- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02324231
SPOG 2015 FN Definition. A Multi-center Non-inferiority Trial on Safety of a High Versus Low Temperature Limit Defining Fever in Pediatric Patients With Cancer at Risk for Fever in Chemotherapy-induced Neutropenia
February 19, 2019 updated by: Swiss Pediatric Oncology Group
SPOG 2015 FN Definition. A Swiss Pediatric Oncology Group (SPOG) Initiated Multi-center Open-label Randomized Controlled Multiple Crossover Non-inferiority Trial on Safety of a High Versus Low Temperature Limit Defining Fever in Pediatric Patients With Cancer at Risk for Fever in Chemotherapy-induced Neutropenia (FN)
In a multi-center open-label cluster-randomized controlled parallel-group multiple crossover non-inferiority trial in children and adolescents up to 20 years diagnosed with cancer requiring chemotherapy, primarily the safety, and secondarily the efficacy and other endpoints, of a high (39.0°C)
versus low (38.5°C)
temperature limit defining fever (TLDF) for the diagnosis of fever in chemotherapy-induced neutropenia (FN) is studied.
Safety is assessed by the rate of safety relevant events per chemotherapy exposure time, a composite endpoint including serious medical complications and bacteremia during FN.
Patients are repeatedly randomized (cluster: study site) to the high or the low TLDF every month, resulting in possible multiple crossovers in one patient.
The high TLDF is declared not to be inferior regarding safety compared to the low TLDF if non-inferiority of the rate ratio of safety relevant events is proven, with a single-sided non-inferiority margin of 1.33, applying mixed Poisson regression.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
269
Phase
- Not Applicable
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
-
-
-
Basel, Switzerland, CH-4031
- Basel: Universitätskinderklinik beider Basel
-
Bern, Switzerland, CH-3010
- Bern: Universitätsklinik für Kinderheilkunde, Inselspital
-
Geneva, Switzerland, CH-1211
- Geneva: Département de Pédiatrie, Hôpital Cantonal de Genève
-
Lausanne, Switzerland, CH-1011
- Lausanne: Hémato-Oncologie Pédiatrique, CHUV
-
Lucerne, Switzerland, CH-6000
- Luzern: Pädiatrische Hämatologie/Onkologie, Kinderspital
-
Zurich, Switzerland, CH-8032
- Zürich: Pädiatrische Onkologie Kinderspital
-
-
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
1 year to 18 years (Child, Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Chemotherapy treatment because of any malignancy for at least 2 months at time of recruitment for myelosuppressive therapy, or at least 1 cycle of myeloablative chemotherapy followed by autologous hematopoietic stem cell transplantation
- Age ≥12 months and <18 years at time of recruitment
- Written informed consent from patients and/or parents
Exclusion Criteria:
- Infants <1 years old (reason: differences in temperature measurement method)
- Past allogeneic hematopoietic stem cell transplantation
- Denied written informed consent from patients and/or parents
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: Supportive Care
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: 39.0°C temperature limit defining fever
Temperature limit defining fever, for definition of fever in neutropenia (FN), is single temperature >=39.0°C
measured in the ear by infrared tympanic thermometry.
If clinically indicated, the treating physician is allowed to make the diagnosis of FN at lower temperatures.
|
Diagnosis of FN, correspondingly hospitalization and start of empirical intravenous broad-spectrum antimicrobial therapy.
Further treatment according to treating physician.
|
Other: 38.5°C temperature limit defining fever
Temperature limit defining fever, for definition of fever in neutropenia (FN), is single temperature >=38.5°C
measured in the ear by infrared tympanic thermometry.
If clinically indicated, the treating physician is allowed to make the diagnosis of FN at lower temperatures.
|
Diagnosis of FN, correspondingly hospitalization and start of empirical intravenous broad-spectrum antimicrobial therapy.
Further treatment according to treating physician.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rate of clinically defined FN with at least one safety relevant event
Time Frame: 1 year (estimated average)
|
Poisson rate: number of clinically defined FN with at least one SRE divided by the entire chemotherapy exposure time for each patient, estimated to be 1 year on average (Unit: FN per year of chemotherapy exposure time) SRE: Composite endpoint (serious medical complication AND/OR bacteremia), reached until the end of each individual FN episode (Unit: binary)
|
1 year (estimated average)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Times and delays of diagnosis and therapy (A)
Time Frame: 1 year (estimated average)
|
Times (hh:mm) of measurement of fever - telephone to study site - arrival at emergency department - prescription of antibiotics - start and end of first dose of i.v.
antibiotics (assessed per FN episode by the responsible local PHO and in patient chart, reported per FN episode; unit: hours:minutes)
|
1 year (estimated average)
|
Adverse events (B)
Time Frame: 1 year (estimated average)
|
AE: clinically / microbiologically documented infection, unexplained fever, sepsis / severe sepsis / septic shock, relapse of primary infection (assessed in patient charts, reported per FN; unit:binary)
|
1 year (estimated average)
|
Delay from crossing low to high TLDF (C)
Time Frame: 1 year (estimated average)
|
Only for currently active high TLDF: delay time between crossing low and high TLDF; delayed FN diagnosis (see 5.1.4)
by high vs. low TLDF (assessed from patients charts, reported per FN; unit: hours:minutes)
|
1 year (estimated average)
|
Rate of clinically defined FN (D)
Time Frame: 1 year (estimated average)
|
Poisson rate: number of clinically defined FN divided by the entire chemotherapy exposure time for each patient, estimated to be 1 year on average (Unit: FN per year of chemotherapy exposure time)
|
1 year (estimated average)
|
Rate of FN diagnosed at/above TLDF (E)
Time Frame: 1 year (estimated average)
|
Poisson rate: number of FN diagnosed at/above TLDF divided by the entire chemotherapy exposure time for each patient, estimated to be 1 year on average (Unit: FN per year of chemotherapy exposure time)
|
1 year (estimated average)
|
Rate of FN diagnosed below TLDF (E)
Time Frame: 1 year (estimated average)
|
Poisson rate: number of FN diagnosed below TLDF divided by the entire chemotherapy exposure time for each patient, estimated to be 1 year on average (Unit: FN per year of chemotherapy exposure time)
|
1 year (estimated average)
|
Duration of treatment (F)
Time Frame: 1 year (estimated average)
|
. Duration of hospitalization, ICU treatment, i.v.
antibiotics, p.o. antibiotics, any antibiotics, delay of chemotherapy for FN (unit: days)
|
1 year (estimated average)
|
Simultaneous and avoided FN diagnoses (G)
Time Frame: 1 year (estimated average)
|
Only for currently active high TLDF: Simultaneous and avoided FN diagnoses by high vs. low TLDF (assessed from patients charts, reported per FN; unit: binary)
|
1 year (estimated average)
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Development of rules predicting risk of FN during chemotherapy
Time Frame: 1 year (estimated average)
|
Risk prediction rules for clinically defined FN, clinically defined FN with bacteremia, with serious medical complication, and with safety relevant event during chemotherapy, all based on multivariate mixed Poisson regression (stepwise forward variable selection procedure; unit: predictor)
|
1 year (estimated average)
|
Development of rules predicting risk of adverse events during FN
Time Frame: 1 year (estimated average)
|
Risk prediction rules for bacteremia, for serious medical complication, and for safety relevant event during FN, all based on multivariate mixed logistic regression (stepwise forward variable selection procedure; unit: predictor)
|
1 year (estimated average)
|
External validation of rules predicting risk of FN during chemotherapy
Time Frame: 1 year (estimated average)
|
Validation of published risk prediction rules for clinically defined FN, clinically defined FN with bacteremia, with serious medical complication, and with safety relevant event during chemotherapy (units: sensitivity, specificity, positive and negative predictive value, area under receiver operating characteristic curve)
|
1 year (estimated average)
|
External validation of rules predicting risk of adverse events during FN
Time Frame: 1 year (estimated average)
|
Validation of published risk prediction rules for bacteremia, for serious medical complication, and for safety relevant event during FN (units: sensitivity, specificity, positive and negative predictive value, area under receiver operating characteristic curve)
|
1 year (estimated average)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Chair: Roland A Ammann, MD, Universitätsklinik für Kinderheilkunde, Inselspital, Bern
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
- Ammann RA. A sequence of Swiss studies on the temperature Limit defining fever in pediatric oncology. Schweizer Krebsbulletin 35(1): 69-71, 2015.
- Lavieri L, Koenig C, Bodmer N, Agyeman PKA, Scheinemann K, Ansari M, Roessler J, Ammann RA. Predicting fever in neutropenia with safety-relevant events in children undergoing chemotherapy for cancer: The prospective multicenter SPOG 2015 FN Definition Study. Pediatr Blood Cancer. 2021 Dec;68(12):e29253. doi: 10.1002/pbc.29253. Epub 2021 Jul 26.
- Koenig C, Bodmer N, Agyeman PKA, Niggli F, Adam C, Ansari M, Eisenreich B, Keller N, Leibundgut K, Nadal D, Roessler J, Scheinemann K, Simon A, Teuffel O, von der Weid NX, Zeller M, Zimmermann K, Ammann RA. 39.0 degrees C versus 38.5 degrees C ear temperature as fever limit in children with neutropenia undergoing chemotherapy for cancer: a multicentre, cluster-randomised, multiple-crossover, non-inferiority trial. Lancet Child Adolesc Health. 2020 Jul;4(7):495-502. doi: 10.1016/S2352-4642(20)30092-4. Epub 2020 Jun 1.
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)
April 1, 2016
Primary Completion (Actual)
September 15, 2018
Study Completion (Actual)
September 15, 2018
Study Registration Dates
First Submitted
December 18, 2014
First Submitted That Met QC Criteria
December 23, 2014
First Posted (Estimate)
December 24, 2014
Study Record Updates
Last Update Posted (Actual)
February 21, 2019
Last Update Submitted That Met QC Criteria
February 19, 2019
Last Verified
October 1, 2018
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SPOG 2015 FN Definition
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
UNDECIDED
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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