, 2026: Oct 2026 → Oct 2027, on Nov 12, 2026.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Jul 1, 2026
First posted
Aug 26, 2026
StartEst.
Oct 1, 2027was Oct 2026
Primary completionEst.
May 1, 2029
CompletionEst.
May 1, 2029
Last update
Nov 12, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Start date
Oct 1, 2026→Oct 1, 2027
Nov 12, 2026
Show all 1 update
  1. Nov 12, 2026
    Start date Oct 1, 2026→Oct 1, 2027

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT07788677
Lead sponsor
Vall d'Hebron Institute of Oncology
Responsible party
Sponsor
First posted
Aug 26, 2026
Start date
Oct 1, 2027 (estimated)
Primary completion
May 1, 2029 (estimated)
Completion
May 1, 2029 (estimated)
Last update
Nov 12, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

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Studies of the drug tested here: AMG 757

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