DAY101 vs. Standard of Care Chemotherapy in Pediatric Participants With Low-Grade Glioma Requiring First-Line Systemic Therapy (LOGGIC/FIREFLY-2)

Last updated: February 27, 2026
Sponsor: Day One Biopharmaceuticals, Inc.
Overall Status: Active - Recruiting

Phase

3

Condition

Sarcoma (Pediatric)

Cancer/tumors

Soft Tissue Sarcoma

Treatment

DAY101

Tovorafenib

Chemotherapeutic Agent

Clinical Study ID

NCT05566795
DAY101-002
2022-001363-27
  • Ages < 25
  • All Genders

Study Summary

This is a 2-arm, randomized, open-label, multicenter, global, Phase 3 trial to evaluate the efficacy, safety, and tolerability of tovorafenib monotherapy versus standard of care (SoC) chemotherapy in participants with pediatric low-grade glioma (LGG) harboring an activating rapidly accelerated fibrosarcoma (RAF) alteration requiring first-line systemic therapy.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Less than 25 years of age with LGG with known activating RAF alteration.

  • Histopathologic diagnosis of glioma or glioneuronal tumor.

  • At least one measurable lesion as defined by RANO criteria.

  • Meet indication for first-line systemic therapy.

Exclusion

Exclusion Criteria:

  • Participant has any of the following tumor-histological findings:
  1. Schwannoma

  2. Subependymal giant cell astrocytoma (Tuberous Sclerosis)

  3. Diffuse intrinsic pontine glioma, even if histologically diagnosed as WorldHealth Organization (WHO) Grade I-II

  • Participant's tumor has additional pathogenic molecular alterations, including butnot limited to a) isocitrate dehydrogenase (IDH) 1/2 mutation, b) Histone H3mutation, and c) neurofibromatosis Type 1 (NF-1) loss of function alteration.

  • Known or suspected diagnosis of NF-1/ neurofibromatosis Type 2 (NF-2).

  • Prior or ongoing nonsurgical anticancer therapy for this indication (eg,chemotherapy, oral/IV targeted therapy) including radiation.

Study Design

Total Participants: 400
Treatment Group(s): 3
Primary Treatment: DAY101
Phase: 3
Study Start date:
February 27, 2023
Estimated Completion Date:
June 30, 2031

Study Description

Approximately 400 treatment-naïve LGG participants will be randomized 1:1 to either tovorafenib (Arm 1) or an Investigator's choice of SoC chemotherapy (Arm 2).

Arm 1 (tovorafenib): Treatment cycles will repeat every 28 days in the absence of disease progression. Participants will continue tovorafenib until any of the following occurs: disease progression, unacceptable toxicity, withdrawal of consent to treatment, or end of study.

Arm 2 (Investigator's Choice of SoC Chemotherapy): Participants will receive one of 4 SoC chemotherapy options selected by the treating Investigator: Children's Oncology Group - Vincristine/Carboplatin (COG-V/C) regimen, International Society for Paediatric Oncology

  • Low-Grade Glioma Vincristine/Carboplatin (SIOPe-LGG-V/C) regimen, vinblastine (VBL) regimen, or monthly carboplatin. The choice of SoC chemotherapy regimen will be selected prior to participant randomization. Treatment will continue until completion of therapy or until any of the following occurs: disease progression, unacceptable toxicity, withdrawal of consent to treatment, or end of study.

Participants who discontinue treatment due to disease progression will have (1) radiographic evidence of disease progression, as determined by the Investigator, or (2) clinical progression, as determined by the Investigator. Investigators are encouraged to discuss cases of clinical progression and early radiographic progression without clinical symptoms with the Sponsor Medical Monitor prior to treatment discontinuation or initiation of a different form of treatment for the malignancy. Participants may continue therapy beyond progressive disease (PD).

Connect with a study center

  • Children's Health Queensland Hospital and Health Service

    South Brisbane, Queensland 4101
    Australia

    Site Not Available

  • Children's Health Queensland Hospital and Health Service

    South Brisbane 2207259, Queensland 2152274 4101
    Australia

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  • Perth Children's Hospital

    Nedlands, 6009
    Australia

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  • Perth Children's Hospital

    Nedlands 2064874, 6009
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  • Women's and Children's Health Network

    North Adelaide, 5006
    Australia

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    North Adelaide 8469169, 5006
    Australia

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  • The Royal Children's Hospital - Children's Cancer Centre

    Parkville, 3052
    Australia

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    Parkville 2153770, 3052
    Australia

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  • Sydney Children's Hospital - Randwick

    Randwick, 2031
    Australia

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  • Sydney Children's Hospital - Randwick

    Randwick 2208285, 2031
    Australia

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  • Children's Hospital at Westmead

    Westmead, 2145
    Australia

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  • Children's Hospital at Westmead

    Westmead 2143973, 2145
    Australia

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  • Medizinische Universität Innsbruck

    Innsbruck, Tirol 6020
    Austria

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  • Medizinische Universität Innsbruck

    Innsbruck 2775220, Tyrol 2763586 6020
    Austria

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  • Medizinische Universität Wien

    Innsbruck, 6020
    Austria

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  • Medizinische Universität Wien

    Vienna 2761369, 1090
    Austria

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    Wien, 1090
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  • Cliniques Universitaires Saint-Luc

    Brussel, 1200
    Belgium

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    Brussels 2800866, 1200
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  • Universitair Ziekenhuis Gent

    Ghent, 9000
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    Ghent 2797656, 9000
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    Leuven, 3000
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    São Paulo, 04039-001
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    São Paulo 3448439, 04039-001
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    Brno, 625 00
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    Hannover, Niedersachsen 30625
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    Essen, Nordrhein-Westfalen 45147
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    Essen 2928810, North Rhine-Westphalia 2861876 45147
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    Leipzig, Sachsen 4103
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    Leipzig 2879139, Saxony 2842566 4103
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  • Charité Universitätsmedizin Berlin

    Berlin, 13353
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    Berlin 2950159, 13353
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  • Evangelische Klinikum Bethel (EvKB)

    Bielefeld, 33617
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    Hamburg, 20246
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    Hamburg 2911298, 20246
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    Tübingen, 72076
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    Ulm, 89075
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    Athens, 11527
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    Athens, 11527
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    Athens 264371, 11527
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  • Semmelweis Egyetem Tűzoltó utcai II. Sz. Gyermekgyógyászati Kliniká

    Budapest, 1094
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    Budapest 3054643, 1094
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  • Children's Health Ireland at Crumlin

    Crumlin, Dublin D12 N512
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    Crumlin 2964963, Dublin D12 N512
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  • Schneider Children's Medical Center of Israel

    Petah Tikva 293918, 49202
    Israel

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    Petah tikva, 49202
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  • The Edmond and Lily Safra Children's Hospital

    Ramat Gan, 5265601
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    Ramat Gan 293788, 5265601
    Israel

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  • Fondazione IRCCS - Istituto Nazionale dei Tumori

    Milan 6951411, Milan 20133
    Italy

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  • Fondazione IRCCS - Istituto Nazionale dei Tumori

    Milano, Milan 20133
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  • Ospedale Pediatrico Bambino Gesù

    Roma, Rome 00165
    Italy

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  • Ospedale Pediatrico Bambino Gesù

    Roma 8957247, Rome 00165
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  • Ospedale Infantile Regina Margherita

    Torino, Turin 10126
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  • Ospedale Infantile Regina Margherita

    Torino 8980539, Turin 10126
    Italy

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  • Azienda Universitaria Ospedaliera Consorziale - Policlinico di Bari

    Bari, 70124
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    Bari 3182351, 70124
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  • Azienda Ospedaliera U. Meyer

    Florence 3176959, 50139
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    Genova, 16147
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    Genova 8969657, 16147
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    Napoli, 80131
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    Napoli 9031661, 80131
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    Padova, 35128
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    Padua 3171728, 35128
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  • Azienda Sanitaria Universitaria Friuli Centrale - P.O. Santa Maria della Misericordia

    Udine, 33100
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    Udine 3165072, 33100
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  • King Hussein Cancer Foundation - King Hussein Cancer Center

    Amman, Muhafazat al-Asima 11941
    Jordan

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    Amman 250441, Muhafazat al-Asima 11941
    Jordan

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  • Seoul National University Hospital

    Seoul, 03080
    Korea, Republic of

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  • Severance Hospital

    Seoul, 03722
    Korea, Republic of

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  • Prinses Maxima Centrum Kinderoncologie

    Utrecht, 3584 CS
    Netherlands

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  • Prinses Maxima Centrum Kinderoncologie

    Utrecht 2745912, 3584 CS
    Netherlands

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  • Starship Paediatric Blood & Cancer Center

    Grafton, 1023
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    Grafton 6232401, 1023
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  • Universitetssykehuset Nord-Norge - Tromsø

    Tromsø, Troms 9038
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    Tromsø 3133895, Troms 3133897 9038
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    Oslo, 372
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    Oslo 3143244, 372
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    Doha 290030, 26999
    Qatar

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    Singapore, 229899
    Singapore

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    Singapore 1880252, 229899
    Singapore

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    Ljubljana, 1000
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    Ljubljana 3196359, 1000
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    Seoul 1835848, 03080
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    Barakaldo, 48903
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    Lund, 221 85
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    Lund 2693678, 221 85
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    Stockholm, 171 77
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    Stockholm 2673730, 171 77
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    Lausanne, 1011
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    Lausanne, 1011
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    Taoyuan, 333
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    Taoyuan District 1667905, 333
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    Southampton 2637487, Hampshire SO16 6YD
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    Belfast, Northern Ireland BT9 7AB
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    Belfast 2655984, Northern Ireland 2641364 BT9 7AB
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    Glasgow, Scotland G51 4TF
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    Sutton 2636503, Surrey SM2 5PT
    United Kingdom

    Active - Recruiting

  • University Hospitals Bristol and Weston NHS Foundation Trust

    Bristol, BS2 8HW
    United Kingdom

    Site Not Available

  • University Hospitals Bristol and Weston NHS Foundation Trust

    Bristol 2654675, BS2 8HW
    United Kingdom

    Active - Recruiting

  • Cambridge University Hospitals NHS Foundation Trust

    Cambridge, CB2 0QQ
    United Kingdom

    Site Not Available

  • Cambridge University Hospitals NHS Foundation Trust

    Cambridge 2653941, CB2 0QQ
    United Kingdom

    Active - Recruiting

  • The Christie Hospital

    Manchester 2643123, M20 4BX
    United Kingdom

    Active - Recruiting

  • Children's of Alabama

    Birmingham, Alabama 35233
    United States

    Active - Recruiting

  • Children's of Alabama

    Birmingham 4049979, Alabama 4829764 35233
    United States

    Active - Recruiting

  • Phoenix Children's Hospital

    Phoenix, Arizona 85016
    United States

    Site Not Available

  • Phoenix Children's Hospital

    Phoenix 5308655, Arizona 5551752 85016
    United States

    Active - Recruiting

  • Children's Hospital Los Angeles

    Los Angeles, California 90027
    United States

    Site Not Available

  • Children's Hospital of Orange County Main Campus - Orange

    Orange, California 92868
    United States

    Site Not Available

  • UCSF Benioff Children's Hospital

    San Francisco, California 94158
    United States

    Site Not Available

  • Children's Hospital Los Angeles

    Los Angeles 5368361, California 5332921 90027
    United States

    Active - Recruiting

  • Children's Hospital of Orange County Main Campus - Orange

    Orange 5379513, California 5332921 92868
    United States

    Active - Recruiting

  • Packard Children's Hospital Stanford

    Palo Alto 5380748, California 5332921 94304
    United States

    Active - Recruiting

  • UCSF Benioff Children's Hospital

    San Francisco 5391959, California 5332921 94158
    United States

    Active - Recruiting

  • Children's Hospital Colorado

    Aurora, Colorado 80045
    United States

    Site Not Available

  • Children's Hospital Colorado

    Aurora 5412347, Colorado 5417618 80045
    United States

    Active - Recruiting

  • Connecticut Children's Medical Center

    Hartford, Connecticut 06106-3322
    United States

    Site Not Available

  • Connecticut Children's Medical Center

    Hartford 4835797, Connecticut 4831725 06106-3322
    United States

    Active - Recruiting

  • Children's National Medical Center

    Washington, District of Columbia 20010
    United States

    Site Not Available

  • Children's National Medical Center

    Washington D.C. 4140963, District of Columbia 4138106 20010
    United States

    Active - Recruiting

  • University of Florida Health

    Gainesville, Florida 32610
    United States

    Site Not Available

  • Arnold Palmer Hospital for Children

    Orlando, Florida 32806
    United States

    Site Not Available

  • Johns Hopkins All Children's Hospital

    St. Petersburg, Florida 33701
    United States

    Site Not Available

  • University of Florida Health

    Gainesville 4156404, Florida 4155751 32610
    United States

    Active - Recruiting

  • Nicklaus Children's Hospital

    Miami 4164138, Florida 4155751 33155
    United States

    Active - Recruiting

  • Arnold Palmer Hospital for Children

    Orlando 4167147, Florida 4155751 32806
    United States

    Active - Recruiting

  • Johns Hopkins All Children's Hospital

    St. Petersburg 4171563, Florida 4155751 33701
    United States

    Active - Recruiting

  • Children's Healthcare of Atlanta

    Atlanta, Georgia 30322
    United States

    Site Not Available

  • Children's Healthcare of Atlanta

    Atlanta 4180439, Georgia 4197000 30322
    United States

    Active - Recruiting

  • Ann & Robert H. Lurie Children's Hospital of Chicago

    Chicago, Illinois 60611
    United States

    Site Not Available

  • Ann & Robert H. Lurie Children's Hospital of Chicago

    Chicago 4887398, Illinois 4896861 60611
    United States

    Active - Recruiting

  • University of Chicago

    Chicago 4887398, Illinois 4896861 60637
    United States

    Active - Recruiting

  • Riley Hospital for Children at Indiana University Health

    Indianapolis, Indiana 46202
    United States

    Site Not Available

  • Riley Hospital for Children at Indiana University Health

    Indianapolis 4259418, Indiana 4921868 46202
    United States

    Active - Recruiting

  • University of Iowa Hospitals Clinics

    Iowa City 4862034, Iowa 4862182 52242
    United States

    Active - Recruiting

  • Norton Children's Hospital

    Louisville 4299276, Kentucky 6254925 40202
    United States

    Active - Recruiting

  • Maine Children's Cancer Program

    Scarborough, Maine 04074
    United States

    Site Not Available

  • Maine Children's Cancer Program

    Scarborough 4977882, Maine 4971068 04074
    United States

    Active - Recruiting

  • Dana-Farber Cancer Institute

    Boston, Massachusetts 02215
    United States

    Site Not Available

  • Dana-Farber Cancer Institute

    Boston 4930956, Massachusetts 6254926 02215
    United States

    Active - Recruiting

  • University of Michigan - - C.S. Mott Children's Hospital

    Ann Arbor, Michigan 48109
    United States

    Site Not Available

  • University of Michigan - - C.S. Mott Children's Hospital

    Ann Arbor 4984247, Michigan 5001836 48109
    United States

    Active - Recruiting

  • Children's Minnesota

    Minneapolis, Minnesota 55404
    United States

    Site Not Available

  • Children's Minnesota

    Minneapolis 5037649, Minnesota 5037779 55404
    United States

    Active - Recruiting

  • Childrens MS Cncr Ctr Bld Dsr

    Jackson 4431410, Mississippi 4436296 39216
    United States

    Active - Recruiting

  • St. Louis Children's Hospital

    Saint Louis, Missouri 63110
    United States

    Site Not Available

  • St. Louis Children's Hospital

    St Louis 4407066, Missouri 4398678 63110
    United States

    Active - Recruiting

  • University of Nebraska Medical Center

    Omaha, Nebraska 68198-6878
    United States

    Site Not Available

  • University of Nebraska Medical Center

    Omaha 5074472, Nebraska 5073708 68198-6878
    United States

    Active - Recruiting

  • New York University Langone Health

    New York, New York 10016
    United States

    Site Not Available

  • University of Rochester

    Rochester, New York 14642
    United States

    Site Not Available

  • Albany Medical Center

    Albany 5106834, New York 5128638 12208
    United States

    Active - Recruiting

  • Columbia University

    New York 5128581, New York 5128638 10032
    United States

    Active - Recruiting

  • New York University Langone Health

    New York 5128581, New York 5128638 10016
    United States

    Active - Recruiting

  • University of Rochester

    Rochester 5134086, New York 5128638 14642
    United States

    Active - Recruiting

  • Duke Cancer Institute

    Durham, North Carolina 27705
    United States

    Site Not Available

  • Duke Cancer Institute

    Durham 4464368, North Carolina 4482348 27705
    United States

    Active - Recruiting

  • Cleveland Clinic Main Campus

    Cleveland, Ohio 44195
    United States

    Site Not Available

  • Cleveland Clinic Main Campus

    Cleveland 5150529, Ohio 5165418 44195
    United States

    Active - Recruiting

  • Oregon Health Science University

    Portland 5746545, Oregon 5744337 97239
    United States

    Active - Recruiting

  • University of Texas Southwestern Medical Center

    Dallas, Texas 75390
    United States

    Site Not Available

  • Texas Children's Hospital

    Houston, Texas 77030
    United States

    Site Not Available

  • Dell Children's Medical Center of Central Texas

    Austin 4671654, Texas 4736286 78723
    United States

    Active - Recruiting

  • University of Texas Southwestern Medical Center

    Dallas 4684888, Texas 4736286 75390
    United States

    Active - Recruiting

  • Texas Children's Hospital

    Houston 4699066, Texas 4736286 77030
    United States

    Active - Recruiting

  • Seattle Children's Hospital

    Seattle, Washington 98105
    United States

    Site Not Available

  • Seattle Children's Hospital

    Seattle 5809844, Washington 5815135 98105
    United States

    Active - Recruiting

  • University of Wisconsin - Madison

    Madison, Wisconsin 53792
    United States

    Site Not Available

  • University of Wisconsin - Madison

    Madison 5261457, Wisconsin 5279468 53792
    United States

    Active - Recruiting

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