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Kombinationschemotherapie mit oder ohne Ganitumab bei der Behandlung von Patienten mit neu diagnostiziertem metastasiertem Ewing-Sarkom

21. Oktober 2026 aktualisiert von: National Cancer Institute (NCI)

Randomisierte Phase-3-Studie zur Bewertung der Zugabe des monoklonalen IGF-1R-Antikörpers Ganitumab (AMG 479, NSC-Nr. 750008) zur Chemotherapie mit mehreren Wirkstoffen für Patienten mit neu diagnostiziertem metastasiertem Ewing-Sarkom

This randomized phase III trial studies how well combination chemotherapy with or without ganitumab works in treating patients with newly diagnosed Ewing sarcoma that has spread to other parts of the body. Treatment with drugs that block the IGF-1R pathway, such as ganitumab, may interfere with the ability of tumor cells to grow and spread. Drugs used in chemotherapy, such as vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether adding ganitumab to combination chemotherapy is more effective in treating patients with newly diagnosed metastatic Ewing sarcoma.

Studienübersicht

Status

Aktiv, nicht rekrutierend

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

PRIMARY OBJECTIVES:

I. To determine if event-free survival (EFS) in patients with newly diagnosed metastatic Ewing sarcoma treated with multiagent chemotherapy is improved with the addition of ganitumab (AMG 479).

SECONDARY OBJECTIVES:

I. To describe the toxicity of the addition of ganitumab to multimodality therapy for patients with newly diagnosed metastatic Ewing sarcoma.

II. To compare overall survival in patients with newly diagnosed metastatic Ewing sarcoma treated with multiagent chemotherapy with and without the addition of ganitumab.

EXPLORATORY OBJECTIVES:

I. To compare bone marrow response rates in patients with newly diagnosed metastatic Ewing sarcoma treated with multiagent chemotherapy with and without the addition of ganitumab.

II. To describe the toxicity of 6 months of ganitumab monotherapy as maintenance therapy following multimodality therapy in patients with newly diagnosed metastatic Ewing sarcoma.

III. To describe trough levels of ganitumab in a cohort of patients with Ewing sarcoma < 21 years of age treated with 18 mg/kg.

IV. To describe the feasibility of and local failure rates following hypofractionated stereotactic body radiotherapy (SBRT) directed at bone metastases in patients with newly diagnosed metastatic Ewing sarcoma.

V. To determine if EFS, overall survival, bone marrow response rates, and toxicity differ based on serum markers of the insulin-like growth factor 1 (IGF-1) pathway in patients with newly diagnosed metastatic Ewing sarcoma treated with interval compressed chemotherapy with and without the addition of ganitumab.

VI. To determine if EFS, overall survival, and bone marrow response rates differ based on protein, deoxyribose nucleic acid (DNA), and ribonucleic acid (RNA) marker in patients with newly diagnosed metastatic Ewing sarcoma treated with interval compressed chemotherapy with and without the addition of ganitumab.

VII. To evaluate bone marrow micrometastatic disease and tumor cell surface IGF-1R expression at diagnosis and after 3 and 6 cycles of study therapy in patients with newly diagnosed metastatic Ewing sarcoma.

VIII. To determine if the presence of germline polymorphisms in EGFR correlate with response to multiagent therapy with and without ganitumab.

IX. To investigate the ability of fludeoxyglucose F 18-positron emission tomography (FDG-PET) to augment conventional response assessment of primary Ewing sarcoma tumors by magnetic resonance imaging (MRI).

X. To explore FDG-PET response at the primary tumor as a prognostic marker and as a predictive biomarker of clinical activity of IGF-1R inhibition in patients with newly diagnosed metastatic Ewing sarcoma.

XI. To collect data on institutional testing for Ewing sarcoma breakpoint region 1 (EWSR1) translocation status in patients enrolling on study.

XII. To explore the capacity of plasma cell-free DNA analysis to detect tumor-specific genetic changes at initial diagnosis and after initiation of protocol therapy.

XIII. To collect a population of bone marrow metastatic tumor cells by flow cytometry for genomic profiling.

OUTLINE: Patients are randomized to 1 of 2 treatment regimens. (As of 3/20/2019, the study is closed to accrual and patients in Regimen B no longer receive ganitumab.)

REGIMEN A (vincristine sulfate, doxorubicin hydrochloride and cyclophosphamide [VDC] and ifosfamide and etoposide phosphate [IE]):

INDUCTION THERAPY: Patients receive vincristine sulfate intravenously (IV) over 1 minute on day 1, doxorubicin hydrochloride IV over 1-15 minutes on days 1 and 2, and cyclophosphamide IV over 30-60 minutes on day 1 of weeks 1, 5, and 9, and ifosfamide IV over 1 hour on days 1 to 5 and etoposide phosphate IV over 1-2 hours on days 1 to 5 of weeks 3, 7, and 11.

LOCAL CONTROL THERAPY: Between weeks 13-18, patients undergo surgery and/or radiation therapy.

CONSOLIDATION THERAPY: Patients receive vincristine sulfate IV over 1 minute on day 1 of weeks 1, 7, 9, and 13; doxorubicin hydrochloride IV over 1-15 minutes on days 1 and 2 of weeks 1 and 7, cyclophosphamide IV over 30-60 minutes on day 1 of weeks 1, 7, 9, and 13, ifosfamide IV over 1 hour on days 1 to 5 of weeks 3, 5, 11, and 15, and etoposide phosphate IV over 1-2 hours on days 1 to 5 of weeks 3, 5, 11, and 15.

METASTATIC SITE IRRADIATION: Patients with lung metastases undergo whole lung radiation and patients with bone metastases undergo definitive SBRT or external beam radiation therapy (EBRT).

REGIMEN B (VDC/IE + ganitumab):

INDUCTION THERAPY: Patients receive Induction therapy as in Regimen A and receive ganitumab IV over 30-60 minutes or 60-120 minutes on day 1 of weeks 1, 3, 5, 7, 9, and 11.

LOCAL CONTROL THERAPY: Between weeks 13-18, patients undergo surgery and/or radiation therapy.

CONSOLIDATION THERAPY: Patients receive Consolidation therapy as in Regimen A and receive ganitumab IV over 30-60 minutes or 60-120 minutes on day 1 of weeks 7, 9, 11, 13, and 15.

METASTATIC SITE IRRADIATION: Patients with lung metastases undergo whole lung radiation and patients with bone metastases undergo definitive SBRT or EBRT.

MAINTENANCE: Patients receive ganitumab IV over 30-60 minutes or 60-120 minutes every 3 weeks for 8 cycles.

After completion of study treatment, patients are followed for 10 years.

Studientyp

Interventionell

Einschreibung (Tatsächlich)

312

Phase

  • Phase 3

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

  • Kanada
      • Québec, Kanada, G1V 4G2
        • CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)
    • Alberta
      • Calgary, Alberta, Kanada, T3B 6A8
        • Alberta Children's Hospital
      • Edmonton, Alberta, Kanada, T6G 2B7
        • University of Alberta Hospital
    • British Columbia
      • Vancouver, British Columbia, Kanada, V6H 3V4
        • British Columbia Children's Hospital
    • Manitoba
      • Winnipeg, Manitoba, Kanada, R3E 0V9
        • CancerCare Manitoba
    • Newfoundland and Labrador
      • St. John's, Newfoundland and Labrador, Kanada, A1B 3V6
        • Janeway Child Health Centre
    • Nova Scotia
      • Halifax, Nova Scotia, Kanada, B3K 6R8
        • IWK Health Centre
    • Ontario
      • Hamilton, Ontario, Kanada, L8N 3Z5
        • McMaster Children's Hospital at Hamilton Health Sciences
      • Kingston, Ontario, Kanada, K7L 2V7
        • Kingston Health Sciences Centre
      • London, Ontario, Kanada, N6A 5W9
        • Children's Hospital
      • Ottawa, Ontario, Kanada, K1H 8L1
        • Children's Hospital of Eastern Ontario
      • Toronto, Ontario, Kanada, M5G 1X8
        • Hospital for Sick Children
    • Quebec
      • Montreal, Quebec, Kanada, H3H 1P3
        • The Montreal Children's Hospital of the MUHC
      • Montreal, Quebec, Kanada, H3T 1C5
        • Centre Hospitalier Universitaire Sainte-Justine
  • Puerto Rico
      • San Juan, Puerto Rico, 00926
        • University Pediatric Hospital
      • San Juan, Puerto Rico, 00912
        • San Jorge Children's Hospital
  • Vereinigte Staaten
    • Alabama
      • Birmingham, Alabama, Vereinigte Staaten, 35233
        • Children's Hospital of Alabama
      • Mobile, Alabama, Vereinigte Staaten, 36604
        • USA Health Strada Patient Care Center
    • Alaska
      • Anchorage, Alaska, Vereinigte Staaten, 99508
        • Providence Alaska Medical Center
    • Arizona
      • Mesa, Arizona, Vereinigte Staaten, 85202
        • Banner Children's at Desert
      • Phoenix, Arizona, Vereinigte Staaten, 85016
        • Phoenix Childrens Hospital
      • Tucson, Arizona, Vereinigte Staaten, 85719
        • Banner University Medical Center - Tucson
      • Yuma, Arizona, Vereinigte Staaten, 85364
        • Onvida Health Yuma Medical Center
    • Arkansas
      • Hot Springs, Arkansas, Vereinigte Staaten, 71913
        • CHI Saint Vincent Cancer Center Hot Springs
      • Little Rock, Arkansas, Vereinigte Staaten, 72202-3591
        • Arkansas Children's Hospital
    • California
      • Downey, California, Vereinigte Staaten, 90242
        • Kaiser Permanente Downey Medical Center
      • Duarte, California, Vereinigte Staaten, 91010
        • City of Hope Comprehensive Cancer Center
      • Loma Linda, California, Vereinigte Staaten, 92354
        • Loma Linda University Medical Center
      • Long Beach, California, Vereinigte Staaten, 90806
        • Miller Children's and Women's Hospital Long Beach
      • Los Angeles, California, Vereinigte Staaten, 90027
        • Children's Hospital Los Angeles
      • Madera, California, Vereinigte Staaten, 93636
        • Valley Children's Hospital
      • Oakland, California, Vereinigte Staaten, 94609
        • UCSF Benioff Children's Hospital Oakland
      • Oakland, California, Vereinigte Staaten, 94611
        • Kaiser Permanente-Oakland
      • Orange, California, Vereinigte Staaten, 92868
        • Children's Hospital of Orange County
      • Palo Alto, California, Vereinigte Staaten, 94304
        • Lucile Packard Children's Hospital Stanford University
      • Sacramento, California, Vereinigte Staaten, 95816
        • Sutter Medical Center Sacramento
      • Sacramento, California, Vereinigte Staaten, 95817
        • University of California Davis Comprehensive Cancer Center
      • San Diego, California, Vereinigte Staaten, 92123
        • Rady Children's Hospital - San Diego
      • San Francisco, California, Vereinigte Staaten, 94158
        • UCSF Medical Center-Mission Bay
      • San Francisco, California, Vereinigte Staaten, 94143
        • UCSF Medical Center-Parnassus
      • Torrance, California, Vereinigte Staaten, 90502
        • Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
    • Colorado
      • Aurora, Colorado, Vereinigte Staaten, 80045
        • Children's Hospital Colorado
      • Colorado Springs, Colorado, Vereinigte Staaten, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Vereinigte Staaten, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Denver, Colorado, Vereinigte Staaten, 80218
        • Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
      • Denver, Colorado, Vereinigte Staaten, 80210
        • AdventHealth Porter
      • Durango, Colorado, Vereinigte Staaten, 81301
        • Mercy Medical Center
      • Durango, Colorado, Vereinigte Staaten, 81301
        • CommonSpirit Cancer Center Mercy
      • Golden, Colorado, Vereinigte Staaten, 80401
        • Mountain Blue Cancer Care Center
      • Lakewood, Colorado, Vereinigte Staaten, 80228
        • Rocky Mountain Cancer Centers-Lakewood
      • Lakewood, Colorado, Vereinigte Staaten, 80228
        • CommonSpirit Saint Anthony Hospital Cancer Center
      • Littleton, Colorado, Vereinigte Staaten, 80122
        • AdventHealth Littleton
      • Longmont, Colorado, Vereinigte Staaten, 80501
        • Longmont United Hospital
      • Longmont, Colorado, Vereinigte Staaten, 80501
        • Rocky Mountain Cancer Centers-Longmont
      • Parker, Colorado, Vereinigte Staaten, 80138
        • Rocky Mountain Cancer Centers-Parker
      • Parker, Colorado, Vereinigte Staaten, 80138
        • AdventHealth Parker
      • Pueblo, Colorado, Vereinigte Staaten, 81004
        • Saint Mary Corwin Medical Center
      • Pueblo, Colorado, Vereinigte Staaten, 81008
        • Rocky Mountain Cancer Centers - Pueblo
      • Thornton, Colorado, Vereinigte Staaten, 80260
        • Rocky Mountain Cancer Centers-Thornton
    • Connecticut
      • Hartford, Connecticut, Vereinigte Staaten, 06106
        • Connecticut Children's Medical Center
      • New Haven, Connecticut, Vereinigte Staaten, 06520
        • Yale University
    • Delaware
      • Wilmington, Delaware, Vereinigte Staaten, 19803
        • Alfred I duPont Hospital for Children
    • District of Columbia
      • Washington D.C., District of Columbia, Vereinigte Staaten, 20010
        • Children's National Medical Center
      • Washington D.C., District of Columbia, Vereinigte Staaten, 20007
        • MedStar Georgetown University Hospital
    • Florida
      • Fort Myers, Florida, Vereinigte Staaten, 33908
        • Golisano Children's Hospital of Southwest Florida
      • Gainesville, Florida, Vereinigte Staaten, 32610
        • UF Health Cancer Institute - Gainesville
      • Hollywood, Florida, Vereinigte Staaten, 33021
        • Memorial Regional Hospital/Joe DiMaggio Children's Hospital
      • Jacksonville, Florida, Vereinigte Staaten, 32207
        • Nemours Children's Clinic-Jacksonville
      • Miami, Florida, Vereinigte Staaten, 33155
        • Nicklaus Children's Hospital
      • Miami, Florida, Vereinigte Staaten, 33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Orlando, Florida, Vereinigte Staaten, 32827
        • Nemours Children's Hospital
      • Orlando, Florida, Vereinigte Staaten, 32803
        • AdventHealth Orlando
      • Orlando, Florida, Vereinigte Staaten, 32806
        • Arnold Palmer Hospital for Children
      • Pensacola, Florida, Vereinigte Staaten, 32504
        • Nemours Children's Clinic - Pensacola
      • St. Petersburg, Florida, Vereinigte Staaten, 33701
        • Johns Hopkins All Children's Hospital
      • Tampa, Florida, Vereinigte Staaten, 33607
        • Saint Joseph's Hospital/Children's Hospital-Tampa
      • West Palm Beach, Florida, Vereinigte Staaten, 33407
        • Saint Mary's Medical Center
    • Georgia
      • Atlanta, Georgia, Vereinigte Staaten, 30329
        • Children's Healthcare of Atlanta - Arthur M Blank Hospital
      • Augusta, Georgia, Vereinigte Staaten, 30912
        • Augusta University Medical Center
      • Savannah, Georgia, Vereinigte Staaten, 31404
        • Memorial Health University Medical Center
    • Hawaii
      • Honolulu, Hawaii, Vereinigte Staaten, 96813
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Vereinigte Staaten, 96826
        • Kapiolani Medical Center for Women and Children
      • Honolulu, Hawaii, Vereinigte Staaten, 96819
        • Kaiser Permanente Moanalua Medical Center
    • Idaho
      • Boise, Idaho, Vereinigte Staaten, 83712
        • Saint Luke's Cancer Institute - Boise
    • Illinois
      • Aurora, Illinois, Vereinigte Staaten, 60504
        • Rush-Copley Medical Center
      • Chicago, Illinois, Vereinigte Staaten, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Vereinigte Staaten, 60612
        • University of Illinois
      • Chicago, Illinois, Vereinigte Staaten, 60611
        • Lurie Children's Hospital-Chicago
      • Danville, Illinois, Vereinigte Staaten, 61832
        • Carle at The Riverfront
      • Effingham, Illinois, Vereinigte Staaten, 62401
        • Carle Physician Group-Effingham
      • Mattoon, Illinois, Vereinigte Staaten, 61938
        • Carle Physician Group-Mattoon/Charleston
      • Maywood, Illinois, Vereinigte Staaten, 60153
        • Loyola University Medical Center
      • Mount Vernon, Illinois, Vereinigte Staaten, 62864
        • SSM Health Good Samaritan
      • Oak Lawn, Illinois, Vereinigte Staaten, 60453
        • Advocate Children's Hospital-Oak Lawn
      • Park Ridge, Illinois, Vereinigte Staaten, 60068
        • Advocate Children's Hospital-Park Ridge
      • Peoria, Illinois, Vereinigte Staaten, 61637
        • OSF Children's Hospital of Illinois
      • Springfield, Illinois, Vereinigte Staaten, 62702
        • Southern Illinois University School of Medicine
      • Springfield, Illinois, Vereinigte Staaten, 62702
        • Saint John's Hospital
      • Springfield, Illinois, Vereinigte Staaten, 62781
        • Springfield Memorial Hospital
      • Urbana, Illinois, Vereinigte Staaten, 61801
        • Carle Cancer Center
      • Urbana, Illinois, Vereinigte Staaten, 61801
        • The Carle Foundation Hospital
      • Yorkville, Illinois, Vereinigte Staaten, 60560
        • Rush-Copley Healthcare Center
    • Indiana
      • Evansville, Indiana, Vereinigte Staaten, 47713
        • Deaconess Clinic Downtown
      • Indianapolis, Indiana, Vereinigte Staaten, 46202
        • Riley Hospital for Children
      • Indianapolis, Indiana, Vereinigte Staaten, 46260
        • Ascension Saint Vincent Indianapolis Hospital
      • Michigan City, Indiana, Vereinigte Staaten, 46360
        • Franciscan Saint Anthony Health-Michigan City
      • Michigan City, Indiana, Vereinigte Staaten, 46360
        • Woodland Cancer Care Center
      • Newburgh, Indiana, Vereinigte Staaten, 47630
        • Chancellor Center for Oncology
    • Iowa
      • Clive, Iowa, Vereinigte Staaten, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Vereinigte Staaten, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Council Bluffs, Iowa, Vereinigte Staaten, 51503
        • Alegent Health Mercy Hospital
      • Creston, Iowa, Vereinigte Staaten, 50801
        • Greater Regional Medical Center
      • Des Moines, Iowa, Vereinigte Staaten, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Vereinigte Staaten, 50309
        • Blank Children's Hospital
      • Des Moines, Iowa, Vereinigte Staaten, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • Iowa City, Iowa, Vereinigte Staaten, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • West Des Moines, Iowa, Vereinigte Staaten, 50266
        • Mercy Medical Center-West Lakes
    • Kentucky
      • Bardstown, Kentucky, Vereinigte Staaten, 40004
        • CommonSpirit Saint Joseph Hospital - Bardstown
      • Corbin, Kentucky, Vereinigte Staaten, 40701
        • Commonwealth Cancer Center-Corbin
      • Lexington, Kentucky, Vereinigte Staaten, 40536
        • University of Kentucky/Markey Cancer Center
      • Lexington, Kentucky, Vereinigte Staaten, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Vereinigte Staaten, 40509
        • CommonSpirit Saint Joseph Medical Center - East Lexington
      • London, Kentucky, Vereinigte Staaten, 40741
        • CommonSpirit Saint Joseph Hospital London
      • Louisville, Kentucky, Vereinigte Staaten, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Vereinigte Staaten, 40202
        • Norton Children's Hospital
      • Louisville, Kentucky, Vereinigte Staaten, 40245
        • UofL Health Medical Center Northeast
      • Louisville, Kentucky, Vereinigte Staaten, 40215
        • Saints Mary and Elizabeth Hospital
      • Shepherdsville, Kentucky, Vereinigte Staaten, 40165
        • Jewish Hospital Medical Center South
    • Louisiana
      • New Orleans, Louisiana, Vereinigte Staaten, 70121
        • Ochsner Medical Center Jefferson
      • New Orleans, Louisiana, Vereinigte Staaten, 70118
        • Children's Hospital New Orleans
    • Maine
      • Bangor, Maine, Vereinigte Staaten, 04401
        • Eastern Maine Medical Center
      • Scarborough, Maine, Vereinigte Staaten, 04074
        • Maine Children's Cancer Program
    • Maryland
      • Baltimore, Maryland, Vereinigte Staaten, 21287
        • Johns Hopkins University/Sidney Kimmel Cancer Center
      • Baltimore, Maryland, Vereinigte Staaten, 21215
        • Sinai Hospital of Baltimore
      • Baltimore, Maryland, Vereinigte Staaten, 21201
        • University of Maryland/Greenebaum Cancer Center
      • Bethesda, Maryland, Vereinigte Staaten, 20889-5600
        • Walter Reed National Military Medical Center
    • Massachusetts
      • Boston, Massachusetts, Vereinigte Staaten, 02215
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Vereinigte Staaten, 02114
        • Massachusetts General Hospital Cancer Center
      • Springfield, Massachusetts, Vereinigte Staaten, 01199
        • Baystate Medical Center
      • Worcester, Massachusetts, Vereinigte Staaten, 01655
        • UMass Memorial Medical Center - University Campus
    • Michigan
      • Ann Arbor, Michigan, Vereinigte Staaten, 48109
        • C S Mott Children's Hospital
      • Ann Arbor, Michigan, Vereinigte Staaten, 48109
        • University of Michigan Rogel Cancer Center
      • Battle Creek, Michigan, Vereinigte Staaten, 49017
        • Bronson Battle Creek
      • Detroit, Michigan, Vereinigte Staaten, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Detroit, Michigan, Vereinigte Staaten, 48236
        • Henry Ford Health Saint John Hospital
      • Flint, Michigan, Vereinigte Staaten, 48503
        • Hurley Medical Center
      • Grand Rapids, Michigan, Vereinigte Staaten, 49503
        • Trinity Health Grand Rapids Hospital
      • Grand Rapids, Michigan, Vereinigte Staaten, 49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • Grand Rapids, Michigan, Vereinigte Staaten, 49503
        • Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
      • Kalamazoo, Michigan, Vereinigte Staaten, 49007
        • West Michigan Cancer Center
      • Kalamazoo, Michigan, Vereinigte Staaten, 49007
        • Bronson Methodist Hospital
      • Kalamazoo, Michigan, Vereinigte Staaten, 49048
        • Beacon Kalamazoo
      • Muskegon, Michigan, Vereinigte Staaten, 49444
        • Trinity Health Muskegon Hospital
      • Niles, Michigan, Vereinigte Staaten, 49120
        • Corewell Health Lakeland Hospitals - Niles Hospital
      • Port Huron, Michigan, Vereinigte Staaten, 48060
        • Lake Huron Medical Center
      • Port Huron, Michigan, Vereinigte Staaten, 48060
        • Huron Medical Center PC
      • Reed City, Michigan, Vereinigte Staaten, 49677
        • Corewell Health Reed City Hospital
      • Royal Oak, Michigan, Vereinigte Staaten, 48073
        • Corewell Health Children's
      • Saint Joseph, Michigan, Vereinigte Staaten, 49085
        • Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
      • Saint Joseph, Michigan, Vereinigte Staaten, 49085
        • Corewell Health Lakeland Hospitals - Saint Joseph Hospital
      • Traverse City, Michigan, Vereinigte Staaten, 49684
        • Munson Medical Center
    • Minnesota
      • Duluth, Minnesota, Vereinigte Staaten, 55805
        • Essentia Health Cancer Center
      • Minneapolis, Minnesota, Vereinigte Staaten, 55404
        • Children's Hospitals and Clinics of Minnesota - Minneapolis
      • Minneapolis, Minnesota, Vereinigte Staaten, 55455
        • University of Minnesota/Masonic Cancer Center
      • Rochester, Minnesota, Vereinigte Staaten, 55905
        • Mayo Clinic in Rochester
    • Mississippi
      • Jackson, Mississippi, Vereinigte Staaten, 39216
        • University of Mississippi Medical Center
    • Missouri
      • Bolivar, Missouri, Vereinigte Staaten, 65613
        • Central Care Cancer Center - Bolivar
      • Branson, Missouri, Vereinigte Staaten, 65616
        • Cox Cancer Center Branson
      • Columbia, Missouri, Vereinigte Staaten, 65212
        • University of Missouri Children's Hospital
      • Joplin, Missouri, Vereinigte Staaten, 64804
        • Freeman Health System
      • Joplin, Missouri, Vereinigte Staaten, 64804
        • Mercy Hospital Joplin
      • Kansas City, Missouri, Vereinigte Staaten, 64108
        • Children's Mercy Hospitals and Clinics
      • Rolla, Missouri, Vereinigte Staaten, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Rolla, Missouri, Vereinigte Staaten, 65401
        • Phelps Health Delbert Day Cancer Institute
      • Saint Joseph, Missouri, Vereinigte Staaten, 64506
        • Heartland Regional Medical Center
      • Springfield, Missouri, Vereinigte Staaten, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Vereinigte Staaten, 65804
        • Mercy Hospital Springfield
      • St Louis, Missouri, Vereinigte Staaten, 63110
        • Washington University School of Medicine
      • St Louis, Missouri, Vereinigte Staaten, 63109
        • Mercy Infusion Center - Chippewa
      • St Louis, Missouri, Vereinigte Staaten, 63141
        • Mercy Hospital Saint Louis
      • St Louis, Missouri, Vereinigte Staaten, 63104
        • Cardinal Glennon Children's Medical Center
    • Nebraska
      • Bellevue, Nebraska, Vereinigte Staaten, 68123
        • Nebraska Medicine-Bellevue
      • Grand Island, Nebraska, Vereinigte Staaten, 68803
        • Nebraska Cancer Specialists/Oncology Hematology West PC
      • Kearney, Nebraska, Vereinigte Staaten, 68847
        • CHI Health Good Samaritan
      • Kearney, Nebraska, Vereinigte Staaten, 68845
        • Fred and Pamela Buffett Cancer Center - Kearney
      • Lincoln, Nebraska, Vereinigte Staaten, 68510
        • Saint Elizabeth Regional Medical Center
      • Omaha, Nebraska, Vereinigte Staaten, 68198
        • University of Nebraska Medical Center
      • Omaha, Nebraska, Vereinigte Staaten, 68124
        • Alegent Health Bergan Mercy Medical Center
      • Omaha, Nebraska, Vereinigte Staaten, 68118
        • Nebraska Medicine-Village Pointe
      • Omaha, Nebraska, Vereinigte Staaten, 68122
        • Alegent Health Immanuel Medical Center
      • Omaha, Nebraska, Vereinigte Staaten, 68130
        • Alegent Health Lakeside Hospital
      • Omaha, Nebraska, Vereinigte Staaten, 68114
        • Children's Hospital and Medical Center of Omaha
      • Omaha, Nebraska, Vereinigte Staaten, 68122
        • Hematology and Oncology Consultants PC
      • Papillion, Nebraska, Vereinigte Staaten, 68046
        • Midlands Community Hospital
    • Nevada
      • Carson City, Nevada, Vereinigte Staaten, 89703
        • Carson Tahoe Regional Medical Center
      • Henderson, Nevada, Vereinigte Staaten, 89052
        • Comprehensive Cancer Centers of Nevada-Horizon Ridge
      • Las Vegas, Nevada, Vereinigte Staaten, 89144
        • Summerlin Hospital Medical Center
      • Las Vegas, Nevada, Vereinigte Staaten, 89109
        • Sunrise Hospital and Medical Center
      • Las Vegas, Nevada, Vereinigte Staaten, 89135
        • Alliance for Childhood Diseases/Cure 4 the Kids Foundation
      • Las Vegas, Nevada, Vereinigte Staaten, 89102
        • University Medical Center of Southern Nevada
      • Las Vegas, Nevada, Vereinigte Staaten, 89128
        • Ann M Wierman MD LTD
      • Pahrump, Nevada, Vereinigte Staaten, 89048
        • Hope Cancer Care of Nevada-Pahrump
      • Reno, Nevada, Vereinigte Staaten, 89502
        • Renown Regional Medical Center
      • Reno, Nevada, Vereinigte Staaten, 89503
        • Saint Mary's Regional Medical Center
      • Reno, Nevada, Vereinigte Staaten, 89509
        • Radiation Oncology Associates
    • New Hampshire
      • Lebanon, New Hampshire, Vereinigte Staaten, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
    • New Jersey
      • Hackensack, New Jersey, Vereinigte Staaten, 07601
        • Hackensack University Medical Center
      • Morristown, New Jersey, Vereinigte Staaten, 07960
        • Morristown Medical Center
      • New Brunswick, New Jersey, Vereinigte Staaten, 08901
        • Saint Peter's University Hospital
      • New Brunswick, New Jersey, Vereinigte Staaten, 08903
        • Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
      • Newark, New Jersey, Vereinigte Staaten, 07112
        • Newark Beth Israel Medical Center
      • Paterson, New Jersey, Vereinigte Staaten, 07503
        • Saint Joseph's Regional Medical Center
    • New York
      • Albany, New York, Vereinigte Staaten, 12208
        • Albany Medical Center
      • Buffalo, New York, Vereinigte Staaten, 14263
        • Roswell Park Cancer Institute
      • Glens Falls, New York, Vereinigte Staaten, 12801
        • Glens Falls Hospital
      • Mineola, New York, Vereinigte Staaten, 11501
        • NYU Langone Hospital - Long Island
      • New Hyde Park, New York, Vereinigte Staaten, 11040
        • The Steven and Alexandra Cohen Children's Medical Center of New York
      • New York, New York, Vereinigte Staaten, 10029
        • Mount Sinai Hospital
      • New York, New York, Vereinigte Staaten, 10032
        • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
      • New York, New York, Vereinigte Staaten, 10016
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
      • Rochester, New York, Vereinigte Staaten, 14642
        • University of Rochester
      • Stony Brook, New York, Vereinigte Staaten, 11794
        • Stony Brook University Medical Center
      • Syracuse, New York, Vereinigte Staaten, 13210
        • State University of New York Upstate Medical University
      • The Bronx, New York, Vereinigte Staaten, 10461
        • Montefiore Medical Center-Einstein Campus
      • The Bronx, New York, Vereinigte Staaten, 10467
        • Children's Hospital at Montefiore
      • The Bronx, New York, Vereinigte Staaten, 10467
        • Montefiore Medical Center - Moses Campus
      • The Bronx, New York, Vereinigte Staaten, 10461
        • Montefiore Medical Center-Weiler Hospital
      • Valhalla, New York, Vereinigte Staaten, 10595
        • New York Medical College
    • North Carolina
      • Asheville, North Carolina, Vereinigte Staaten, 28801
        • Mission Hospital
      • Chapel Hill, North Carolina, Vereinigte Staaten, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Charlotte, North Carolina, Vereinigte Staaten, 28203
        • Carolinas Medical Center/Levine Cancer Institute
      • Durham, North Carolina, Vereinigte Staaten, 27710
        • Duke University Medical Center
      • Winston-Salem, North Carolina, Vereinigte Staaten, 27157
        • Wake Forest University Health Sciences
    • North Dakota
      • Fargo, North Dakota, Vereinigte Staaten, 58122
        • Sanford Broadway Medical Center
    • Ohio
      • Akron, Ohio, Vereinigte Staaten, 44308
        • Children's Hospital Medical Center of Akron
      • Cincinnati, Ohio, Vereinigte Staaten, 45229
        • Cincinnati Children's Hospital Medical Center
      • Cincinnati, Ohio, Vereinigte Staaten, 45220
        • Good Samaritan Hospital - Cincinnati
      • Cincinnati, Ohio, Vereinigte Staaten, 45242
        • Bethesda North Hospital
      • Cincinnati, Ohio, Vereinigte Staaten, 45247
        • TriHealth Cancer Institute-Westside
      • Cincinnati, Ohio, Vereinigte Staaten, 45255
        • TriHealth Cancer Institute-Anderson
      • Cleveland, Ohio, Vereinigte Staaten, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Vereinigte Staaten, 44106
        • Rainbow Babies and Childrens Hospital
      • Columbus, Ohio, Vereinigte Staaten, 43205
        • Nationwide Children's Hospital
      • Dayton, Ohio, Vereinigte Staaten, 45404
        • Dayton Children's Hospital
      • Toledo, Ohio, Vereinigte Staaten, 43606
        • ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
    • Oklahoma
      • Oklahoma City, Oklahoma, Vereinigte Staaten, 73104
        • University of Oklahoma Health Sciences Center
      • Oklahoma City, Oklahoma, Vereinigte Staaten, 73120
        • Mercy Hospital Oklahoma City
    • Oregon
      • Portland, Oregon, Vereinigte Staaten, 97239
        • Oregon Health and Science University
      • Portland, Oregon, Vereinigte Staaten, 97227
        • Legacy Emanuel Children's Hospital
    • Pennsylvania
      • Allentown, Pennsylvania, Vereinigte Staaten, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Bethlehem, Pennsylvania, Vereinigte Staaten, 18017
        • Lehigh Valley Hospital - Muhlenberg
      • Danville, Pennsylvania, Vereinigte Staaten, 17822
        • Geisinger Medical Center
      • Hershey, Pennsylvania, Vereinigte Staaten, 17033
        • Penn State Children's Hospital
      • Philadelphia, Pennsylvania, Vereinigte Staaten, 19104
        • Children's Hospital of Philadelphia
      • Philadelphia, Pennsylvania, Vereinigte Staaten, 19134
        • Saint Christopher's Hospital for Children
      • Philadelphia, Pennsylvania, Vereinigte Staaten, 19102
        • Drexel University School of Medicine
      • Pittsburgh, Pennsylvania, Vereinigte Staaten, 15224
        • Children's Hospital of Pittsburgh of UPMC
    • Rhode Island
      • Providence, Rhode Island, Vereinigte Staaten, 02903
        • Rhode Island Hospital
    • South Carolina
      • Charleston, South Carolina, Vereinigte Staaten, 29425
        • Medical University of South Carolina
      • Columbia, South Carolina, Vereinigte Staaten, 29203
        • Prisma Health Richland Hospital
      • Greenville, South Carolina, Vereinigte Staaten, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Vereinigte Staaten, 29601
        • Saint Francis Hospital
      • Greenville, South Carolina, Vereinigte Staaten, 29605
        • BI-LO Charities Children's Cancer Center
    • South Dakota
      • Sioux Falls, South Dakota, Vereinigte Staaten, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
    • Tennessee
      • Chattanooga, Tennessee, Vereinigte Staaten, 37403
        • T C Thompson Children's Hospital
      • Chattanooga, Tennessee, Vereinigte Staaten, 37404
        • Memorial Hospital
      • Hixson, Tennessee, Vereinigte Staaten, 37343
        • Pulmonary Medicine Center of Chattanooga-Hixson
      • Knoxville, Tennessee, Vereinigte Staaten, 37916
        • East Tennessee Childrens Hospital
      • Memphis, Tennessee, Vereinigte Staaten, 38105
        • Saint Jude Children's Research Hospital
      • Nashville, Tennessee, Vereinigte Staaten, 37232
        • Vanderbilt University/Ingram Cancer Center
      • Nashville, Tennessee, Vereinigte Staaten, 37203
        • The Children's Hospital at TriStar Centennial
      • Ooltewah, Tennessee, Vereinigte Staaten, 37363
        • Memorial GYN Plus
    • Texas
      • Austin, Texas, Vereinigte Staaten, 78723
        • Dell Children's Medical Center of Central Texas
      • Bryan, Texas, Vereinigte Staaten, 77802
        • Saint Joseph Regional Cancer Center
      • Corpus Christi, Texas, Vereinigte Staaten, 78411
        • Driscoll Children's Hospital
      • Dallas, Texas, Vereinigte Staaten, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Dallas, Texas, Vereinigte Staaten, 75230
        • Medical City Dallas Hospital
      • El Paso, Texas, Vereinigte Staaten, 79905
        • El Paso Children's Hospital
      • Fort Worth, Texas, Vereinigte Staaten, 76104
        • Cook Children's Medical Center
      • Houston, Texas, Vereinigte Staaten, 77030
        • UT MD Anderson Cancer Center
      • Houston, Texas, Vereinigte Staaten, 77030
        • Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
      • Lubbock, Texas, Vereinigte Staaten, 79410
        • Covenant Children's Hospital
      • Lubbock, Texas, Vereinigte Staaten, 79415
        • UMC Cancer Center / UMC Health System
      • Lubbock, Texas, Vereinigte Staaten, 79430
        • Texas Tech University Health Sciences Center-Lubbock
      • San Antonio, Texas, Vereinigte Staaten, 78229
        • University of Texas Health Science Center at San Antonio
      • San Antonio, Texas, Vereinigte Staaten, 78207
        • Children's Hospital of San Antonio
      • San Antonio, Texas, Vereinigte Staaten, 78229
        • Methodist Children's Hospital of South Texas
      • Temple, Texas, Vereinigte Staaten, 76508
        • Scott and White Memorial Hospital
    • Utah
      • Salt Lake City, Utah, Vereinigte Staaten, 84113
        • Primary Children's Hospital
    • Vermont
      • Berlin Corners, Vermont, Vereinigte Staaten, 05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington, Vermont, Vereinigte Staaten, 05401
        • University of Vermont Medical Center
      • Burlington, Vermont, Vereinigte Staaten, 05405
        • University of Vermont and State Agricultural College
    • Virginia
      • Falls Church, Virginia, Vereinigte Staaten, 22042
        • Inova Fairfax Hospital
      • Norfolk, Virginia, Vereinigte Staaten, 23507
        • Children's Hospital of The King's Daughters
      • Portsmouth, Virginia, Vereinigte Staaten, 23708-2197
        • Naval Medical Center - Portsmouth
      • Richmond, Virginia, Vereinigte Staaten, 23298
        • VCU Massey Comprehensive Cancer Center
      • Roanoke, Virginia, Vereinigte Staaten, 24014
        • Carilion Children's
    • Washington
      • Burien, Washington, Vereinigte Staaten, 98166
        • Saint Anne Hospital
      • Enumclaw, Washington, Vereinigte Staaten, 98022
        • Saint Elizabeth Hospital
      • Federal Way, Washington, Vereinigte Staaten, 98003
        • Saint Francis Hospital
      • Lakewood, Washington, Vereinigte Staaten, 98499
        • Saint Clare Hospital
      • Poulsbo, Washington, Vereinigte Staaten, 98370
        • Harrison HealthPartners Hematology and Oncology-Poulsbo
      • Seattle, Washington, Vereinigte Staaten, 98105
        • Seattle Children's Hospital
      • Silverdale, Washington, Vereinigte Staaten, 98383
        • Saint Joseph Medical Center Hematology and Oncology - Silverdale
      • Spokane, Washington, Vereinigte Staaten, 99204
        • Providence Sacred Heart Medical Center and Children's Hospital
      • Tacoma, Washington, Vereinigte Staaten, 98405
        • Mary Bridge Children's Hospital and Health Center
      • Tacoma, Washington, Vereinigte Staaten, 98405
        • Northwest Medical Specialties PLLC
      • Tacoma, Washington, Vereinigte Staaten, 98431
        • Madigan Army Medical Center
      • Tacoma, Washington, Vereinigte Staaten, 98405
        • Franciscan Research Center-Northwest Medical Plaza
    • West Virginia
      • Morgantown, West Virginia, Vereinigte Staaten, 26506
        • West Virginia University Healthcare
    • Wisconsin
      • Green Bay, Wisconsin, Vereinigte Staaten, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Marinette, Wisconsin, Vereinigte Staaten, 54143
        • Saint Vincent Hospital Cancer Center at Marinette
      • Marshfield, Wisconsin, Vereinigte Staaten, 54449
        • Marshfield Medical Center-Marshfield
      • Milwaukee, Wisconsin, Vereinigte Staaten, 53226
        • Children's Hospital of Wisconsin

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

Nicht älter als 50 Jahre (Kind, Erwachsene)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Patients with histologic diagnosis (by institutional pathologist) of newly diagnosed Ewing sarcoma or peripheral primitive neuroectodermal tumor (PNET) arising from bone or soft tissue and with metastatic disease involving lung, bone, bone marrow, or other metastatic site

  • For the purpose of this study metastatic disease is defined as one or more of the following:

    • Lesions which are discontinuous from the primary tumor, are not regional lymph nodes, and do not share a bone or body cavity with the primary tumor; skip lesions in the same bone as the primary tumor do not constitute metastatic disease; skip lesions in an adjacent bone are considered bone metastases; if there is any doubt whether lesions are metastatic, a biopsy of those lesions should be performed

    • Contralateral pleural effusion and/or contralateral pleural nodules

    • Distant lymph node involvement

    • Patients with pulmonary nodules are considered to have metastatic disease if the patient has:

      • Solitary nodule >= 0.5 cm or multiple nodules of >= 0.3 cm unless lesion is biopsied and negative for tumor
      • Patients with solitary nodule < 0.5 cm or multiple nodules < 0.3 cm are not considered to have lung metastasis unless biopsy documents tumor

    • Bone marrow metastatic disease is based on morphologic evidence of Ewing sarcoma 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

      • This study requires bilateral bone marrow biopsies at study entry; the suggested approach for patients with large pelvic tumors in which a posterior iliac crest bone marrow biopsy would track through the tumor is to instead undergo 2 marrow biopsies on the contralateral side (either 2 posterior biopsies or one posterior and one anterior biopsy)

    • Bone metastasis: This study utilizes whole body FDG-PET scans to screen patients for bone metastases; areas suspicious for bone metastasis based on FDG-PET scans require confirmatory anatomic imaging with either MRI or computed tomography (CT) (whole body FDG-PET/CT or FDG-PET/magnetic resonance [MR] scan acceptable); whole body technetium bone scans may be performed at the discretion of the investigator and are not required; for patients without other sites of metastatic disease whose sole metastatic site to qualify for study entry is a single area suspicious for bone metastasis identified by FDG-PET, confirmatory biopsy or anatomic imaging evidence of an associated soft tissue mass at that site is required for study entry

  • Patients must have adequate tumor tissue to meet the minimum requirement for submission

  • Enrolling institutions are reminded that submission of pre-treatment serum, tumor tissue and whole blood is required

  • Patients should only have had a biopsy of the primary tumor without an attempt at complete or partial resection; patients will still be eligible if excision was attempted or accomplished as long as adequate anatomic imaging (MRI for most primary tumor sites) was obtained prior to surgery

  • Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 mL/min/1.73 m^2 or a serum creatinine based on age/gender as follows (performed within 7 days prior to enrollment):

    • Age < 6 months: Maximum serum creatinine (mg/dL): 0.4 for males and females
    • Age 6 months to < 1 year: Maximum serum creatinine (mg/dL): 0.5 for males and females
    • Age 1 to < 2 years: Maximum serum creatinine (mg/dL): 0.6 for males and females
    • Age 2 to < 6 years: Maximum serum creatinine (mg/dL): 0.8 for males and females
    • Age 6 to < 10 years: Maximum serum creatinine (mg/dL): 1 for males and females
    • Age 10 to < 13 years: Maximum serum creatinine (mg/dL): 1.2 for males and females
    • Age 13 to < 16 years: Maximum serum creatinine (mg/dL): 1.5 for males and 1.4 for females
    • Age >= 16 years: Maximum serum creatinine (mg/dL): 1.7 for males and 1.4 for females

  • Total bilirubin =< 1.5 x upper limit of normal (ULN) for age (performed within 7 days prior to enrollment), and

  • Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) < 3 x upper limit of normal (ULN) for age (performed within 7 days prior to enrollment) (except for patients with liver metastasis who may enroll if ALT < 5 times ULN for age)

  • Shortening fraction of >= 27% or

  • Ejection fraction of >= 50%

  • Patients must have a normal blood sugar level for age to participate; if an initial random draw (ie. non-fasting) blood glucose value is out of range, it is acceptable to repeat this test as a fasting draw

  • 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 regional node involvement as their only site of disease beyond the primary tumor will not be eligible
  • Patients whose primary tumors arise in the intra-dural soft tissue (e.g. brain and spinal cord) are not eligible
  • Patients who have received prior chemotherapy or radiation therapy are not eligible
  • Female patients of childbearing potential are not eligible unless a negative pregnancy test result has been obtained; lactating females are not eligible unless they have agreed not to breastfeed their infants for the duration of protocol therapy; sexually active patients of reproductive potential are not eligible unless they have agreed to use an effective contraceptive method for the duration of protocol therapy
  • Patients with known pre-existing diabetes mellitus will be excluded from study
  • Patients receiving chronic pharmacologic doses of corticosteroids are not eligible; for the purposes of eligibility, chronic exposure is defined as anticipated exposure of > 3 weeks, including the sum of both pre-enrollment and anticipated post-enrollment dosing; patients on acute corticosteroid therapy (=< 3 weeks of total planned exposure) must still meet the normal blood glucose requirement; patients receiving chronic inhaled corticosteroids or chronic physiologic replacement doses of corticosteroids are eligible

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Regimen A (VDC/IE)

See Design Details.
Arzneimittel: Cyclophosphamide

Given IV

Andere Namen:
  • Cytoxan
  • CTX
  • (-)-Cyclophosphamid
  • 2H-1,3,2-Oxazaphosphorin, 2-[Bis(2-chlorethyl)amino]tetrahydro-, 2-Oxid, Monohydrat
  • Carloxan
  • Ciclofosfamida
  • Ciclofosfamid
  • Cicloxal
  • Clafen
  • Claphene
  • CP-Monohydrat
  • CYCLO-Zelle
  • Cycloblastin
  • Cyclophospham
  • Cyclophosphamid-Monohydrat
  • Cyclophosphamid
  • Cyclophosphan
  • Cyclophosphanum
  • Cyclostin
  • Cytophosphan
  • Fosfaseron
  • Genoxal
  • Genuxal
  • Ledoxina
  • Mitoxan
  • Neosar
  • Revimmun
  • Syklofosfamid
  • WR-138719
  • Asta B 518
  • B-518
  • B 518
  • B518
  • WR 138719
  • WR138719
  • Frindovyx
Arzneimittel: Doxorubicin Hydrochloride

Given IV

Andere Namen:
  • Adriamycin
  • 5,12-Naphthacendion, 10-[(3-Amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8,9,10-tetrahydro-6,8,11-trihydroxy -8-(Hydroxyacetyl)-1-methoxy-, Hydrochlorid, (8S-cis)-(9CI)
  • ADM
  • Adriacin
  • Adriamycinhydrochlorid
  • Adriamycin PFS
  • Adriamycin RDF
  • ADRIAMYCIN, HYDROCHLORID
  • Adriblastina
  • Adriblastin
  • Adrimedac
  • Chloridrato de Doxorrubicina
  • DOX
  • DOXO-ZELLE
  • Doxolem
  • Doxorubicin-HCl
  • Doxorubicin.HCl
  • Doxorubin
  • Farmiblastina
  • FI 106
  • FI-106
  • Hydroxydaunorubicin
  • Rubex
  • FI106
Arzneimittel: Doxorubicin

Given IV

Andere Namen:
  • Adriablastin
  • Hydroxydaunomycin
  • Hydroxyl-Daunorubicin
  • Hydroxyldaunorubicin
Arzneimittel: Vincristine

Given IV

Andere Namen:
  • Videorecorder
  • Leurocristin
  • Vincrystin
  • LCR
Arzneimittel: Vincristine Sulfate

Given IV

Andere Namen:
  • Oncovin
  • Kyokristin
  • Leurocristinsulfat
  • Leurocristin, Sulfat
  • Vincasar
  • Vincosid
  • Vincrex
  • Vincristin, Sulfat
Arzneimittel: Etoposide

Given IV

Andere Namen:
  • Demethyl Epipodophyllotoxin Ethylidinglucosid
  • EPEG
  • Lastet
  • Toposar
  • Vepesid
  • VP 16
  • VP 16-213
  • VP-16
  • VP-16-213
  • VP16
  • VP 16213
  • VP-16213
  • VP16213
Arzneimittel: Etoposide Phosphate

Given IV

Andere Namen:
  • Etopophos
Strahlung: External Beam Radiation Therapy

Undergo EBRT

Andere Namen:
  • EBRT
  • Definitive Strahlentherapie
  • Externe Strahlstrahlung
  • Externe Strahlentherapie
  • Außenstrahl RT
  • externe Strahlung
  • Strahlung von außen
  • Strahlung, externer Strahl
  • Teleradiotherapie
  • Teletherapie
  • Teletherapie Bestrahlung
  • Externe Strahlentherapie (konventionell)
Arzneimittel: Ifosfamide

Given IV

Andere Namen:
  • Ast Z 4942
  • Ast Z-4942
  • Cyfos
  • Holoxan
  • Ifex
  • IFO
  • IFO-Zelle
  • Ifolem
  • Ifomida
  • Ifomid
  • Ifosfamid
  • Ifoxan
  • IFX
  • Iphosphamid
  • Iso-Endoxan
  • Isoendoxan
  • Isophosphamid
  • Mitoxana
  • MJF 9325
  • MJF-9325
  • Naxamid
  • Seromida
  • Tronoxal
  • Z 4942
  • Z-4942
Strahlung: Stereotactic Radiosurgery

Undergo SBRT

Andere Namen:
  • Stereotaktische externe Strahlbestrahlung
  • stereotaktische Strahlentherapie mit externem Strahl
  • Stereotaktische Strahlentherapie
  • stereotaktische Strahlentherapie
  • stereotaktische Radiochirurgie
  • SRS
Verfahren: Therapeutic Surgical Procedure

Undergo surgery
Experimental: Regimen B (VDC/IE + ganitumab)

INDUCTION THERAPY: Patients receive Induction therapy as in Regimen A and receive ganitumab IV over 30-60 minutes or 60-120 minutes on day 1 of weeks 1, 3, 5, 7, 9, and 11.

LOCAL CONTROL THERAPY: Between weeks 13-18, patients undergo surgery and/or radiation therapy.

CONSOLIDATION THERAPY: Patients receive Consolidation therapy as in Regimen A and receive ganitumab IV over 30-60 minutes or 60-120 minutes on day 1 of weeks 7, 9, 11, 13, and 15.

METASTATIC SITE IRRADIATION: Patients with lung metastases undergo whole lung radiation and patients with bone metastases undergo definitive SBRT or EBRT.

MAINTENANCE: Patients receive ganitumab IV over 30-60 minutes or 60-120 minutes every 3 weeks for 8 cycles.
Arzneimittel: Cyclophosphamide

Given IV

Andere Namen:
  • Cytoxan
  • CTX
  • (-)-Cyclophosphamid
  • 2H-1,3,2-Oxazaphosphorin, 2-[Bis(2-chlorethyl)amino]tetrahydro-, 2-Oxid, Monohydrat
  • Carloxan
  • Ciclofosfamida
  • Ciclofosfamid
  • Cicloxal
  • Clafen
  • Claphene
  • CP-Monohydrat
  • CYCLO-Zelle
  • Cycloblastin
  • Cyclophospham
  • Cyclophosphamid-Monohydrat
  • Cyclophosphamid
  • Cyclophosphan
  • Cyclophosphanum
  • Cyclostin
  • Cytophosphan
  • Fosfaseron
  • Genoxal
  • Genuxal
  • Ledoxina
  • Mitoxan
  • Neosar
  • Revimmun
  • Syklofosfamid
  • WR-138719
  • Asta B 518
  • B-518
  • B 518
  • B518
  • WR 138719
  • WR138719
  • Frindovyx
Arzneimittel: Doxorubicin Hydrochloride

Given IV

Andere Namen:
  • Adriamycin
  • 5,12-Naphthacendion, 10-[(3-Amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8,9,10-tetrahydro-6,8,11-trihydroxy -8-(Hydroxyacetyl)-1-methoxy-, Hydrochlorid, (8S-cis)-(9CI)
  • ADM
  • Adriacin
  • Adriamycinhydrochlorid
  • Adriamycin PFS
  • Adriamycin RDF
  • ADRIAMYCIN, HYDROCHLORID
  • Adriblastina
  • Adriblastin
  • Adrimedac
  • Chloridrato de Doxorrubicina
  • DOX
  • DOXO-ZELLE
  • Doxolem
  • Doxorubicin-HCl
  • Doxorubicin.HCl
  • Doxorubin
  • Farmiblastina
  • FI 106
  • FI-106
  • Hydroxydaunorubicin
  • Rubex
  • FI106
Arzneimittel: Doxorubicin

Given IV

Andere Namen:
  • Adriablastin
  • Hydroxydaunomycin
  • Hydroxyl-Daunorubicin
  • Hydroxyldaunorubicin
Arzneimittel: Vincristine

Given IV

Andere Namen:
  • Videorecorder
  • Leurocristin
  • Vincrystin
  • LCR
Arzneimittel: Vincristine Sulfate

Given IV

Andere Namen:
  • Oncovin
  • Kyokristin
  • Leurocristinsulfat
  • Leurocristin, Sulfat
  • Vincasar
  • Vincosid
  • Vincrex
  • Vincristin, Sulfat
Arzneimittel: Etoposide

Given IV

Andere Namen:
  • Demethyl Epipodophyllotoxin Ethylidinglucosid
  • EPEG
  • Lastet
  • Toposar
  • Vepesid
  • VP 16
  • VP 16-213
  • VP-16
  • VP-16-213
  • VP16
  • VP 16213
  • VP-16213
  • VP16213
Arzneimittel: Etoposide Phosphate

Given IV

Andere Namen:
  • Etopophos
Strahlung: External Beam Radiation Therapy

Undergo EBRT

Andere Namen:
  • EBRT
  • Definitive Strahlentherapie
  • Externe Strahlstrahlung
  • Externe Strahlentherapie
  • Außenstrahl RT
  • externe Strahlung
  • Strahlung von außen
  • Strahlung, externer Strahl
  • Teleradiotherapie
  • Teletherapie
  • Teletherapie Bestrahlung
  • Externe Strahlentherapie (konventionell)
Arzneimittel: Ifosfamide

Given IV

Andere Namen:
  • Ast Z 4942
  • Ast Z-4942
  • Cyfos
  • Holoxan
  • Ifex
  • IFO
  • IFO-Zelle
  • Ifolem
  • Ifomida
  • Ifomid
  • Ifosfamid
  • Ifoxan
  • IFX
  • Iphosphamid
  • Iso-Endoxan
  • Isoendoxan
  • Isophosphamid
  • Mitoxana
  • MJF 9325
  • MJF-9325
  • Naxamid
  • Seromida
  • Tronoxal
  • Z 4942
  • Z-4942
Strahlung: Stereotactic Radiosurgery

Undergo SBRT

Andere Namen:
  • Stereotaktische externe Strahlbestrahlung
  • stereotaktische Strahlentherapie mit externem Strahl
  • Stereotaktische Strahlentherapie
  • stereotaktische Strahlentherapie
  • stereotaktische Radiochirurgie
  • SRS
Verfahren: Therapeutic Surgical Procedure

Undergo surgery

Biologisch: Ganitumab

Given IV

Andere Namen:
  • AMG479
  • Anti-IGF-1R menschlicher monoklonaler Antikörper AMG-479
  • AMG-479

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Event-free Survival
Zeitfenster: 5 years after enrollment

Estimated 5-year EFS where EFS is calculated as the time from study enrollment to disease progression, disease relapse, occurrence of a second malignant neoplasm, death from any cause or last follow-up whichever occurs first. Kaplan-Meier method is used for estimation. Patients without an event are censored at last contact.
5 years after enrollment

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Overall Survival
Zeitfenster: 5 years after enrollment

Time from study enrollment to death or last patient contact.
5 years after enrollment
Frequency of Toxicity-events
Zeitfenster: Up to 202 days

The number of induction or consolidation reporting periods in which a CTC version 4 codeable grade 4 or greater non-hematological adverse event, grade 3 or greater left ventricular systolic dysfunction or the reporting period is terminated because of a CTC codeable event.
Up to 202 days

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Serum IGF Pathway Component and Tissue Protein, Deoxyribonucleic Acid (DNA), and Ribonucleic Acid Markers
Zeitfenster: Up to 10 years

In addition to the log rank test the modeling approach will be used for the primary study comparison. Linear trend in EFS-risk will be investigated by segregating the marker level according to quartiles. For bone marrow response rate analyses, Fisher's exact test will be used to compare the objective bone marrow response rate (complete response vs. incomplete response) at start of local control between patients with biomarker levels above and below the group median.
Up to 10 years
Tumor Cell Surface IGF-1R Expression
Zeitfenster: Up to 307 days

Extent of tumor cell IGF-1R co-expression will also be reported. Change in tumor cell IGF-1R co-expression in patients treated with and without ganitumab will be reported descriptively.
Up to 307 days
Germline Polymorphisms in EGFR
Zeitfenster: Up to 10 years

EFS will be compared between patients with and without the presence of the minor allele using the log rank test, both for the entire patient population and for patients randomized to ganitumab.
Up to 10 years
EWS Translocation
Zeitfenster: Up to 10 years

The institutional result of EWS tumor testing will be categorized as translocation detected (yes v. no) and the type of translocation detected will also be recorded. The proportion of patients with a particular EWS translocation variant will be tabulated.
Up to 10 years
Circulating Tumor DNA (ctDNA) Testing
Zeitfenster: Up to 202 days

Will report the proportion of patients that have a change in translocation result associated with ctDNA testing across time periods.
Up to 202 days
Serial Genomic Profiling
Zeitfenster: Up to 307 days

Will be identified by flow cytometry. Profiles will be presented graphically, and samples obtained from different sites of tumor within the same individual will also be presented.
Up to 307 days
Occurrence of Sinusoidal Obstructive Disease (SOS) Associated With the Addition of Ganitumab to VDC/IE
Zeitfenster: Up to 202 days

The number of induction and maintenance cycles received by patients randomized to the experimental therapy where SOS is observed. Only patients who receive all reporting period therapy or experience SOS will contribute to this outcome measure.
Up to 202 days
Frequency of Resolution of Bone Marrow Metastases
Zeitfenster: Up to 84 days

The number of patients who are enrolled with bone marrow metastases whose bone marrow disease is not detected after evaluation at the time of of first local control measure or the end of the Induction reporting period, whichever comes first. Only eligible patients who receive at least one dose of randomized treatment assignment will be considered for this measure.
Up to 84 days
Frequency of Toxicity Events During Ganitumab Maintenance
Zeitfenster: Up to 307 days

The number of induction or consolidation reporting periods in which a CTC version 4 codeable non-hematological adverse event, grade 3 left ventricular systolic dysfunction or the reporting period is terminated because of a CTC codeable event.
Up to 307 days
Trough Levels of Serum Ganitumab
Zeitfenster: Up to 15 days

Trough levels of serum ganitumab prior to the second dose of ganitumab during induction obtained will be categorized as less than 10 micrograms per milliliter or greater than or equal to 10 micrograms per milliliter. This analysis will be conducted for the first 10 eligible patients who receive ganitumab.
Up to 15 days
Proportion of Patients Who Successfully Receive Planned Stereotactic Body Radiotherapy (SBRT)
Zeitfenster: 202 days

A patient who has SBRT planned for at least one metastatic site and receives successful SBRT treatment to at least 85% of metastatic sites in the treatment plan. Successful treatment is determined by IROC review criteria. Only eligible patients start the metastatic site radiation reporting period will be considered for this outcome measure.
202 days

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

National Cancer Institute (NCI)

Ermittler

  • Hauptermittler: Steven G DuBois, Children's Oncology Group

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Allgemeine Veröffentlichungen

Nützliche Links

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

12. Dezember 2014

Primärer Abschluss (Tatsächlich)

31. März 2021

Studienabschluss (Geschätzt)

16. September 2027

Studienanmeldedaten

Zuerst eingereicht

1. Dezember 2014

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

1. Dezember 2014

Zuerst gepostet (Geschätzt)

3. Dezember 2014

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

22. Oktober 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

21. Oktober 2026

Zuletzt verifiziert

1. September 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • NCI-2014-02380
  • U10CA180886 (US NIH Stipendium/Vertrag)
  • U10CA098543 (US NIH Stipendium/Vertrag)
  • NCI-2014-02380 (Registrierungskennung: CTRP (Clinical Trial Reporting Program))
  • AEWS1221 (Andere Kennung: CTEP)
  • s15-00442
  • AEWS1221
  • AEWS1221 (Andere Kennung: Children's Oncology Group)

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