A Phase 3, Pivotal Trial of VB-111 Plus Bevacizumab vs. Bevacizumab in Patients With Recurrent Glioblastoma (GLOBE)

Inclusion Criteria:

   1. First or second progression of Glioblastoma;

   2. Measurable disease by RANO criteria at progression;

   3. Patients ≥18 years of age;

   4. Patient may have been operated for recurrence. If operated: residual and measurable
   disease after surgery is required;

   5. Surgery completed at least 28 days before randomization;

   6. An interval of at least 12 weeks between prior radiotherapy or at least 23 days from
   prior chemotherapy, 42 days from nitrosoureas and enrollment in this study;

   7. Adequate performance, i.e."Karnofsky Performance Score" of at least 70%;

   8. Adequate renal, liver, and bone marrow function according to the following criteria:

      - Absolute neutrophil count ≥1500 cells/ml,

      - Platelets ≥ 100,000 cells/ml,

      - Total bilirubin within upper limit of normal (ULN),

      - Aspartate aminotransferase (AST) ≤ 2.0 X ULN,

      - Serum creatinine level ≤ ULN or creatinine clearance ≥ 50 ml/min for patients
      with creatinine levels above normal limits (creatinine clearance calculated by
      the Cockcroft-Gault formula, see Appendix II),

      - PT, PTT (in seconds) not to be prolonged beyond >20% of the upper limits of
      normal.

Exclusion Criteria:

   1. Prior anti-angiogenic therapy including VEGF sequestering agents (i.e. bevacizumab,
   aflibercept, etc.) or VEGFR inhibitors (cedirinib, pazopanib, sunitinib, sorafenib,
   etc.);

   2. Prior stereotactic radiotherapy;

   3. Pregnant or breastfeeding patients;

   4. Concomitant medication that may interfere with study results; e.g. immunosuppressive
   agents other than corticosteroids;

   5. Active infection;

   6. Evidence of significant CNS haemorrhage i.e. CTCAE grade 2 or above;

   7. Expected to have surgery during study period;

   8. Patients with active vascular disease, either myocardial or peripheral (i.e. acute
   coronary syndrome, cerebral stroke, transient ischemic attack or arterial thrombosis
   or symptomatic peripheral vascular disease within the past 3 months);

   9. Patients with known proliferative and/or vascular retinopathy;

10. Patients with known liver disease (alcoholic, drug/toxin induced, genetic, or
   autoimmune);

11. Patients with known active second malignancy other than non-melanoma skin cancers,
   non-metastatic prostate cancer, in situ cervical cancer, and ductal or lobular
   carcinoma in situ of the breast. Patients are not considered to have a currently
   active malignancy if they have completed anticancer therapy and have been disease free
   for greater than 2 years prior to screening;

12. Patients testing positive to one of the following viruses: HIV, HBV and HCV within the
   last 6 months;

13. Patients that have undergone major surgery within the last 4 weeks before enrollment;

14. Patients who have received treatment with any other investigational agent within 4
   weeks before enrollment.