What question did this study set out to answer?

This study aims to evaluate the feasibility and potential efficacy of ramipril in preventing cognitive decline during chemoradiation for glioblastoma patients.

May 27, 2026

WF-1801: Single Arm Pilot Study of Ramipril for Prevention of Radiation-Induced Cognitive Decline in Glioblastoma Patients Receiving Chemoradiotherapy

Key Points

This study aims to evaluate the feasibility and potential efficacy of ramipril in preventing cognitive decline during chemoradiation for glioblastoma patients.
Single arm pilot study with 75 participants
Patient retention and CTB COMP score measured during and after chemoradiotherapy
Outcome comparison with NRG/RTOG 0825 cohort
Overall retention rate at one month post radiotherapy was 48% with a one-sided 95% CI of 38%-100%
61% of patients completed at least 75% of ramipril doses
No significant difference in CTB COMP scores between intervention group and NRG/RTOG 0825 control (P=0.49)

Abstract

Abstract Background To examine the feasibility of adding ramipril for prevention of cognitive decline to chemoradiation treatment of glioblastoma. Methods This prospective single arm study (WF-1801) coordinated by the Wake Forest NCI Community Oncology Research Program Research Base (UG1CA189824) assessed feasibility, tolerability, and potential efficacy of ramipril to prevent treatment-induced cognitive decline in patients with GBM. Inclusion criteria and chemoradiotherapeutic paradigms were mirrored to the standard arm of NRG/RTOG 0825, such that cognitive outcomes could be compared. All patients were treated with ramipril during chemoradiation and for 4 weeks after completion of radiotherapy (RT). Major outcomes were retention and the Clinical Trial Battery Composite (CTB COMP) score of the cognitive tests. Results were compared to the corresponding outcomes from NRG/RTOG 0825. Results 75 participants were accrued between 3/25/2019 and 11/14/23: median age was 63 years. The NRG/RTOG 0825 cohort was younger (median 57 years, P .0001). Overall retention rate at 1-month post RT (defined as compliant with 75% of doses and completion of cognitive testing) was 48% (one-sided 95% CI: 38%-100%); 61% of patients completed =75% of doses and 57% had a CTB COMP score through week 10. The median (range) change in the CTB COMP score at 1 month after RT completion was 0.01 (-82.6, 13.0) versus NRG/RTOG 0825 median of 0.10 (-48.2, 8.6); P = .49. Conclusions The ramipril intervention did not meet the prespecified feasibility endpoint, neither did the cognitive scores differ significantly from the NRG/RTOG 0925 control group. We expect other agents will be the focus of future cytoprotective trials.

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