- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04659421
Study of Recombinant Human Endostatin Combined With CV Regimen in the Treatment of Pediatric Low-grade Gliomas
A Prospective, Singal-arm Clinical Study of Recombinant Human Endostatin (ENDOSTAR) Combined With Carboplatin and Vincristine in the Treatment of Low-grade Gliomas in Children
Low-grade gliomas (LGGs) are the most common intracranial tumors in children, accounting for about 40% of intracranial tumors in children. The biological characteristics and clinical prognosis of LGGs vary greatly, and they can present different biological characteristics such as restricted growth, invasive growth, and malignant transformation during their development. The prognosis of LGGs is related to the degree of tumor resection, histological type, and whether it has spread.
For LGGs, surgical resection is the main treatment method. However, many tumors located in the visual pathway, brainstem, hypothalamus and other midline parts, it is impossible to completely remove. Radiotherapy can effectively control tumor progression to a certain extent, but radiotherapy can cause obvious and serious delayed damage, such as cognitive impairment, endocrine disorders, cerebrovascular events, and second tumors. Chemotherapy can effectively treat LGGs in children, and can postpone or avoid radiotherapy. It is the preferred treatment for children with LGGs after surgery. Carboplatin combined with vincristine, the CV regimen, is currently the main chemotherapy regimen for the treatment of children with LGGs.
Anti-angiogenesis is a new type of treatment. Bevacizumab, a humanized monoclonal antibody that targets vascular endothelial growth factor (VEGF). Among children with relapsed, refractory or progressing LGGs, the effective rate of Bev combined with irinotecan was 44%, and the 6-month and 2-year progression-free survival rates were 85% and 48%, respectively. However, almost all of them were treated with Bev progressed again. Tumor growth is more aggressive after Bev treatment fails. Recombinant human endostatin (rh-ES) is an endogenous broad-spectrum angiogenesis inhibitor that has been shown to significantly improve therapeutic efficacy when combining with conventional chemotherapy agents in non-small-cell lung cancer, breast cancer and melanoma.Previous retrospective studies of the research team found that rh-ES combined with CV can treat LGGs in children effectively, shorten the onset time, help quickly alleviate the symptoms of brainstem damage, and improve the quality of life.
This study intends to use prospective clinical studies to further confirm the efficacy and safety of the anti-angiogenic drug rh-ES combined with traditional CV regimens in the treatment of children with LGGs.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Zhang Jun-ping
- Phone Number: 86-010-62856783
- Email: doczhjp@hotmail.com
Study Locations
-
-
-
Beijing, China
- Capital Medical University Sanbo Brain Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 3months and ≤18years;
- Histopathologically confirmed low-grade glioma (WHO grade I and II), including astrocytoma, pilocytic astrocytoma, pleomorphic xanthoastrocytoma, subependymal giant cell astrocytoma, infantile desmoplastic astrocytoma, low-grade oligodendroglioma, oligoastrocytoma, ganglioglioma, and infantile desmoplastic ganglioglioma. Chiasmatic-hypothalamic tumors intrinsic to the optic pathway were eligible without pathologic confirmation.
- There is a clear evaluable lesion with less than 95% resection or residual tumor of more than 1.5 cm^2;
- KPS score ≥50 (age> 12 years old) or Lansky score ≥ 50 (age ≤ 12 years old);
- Estimated survival of at least 12 weeks;
- Have not been received radiotherapy or chemotherapy before;
Participants must have adequate organ function as defined by the following criteria (within 7 days before treatment):
Hematology (No transfusion within 14 days):
Hemoglobin(HB)≥90g/L; Absolute neutrophil count (ANC)≥1.5×10^9/L; Platelet (PLT)≥80×10^9/L.
Chemistry:
Serum bilirubin ≤ 1.5×upper limit of normal (ULN) ALT and AST≤2.5ULN; Serum creatinine ≤1.5ULN or creatinine clearance rate(CCr)≥60ml/min; ECG: heart rate in the normal range (55-100beats/min), normal or slightly prolonged QT interval (QTc<480ms), normal or low T wave, normal or non-specific ST segment changes;
- The patient or his legal guardian signs an informed consent form.
Exclusion Criteria:
- MRI examination is not available;
- Diffuse intrinsic pontine glioma or diffuse midline glioma with H3K27 mutation, even though the histopathology is grade I/II;
- Non-glial low-grade rare intracranial tumors;
- Receiving any other investigational agent;
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to the drugs used in this study;
- Patients who have received organ transplants;
- Patients with HIV or Treponema pallidum infection;
- Severe heart disease; ECG shows T wave inversion or elevation or ST segment specific changes;
- There were clinically significant bleeding symptoms or clear bleeding tendency in the first 3 months before enrollment, such as gastrointestinal bleeding, hemorrhagic gastric ulcer, gastrointestinal perforation, baseline fecal occult blood ++ and above, intracranial or intracranial hemorrhage, or vasculitis;
- Arteriovenous thrombosis events occurred within 6 months before enrollment, such as cerebrovascular accidents (including temporary ischemic attack, cerebral hemorrhage, cerebral infarction), deep vein thrombosis and pulmonary embolism, etc.;
- Having bleeding disorder and are being treated with thrombolytic or anticoagulant drugs.
- Patients who are pregnant or breastfeeding.
- Other conditions considered inappropriate by the researcher for inclusion.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Low-grade gliomas
Treated with Recombinant human endostatin, Carboplatin, and Vincristine
|
All the patients receive combined therapy with recombinant human endostatin and traditional weekly CV regimen. Carboplatin is administered at a dose of 220 mg/m2. Vincristine is administered at a dose of 1.5 mg/m2 (maximum dose 2 mg). Recombinant human endostatin (rh-ES) is administrated at a dose of 15mg daily, for 14 consecutive days every 3 weeks. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
objective response rate
Time Frame: up to 5years
|
the percentage of patients who achieved confirmed complete response or partial response according to the Response Assessment in Neuro-Oncology (RANO) criteria
|
up to 5years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
median time to response
Time Frame: up to 5years
|
Time interval from the beginning of chemotherapy to achieving CR, PR or MR
|
up to 5years
|
Progression-free survival
Time Frame: up to 5years
|
the time interval from treatment initiation to disease progression or death, whichever occurs first.
|
up to 5years
|
Overall survival
Time Frame: up to 5years
|
the time interval from treatment initiation to death from any cause.
|
up to 5years
|
The correlation between KPS change and efficacy
Time Frame: up to 5years
|
the correlation between KPS baseline, KPS change (increase, decrease,stable) and best efficacy (CR, PR, SD, PD).
|
up to 5years
|
Frequency and severity of treatment-related adverse events as assessed by CTCAE v5.0
Time Frame: up to 5years
|
Frequency and severity of treatment-related adverse events as assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0
|
up to 5years
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SBNK-YJ-2020-016-02
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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 Low-grade Glioma
-
St. Jude Children's Research HospitalSpringWorks Therapeutics, Inc.RecruitingLow-Grade Glioma | Recurrent Low-Grade Glioma | Progressive Low-Grade GliomaUnited States
-
National Cancer Institute (NCI)RecruitingLow Grade Glioma | Low Grade Astrocytoma | Metastatic Low Grade Astrocytoma | Metastatic Low Grade GliomaUnited States, Canada, Puerto Rico
-
National Cancer Institute (NCI)RecruitingRecurrent WHO Grade 2 Glioma | Recurrent Low Grade Astrocytoma | Refractory Low Grade Astrocytoma | Refractory Low Grade Glioma | Refractory WHO Grade 1 GliomaUnited States, Canada
-
Children's Hospital of PhiladelphiaBlue Earth Diagnostics; Dragon Master FoundationNot yet recruitingGlioma | Low-grade Glioma | Glioma, Malignant | Low Grade Glioma of Brain | Glioma IntracranialUnited States
-
Neurological Associates of West Los AngelesEnrolling by invitationLow Grade Glioma of BrainUnited States
-
National Cancer Institute (NCI)RecruitingGlioma | High Grade Glioma | Malignant Glioma | Gliomas | Low Grade GliomaUnited States
-
Maastricht Radiation OncologyMaastricht University Medical Center; Ziekenhuis Oost-Limburg; Zuyderland Medisch...Active, not recruitingHigh Grade Glioma | Low-grade GliomaNetherlands
-
University of California, San FranciscoBeiGene USA, Inc.; Pacific Pediatric Neuro-Oncology ConsortiumRecruitingGlioblastoma | Malignant Glioma | Recurrent Glioblastoma | Recurrent WHO Grade III Glioma | WHO Grade III Glioma | IDH2 Gene Mutation | IDH1 Gene Mutation | Low Grade Glioma | Recurrent WHO Grade II Glioma | WHO Grade II GliomaUnited States
-
Hospital del Río HortegaCompletedGlioma | Glioblastoma | Low-grade Glioma | Glioma, Malignant | High-grade GliomaSpain
-
Massachusetts General HospitalNational Cancer Institute (NCI)Active, not recruitingLow Grade Glioma | WHO Grade 3 Glioma With IDH1 Mutation | WHO Grade 3 Glioma With 1p/19q CodeletionUnited States
Clinical Trials on combined therapy with rh-ES and CV
-
Hasan Kalyoncu UniversityCompletedTemporomandibular Disorders | Dysphagia, Oral PhaseTurkey
-
University of MinnesotaCompleted
-
Henan Cancer HospitalWithdrawnStage IV Breast CancerChina
-
Universitat Internacional de CatalunyaRecruitingTemporomandibular Disorder | Myofascial Pain Syndrome | Central Sensitisation | Endurance TrainingSpain
-
Chinese PLA General HospitalNot yet recruitingPancreatic Neoplasms | Ablation
-
Indiana UniversityCompletedPhantom Limb Pain
-
Hacettepe UniversityCompletedFatigue | Hemodialysis Complication | Anxiety DepressionTurkey
-
Stanford UniversityNational Institutes of Health (NIH)CompletedAnorexia NervosaUnited States
-
Cairo UniversityRecruiting
-
NICHD Pelvic Floor Disorders NetworkCompletedUrinary Incontinence | Stress Urinary IncontinenceUnited States