- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT00003203
Carboplatin and Vincristine Plus Radiation Therapy Followed By Adjuvant Chemotherapy in Treating Young Patients With Newly Diagnosed CNS Embryonal Tumors
An Intergroup Pilot Study of Concurrent Carboplatin, Vincristine and Radiotherapy Followed by Adjuvant Chemotherapy in Patients With Newly Diagnosed High-Risk Central Nervous System Embryonal Tumors
RATIONALE: Drugs used in chemotherapy, such as carboplatin and vincristine, work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining carboplatin and vincristine with radiation therapy followed by adjuvant chemotherapy may kill more tumor cells.
PURPOSE: Randomized phase II trial to study the effectiveness of combination chemotherapy plus radiation therapy followed adjuvant chemotherapy in treating young patients who have newly diagnosed high-risk CNS embryonal tumors.
Studienübersicht
Status
Bedingungen
Detaillierte Beschreibung
OBJECTIVES:
- Determine the feasible dose and duration of carboplatin combined with craniospinal and local radiotherapy and adjuvant chemotherapy in children with newly diagnosed, high-risk CNS embryonal tumors (Phase I completed as of 11-25-03).
- Determine the feasibility of administering cyclophosphamide and vincristine with or without cisplatin after concurrent carboplatin, vincristine, and radiotherapy in these patients.
- Determine the overall and individual toxicity rates of this regimen in these patients.
- Determine the complete response rate in patients treated with this regimen.
- Obtain preliminary estimates of event-free survival of patients treated with this regimen.
- Determine the prognostic significance of enhancing tumor after completion of radiotherapy on event-free survival of these patients.
OUTLINE: This is a pilot, dose-escalation study of carboplatin. (Phase I completed as of 11-25-03.)
Within 31 days of definitive surgery, all patients receive vincristine IV weekly for 6 weeks and carboplatin IV over 15-20 minutes (after completion of vincristine infusion) 5 days a week for 6 weeks. Patients undergo radiotherapy (1-4 hours after carboplatin infusion) 5 days a week for 6 weeks.
Cohorts of 6-12 patients receive escalating doses of carboplatin until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose at which no more than 3 of 12 patients experience dose-limiting toxicity. (Phase I completed as of 11-25-03.)
At 6 weeks after completion of radiotherapy, patients are assigned to arm II for adjuvant/maintenance chemotherapy. (Arm I closed to accrual as of 11-25-03.)
- Arm I (closed to accrual as of 11-25-03): Patients receive cyclophosphamide IV over 1 hour on days 0 and 1, vincristine IV on days 0 and 7, and filgrastim (G-CSF) IV or subcutaneously (SC) beginning on day 2 and continuing for at least 10 days until blood counts recover.
- Arm II: Patients receive cyclophosphamide IV over 1 hour on days 1 and 2, vincristine IV on days 0 and 7, cisplatin IV over 6 hours on day 0, and G-CSF IV or SC beginning on day 3 and continuing for at least 10 days until blood counts recover.
In both arms, adjuvant/maintenance chemotherapy repeats every 4 weeks for 6 courses.
Patients are followed every 3 months for 8 months, every 4 months for 1 year, every 6 months for 2 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 162 patients will be accrued for this study.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Phase 2
Kontakte und Standorte
Studienorte
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Western Australia
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Perth, Western Australia, Australien, 6001
- Princess Margaret Hospital for Children
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British Columbia
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Vancouver, British Columbia, Kanada, V6H 3V4
- British Columbia Children's Hospital
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Nova Scotia
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Halifax, Nova Scotia, Kanada, B3J 3G9
- IWK Grace Health Centre
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California
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Long Beach, California, Vereinigte Staaten, 90806
- Long Beach Memorial Medical Center
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Los Angeles, California, Vereinigte Staaten, 90095-1781
- Jonsson Comprehensive Cancer Center, UCLA
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Los Angeles, California, Vereinigte Staaten, 90027-0700
- Children's Hospital Los Angeles
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Orange, California, Vereinigte Staaten, 92668
- Children's Hospital of Orange County
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San Francisco, California, Vereinigte Staaten, 94115-0128
- UCSF Cancer Center and Cancer Research Institute
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Colorado
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Denver, Colorado, Vereinigte Staaten, 80218
- Children's Hospital of Denver
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District of Columbia
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Washington, District of Columbia, Vereinigte Staaten, 20010-2970
- Children's National Medical Center
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Illinois
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Chicago, Illinois, Vereinigte Staaten, 60637
- University of Chicago Cancer Research Center
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Indiana
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Indianapolis, Indiana, Vereinigte Staaten, 46202-5265
- Indiana University Cancer Center
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Iowa
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Iowa City, Iowa, Vereinigte Staaten, 52242
- University of Iowa Hospitals and Clinics
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Michigan
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Ann Arbor, Michigan, Vereinigte Staaten, 48109-0752
- University of Michigan Comprehensive Cancer Center
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Kalamazoo, Michigan, Vereinigte Staaten, 49007-3731
- CCOP - Kalamazoo
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Minnesota
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Minneapolis, Minnesota, Vereinigte Staaten, 55455
- University of Minnesota Cancer Center
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Rochester, Minnesota, Vereinigte Staaten, 55905
- Mayo Clinic Cancer Center
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Missouri
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Kansas City, Missouri, Vereinigte Staaten, 64108
- Children's Mercy Hospital
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Nebraska
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Omaha, Nebraska, Vereinigte Staaten, 68198-3330
- University of Nebraska Medical Center
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New Jersey
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Paterson, New Jersey, Vereinigte Staaten, 07503
- St. Joseph's Hospital and Medical Center
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New York
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New York, New York, Vereinigte Staaten, 10021
- Memorial Sloan-Kettering Cancer Center
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New York, New York, Vereinigte Staaten, 10016
- NYU School of Medicine's Kaplan Comprehensive Cancer Center
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New York, New York, Vereinigte Staaten, 10032
- Herbert Irving Comprehensive Cancer Center
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North Carolina
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Chapel Hill, North Carolina, Vereinigte Staaten, 27599-7295
- Lineberger Comprehensive Cancer Center, UNC
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North Dakota
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Fargo, North Dakota, Vereinigte Staaten, 58122
- CCOP - Merit Care Hospital
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Ohio
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Cincinnati, Ohio, Vereinigte Staaten, 45229-3039
- Children's Hospital Medical Center - Cincinnati
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Cleveland, Ohio, Vereinigte Staaten, 44106-5065
- Ireland Cancer Center
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Columbus, Ohio, Vereinigte Staaten, 43205-2696
- Children's Hospital of Columbus
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Oregon
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Portland, Oregon, Vereinigte Staaten, 97201-3098
- Doernbecher Children's Hospital
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Pennsylvania
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Philadelphia, Pennsylvania, Vereinigte Staaten, 19104
- Children's Hospital of Philadelphia
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Philadelphia, Pennsylvania, Vereinigte Staaten, 19104
- University of Pennsylvania Cancer Center
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Pittsburgh, Pennsylvania, Vereinigte Staaten, 15213
- Children's Hospital of Pittsburgh
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Tennessee
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Nashville, Tennessee, Vereinigte Staaten, 37232-6838
- Vanderbilt Cancer Center
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Texas
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Houston, Texas, Vereinigte Staaten, 77030
- University of Texas - MD Anderson Cancer Center
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Utah
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Salt Lake City, Utah, Vereinigte Staaten, 84132
- Huntsman Cancer Institute
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Washington
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Seattle, Washington, Vereinigte Staaten, 98109
- Fred Hutchinson Cancer Research Center
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Seattle, Washington, Vereinigte Staaten, 98105
- Children's Hospital and Regional Medical Center - Seattle
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Wisconsin
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Madison, Wisconsin, Vereinigte Staaten, 53792
- University of Wisconsin Comprehensive Cancer Center
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
DISEASE CHARACTERISTICS:
Histologically proven high-risk CNS embryonal tumors, including:
- Primitive neuroectodermal tumors
- Atypical teratoid/rhabdoid tumor
- Medulloblastoma
- Desmoplastic medulloblastoma
- Ependymoblastoma
- Medullomyoblastoma
- Spongioblastoma
- Spongioblastoma polare
- Primitive polar spongioblastoma
- Neuroepitheliomatous neoplasms
- Medulloepithelioma
- Neuroblastoma
- Pineoblastoma
- No bone marrow involvement or bone metastases
- No M4 disease
- M3 disease must have evidence of tumor on spinal MRI
PATIENT CHARACTERISTICS:
Age:
- 3 to 21 at diagnosis
Performance status:
- Not specified
Life expectancy:
- At least 8 weeks
Hematopoietic:
- Absolute neutrophil count greater than 1,500/mm^3
- Platelet count at least 100,000/mm^3 (transfusion independent)
- Hemoglobin at least 10.0 g/dL (packed red blood cell transfusions allowed)
Hepatic:
- Bilirubin less than 1.5 mg/dL
- SGOT/SGPT less than 2.5 times normal
Renal:
- Creatinine less than 1.5 times upper limit of normal OR
- Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- Not specified
Chemotherapy:
- No prior chemotherapy
Endocrine therapy:
- Not specified
Radiotherapy:
- No prior radiotherapy
Surgery:
- Prior definitive surgery allowed
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Experimental: Newly diagnosed cerebral PNET with histologic verification
Begin therapy within 31 days of surgery.
Radiation therapy will be given in standard fractions along with filgrastim.
The craniospinal axis will be treated first.
Patients will receive carboplatin at 35 mg/m2/day IV over 15-20 minutes Monday through Friday, 1-4 hours prior to radiation for 6 weeks (total of 30 doses).
Vincristine sulfate 1.5 mg/m2 IV will be given weekly x 6.
Following radiation, patients will receive Maintenance chemotherapy.
Patients enrolled prior to Amendment #5 will receive six cycles of cyclophosphamide and vincristine (Regimen A).
Patients enrolled after Amendment #5 will receive six cycles of cyclophosphamide, vincristine sulfate and cisplatin (Regimen B).
|
Gegeben IV
Andere Namen:
Gegeben IV
Andere Namen:
Gegeben IV
Andere Namen:
Gegeben IV
Andere Namen:
Gegeben IV
Andere Namen:
1.8 Gy/fx x 20fx=36Gy Craniospinal XRT*
Andere Namen:
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Event Free Survival
Zeitfenster: Length of study
|
Minimum time to disease progression or recurrence, time to death for any reason, or time to occurrence of a second malignant neoplasm (SMN).
|
Length of study
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Survival
Zeitfenster: Length of study
|
Time to death from any cause
|
Length of study
|
Mitarbeiter und Ermittler
Sponsor
Mitarbeiter
Ermittler
- Studienstuhl: Regina Jakacki, MD, University of Pittsburgh
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- Jakacki RI, Burger PC, Zhou T, Holmes EJ, Kocak M, Onar A, Goldwein J, Mehta M, Packer RJ, Tarbell N, Fitz C, Vezina G, Hilden J, Pollack IF. Outcome of children with metastatic medulloblastoma treated with carboplatin during craniospinal radiotherapy: a Children's Oncology Group Phase I/II study. J Clin Oncol. 2012 Jul 20;30(21):2648-53. doi: 10.1200/JCO.2011.40.2792. Epub 2012 Jun 4.
- Jakacki R, Burger P, Zhou T, et al.: Outcome for metastatic (M+) medulloblastoma (MB) treated with carboplatin during craniospinal radiotherapy (CSRT) followed by cyclophosphamide (CPM) and vincristine (VCR): preliminary results of COG 99701. [Abstract] J Clin Oncol 25 (Suppl 18): A-2017, 2007.
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Erkrankungen des Nervensystems
- Neubildungen nach histologischem Typ
- Neubildungen nach Standort
- Neubildungen, Drüsen und Epithelien
- Neubildungen, Neuroepithel
- Neuroektodermale Tumoren
- Neoplasmen, Keimzelle und Embryonal
- Neubildungen, Nervengewebe
- Neuroektodermale Tumore, primitiv
- Neuroektodermale Tumore, primitiv, peripher
- Neubildungen
- Neubildungen des Nervensystems
- Neubildungen des zentralen Nervensystems
- Neuroblastom
- Physiologische Wirkungen von Arzneimitteln
- Molekulare Mechanismen der pharmakologischen Wirkung
- Antirheumatika
- Antineoplastische Mittel
- Immunsuppressive Mittel
- Immunologische Faktoren
- Tubulin-Modulatoren
- Antimitotische Mittel
- Mitose-Modulatoren
- Antineoplastische Mittel, alkylierend
- Alkylierungsmittel
- Myeloablative Agonisten
- Antineoplastische Mittel, Phytogen
- Cyclophosphamid
- Carboplatin
- Cisplatin
- Vincristin
Andere Studien-ID-Nummern
- A9971
- COG-A9971 (Andere Kennung: Children's Oncology Group)
- CCG-99701 (Andere Kennung: Children's Cancer Group)
- CDR0000066055 (Andere Kennung: Clinical Trials.gov)
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .
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