A Prospective, Single-arm Clinical Study of Liposomal Mitoxantrone Combination Regimen in the Treatment of Relapsed and Refractory Solid Tumors in Children, Adolescents and Young Adults

The aim of this clinical study is to determine the efficacy and safety of the liposomal mitoxantrone combination regimen in treating relapsed and refractory solid tumors among children, adolescents, and young adults. The key questions it intends to address are:

Can the liposomal mitoxantrone combination regimen improve the objective response rate (ORR) compared to historical data? What are the adverse events associated with this combination regimen? Researchers will administer the liposomal mitoxantrone combination regimen (including capecitabine and anlotinib with specific dosing regimens) to the participants and closely monitor their conditions.

Participants will:

Receive the treatment regimen for 4 - 6 cycles, with each cycle lasting 21 days Undergo regular checkups and tests during the treatment period and follow-up period as per the protocol.

Have their tumor status, blood parameters, and other relevant indicators measured to evaluate the treatment effect and safety.

Study Overview

Detailed Description

This is a prospective, single-arm, multicenter clinical study named "A Prospective, Single-arm, Multicenter Clinical Study of Liposomal Mitoxantrone Combination Regimen in the Treatment of Relapsed and Refractory Solid Tumors in Children, Adolescents and Young Adults". The study aims to assess the safety and effectiveness of the liposomal mitoxantrone combination regimen in treating relapsed and refractory solid tumors among children, adolescents, and young adults.

The research anticipates enrolling 49 patients meeting specific criteria. The inclusion criteria require patients to have a clear understanding of the study, sign the informed consent form voluntarily, fall within the age range of 6 - 24 years with an expected survival time exceeding 3 months, have histopathologically confirmed relapsed and refractory solid tumors of certain subtypes (such as bone and soft tissue tumors, neuroblastoma, etc.), possess measurable tumor lesions detectable by CT, enhanced CT, PET/CT or MRI, and meet specific Karnofsky and ECOG scores as well as requirements for bone marrow, liver, and kidney functions. Exclusion criteria cover those with hypersensitivity to study drugs, uncontrolled other malignancies, pregnant or lactating women, and those judged unsuitable by investigators.

The treatment regimen consists of capecitabine at a dose of 1000 mg/m² from day 1 to 14, twice daily, and anlotinib with the dose adjusted according to body weight for 14 days, with a 21-day cycle repeated 4 - 6 times. Patients achieving a partial response or better will undergo local treatment like surgery or radiotherapy.

The primary endpoint of the study is the objective response rate (ORR), while secondary endpoints include the proportion of patients eligible for local treatment after treatment, disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events evaluated by NCI CTCAE v5.0. This study holds great significance for exploring new treatment options for relapsed and refractory solid tumors in the target population.

Study Type

Interventional

Enrollment (Estimated)

49

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 Contact

Study Locations

      • Beijing, China
        • Recruiting
        • Cancer Hospital, Chinese Academy of Medical Sciences
        • Contact:

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

  • Child
  • Adult

Accepts Healthy Volunteers

No

Description

Main inclusion Criteria:

  1. The patient fully understands this study, voluntarily participates and signs the informed consent form (ICF).
  2. Age: children (6 - 12 years old), adolescents (13 - 18 years old) and young adults (19 - 24 years old) (CAYA). The expected survival time is > 3 months.
  3. Diagnosed with relapsed and refractory solid tumors by histopathology, and it is one of the following subtypes: (1) bone and soft tissue tumors; (2) neuroblastoma; (3) other types of solid tumors that the investigator deems eligible for enrollment.
  4. There must be measurable tumor lesions by CT, enhanced CT, PET/CT or MRI.
  5. Karnofsky score > 50; ECOG score ≤ 2.
  6. Bone marrow function: neutrophil count > 1.5 × 10⁹/L, platelet count > 75 × 10⁹/L, hemoglobin ≥ 80 g/L.
  7. Liver and kidney function: serum creatinine ≤ 1.5 times the upper limit of normal value; AST and ALT < 2.5 times the upper limit of normal value (for patients with liver invasion < 5 times the upper limit of normal value); total bilirubin < 1.5 times the upper limit of normal value (for patients with liver invasion < 3 times the upper limit of normal value).
  8. No history of myocardial infarction, unstable angina, severe unstable ventricular arrhythmia or any other arrhythmia requiring treatment, no history of clinically severe pericardial disease, or no electrocardiogram evidence of acute ischemic or active conduction system abnormality within 6 months before recruitment.

Main exclusion Criteria:

  1. Patients with known hypersensitivity to any component of the study drugs.
  2. Patients with other malignant tumors that are not under control (except for basal cell carcinoma of the skin, in-situ breast/cervical cancer, and other malignant tumors that have been effectively controlled without treatment in the past five years).
  3. Pregnant, lactating women and women of childbearing age who are unwilling to take contraceptive measures.
  4. Other situations judged by the investigator as not suitable for participating in this study.

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)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Liposomal Mitoxantrone Combination Regimen
Mitoxantrone liposome+Capecitabine+Anlotinib
Mitoxantrone liposome: 16 mg/m^2, d1; Each 21-day cycle was used for a total of 4-6 cycles.
Capecitabine 1000 mg/m^2, d1-14, bid; Each 21-day cycle was used for a total of 4-6 cycles.
Anlotinib: according to patient weight: 8mg/ day in patients <35kg; 10mg/ day for patients with 35kg≤ patient weight ≤50kg; 12mg/ day for patients > 50kg; d1-14; Each 21-day cycle was used for a total of 4-6 cycles.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of Objective response(ORR)
Time Frame: Up to 6 cycles of chemotherapy (each cycle is 21 days)
Rate of Objective response (ORR) after 4 or 6 cycles of Liposomal Mitoxantrone Combination Regimen, including complete response (CR) and partial response (PR)
Up to 6 cycles of chemotherapy (each cycle is 21 days)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of Disease control (DCR)
Time Frame: Up to 6 cycles of Liposomal Mitoxantrone Combination Regimen (each cycle is 21 days)
Refers to the percentage of patients with confirmed complete response, partial response, and disease stability in patients with evaluable efficacy
Up to 6 cycles of Liposomal Mitoxantrone Combination Regimen (each cycle is 21 days)
Progression-free survival (PFS)
Time Frame: From date of enrollment unit the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months.
Means from the date of enrollment to the date of first disease progression or death from any cause, whichever comes first. If the subject has no disease progression during the trial period, PFS is defined as the last date until the subject's last confirmed progression-free survival.
From date of enrollment unit the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months.
Overall survival (OS)
Time Frame: From date of enrollment unit the date of first documented date of death from any cause, assessed up to 24 months.
Overall survival (OS) was defined from the date of enrollment to the date of death from any cause.
From date of enrollment unit the date of first documented date of death from any cause, assessed up to 24 months.
Proportion of patients eligible for local treatment after treatment
Time Frame: Up to 6 cycles of chemotherapy (each cycle is 21 days)
Proportion of patients who meet the conditions for local treatment after treatment. mathematically, it can be expressed as: Proportion = (Number of patients eligible for local treatment / Total number of patients in the study) × 100%.
Up to 6 cycles of chemotherapy (each cycle is 21 days)
Safty
Time Frame: After signing the informed consent form, the safety monitoring began and continued until the end of the follow-up (follow-up period of 1 year).
Number of subjects with each adverse event. Safety Evaluation Criteria: The National Cancer Institute Adverse Event Common Terminology Criteria (NCICTCAE V.5.0) were used to judge the adverse events and severity during the study.
After signing the informed consent form, the safety monitoring began and continued until the end of the follow-up (follow-up period of 1 year).

Collaborators and Investigators

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

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)

January 24, 2025

Primary Completion (Estimated)

April 1, 2027

Study Completion (Estimated)

February 1, 2028

Study Registration Dates

First Submitted

December 29, 2024

First Submitted That Met QC Criteria

January 5, 2025

First Posted (Actual)

January 7, 2025

Study Record Updates

Last Update Posted (Actual)

May 7, 2026

Last Update Submitted That Met QC Criteria

May 6, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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.

Subscribe