Dose Intensification Study in Refractory Germ Cell Tumors With Relapse and Bad Prognosis (TICE)

January 11, 2021 updated by: Institut Claudius Regaud

Dose Intensification Phase II Study in Refractory Germ Cell Tumors With Relapse and Bad Prognosis. TICE Protocol : Paclitaxel and Ifosfamide Followed by Carboplatine and Etoposide Intensification With Individual Carboplatine Dose Adjustment.

Not randomized, multicentric, national phase II trial estimating the efficacy of an intensification protocol in patients with refractory germ cell tumors with relapse and bad prognosis.

Treatment consists in two Paclitaxel and Ifosfamide intensification cycles followed by three Carboplatine and Etoposide high dose cycles. The point is the individual Carboplatine adjustment to take into account inter-individual patients variability.

This adaptation allow to control each patient plasmatic exposition to avoid both inacceptable toxicities (such as ear toxicity) and a low exposition losing then the benefit of this high dose protocol.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

101

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • France
      • Angers, France, 49933
        • Centre Paul Papin
      • Bordeaux, France, 33076
        • Institut Bergonié
      • Bordeaux, France, 33075
        • Hopital St André
      • Clermont Ferrand, France, 63003
        • CHU
      • Lyon, France, 69373
        • Centre Leon Berard
      • Marseille, France, 13273
        • Institut Paoli Calmette
      • Montpellier, France, 34298
        • Institut Val d'aurelle
      • Nice, France, 06050
        • Centre Antoine Lacassagne
      • Paris, France, 75970
        • Hopital Tenon
      • Strasbourg, France, 67091
        • CHU
      • Toulouse, France, 31052
        • Institut Claudius Regaud
      • Villejuif, France, 94805
        • Institut Gustave Roussy

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Germ cell tumors whatever histology (TGNS or séminoma : TGS ) whose origin is gonadic, extra-gonadic, retro-peritoneal or primitive mediastinal
  2. Age >= 18 years old
  3. Histologically confirmed germ cell tumor (TGS) or biomarkers rate allowing to diagnose germ cell tumor without histology (TGNS)

  4. Relapse or progression with bad prognosis in 1st treatment line : One of these criteria valid point 4 :

    progression after incomplete clinical response (Stable disease) to a Cisplatin basis chemotherapy; biomarker progression 4 weeks following the last chemotherapy cycle administration; progression during the first treatment line without obtention of at least stable disease; primitive mediastinal origin in first relapse.

  5. TGNS or TGS in relapse after 2 treatment lines

  6. Disease progression ( previous points 4 or 5) documented by :

    tumors biomarkers increase (AFP and/or HCG) if no, a biopsy is needed to confirm presence of tumors active cells

  7. ECOG Performance status 0-2

  8. Biological Function :

    Neutrophils >= 1500/mm3, Platelets >= 150.000/mm3 ; normal creatinine (or clearance >= 50 ml/mn) ; SGOT, SGPT <= 2,5N (or 5N if hepatic metastases), Bilirubin < 1,5N

  9. Cardiac Functions (FEV >= 50%), Respiratory Functions , neurological Functions compatibles with high dose chemotherapy administration
  10. Absence of previous intensification
  11. Patient Information and Informed consent signature
  12. HIV and B and C hepatitis negative serologies
  13. Negative pregnancy test for women with reproductive potential and adequate contraception before study entry
  14. Patient affiliated to social security system

Exclusion Criteria:

  1. Patients whose diagnosis of relapse was not confirmed by an anatomopathological examination or by an increase of tumors markers
  2. Primitive encephalic germ cell tumors
  3. Germ cell tumors in relapse with favorable factors of treatment response to conventional chemotherapy (RC sustainable after Cisplatin): prior cRC or incomplete clinical response but with normalization of markers and testicular origin
  4. Growing Teratoma lesions
  5. Patients with HIV infection, hepatitis B and C
  6. Patients with symptomatic brain metastases despite appropriate corticosteroid treatment
  7. Associated pathology may prevent the patient to receive treatment, creatinine clearance ≤ 50 mL / min (calculated by Cockcroft-Gault)
  8. FEV <50%
  9. History of cancer (except basal cell epithelioma skin cancer) in the 3 years preceding the entry into the trial
  10. Patient already included in another clinical trial involving an experimental molecule
  11. Pregnant or breast feeding women
  12. Persons without liberty or under guardianship,
  13. Geographical, social or psychological conditions that do not permit compliance with protocol

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Complete response rate(by chemotherapy or chemotherapy + surgery), pathological complete response rate.
Time Frame: 6 months
6 months

Secondary Outcome Measures

Outcome Measure
Time Frame
Toxicity
Time Frame: 6 months
6 months
Progression free survival
Time Frame: 8 years
8 years
Time to progression
Time Frame: 8 years
8 years
To find a predictive value for Cystatin C as a biomarker of renal function to avoid next to follow plasmatic concentrations to adapt Carboplatine dose in TICE protocol.
Time Frame: 4 years
4 years
Etoposide pharmacokinetics (in particular inter-individual variability of Etoposide plasmatic concentrations AUC in such patients
Time Frame: 4 years
4 years
Genetic polymorphisms involved in response and safety treatments
Time Frame: 4 years
4 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Institut Claudius Regaud

Investigators

  • Principal Investigator: Christine CHEVREAU, MD, Institut Claudius Regaud

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 13, 2009

Primary Completion (Actual)

October 5, 2020

Study Completion (Actual)

October 5, 2020

Study Registration Dates

First Submitted

March 16, 2009

First Submitted That Met QC Criteria

March 17, 2009

First Posted (Estimate)

March 18, 2009

Study Record Updates

Last Update Posted (Actual)

January 12, 2021

Last Update Submitted That Met QC Criteria

January 11, 2021

Last Verified

January 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 08 GENH 06

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.

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