- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00003994
Combination Chemotherapy With or Without Amifostine in Treating Young Patients With Liver Cancer
Intergroup Protocol for Treatment of Children With Hepatoblastoma
Study Overview
Status
Detailed Description
PRIMARY OBJECTIVES:
I. To estimate the response and efficacy of amifostine (amifostine trihydrate) in reducing the toxicity associated with platinum agents.
II. To test whether there is any effect of amifostine on event-free survival by comparing outcome of those treated with amifostine to those treated without on this study and with historic controls.
SECONDARY OBJECTIVES:
I. To estimate the event-free survival of patients with stage I pure fetal histology treated with surgery alone.
II. To estimate the efficacy of amifostine in reducing the toxicity associated with cisplatinum in children with resected tumors receiving treatment 01 by randomizing to receive or not receive amifostine.
III. To collect tumor tissue in all patients for cytogenetic and genetic analysis in order to prospectively analyze biologic features and prognosis of patients with detailed treatment history, and to provide a resource for future biologic studies in hepatoblastoma.
IV. To assess the prognostic significance with respect to event-free survival of hepatoblastoma pathologic variants in patients with stage I tumors treated with surgery and chemotherapy (cisplatin + 5FU + vincristine).
OUTLINE: This is a randomized study. Patients are stratified according to disease stage (stage I pure fetal histology vs stage I other histology or stage II [stage II closed to accrual as of 11-25-03] vs stage III or IV [stages III and IV closed to accrual as of 11-25-03]). Patients are randomized to one of four treatment arms. (Arms III and IV closed to accrual as of 4-5-02) (Arm II closed to accrual as of 11-25-03)
All patients undergo surgical resection or attempted resection of tumor. Patients with pure fetal histology achieving complete tumor resection receive no further treatment. All other patients receive postoperative chemotherapy.
Arm I: Patients receive cisplatin IV over 4 hours on day 1, vincristine IV on days 3, 10, and 17, and fluorouracil on day 3.
Arm II (closed to accrual as of 11-25-03): Patients receive treatment as in arm I with the addition of amifostine IV over 15 minutes prior to cisplatin on day 1.
Arm III (closed to accrual as of 4-5-02): Patients receive carboplatin IV over 1 hour on day 1 and cisplatin IV over 4 hours on day 15.
Arm IV (closed to accrual as of 4-5-02): Patients receive treatment as in arm III with the addition of amifostine IV over 15 minutes prior to carboplatin on day 1.
Treatment repeats every 3 weeks for 4 courses in arms I and II (arm II closed to accrual as of 11-25-03) and every 4 weeks for 4 courses in arms III and IV (arms III and IV closed to accrual as of 4-5-02) in the absence of disease progression or unacceptable toxicity. Patients with stage III or IV disease (stages III and IV closed to accrual as of 11-25-03) undergo second look surgery and receive 2 additional courses of chemotherapy if achieving complete response after surgery.
Patients are followed monthly for 6 months, every 2 months for 2 years, every 3 months for 2 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 356 patients will be accrued for this study within 5.5 years.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
California
-
Arcadia, California, United States, 91006-3776
- Children's Oncology Group
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Histologically proven hepatoblastoma
- Any stage allowed(stages II-IV closed to accrual as of 11-25-03)
Stratum 1 (stage I):
- Pure fetal histology
- Complete surgical resection of tumor
Stratum 2 (stages I or II) (stage II closed to accrual as of 11-25-03), meeting 1 of the following criteria:
- Complete resection of tumor with histology other than pure fetal
- Gross resection of tumor, including resected tumors with preoperative/intraoperative rupture
Stratum 3 (stages III or IV) (stages III and IV closed to accrual as of 11-25-03), meeting 1 of the following criteria:
Unresectable tumors
- Partial resection of tumor with measurable residual disease OR lymph node involvement
- Measurable metastatic disease to lungs or other organs
- No hepatocellular carcinoma
- Creatinine normal for age
- Glomerular filtration rate normal for age
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No prior biologic therapy
- No prior chemotherapy
- No prior endocrine therapy
- No prior radiotherapy
- See Disease Characteristics
- No prior therapy except tumor resection
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Arm I (cisplatin, vincristine sulfate, fluorouracil)
Patients receive therapeutic conventional surgery (tumor resection).
Patients receive cisplatin IV over 4 hours on day 1, vincristine sulfate IV on days 3, 10, and 17, and fluorouracil on day 3.
|
Given IV
Other Names:
Given IV
Other Names:
Given IV
Other Names:
Undergo surgical resection
|
Experimental: Arm II (cisplatin, vincristine, fluorouracil, amifostine)
Patients receive therapeutic conventional surgery (tumor resection).
Patients receive treatment as in arm I with the addition of amifostine trihydrate IV over 15 minutes prior to cisplatin on day 1.
|
Given IV
Other Names:
Given IV
Other Names:
Given IV
Other Names:
Undergo surgical resection
Given IV
Other Names:
|
Experimental: Arm III (carboplatin, cisplatin)
Patients receive therapeutic conventional surgery (tumor resection).
Patients receive carboplatin IV over 1 hour on day 1 and cisplatin IV over 4 hours on day 15.
|
Given IV
Other Names:
Given IV
Other Names:
Undergo surgical resection
|
Experimental: Arm IV (carboplain, cisplatin, amifostine)
Patients receive therapeutic conventional surgery (tumor resection).
Patients receive treatment as in arm III with the addition of amifostine trihydrate IV over 15 minutes prior to carboplatin on day 1.
|
Given IV
Other Names:
Given IV
Other Names:
Undergo surgical resection
Given IV
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Event-free survival (EFS) rates
Time Frame: Up to 8 years
|
EFS rates will be estimated using the method of Kaplan and Meier.
Survival curves will be compared using stratified logrank tests.
|
Up to 8 years
|
Toxicity rates assessed using National Cancer Institute (NCI) Common Toxicity Criteria (CTC)
Time Frame: Up to 8 years
|
For comparing the toxicity rates in the +/- amifostine arms, stratified binomial test for proportions (Mantel-Haenszel) will be used assuming no qualitative interaction between the two chemotherapy regimens and amifostine trihydrate.
|
Up to 8 years
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Howard Katzenstein, Children's Oncology Group
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Digestive System Neoplasms
- Liver Diseases
- Neoplasms, Complex and Mixed
- Liver Neoplasms
- Hepatoblastoma
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Protective Agents
- Antineoplastic Agents, Phytogenic
- Radiation-Protective Agents
- Carboplatin
- Cisplatin
- Fluorouracil
- Vincristine
- Amifostine
Other Study ID Numbers
- P9645
- U10CA098543 (U.S. NIH Grant/Contract)
- NCI-2012-02306 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- COG-P9645 (Other Identifier: Children's Oncology Group)
- CCG-P9645 (Other Identifier: Children's Cancer Group)
- POG-9645 (Other Identifier: Pediatric Oncology Group)
- CDR0000067200 (Other Identifier: Clinical Trials.gov)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Recurrent Childhood Liver Cancer
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedChildhood Hepatoblastoma | Stage I Childhood Liver Cancer | Stage II Childhood Liver Cancer | Stage III Childhood Liver Cancer | Stage IV Childhood Liver CancerUnited States
-
National Cancer Institute (NCI)CompletedRecurrent Thyroid Cancer | Recurrent Childhood Rhabdomyosarcoma | Papillary Thyroid Cancer | Recurrent Wilms Tumor and Other Childhood Kidney Tumors | Previously Treated Childhood Rhabdomyosarcoma | Recurrent Childhood Liver Cancer | Childhood Hepatocellular CarcinomaUnited States, Canada, Australia
-
National Cancer Institute (NCI)CompletedRecurrent Childhood Ependymoma | Recurrent Neuroblastoma | Recurrent Osteosarcoma | Recurrent Childhood Rhabdomyosarcoma | Recurrent Renal Cell Cancer | Recurrent Colon Cancer | Recurrent Rectal Cancer | Recurrent Childhood Soft Tissue Sarcoma | Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal... and other conditionsUnited States
-
National Cancer Institute (NCI)CompletedHilar Cholangiocarcinoma | Advanced Adult Hepatocellular Carcinoma | Localized Non-Resectable Adult Liver Carcinoma | Recurrent Adult Liver Carcinoma | Recurrent Gallbladder Carcinoma | Stage IV Distal Bile Duct Cancer | Unresectable Extrahepatic Bile Duct Carcinoma | Stage II Gallbladder Cancer | Stage... and other conditionsUnited States
-
National Cancer Institute (NCI)CompletedRecurrent Childhood Medulloblastoma | Recurrent Childhood Ependymoma | Recurrent Childhood Anaplastic Astrocytoma | Recurrent Childhood Brain Stem Glioma | Recurrent Childhood Giant Cell Glioblastoma | Recurrent Childhood Glioblastoma | Recurrent Childhood Gliosarcoma | Recurrent Childhood OligodendrogliomaUnited States
-
Erik MittraNational Cancer Institute (NCI)TerminatedUntreated Childhood Brain Stem Glioma | Adult Anaplastic Ependymoma | Adult Anaplastic Oligodendroglioma | Adult Diffuse Astrocytoma | Adult Giant Cell Glioblastoma | Adult Glioblastoma | Adult Gliosarcoma | Adult Mixed Glioma | Adult Oligodendroglioma | Adult Pilocytic Astrocytoma | Adult Pineal Gland Astrocytoma and other conditionsUnited States
-
National Cancer Institute (NCI)CompletedChildhood High-grade Cerebellar Astrocytoma | Childhood High-grade Cerebral Astrocytoma | Recurrent Childhood Anaplastic Astrocytoma | Recurrent Childhood Anaplastic Oligoastrocytoma | Recurrent Childhood Anaplastic Oligodendroglioma | Recurrent Childhood Cerebellar Astrocytoma | Recurrent Childhood... and other conditionsUnited States, Canada
-
Pediatric Brain Tumor ConsortiumNational Cancer Institute (NCI)TerminatedRecurrent Childhood Medulloblastoma | Childhood Choroid Plexus Tumor | Childhood Ependymoblastoma | Childhood Grade III Meningioma | Childhood High-grade Cerebellar Astrocytoma | Childhood High-grade Cerebral Astrocytoma | Childhood Medulloepithelioma | Recurrent Childhood Anaplastic Astrocytoma | Recurrent... and other conditionsUnited States
-
National Cancer Institute (NCI)CompletedUnspecified Childhood Solid Tumor, Protocol Specific | Recurrent Childhood Medulloblastoma | Recurrent Childhood Ependymoma | Recurrent Neuroblastoma | Recurrent Osteosarcoma | Recurrent Childhood Rhabdomyosarcoma | Recurrent Wilms Tumor and Other Childhood Kidney Tumors | Recurrent Childhood Soft... and other conditionsUnited States
-
National Cancer Institute (NCI)CompletedUnspecified Childhood Solid Tumor, Protocol Specific | Recurrent Childhood Medulloblastoma | Recurrent Childhood Ependymoma | Recurrent Melanoma | Recurrent Neuroblastoma | Recurrent Osteosarcoma | Recurrent Childhood Rhabdomyosarcoma | Recurrent Colon Cancer | Recurrent Wilms Tumor and Other Childhood... and other conditionsUnited States
Clinical Trials on fluorouracil
-
The Netherlands Cancer InstituteCompleted
-
Sun Yat-sen UniversityZhejiang Cancer Hospital; Fudan University; Peking University Cancer Hospital... and other collaboratorsUnknownNasopharyngeal CarcinomaChina
-
CStone PharmaceuticalsActive, not recruitingUnresectable Locally Advanced, Recurrent or Metastatic Esophageal Squamous Cell CarcinomaChina
-
Sun Yat-sen UniversityUnknown
-
Actavis Inc.CompletedActinic KeratosisUnited States
-
The Netherlands Cancer InstituteCompleted
-
Hui ting Xu,MDJiangsu HengRui Medicine Co., Ltd.UnknownClinical Study of Apatinib and 5-Fu Combination Regimen to Treat Advanced Colorectal Cancer PatientsMetastatic Colorectal CancerChina
-
Kansai Hepatobiliary Oncology GroupUnknownHepatocellular CarcinomaJapan
-
Melissa Pugliano-MauroNational Cancer Institute (NCI)RecruitingCarcinoma, Squamous CellUnited States
-
The Cleveland ClinicNational Cancer Institute (NCI)TerminatedActinic Keratosis | Organ or Tissue Transplant; ComplicationsUnited States