- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04994132
A Study to Compare Early Use of Vinorelbine and Maintenance Therapy for Patients With High Risk Rhabdomyosarcoma
A Randomized Phase 3 Trial of Vinorelbine, Dactinomycin, and Cyclophosphamide (VINO-AC) Plus Maintenance Chemotherapy With Vinorelbine and Oral Cyclophosphamide (VINO-CPO) vs Vincristine, Dactinomycin and Cyclophosphamide (VAC) Plus VINO-CPO Maintenance in Patients With High Risk Rhabdomyosarcoma (HR-RMS)
Study Overview
Status
Conditions
Intervention / Treatment
- Procedure: Magnetic Resonance Imaging
- Procedure: Computed Tomography
- Procedure: Biospecimen Collection
- Drug: Vincristine Sulfate
- Procedure: X-Ray Imaging
- Radiation: Radiation Therapy
- Procedure: Positron Emission Tomography
- Procedure: Bone Marrow Aspiration
- Biological: Dactinomycin
- Drug: Vinorelbine Tartrate
- Procedure: Bone Marrow Biopsy
- Drug: Cyclophosphamide
- Procedure: Bone Scan
Detailed Description
PRIMARY OBJECTIVE:
I. To compare event-free survival (EFS) of patients with high-risk rhabdomyosarcoma (HR-RMS) treated with vinorelbine, dactinomycin and cyclophosphamide (VINO-AC) followed by 24 weeks of vinorelbine and oral cyclophosphamide (VINO-CPO) maintenance therapy to that of patients treated with vincristine, dactinomycin and cyclophosphamide (VAC) followed by 24 weeks of VINO-CPO maintenance therapy.
SECONDARY OBJECTIVES:
I. To assess the safety and feasibility of administering VINO-AC in newly diagnosed patients with HR-RMS.
II. To describe the toxicity experience of patients with HR-RMS treated with VINO-AC compared to VAC.
III. To compare overall survival (OS) of patients with HR-RMS treated with VINO AC followed by 24 weeks of VINO-CPO maintenance therapy to that of patients treated with VAC followed by 24 weeks of VINO-CPO maintenance therapy.
IV. To compare objective radiologic response rates at week 12 between patients with HR-RMS treated with VINO-AC to those treated with VAC.
V. To determine whether the addition of 24 weeks of VINO-CPO maintenance therapy improves EFS in patients with HR-RMS when compared to historical controls.
VI. To determine the association between circulating tumor-derived deoxyribonucleic acid (ctDNA) levels at diagnosis and during initial chemotherapy and event-free survival (EFS) in patients with HR RMS.
VII. To prospectively validate the prognostic impact of genomic variants in HR RMS.
EXPLORATORY OBJECTIVE:
I. To collect serial blood samples and tumor tissue for banking at baseline, during treatment, at the end of therapy, and at the time of progression for future tumor and liquid biopsy studies.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM A: Patients receive vincristine sulfate intravenously (IV) on days 1, 8 and 15 of cycles 1-4, 7, 8, 11, and 12, and day 1 of cycles 5, 6, 9, 10, 13, and 14. Patients also receive dactinomycin IV over 1-15 minutes or IV push (IVP) over 1-5 minutes on day 1 of cycles 1-5, 8-10, and 11-14, and cyclophosphamide IV over 60 minutes on day 1 of each cycle. Treatment repeats every 21 days for up to 14 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo radiation therapy on weeks 13 and 40.
ARM B: Patients receive vinorelbine tartrate IV over 6-10 minutes on days 1 and 8, vincristine sulfate IV on day 15, dactinomycin IV over 1-15 minutes or IVP over 1-5 minutes on day 1 of cycles 1-5 and 8-14, and cyclophosphamide IV over 60 minutes on day 1. Treatment repeats every 21 days for up to 14 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo radiation therapy on weeks 13 and 40.
MAINTENANCE: All patients receive vinorelbine tartrate IV over 6-10 minutes on days 1, 8, and 15 and cyclophosphamide orally (PO) on days 1-28. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity.
Patients in both arms undergo computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), x-ray imaging, and/or bone scan, as well as blood sample collection throughout the trial. Patients may also undergo bone marrow aspiration and/or biopsy as clinically indicated
After completion of study treatment, patients are followed up every 3 months for year 1, every 4 months for years 2-3, and every 6 months for years 4-5.
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Locations
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New South Wales
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Hunter Regional Mail Centre, New South Wales, Australia, 2310
- John Hunter Children's Hospital
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Randwick, New South Wales, Australia, 2031
- Sydney Children's Hospital
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Westmead, New South Wales, Australia, 2145
- The Children's Hospital at Westmead
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Victoria
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Parkville, Victoria, Australia, 3052
- Royal Children's Hospital
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Western Australia
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Perth, Western Australia, Australia, 6009
- Perth Children's Hospital
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Québec, Canada, G1V 4G2
- CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)
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Alberta
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Calgary, Alberta, Canada, T3B 6A8
- Alberta Children's Hospital
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Edmonton, Alberta, Canada, T6G 2B7
- University of Alberta Hospital
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Manitoba
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Winnipeg, Manitoba, Canada, R3E 0V9
- CancerCare Manitoba
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Nova Scotia
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Halifax, Nova Scotia, Canada, B3K 6R8
- IWK Health Centre
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Ontario
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Hamilton, Ontario, Canada, L8N 3Z5
- McMaster Children's Hospital at Hamilton Health Sciences
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Kingston, Ontario, Canada, K7L 2V7
- Kingston Health Sciences Centre
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London, Ontario, Canada, N6A 5W9
- Children's Hospital
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Ottawa, Ontario, Canada, K1H 8L1
- Children's Hospital of Eastern Ontario
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Toronto, Ontario, Canada, M5G 1X8
- Hospital for Sick Children
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Quebec
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Montreal, Quebec, Canada, H3H 1P3
- The Montreal Children's Hospital of the MUHC
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Montreal, Quebec, Canada, H3T 1C5
- Centre Hospitalier Universitaire Sainte-Justine
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Sherbrooke, Quebec, Canada, J1H 5N4
- Centre Hospitalier Universitaire de Sherbrooke-Fleurimont
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Saskatchewan
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Saskatoon, Saskatchewan, Canada, S7N 4H4
- Saskatoon Cancer Centre
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Saskatoon, Saskatchewan, Canada, S7N 0W8
- Jim Pattison Children's Hospital
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Caguas, Puerto Rico, 00726
- HIMA San Pablo Oncologic Hospital
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Riyadh, Saudi Arabia, 11211
- King Faisal Specialist Hospital and Research Centre
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Alabama
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Birmingham, Alabama, United States, 35233
- Children's Hospital of Alabama
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Mobile, Alabama, United States, 36604
- USA Health Strada Patient Care Center
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Alaska
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Anchorage, Alaska, United States, 99508
- Providence Alaska Medical Center
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Arizona
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Kingman, Arizona, United States, 86401
- Kingman Regional Medical Center
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Mesa, Arizona, United States, 85202
- Banner Children's at Desert
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Phoenix, Arizona, United States, 85016
- Phoenix Childrens Hospital
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Tucson, Arizona, United States, 85719
- Banner University Medical Center - Tucson
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Arkansas
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Little Rock, Arkansas, United States, 72202-3591
- Arkansas Children's Hospital
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California
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Anaheim, California, United States, 92806
- Kaiser Permanente-Anaheim
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Arroyo Grande, California, United States, 93420
- PCR Oncology
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Bellflower, California, United States, 90706
- Kaiser Permanente-Bellflower
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Downey, California, United States, 90242
- Kaiser Permanente Downey Medical Center
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Duarte, California, United States, 91010
- City of Hope Comprehensive Cancer Center
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Fontana, California, United States, 92335
- Kaiser Permanente-Fontana
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Loma Linda, California, United States, 92354
- Loma Linda University Medical Center
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Long Beach, California, United States, 90806
- Miller Children's and Women's Hospital Long Beach
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Los Angeles, California, United States, 90048
- Cedars-Sinai Medical Center
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Los Angeles, California, United States, 90027
- Children's Hospital Los Angeles
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Los Angeles, California, United States, 90027
- Kaiser Permanente Los Angeles Medical Center
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Los Angeles, California, United States, 90095
- Mattel Children's Hospital UCLA
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Madera, California, United States, 93636
- Valley Children's Hospital
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Oakland, California, United States, 94609
- UCSF Benioff Children's Hospital Oakland
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Oakland, California, United States, 94611
- Kaiser Permanente-Oakland
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Orange, California, United States, 92868
- Children's Hospital of Orange County
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Palo Alto, California, United States, 94304
- Lucile Packard Children's Hospital Stanford University
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Sacramento, California, United States, 95817
- University of California Davis Comprehensive Cancer Center
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San Diego, California, United States, 92123
- Rady Children's Hospital - San Diego
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San Diego, California, United States, 92120
- Kaiser Permanente-San Diego Zion
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San Diego, California, United States, 92134
- Naval Medical Center -San Diego
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San Francisco, California, United States, 94158
- UCSF Medical Center-Mission Bay
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Colorado
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Aurora, Colorado, United States, 80045
- Children's Hospital Colorado
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Denver, Colorado, United States, 80218
- Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
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Connecticut
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Hartford, Connecticut, United States, 06106
- Connecticut Children's Medical Center
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New Haven, Connecticut, United States, 06520
- Yale University
-
New Haven, Connecticut, United States, 06510
- Smilow Cancer Center/Yale-New Haven Hospital
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Delaware
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Wilmington, Delaware, United States, 19803
- Alfred I duPont Hospital for Children
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District of Columbia
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Washington D.C., District of Columbia, United States, 20010
- Children's National Medical Center
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Washington D.C., District of Columbia, United States, 20007
- MedStar Georgetown University Hospital
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Florida
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Fort Lauderdale, Florida, United States, 33316
- Broward Health Medical Center
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Fort Myers, Florida, United States, 33908
- Golisano Children's Hospital of Southwest Florida
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Gainesville, Florida, United States, 32610
- UF Health Cancer Institute - Gainesville
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Hollywood, Florida, United States, 33021
- Memorial Regional Hospital/Joe DiMaggio Children's Hospital
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Jacksonville, Florida, United States, 32207
- Nemours Children's Clinic-Jacksonville
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Miami, Florida, United States, 33155
- Nicklaus Children's Hospital
-
Miami, Florida, United States, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Orlando, Florida, United States, 32827
- Nemours Children's Hospital
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Orlando, Florida, United States, 32806
- Arnold Palmer Hospital for Children
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Pensacola, Florida, United States, 32504
- Sacred Heart Hospital
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Tampa, Florida, United States, 33606
- Tampa General Hospital
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Tampa, Florida, United States, 33607
- Saint Joseph's Hospital/Children's Hospital-Tampa
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West Palm Beach, Florida, United States, 33407
- Saint Mary's Medical Center
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Georgia
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Atlanta, Georgia, United States, 30329
- Children's Healthcare of Atlanta - Arthur M Blank Hospital
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Augusta, Georgia, United States, 30912
- Augusta University Medical Center
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Macon, Georgia, United States, 31201
- Atrium Health Navicent
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Savannah, Georgia, United States, 31404
- Memorial Health University Medical Center
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Hawaii
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Honolulu, Hawaii, United States, 96826
- Kapiolani Medical Center for Women and Children
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Idaho
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Boise, Idaho, United States, 83712
- Saint Luke's Cancer Institute - Boise
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Illinois
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Chicago, Illinois, United States, 60637
- University of Chicago Comprehensive Cancer Center
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Chicago, Illinois, United States, 60612
- University of Illinois
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Chicago, Illinois, United States, 60611
- Lurie Children's Hospital-Chicago
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Maywood, Illinois, United States, 60153
- Loyola University Medical Center
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Oak Lawn, Illinois, United States, 60453
- Advocate Children's Hospital-Oak Lawn
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Park Ridge, Illinois, United States, 60068
- Advocate Children's Hospital-Park Ridge
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Peoria, Illinois, United States, 61637
- Saint Jude Midwest Affiliate
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Springfield, Illinois, United States, 62702
- Southern Illinois University School of Medicine
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Springfield, Illinois, United States, 62702
- Saint John's Hospital
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Winfield, Illinois, United States, 60190
- Northwestern Medicine Central DuPage Hospital
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Indiana
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Indianapolis, Indiana, United States, 46202
- Riley Hospital for Children
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Indianapolis, Indiana, United States, 46260
- Ascension Saint Vincent Indianapolis Hospital
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Iowa
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Des Moines, Iowa, United States, 50309
- Blank Children's Hospital
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Iowa City, Iowa, United States, 52242
- University of Iowa/Holden Comprehensive Cancer Center
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Kentucky
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Lexington, Kentucky, United States, 40536
- University of Kentucky/Markey Cancer Center
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Louisville, Kentucky, United States, 40202
- Norton Children's Hospital
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Louisiana
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New Orleans, Louisiana, United States, 70121
- Ochsner Medical Center Jefferson
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New Orleans, Louisiana, United States, 70118
- Children's Hospital New Orleans
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Maine
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Bangor, Maine, United States, 04401
- Eastern Maine Medical Center
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Scarborough, Maine, United States, 04074
- Maine Children's Cancer Program
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Maryland
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Baltimore, Maryland, United States, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
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Baltimore, Maryland, United States, 21215
- Sinai Hospital of Baltimore
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Bethesda, Maryland, United States, 20889-5600
- Walter Reed National Military Medical Center
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Massachusetts
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Boston, Massachusetts, United States, 02215
- Dana-Farber Cancer Institute
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Boston, Massachusetts, United States, 02111
- Tufts Medical Center
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital Cancer Center
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Boston, Massachusetts, United States, 02111
- Tufts Children's Hospital
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Worcester, Massachusetts, United States, 01655
- UMass Memorial Medical Center - University Campus
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Michigan
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Ann Arbor, Michigan, United States, 48109
- C S Mott Children's Hospital
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Battle Creek, Michigan, United States, 49017
- Bronson Battle Creek
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Detroit, Michigan, United States, 48201
- Children's Hospital of Michigan
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East Lansing, Michigan, United States, 48823
- Michigan State University
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Grand Rapids, Michigan, United States, 49503
- Trinity Health Grand Rapids Hospital
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Grand Rapids, Michigan, United States, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
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Grand Rapids, Michigan, United States, 49503
- Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
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Kalamazoo, Michigan, United States, 49007
- West Michigan Cancer Center
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Kalamazoo, Michigan, United States, 49007
- Bronson Methodist Hospital
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Kalamazoo, Michigan, United States, 49048
- Beacon Kalamazoo
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Muskegon, Michigan, United States, 49444
- Trinity Health Muskegon Hospital
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Niles, Michigan, United States, 49120
- Corewell Health Lakeland Hospitals - Niles Hospital
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Norton Shores, Michigan, United States, 49444
- Cancer and Hematology Centers of Western Michigan - Norton Shores
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Reed City, Michigan, United States, 49677
- Corewell Health Reed City Hospital
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Royal Oak, Michigan, United States, 48073
- Corewell Health Children's
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Saint Joseph, Michigan, United States, 49085
- Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
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Saint Joseph, Michigan, United States, 49085
- Corewell Health Lakeland Hospitals - Saint Joseph Hospital
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Traverse City, Michigan, United States, 49684
- Munson Medical Center
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Wyoming, Michigan, United States, 49519
- University of Michigan Health - West
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Minnesota
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Minneapolis, Minnesota, United States, 55404
- Children's Hospitals and Clinics of Minnesota - Minneapolis
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Minneapolis, Minnesota, United States, 55455
- University of Minnesota/Masonic Cancer Center
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Rochester, Minnesota, United States, 55905
- Mayo Clinic in Rochester
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Mississippi
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Jackson, Mississippi, United States, 39216
- University of Mississippi Medical Center
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Missouri
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Columbia, Missouri, United States, 65212
- University of Missouri Children's Hospital
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Kansas City, Missouri, United States, 64108
- Children's Mercy Hospitals and Clinics
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St Louis, Missouri, United States, 63110
- Washington University School of Medicine
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St Louis, Missouri, United States, 63141
- Mercy Hospital Saint Louis
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St Louis, Missouri, United States, 63104
- Cardinal Glennon Children's Medical Center
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Nebraska
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Omaha, Nebraska, United States, 68198
- University of Nebraska Medical Center
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Omaha, Nebraska, United States, 68114
- Children's Hospital and Medical Center of Omaha
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Nevada
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Henderson, Nevada, United States, 89052
- Comprehensive Cancer Centers of Nevada - Henderson
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Henderson, Nevada, United States, 89074
- Oncology Las Vegas - Henderson
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Las Vegas, Nevada, United States, 89102
- OptumCare Cancer Care at Charleston
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Las Vegas, Nevada, United States, 89106
- Radiation Oncology Centers of Nevada Central
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Las Vegas, Nevada, United States, 89119
- Radiation Oncology Centers of Nevada Southeast
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Las Vegas, Nevada, United States, 89128
- Comprehensive Cancer Centers of Nevada - Northwest
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Las Vegas, Nevada, United States, 89128
- OptumCare Cancer Care at MountainView
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Las Vegas, Nevada, United States, 89135
- Alliance for Childhood Diseases/Cure 4 the Kids Foundation
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Las Vegas, Nevada, United States, 89144
- Comprehensive Cancer Centers of Nevada - Town Center
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Las Vegas, Nevada, United States, 89144
- Comprehensive Cancer Centers of Nevada-Summerlin
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Las Vegas, Nevada, United States, 89148
- Comprehensive Cancer Centers of Nevada
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Las Vegas, Nevada, United States, 89169
- Comprehensive Cancer Centers of Nevada - Central Valley
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Las Vegas, Nevada, United States, 89128
- Oncology Las Vegas - Tenaya
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Las Vegas, Nevada, United States, 89183
- OptumCare Cancer Care at Fort Apache
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Reno, Nevada, United States, 89502
- Renown Regional Medical Center
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Reno, Nevada, United States, 89503
- Saint Mary's Regional Medical Center
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Reno, Nevada, United States, 89509
- Radiation Oncology Associates
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Reno, Nevada, United States, 89511
- Cancer Care Specialists - Reno
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New Jersey
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Hackensack, New Jersey, United States, 07601
- Hackensack University Medical Center
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Morristown, New Jersey, United States, 07960
- Morristown Medical Center
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New Brunswick, New Jersey, United States, 08903
- Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
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Newark, New Jersey, United States, 07112
- Newark Beth Israel Medical Center
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Paterson, New Jersey, United States, 07503
- Saint Joseph's Regional Medical Center
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New York
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Albany, New York, United States, 12208
- Albany Medical Center
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Brooklyn, New York, United States, 11219
- Maimonides Medical Center
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Buffalo, New York, United States, 14263
- Roswell Park Cancer Institute
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New Hyde Park, New York, United States, 11040
- The Steven and Alexandra Cohen Children's Medical Center of New York
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center
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New York, New York, United States, 10029
- Mount Sinai Hospital
-
New York, New York, United States, 10032
- NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
-
New York, New York, United States, 10065
- NYP/Weill Cornell Medical Center
-
Stony Brook, New York, United States, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, United States, 13210
- State University of New York Upstate Medical University
-
The Bronx, New York, United States, 10461
- Montefiore Medical Center-Einstein Campus
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The Bronx, New York, United States, 10467
- Montefiore Medical Center - Moses Campus
-
The Bronx, New York, United States, 10461
- Montefiore Medical Center-Weiler Hospital
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Valhalla, New York, United States, 10595
- New York Medical College
-
Valhalla, New York, United States, 10595
- Westchester Medical Center
-
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North Carolina
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Asheville, North Carolina, United States, 28801
- Mission Hospital
-
Charlotte, North Carolina, United States, 28203
- Carolinas Medical Center/Levine Cancer Institute
-
Charlotte, North Carolina, United States, 28204
- Novant Health Presbyterian Medical Center
-
Greenville, North Carolina, United States, 27834
- East Carolina University
-
Winston-Salem, North Carolina, United States, 27157
- Wake Forest University Health Sciences
-
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North Dakota
-
Fargo, North Dakota, United States, 58122
- Sanford Broadway Medical Center
-
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Ohio
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Akron, Ohio, United States, 44308
- Children's Hospital Medical Center of Akron
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Cincinnati, Ohio, United States, 45229
- Cincinnati Children's Hospital Medical Center
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Cleveland, Ohio, United States, 44195
- Cleveland Clinic Foundation
-
Cleveland, Ohio, United States, 44106
- Rainbow Babies and Childrens Hospital
-
Columbus, Ohio, United States, 43205
- Nationwide Children's Hospital
-
Dayton, Ohio, United States, 45404
- Dayton Children's Hospital
-
Sylvania, Ohio, United States, 43560
- ProMedica Flower Hospital
-
Toledo, Ohio, United States, 43606
- ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
-
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Oklahoma
-
Oklahoma City, Oklahoma, United States, 73104
- University of Oklahoma Health Sciences Center
-
-
Oregon
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Portland, Oregon, United States, 97239
- Oregon Health and Science University
-
Portland, Oregon, United States, 97227
- Legacy Emanuel Children's Hospital
-
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Pennsylvania
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Allentown, Pennsylvania, United States, 18103
- Lehigh Valley Hospital-Cedar Crest
-
Danville, Pennsylvania, United States, 17822
- Geisinger Medical Center
-
Hershey, Pennsylvania, United States, 17033
- Penn State Children's Hospital
-
Philadelphia, Pennsylvania, United States, 19104
- Children's Hospital of Philadelphia
-
Philadelphia, Pennsylvania, United States, 19134
- Saint Christopher's Hospital for Children
-
Pittsburgh, Pennsylvania, United States, 15224
- Children's Hospital of Pittsburgh of UPMC
-
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Rhode Island
-
Providence, Rhode Island, United States, 02903
- Rhode Island Hospital
-
-
South Carolina
-
Charleston, South Carolina, United States, 29425
- Medical University of South Carolina
-
Columbia, South Carolina, United States, 29203
- Prisma Health Richland Hospital
-
Greenville, South Carolina, United States, 29605
- Prisma Health Cancer Institute - Faris
-
Greenville, South Carolina, United States, 29607
- Saint Francis Cancer Center
-
Greenville, South Carolina, United States, 29615
- Prisma Health Cancer Institute - Eastside
-
Greenville, South Carolina, United States, 29601
- Saint Francis Hospital
-
Greenville, South Carolina, United States, 29605
- BI-LO Charities Children's Cancer Center
-
Greer, South Carolina, United States, 29650
- Prisma Health Cancer Institute - Greer
-
Seneca, South Carolina, United States, 29672
- Prisma Health Cancer Institute - Seneca
-
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South Dakota
-
Sioux Falls, South Dakota, United States, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
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Tennessee
-
Chattanooga, Tennessee, United States, 37403
- T C Thompson Children's Hospital
-
Knoxville, Tennessee, United States, 37916
- East Tennessee Childrens Hospital
-
Memphis, Tennessee, United States, 38105
- Saint Jude Children's Research Hospital
-
Nashville, Tennessee, United States, 37232
- Vanderbilt University/Ingram Cancer Center
-
Nashville, Tennessee, United States, 37203
- The Children's Hospital at TriStar Centennial
-
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Texas
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Amarillo, Texas, United States, 79106
- Texas Tech University Health Sciences Center-Amarillo
-
Austin, Texas, United States, 78723
- Dell Children's Medical Center of Central Texas
-
Corpus Christi, Texas, United States, 78411
- Driscoll Children's Hospital
-
Dallas, Texas, United States, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Dallas, Texas, United States, 75230
- Medical City Dallas Hospital
-
El Paso, Texas, United States, 79905
- El Paso Children's Hospital
-
Fort Worth, Texas, United States, 76104
- Cook Children's Medical Center
-
Houston, Texas, United States, 77030
- M D Anderson Cancer Center
-
Houston, Texas, United States, 77030
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
Lubbock, Texas, United States, 79410
- Covenant Children's Hospital
-
Lubbock, Texas, United States, 79415
- UMC Cancer Center / UMC Health System
-
San Antonio, Texas, United States, 78207
- Children's Hospital of San Antonio
-
San Antonio, Texas, United States, 78229
- Methodist Children's Hospital of South Texas
-
Temple, Texas, United States, 76508
- Scott and White Memorial Hospital
-
-
Utah
-
Salt Lake City, Utah, United States, 84113
- Primary Children's Hospital
-
-
Vermont
-
Burlington, Vermont, United States, 05405
- University of Vermont and State Agricultural College
-
-
Virginia
-
Charlottesville, Virginia, United States, 22908
- University of Virginia Cancer Center
-
Falls Church, Virginia, United States, 22042
- Inova Fairfax Hospital
-
Norfolk, Virginia, United States, 23507
- Children's Hospital of The King's Daughters
-
Portsmouth, Virginia, United States, 23708-2197
- Naval Medical Center - Portsmouth
-
Richmond, Virginia, United States, 23298
- VCU Massey Comprehensive Cancer Center
-
Roanoke, Virginia, United States, 24014
- Carilion Children's
-
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Washington
-
Bellevue, Washington, United States, 98004
- Overlake Medical Center
-
Renton, Washington, United States, 98055
- Valley Medical Center
-
Seattle, Washington, United States, 98105
- Seattle Children's Hospital
-
Spokane, Washington, United States, 99204
- Providence Sacred Heart Medical Center and Children's Hospital
-
Tacoma, Washington, United States, 98405
- Mary Bridge Children's Hospital and Health Center
-
Tacoma, Washington, United States, 98431
- Madigan Army Medical Center
-
Yakima, Washington, United States, 98902
- North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
-
-
West Virginia
-
Charleston, West Virginia, United States, 25304
- West Virginia University Charleston Division
-
Morgantown, West Virginia, United States, 26506
- West Virginia University Healthcare
-
-
Wisconsin
-
Green Bay, Wisconsin, United States, 54301
- Saint Vincent Hospital Cancer Center Green Bay
-
Green Bay, Wisconsin, United States, 54303
- Saint Vincent Hospital Cancer Center at Saint Mary's
-
Madison, Wisconsin, United States, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Marshfield, Wisconsin, United States, 54449
- Marshfield Medical Center-Marshfield
-
Milwaukee, Wisconsin, United States, 53226
- Medical College of Wisconsin
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients must be =< 50 years of age at the time of enrollment
Patients with newly diagnosed RMS of any subtype, except adult-type pleomorphic, based upon institutional histopathologic classification are eligible to enroll on the study based upon stage, group, and age, as below. FOXO1 fusion status must be determined by week 4 (day 28) of therapy. RMS types included under embryonal RMS (ERMS) include those classified in the 1995 International Classification of Rhabdomyosarcoma (ICR) as ERMS (classic, spindle cell, and botryoid variants), which are reclassified in the 2020 World Health Organization (WHO) Classification as ERMS (classic, dense and botryoid variants) and spindle cell/sclerosing RMS (encompassing the historical spindle cell ERMS variant and the newly recognized sclerosing RMS variant). Classification of alveolar RMS (ARMS) in the 2020 WHO Classification is the same as in the ICR and includes classic and solid variants
ERMS
- Stage 4, group IV, >= 10 years of age
ARMS
- Stage 4, group IV Patients will be eligible to remain on protocol therapy based upon stage, group, and age
- Bone marrow metastatic disease is based on morphologic evidence of RMS based on hematoxylin and eosin (H&E) stains. In the absence of morphologic evidence of marrow involvement on H&E, patients with bone marrow involvement detected ONLY by flow cytometry, reverse transcriptase (RT)-polymerase chain reaction (PCR), fluorescence in situ hybridization (FISH), or immunohistochemistry will NOT be considered to have clinical bone marrow involvement for the purposes of this study
Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 mL/min/1.73 m^2 or a serum creatinine based on age/sex as follows (must be performed within 7 days prior to enrollment):
- Age; Maximum serum creatinine (mg/dL)
- 1 month to < 6 months; 0.4 mg/dL (male); 0.4 mg/dL (female)
- 6 months to < 1 year; 0.5 mg/dL (male); 0.5 mg/dL (female)
- 1 to < 2 years; 0.6 mg/dL (male); 0.6 mg/dL (female)
- 2 to < 6 years; 0.8 mg/dL (male); 0.8 mg/dL (female)
- 6 to < 10 years; 1 mg/dL (male); 1 mg/dL (female)
- 10 to < 13 years; 1.2 mg/dL (male); 1.2 mg/dL (female)
- 13 to < 16 years; 1.5 mg/dL (male); 1.4 mg/dL (female)
- >= 16 years; 1.7 mg/dL (male); 1.4 mg/dL (female)
Total bilirubin =< 1.5 x upper limit of normal (ULN) for age (must be performed within 7 days prior to enrollment)
- If there is evidence of biliary obstruction by tumor, then total bilirubin must be < 3 x ULN for age
- All patients and/or their parents or legal guardians must sign a written informed consent
- All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met
Exclusion Criteria:
- Patients with evidence of uncontrolled infection are not eligible
- RMS that is considered a second malignancy and previous cancer(s) that were treated with chemotherapy and/or radiation. Surgical resection alone of previous cancer(s) is allowed
Patients with central nervous system involvement of RMS as defined below:
- Malignant cells detected in cerebrospinal fluid
- Intra-parenchymal brain metastasis separate and distinct from primary tumor (i.e., direct extension from parameningeal primary tumors is allowed).
- Diffuse leptomeningeal disease
Patients who have received any chemotherapy (excluding steroids) and/or radiation therapy for RMS prior to enrollment.
Note: the following exception:
- Patients requiring emergency radiation therapy for RMS. These patients are eligible, provided they are consented to ARST2031 prior to administration of radiation
- Note: Patients who have received or are receiving chemotherapy or radiation for non-malignant conditions (e.g. autoimmune diseases) are eligible. Patients must discontinue chemotherapy for non-malignant conditions prior to starting protocol therapy
- Vincristine and vinorelbine are sensitive substrates of CYP450 3A4 isozyme. Patients must not have received drugs that are moderate to strong CYP3A4 inhibitors and inducers within 7 days prior to study enrollment
- Female patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs. A pregnancy test is required for female patients of childbearing potential
- Lactating females who plan to breastfeed their infants
- Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation
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 |
|---|---|
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Experimental: Arm A (VAC, VINO-CPO)
Patients receive vincristine sulfate IV on days 1, 8 and 15 of cycles 1-4, 7, 8, 11, and 12, and day 1 of cycles 5, 6, 9, 10, 13, and 14. Patients also receive dactinomycin IV over 1-15 minutes or IVP over 1-5 minutes on day 1 of cycles 1-5, 8-10, and 11-14, and cyclophosphamide IV over 60 minutes on day 1 of each cycle. Treatment repeats every 21 days for up to 14 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo radiation therapy on weeks 13 and 40. MAINTENANCE: Patients receive vinorelbine tartrate IV over 6-10 minutes on days 1, 8, and 15, and cyclophosphamide PO on days 1-28. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. Patients in both arms undergo CT, MRI, PET, x-ray imaging, and/or bone scan, as well as blood sample collection throughout the trial. Patients may also undergo bone marrow aspiration and/or biopsy as clinically indicated. |
Undergo MRI
Other Names:
Undergo CT
Other Names:
Undergo blood sample collection
Other Names:
Given IV
Other Names:
Undergo x-ray imaging
Other Names:
Undergo radiation therapy
Other Names:
Undergo PET
Other Names:
Undergo bone marrow aspiration
Given IV
Other Names:
Given IV
Other Names:
Undergo bone marrow biopsy
Other Names:
Given IV or PO
Other Names:
Undergo bone scan
Other Names:
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Experimental: Arm B (vinorelbine, VAC, VINO-CPO)
Patients receive vinorelbine tartrate IV over 6-10 minutes on days 1 and 8, vincristine sulfate IV on day 15, dactinomycin IV over 1-15 minutes or IVP over 1-5 minutes on day 1 of cycles 1-5 and 8-14, and cyclophosphamide IV over 60 minutes on day 1. Treatment repeats every 21 days for up to 14 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo radiation therapy on weeks 13 and 40. MAINTENANCE: Patients receive vinorelbine tartrate IV over 6-10 minutes on days 1, 8, and 15, and cyclophosphamide PO on days 1-28. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. Patients in both arms undergo CT, MRI, PET, x-ray imaging, and/or bone scan, as well as blood sample collection throughout the trial. Patients may also undergo bone marrow aspiration and/or biopsy as clinically indicated. |
Undergo MRI
Other Names:
Undergo CT
Other Names:
Undergo blood sample collection
Other Names:
Given IV
Other Names:
Undergo x-ray imaging
Other Names:
Undergo radiation therapy
Other Names:
Undergo PET
Other Names:
Undergo bone marrow aspiration
Given IV
Other Names:
Given IV
Other Names:
Undergo bone marrow biopsy
Other Names:
Given IV or PO
Other Names:
Undergo bone scan
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Event-free survival (EFS)
Time Frame: Time from randomization to an event defined as disease relapse/progression, second malignancy, or death, whichever occurs first, assessed up to 5 years from study enrollment
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Will be estimated using the Kaplan-Meier method and will be compared between the two regimens using a log-rank test.
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Time from randomization to an event defined as disease relapse/progression, second malignancy, or death, whichever occurs first, assessed up to 5 years from study enrollment
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Feasibility and safety assessed by the adverse events, toxicities and treatment delays
Time Frame: From study enrollment to completion of the initial 12 weeks of therapy
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If more than 40% of patients enrolled in the safety phase experience one or more of the toxicities, the study will be paused, the study team will review the data and determine if an amendment is needed. Specifically, toxicities of interest include:
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From study enrollment to completion of the initial 12 weeks of therapy
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Overall survival
Time Frame: Time from randomization to death of any cause, assessed up to 5 years from study enrollment
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Will be estimated using the Kaplan-Meier method and will be compared between the therapy groups using a log-rank test.
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Time from randomization to death of any cause, assessed up to 5 years from study enrollment
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Radiologic response rate
Time Frame: At week 12 after study enrollment
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Includes both complete response and partial response.
Response Evaluation Criteria in Solid Tumors 1.1 criteria will be used to define complete and partial responses.
Will be compared between arms using chi square test.
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At week 12 after study enrollment
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Incidence of adverse events
Time Frame: Up to 5 years from study enrollment
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Adverse events of particular interest including grade 4 hematologic toxicity, grade 2 sinusoidal obstruction syndrome, grade 3 or higher neuropathy and any non-hematologic toxicity that result in delays > 14 days in the delivery of a 21-day cycle of therapy or results in a dose reduction of any chemotherapy drugs.
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Up to 5 years from study enrollment
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Association between circulating tumor-derived deoxyribonucleic acid (ctDNA) and EFS
Time Frame: Up to 5 years from study enrollment
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Will use Kaplan-Meier methods to calculate EFS, defined as the time from randomization to an event defined as disease relapse/progression, second malignancy, or death, whichever occurs first, for patients with and without detectable ctDNA.
Will classify patients as having detectable or undetectable ctDNA at baseline.
Will compare EFS between these two groups using a one-sided log-rank test.
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Up to 5 years from study enrollment
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Prognostic impact of genomic variants
Time Frame: Up to 5 years from study enrollment
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Will provide descriptive statistics for amplifications in MYCN and mutations in TP53 and MYOD1.
Will compare EFS between patients with and without these mutations detected at baseline.
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Up to 5 years from study enrollment
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Wendy Allen-Rhoades, Children's Oncology Group
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms
- Neoplasms by Histologic Type
- Sarcoma
- Neoplasms, Connective and Soft Tissue
- Neoplasms, Muscle Tissue
- Myosarcoma
- Rhabdomyosarcoma
- Rhabdomyosarcoma, Embryonal
- Rhabdomyosarcoma, Alveolar
- Peptides
- Amino Acids, Peptides, and Proteins
- Organic Chemicals
- Heterocyclic Compounds
- Heterocyclic Compounds, 2-Ring
- Heterocyclic Compounds, Fused-Ring
- Investigative Techniques
- Therapeutics
- Clinical Laboratory Techniques
- Diagnostic Techniques and Procedures
- Diagnosis
- Surgical Procedures, Operative
- Cytological Techniques
- Cytodiagnosis
- Hydrocarbons
- Physical Phenomena
- Alkaloids
- Polycyclic Compounds
- Equipment and Supplies
- Indoles
- Diagnostic Techniques, Surgical
- Chemistry Techniques, Analytical
- Spectrum Analysis
- Phosphoramide Mustards
- Nitrogen Mustard Compounds
- Mustard Compounds
- Hydrocarbons, Halogenated
- Phosphoramides
- Organophosphorus Compounds
- Vinca Alkaloids
- Secologanin Tryptamine Alkaloids
- Indole Alkaloids
- Indolizidines
- Indolizines
- Electromagnetic Phenomena
- Magnetic Phenomena
- Macrocyclic Compounds
- Peptides, Cyclic
- Electromagnetic Radiation
- Radiation, Ionizing
- Heterocyclic Compounds, 3-Ring
- Vinorelbine
- Cyclophosphamide
- Vincristine
- Dactinomycin
- Radiotherapy
- Radiation
- Biopsy
- Specimen Handling
- Magnetic Resonance Spectroscopy
- X-Rays
- Phantoms, Imaging
Other Study ID Numbers
- ARST2031 (Other Identifier: CTEP)
- U10CA180886 (U.S. NIH Grant/Contract)
- NCI-2021-06711 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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