新たに骨肉腫と診断された患者における化学療法へのカボザンチニブ薬剤の追加を試験する研究
新たに診断された骨肉腫に対するVEFGR2 / MET阻害剤カボザンチニブと細胞傷害性化学療法の併用の実現可能性および無作為化第2/3相試験
This phase II/III trial tests the safety, side effects, and best dose of the drug cabozantinib in combination with standard chemotherapy, and to compare the effect of adding cabozantinib to standard chemotherapy alone in treating patients with newly diagnosed osteosarcoma. Cabozantinib is in a class of medications called kinase inhibitors which block protein signals affecting new blood vessel formation and the ability to activate growth signaling pathways. This may help slow the growth of tumor cells. The drugs used in standard chemotherapy for this trial are methotrexate, doxorubicin, and cisplatin (MAP). Methotrexate stops cells from making DNA and may kill tumor cells. It is a type of antimetabolite. Doxorubicin is in a class of medications called anthracyclines. It works by slowing or stopping the growth of tumor cells in the body. Cisplatin is in a class of medications known as platinum-containing compounds. It works by killing, stopping or slowing the growth of tumor cells. Adding cabozantinib to standard chemotherapy may work better in treating newly diagnosed osteosarcoma.
調査の概要
状態
詳細な説明
PRIMARY OBJECTIVES:
I. To determine the feasibility of adding cabozantinib S-malate (cabozantinib) to standard MAP (high dose methotrexate, doxorubicin hydrochloride [doxorubicin], and cisplatin) chemotherapy in patients with newly diagnosed metastatic osteosarcoma with a resectable primary tumor.
II. To determine whether MAP chemotherapy plus cabozantinib results in more favorable event-free survival (EFS) than MAP chemotherapy alone in patients with localized, resectable osteosarcoma.
III. To determine whether MAP chemotherapy plus cabozantinib results in more favorable event-free survival (EFS) than MAP chemotherapy alone in patients with metastatic, pelvic and unresectable osteosarcoma.
SECONDARY OBJECTIVES:
I. To determine whether MAP chemotherapy plus cabozantinib results in more favorable overall survival (OS) than MAP chemotherapy alone in patients with localized, resectable osteosarcoma.
II. To determine whether MAP chemotherapy plus cabozantinib results in more favorable overall survival (OS) than MAP chemotherapy alone in patients with metastatic, pelvic and unresectable osteosarcoma.
III. To prospectively validate that elevated circulating tumor DNA (ctDNA) levels greater than or equal to 5% at the time of diagnosis are associated with increased risk of EFS-event in patients with localized, resectable osteosarcoma.
IV. To prospectively validate that elevated ctDNA levels greater than or equal to 5% at the time of diagnosis are associated with increased risk of EFS-event in patients with metastatic, pelvic and unresectable osteosarcoma.
V. To prospectively validate that elevated ctDNA levels greater than or equal to 3% after initiation of therapy and prior to definitive surgery are associated with increased risk of EFS-event in patients with localized, resectable osteosarcoma.
VI. To prospectively validate that elevated ctDNA levels greater than or equal to 3% after initiation of therapy and prior to definitive surgery are associated with increased risk of EFS-event in patients with metastatic, pelvic and unresectable osteosarcoma.
VII. To determine whether MAP chemotherapy plus cabozantinib results in increased symptom burden and decreased tolerability to patients as measured by patient reported therapy-specific acute toxicities (Patient-Reported Outcomes-Common Terminology Criteria for Adverse Events [PRO-CTCAE]).
EXPLORATORY OBJECTIVES:
I. To determine the rate of good histologic response (> 90%) of resected primary tumor specimens following neoadjuvant chemotherapy with MAP plus cabozantinib and compare with response rates for MAP chemotherapy alone.
II. To describe the toxicities of the addition of cabozantinib to MAP chemotherapy in patients with newly diagnosed osteosarcoma.
III. To compare the probability of Grade 3 or higher port site wound complications on the MAP plus cabozantinib regimen to that of MAP chemotherapy alone in patients with newly diagnosed osteosarcoma who received a port for the administration of chemotherapy.
IV. To describe frequency of application of local control methods (surgery, hypofractionated stereotactic body radiotherapy, or radiofrequency ablation) for extrapulmonary metastatic osteosarcoma.
V. To compare total cumulative delivered doses of MAP chemotherapy agents between standard and experimental arms across multiple phases of therapy.
VI. To assess the pharmacokinetics of cabozantinib when administered concomitantly with standard chemotherapy agents during feasibility.
VII. To collect pulmonary metastatic lesions, paired primary tumor tissue, and serial blood samples for tumor profiling, liquid biopsies, and future testing of correlative biology studies.
VIII. To determine whether ctDNA at diagnosis and early on-treatment, as a continuous measurement of ctDNA burden, is associated with an increased risk of EFS-event in patients with newly diagnosed osteosarcoma.
IX. To evaluate whether the magnitude of change in ctDNA levels from diagnosis to planned surgical procedure is associated with risk of EFS-event in patients with newly diagnosed osteosarcoma.
X. To determine whether ctDNA levels greater than or equal to 3% after planned surgical procedures are associated with increased risk of EFS-event.
XI. To describe the presence of specific copy-number alterations, including MYC amplifications, detected in ctDNA and matched diagnostic tumor samples in patients with newly diagnosed osteosarcoma and determine whether frequently occurring copy-number alterations are associated with increased risk of EFS-event.
XII. To determine whether ctDNA burden is predictive of response to the experimental therapy in patients with newly diagnosed osteosarcoma.
XIII. To prospectively compare the impact of combination therapy on symptom bother as measured by the Functional Assessment of Cancer Therapy-General Questionnaire (FACT-G) item GP5 in patients with osteosarcoma receiving MAP chemotherapy with or without cabozantinib, and to assess the relationship between symptom bother and number of patient-reported acute toxicities (as measured by the PRO-CTCAE).
OUTLINE: This is a dose-escalation study of cabozantinib (Feasibility Phase) followed by a randomized phase II/III study (Efficacy Phase).
FEASIBILITY PHASE (CLOSED TO ACCRUAL 05/09/2025): Patients receive cabozantinib orally (PO), methotrexate intravenously (IV), doxorubicin IV, and cisplatin IV for two 35-day "induction" cycles. Patients are then considered for appropriate local control. Then they receive "consolidation" with methotrexate IV, doxorubicin IV, and cisplatin IV for one 35-day cycle, followed by cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV for one 35-day cycle, and cabozantinib PO, methotrexate IV, and doxorubicin IV for two 35-day cycles. Patients then receive cabozantinib PO for six 28-day "maintenance" cycles.
EFFICACY PHASE: Patients with standard risk osteosarcoma are randomized to Arm A or Arm B. Patients with high risk osteosarcoma are randomized to Arm C or Arm D.
ARM A: Standard risk patients receive methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day "induction" cycles, followed by appropriate local control. Patients then receive "consolidation" with methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day cycles and methotrexate IV and doxorubicin IV for two additional 35-day cycles.
ARM B: Standard risk patients receive cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day "induction" cycles, followed by appropriate local control. Patients then receive one 35-day "consolidation" cycle with methotrexate IV, doxorubicin IV, and cisplatin IV, then a second 35-day "consolidation" cycle with cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV, followed by two additional 35-day "consolidation" cycles with cabozantinib PO, methotrexate IV, and doxorubicin IV. Patients then receive cabozantinib PO for six 28-day "maintenance" cycles.
ARM C: High risk patients receive methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day "induction" cycles, followed by appropriate local control. Patients then receive "consolidation" with methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day cycles and methotrexate IV and doxorubicin IV for two additional 35-day cycles.
ARM D: High risk patients receive cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day "induction" cycles, followed by appropriate local control. Patients then receive one 35-day "consolidation" cycle with methotrexate IV, doxorubicin IV, and cisplatin IV, then a second 35-day "consolidation" cycle with cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV, followed by two additional 35-day "consolidation" cycles with cabozantinib PO, methotrexate IV, and doxorubicin IV. Patients then receive cabozantinib PO for six 28-day "maintenance" cycles.
All patients also undergo X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) or bone scintigraphy at diagnosis and additional time points throughout the trial. All patients also undergo collection of blood samples during screening and on study.
研究の種類
入学 (推定)
段階
- フェーズ2
- フェーズ 3
連絡先と場所
研究場所
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Alabama
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Birmingham、Alabama、アメリカ、35233
- Children's Hospital of Alabama
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-
Arizona
-
Mesa、Arizona、アメリカ、85202
- Banner Children's at Desert
-
Phoenix、Arizona、アメリカ、85054
- Mayo Clinic Hospital in Arizona
-
Phoenix、Arizona、アメリカ、85016
- Phoenix Childrens Hospital
-
Tucson、Arizona、アメリカ、85719
- Banner University Medical Center - Tucson
-
-
Arkansas
-
Little Rock、Arkansas、アメリカ、72202-3591
- Arkansas Children's Hospital
-
-
California
-
Downey、California、アメリカ、90242
- Kaiser Permanente Downey Medical Center
-
Duarte、California、アメリカ、91010
- City of Hope Comprehensive Cancer Center
-
Loma Linda、California、アメリカ、92354
- Loma Linda University Medical Center
-
Long Beach、California、アメリカ、90806
- Miller Children's and Women's Hospital Long Beach
-
Los Angeles、California、アメリカ、90048
- Cedars-Sinai Medical Center
-
Los Angeles、California、アメリカ、90027
- Children's Hospital Los Angeles
-
Los Angeles、California、アメリカ、90095
- Mattel Children's Hospital UCLA
-
Madera、California、アメリカ、93636
- Valley Children's Hospital
-
Oakland、California、アメリカ、94609
- UCSF Benioff Children's Hospital Oakland
-
Oakland、California、アメリカ、94611
- Kaiser Permanente-Oakland
-
Orange、California、アメリカ、92868
- Children's Hospital of Orange County
-
Palo Alto、California、アメリカ、94304
- Lucile Packard Children's Hospital Stanford University
-
Sacramento、California、アメリカ、95817
- University of California Davis Comprehensive Cancer Center
-
San Diego、California、アメリカ、92123
- Rady Children's Hospital - San Diego
-
San Francisco、California、アメリカ、94158
- UCSF Medical Center-Mission Bay
-
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Colorado
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Aurora、Colorado、アメリカ、80045
- Children's Hospital Colorado
-
Denver、Colorado、アメリカ、80218
- Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
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-
Connecticut
-
Hartford、Connecticut、アメリカ、06106
- Connecticut Children's Medical Center
-
New Haven、Connecticut、アメリカ、06520
- Yale University
-
-
Delaware
-
Wilmington、Delaware、アメリカ、19803
- Alfred I duPont Hospital for Children
-
-
District of Columbia
-
Washington D.C.、District of Columbia、アメリカ、20010
- Children's National Medical Center
-
Washington D.C.、District of Columbia、アメリカ、20007
- MedStar Georgetown University Hospital
-
-
Florida
-
Fort Myers、Florida、アメリカ、33908
- Golisano Children's Hospital of Southwest Florida
-
Gainesville、Florida、アメリカ、32610
- UF Health Cancer Institute - Gainesville
-
Hollywood、Florida、アメリカ、33021
- Memorial Regional Hospital/Joe DiMaggio Children's Hospital
-
Jacksonville、Florida、アメリカ、32207
- Nemours Children's Clinic-Jacksonville
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Miami、Florida、アメリカ、33155
- Nicklaus Children's Hospital
-
Miami、Florida、アメリカ、33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
-
Miami、Florida、アメリカ、33176
- Miami Cancer Institute
-
Orlando、Florida、アメリカ、32827
- Nemours Children's Hospital
-
Orlando、Florida、アメリカ、32803
- AdventHealth Orlando
-
Orlando、Florida、アメリカ、32806
- Arnold Palmer Hospital for Children
-
Pensacola、Florida、アメリカ、32504
- Nemours Children's Clinic - Pensacola
-
St. Petersburg、Florida、アメリカ、33701
- Johns Hopkins All Children's Hospital
-
Tampa、Florida、アメリカ、33607
- Saint Joseph's Hospital/Children's Hospital-Tampa
-
-
Georgia
-
Atlanta、Georgia、アメリカ、30329
- Children's Healthcare of Atlanta - Arthur M Blank Hospital
-
Augusta、Georgia、アメリカ、30912
- Augusta University Medical Center
-
Savannah、Georgia、アメリカ、31404
- Memorial Health University Medical Center
-
-
Hawaii
-
Honolulu、Hawaii、アメリカ、96826
- Kapiolani Medical Center for Women and Children
-
-
Idaho
-
Boise、Idaho、アメリカ、83712
- Saint Luke's Cancer Institute - Boise
-
-
Illinois
-
Chicago、Illinois、アメリカ、60611
- Northwestern University
-
Chicago、Illinois、アメリカ、60637
- University of Chicago Comprehensive Cancer Center
-
Chicago、Illinois、アメリカ、60612
- University of Illinois
-
Chicago、Illinois、アメリカ、60611
- Lurie Children's Hospital-Chicago
-
Peoria、Illinois、アメリカ、61637
- OSF Children's Hospital of Illinois
-
Springfield、Illinois、アメリカ、62702
- Southern Illinois University School of Medicine
-
-
Indiana
-
Indianapolis、Indiana、アメリカ、46202
- Riley Hospital for Children
-
-
Iowa
-
Des Moines、Iowa、アメリカ、50309
- Blank Children's Hospital
-
Iowa City、Iowa、アメリカ、52242
- University of Iowa/Holden Comprehensive Cancer Center
-
-
Kentucky
-
Lexington、Kentucky、アメリカ、40536
- University of Kentucky/Markey Cancer Center
-
Louisville、Kentucky、アメリカ、40202
- Norton Children's Hospital
-
-
Louisiana
-
New Orleans、Louisiana、アメリカ、70121
- Ochsner Medical Center Jefferson
-
New Orleans、Louisiana、アメリカ、70118
- Children's Hospital New Orleans
-
-
Maine
-
Bangor、Maine、アメリカ、04401
- Eastern Maine Medical Center
-
Scarborough、Maine、アメリカ、04074
- Maine Children's Cancer Program
-
-
Maryland
-
Baltimore、Maryland、アメリカ、21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
-
Baltimore、Maryland、アメリカ、21215
- Sinai Hospital of Baltimore
-
Baltimore、Maryland、アメリカ、21201
- University of Maryland/Greenebaum Cancer Center
-
Bethesda、Maryland、アメリカ、20889-5600
- Walter Reed National Military Medical Center
-
-
Massachusetts
-
Boston、Massachusetts、アメリカ、02215
- Dana-Farber Cancer Institute
-
Boston、Massachusetts、アメリカ、02114
- Massachusetts General Hospital Cancer Center
-
Worcester、Massachusetts、アメリカ、01655
- UMass Memorial Medical Center - University Campus
-
-
Michigan
-
Ann Arbor、Michigan、アメリカ、48109
- C S Mott Children's Hospital
-
Ann Arbor、Michigan、アメリカ、48109
- University of Michigan Rogel Cancer Center
-
Brownstown、Michigan、アメリカ、48183
- Henry Ford Cancer Institute-Downriver
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Clinton Township、Michigan、アメリカ、48038
- Henry Ford Macomb Hospital-Clinton Township
-
Dearborn、Michigan、アメリカ、48126
- Henry Ford Medical Center-Fairlane
-
Detroit、Michigan、アメリカ、48202
- Henry Ford Hospital
-
Detroit、Michigan、アメリカ、48201
- Children's Hospital of Michigan
-
Grand Rapids、Michigan、アメリカ、49503
- Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
-
Jackson、Michigan、アメリカ、49201
- Allegiance Health
-
Kalamazoo、Michigan、アメリカ、49007
- Bronson Methodist Hospital
-
Novi、Michigan、アメリカ、48377
- Henry Ford Medical Center-Columbus
-
Royal Oak、Michigan、アメリカ、48073
- Corewell Health Children's
-
West Bloomfield、Michigan、アメリカ、48322
- Henry Ford West Bloomfield Hospital
-
Wyandotte、Michigan、アメリカ、48192
- Henry Ford Wyandotte Hospital
-
-
Minnesota
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Minneapolis、Minnesota、アメリカ、55404
- Children's Hospitals and Clinics of Minnesota - Minneapolis
-
Minneapolis、Minnesota、アメリカ、55455
- University of Minnesota/Masonic Cancer Center
-
Rochester、Minnesota、アメリカ、55905
- Mayo Clinic in Rochester
-
-
Mississippi
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Jackson、Mississippi、アメリカ、39216
- University of Mississippi Medical Center
-
-
Missouri
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Columbia、Missouri、アメリカ、65212
- University of Missouri Children's Hospital
-
Kansas City、Missouri、アメリカ、64108
- Children's Mercy Hospitals and Clinics
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St Louis、Missouri、アメリカ、63110
- Washington University School of Medicine
-
St Louis、Missouri、アメリカ、63141
- Mercy Hospital Saint Louis
-
St Louis、Missouri、アメリカ、63104
- Cardinal Glennon Children's Medical Center
-
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Nebraska
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Omaha、Nebraska、アメリカ、68198
- University of Nebraska Medical Center
-
Omaha、Nebraska、アメリカ、68114
- Children's Hospital and Medical Center of Omaha
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Nevada
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Las Vegas、Nevada、アメリカ、89144
- Summerlin Hospital Medical Center
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Las Vegas、Nevada、アメリカ、89135
- Alliance for Childhood Diseases/Cure 4 the Kids Foundation
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New Hampshire
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Lebanon、New Hampshire、アメリカ、03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
-
-
New Jersey
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Hackensack、New Jersey、アメリカ、07601
- Hackensack University Medical Center
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Morristown、New Jersey、アメリカ、07960
- Morristown Medical Center
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New Brunswick、New Jersey、アメリカ、08903
- Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
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Newark、New Jersey、アメリカ、07112
- Newark Beth Israel Medical Center
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Paterson、New Jersey、アメリカ、07503
- Saint Joseph's Regional Medical Center
-
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New York
-
Albany、New York、アメリカ、12208
- Albany Medical Center
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Buffalo、New York、アメリカ、14263
- Roswell Park Cancer Institute
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Mineola、New York、アメリカ、11501
- NYU Langone Hospital - Long Island
-
New Hyde Park、New York、アメリカ、11040
- The Steven and Alexandra Cohen Children's Medical Center of New York
-
New York、New York、アメリカ、10065
- Memorial Sloan Kettering Cancer Center
-
New York、New York、アメリカ、10032
- NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
-
New York、New York、アメリカ、10065
- NYP/Weill Cornell Medical Center
-
New York、New York、アメリカ、10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
Rochester、New York、アメリカ、14642
- University of Rochester
-
Stony Brook、New York、アメリカ、11794
- Stony Brook University Medical Center
-
Syracuse、New York、アメリカ、13210
- State University of New York Upstate Medical University
-
The Bronx、New York、アメリカ、10467
- Montefiore Medical Center - Moses Campus
-
Valhalla、New York、アメリカ、10595
- New York Medical College
-
-
North Carolina
-
Chapel Hill、North Carolina、アメリカ、27599
- UNC Lineberger Comprehensive Cancer Center
-
Charlotte、North Carolina、アメリカ、28203
- Carolinas Medical Center/Levine Cancer Institute
-
Charlotte、North Carolina、アメリカ、28204
- Novant Health Presbyterian Medical Center
-
Charlotte、North Carolina、アメリカ、28210
- Atrium Health Pineville/LCI-Pineville
-
Durham、North Carolina、アメリカ、27710
- Duke University Medical Center
-
Greenville、North Carolina、アメリカ、27834
- East Carolina University
-
Winston-Salem、North Carolina、アメリカ、27157
- Wake Forest University Health Sciences
-
-
North Dakota
-
Fargo、North Dakota、アメリカ、58122
- Sanford Broadway Medical Center
-
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Ohio
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Akron、Ohio、アメリカ、44308
- Children's Hospital Medical Center of Akron
-
Cincinnati、Ohio、アメリカ、45229
- Cincinnati Children's Hospital Medical Center
-
Cleveland、Ohio、アメリカ、44195
- Cleveland Clinic Foundation
-
Cleveland、Ohio、アメリカ、44106
- Rainbow Babies and Childrens Hospital
-
Columbus、Ohio、アメリカ、43205
- Nationwide Children's Hospital
-
Columbus、Ohio、アメリカ、43210
- Ohio State University Comprehensive Cancer Center
-
Dayton、Ohio、アメリカ、45404
- Dayton Children's Hospital
-
Toledo、Ohio、アメリカ、43606
- ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
-
-
Oklahoma
-
Oklahoma City、Oklahoma、アメリカ、73104
- University of Oklahoma Health Sciences Center
-
-
Oregon
-
Portland、Oregon、アメリカ、97239
- Oregon Health and Science University
-
Portland、Oregon、アメリカ、97227
- Legacy Emanuel Children's Hospital
-
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Pennsylvania
-
Danville、Pennsylvania、アメリカ、17822
- Geisinger Medical Center
-
Hershey、Pennsylvania、アメリカ、17033
- Penn State Children's Hospital
-
Philadelphia、Pennsylvania、アメリカ、19104
- Children's Hospital of Philadelphia
-
Philadelphia、Pennsylvania、アメリカ、19107
- Thomas Jefferson University Hospital
-
Philadelphia、Pennsylvania、アメリカ、19134
- Saint Christopher's Hospital for Children
-
Pittsburgh、Pennsylvania、アメリカ、15232
- UPMC Hillman Cancer Center
-
Pittsburgh、Pennsylvania、アメリカ、15224
- Children's Hospital of Pittsburgh of UPMC
-
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South Carolina
-
Charleston、South Carolina、アメリカ、29425
- Medical University of South Carolina
-
Columbia、South Carolina、アメリカ、29203
- Prisma Health Richland Hospital
-
Gaffney、South Carolina、アメリカ、29341
- Gibbs Cancer Center-Gaffney
-
Greenville、South Carolina、アメリカ、29607
- Saint Francis Cancer Center
-
Greenville、South Carolina、アメリカ、29601
- Saint Francis Hospital
-
Greenville、South Carolina、アメリカ、29605
- BI-LO Charities Children's Cancer Center
-
Greer、South Carolina、アメリカ、29651
- Gibbs Cancer Center-Pelham
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Spartanburg、South Carolina、アメリカ、29303
- Spartanburg Medical Center
-
-
South Dakota
-
Sioux Falls、South Dakota、アメリカ、57117-5134
- Sanford USD Medical Center - Sioux Falls
-
-
Tennessee
-
Knoxville、Tennessee、アメリカ、37916
- East Tennessee Childrens Hospital
-
Memphis、Tennessee、アメリカ、38105
- Saint Jude Children's Research Hospital
-
Nashville、Tennessee、アメリカ、37232
- Vanderbilt University/Ingram Cancer Center
-
Nashville、Tennessee、アメリカ、37203
- The Children's Hospital at TriStar Centennial
-
-
Texas
-
Austin、Texas、アメリカ、78723
- Dell Children's Medical Center of Central Texas
-
Corpus Christi、Texas、アメリカ、78411
- Driscoll Children's Hospital
-
Dallas、Texas、アメリカ、75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Dallas、Texas、アメリカ、75230
- Medical City Dallas Hospital
-
El Paso、Texas、アメリカ、79905
- El Paso Children's Hospital
-
Fort Worth、Texas、アメリカ、76104
- Cook Children's Medical Center
-
Houston、Texas、アメリカ、77030
- UT MD Anderson Cancer Center
-
Houston、Texas、アメリカ、77030
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
Lubbock、Texas、アメリカ、79410
- Covenant Children's Hospital
-
Lubbock、Texas、アメリカ、79415
- UMC Cancer Center / UMC Health System
-
San Antonio、Texas、アメリカ、78229
- University of Texas Health Science Center at San Antonio
-
San Antonio、Texas、アメリカ、78207
- Children's Hospital of San Antonio
-
San Antonio、Texas、アメリカ、78229
- Methodist Children's Hospital of South Texas
-
Temple、Texas、アメリカ、76508
- Scott and White Memorial Hospital
-
-
Utah
-
Salt Lake City、Utah、アメリカ、84113
- Primary Children's Hospital
-
-
Virginia
-
Charlottesville、Virginia、アメリカ、22908
- University of Virginia Cancer Center
-
Norfolk、Virginia、アメリカ、23507
- Children's Hospital of The King's Daughters
-
Richmond、Virginia、アメリカ、23235
- VCU Massey Cancer Center at Stony Point
-
Richmond、Virginia、アメリカ、23298
- VCU Massey Comprehensive Cancer Center
-
-
Washington
-
Seattle、Washington、アメリカ、98105
- Seattle Children's Hospital
-
Spokane、Washington、アメリカ、99204
- Providence Sacred Heart Medical Center and Children's Hospital
-
Tacoma、Washington、アメリカ、98405
- Mary Bridge Children's Hospital and Health Center
-
Tacoma、Washington、アメリカ、98431
- Madigan Army Medical Center
-
-
West Virginia
-
Charleston、West Virginia、アメリカ、25304
- Vandalia Health/CAMC Institute for Academic Medicine
-
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Wisconsin
-
Green Bay、Wisconsin、アメリカ、54301
- Saint Vincent Hospital Cancer Center Green Bay
-
Madison、Wisconsin、アメリカ、53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Marshfield、Wisconsin、アメリカ、54449
- Marshfield Medical Center-Marshfield
-
Milwaukee、Wisconsin、アメリカ、53226
- Children's Hospital of Wisconsin
-
-
-
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New South Wales
-
Randwick、New South Wales、オーストラリア、2031
- Sydney Children's Hospital
-
Westmead、New South Wales、オーストラリア、2145
- The Children's Hospital at Westmead
-
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Queensland
-
South Brisbane、Queensland、オーストラリア、4101
- Queensland Children's Hospital
-
-
South Australia
-
North Adelaide、South Australia、オーストラリア、5006
- Women's and Children's Hospital-Adelaide
-
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Victoria
-
Clayton、Victoria、オーストラリア、3168
- Monash Medical Center-Clayton Campus
-
Parkville、Victoria、オーストラリア、3052
- Royal Children's Hospital
-
-
Western Australia
-
Perth、Western Australia、オーストラリア、6009
- Perth Children's Hospital
-
-
-
-
-
Québec、カナダ、G1V 4G2
- CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)
-
-
Alberta
-
Calgary、Alberta、カナダ、T3B 6A8
- Alberta Children's Hospital
-
Edmonton、Alberta、カナダ、T6G 2B7
- University of Alberta Hospital
-
-
Manitoba
-
Winnipeg、Manitoba、カナダ、R3E 0V9
- CancerCare Manitoba
-
-
Nova Scotia
-
Halifax、Nova Scotia、カナダ、B3K 6R8
- IWK Health Centre
-
-
Ontario
-
London、Ontario、カナダ、N6A 5W9
- Children's Hospital
-
Ottawa、Ontario、カナダ、K1H 8L1
- Children's Hospital of Eastern Ontario
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Toronto、Ontario、カナダ、M5G 1X8
- Hospital for Sick Children
-
-
Quebec
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Montreal、Quebec、カナダ、H3H 1P3
- The Montreal Children's Hospital of the MUHC
-
Montreal、Quebec、カナダ、H3T 1C5
- Centre Hospitalier Universitaire Sainte-Justine
-
Sherbrooke、Quebec、カナダ、J1H 5N4
- Centre Hospitalier Universitaire de Sherbrooke-Fleurimont
-
-
Saskatchewan
-
Saskatoon、Saskatchewan、カナダ、S7N 0W8
- Jim Pattison Children's Hospital
-
-
-
-
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Christchurch、ニュージーランド、8011
- Christchurch Hospital
-
-
Auckland
-
Grafton、Auckland、ニュージーランド、1145
- Starship Children's Hospital
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Patients must be < 40 years of age at the time of enrollment.
- Patients must have a body surface area of >= 0.8 m^2 at the time of enrollment.
- Patients must have histologic diagnosis (by institutional pathologist) of newly diagnosed high grade osteosarcoma. Primary tumors of all extremity and axial sites are eligible as long as diagnosis of high-grade osteosarcoma is established. Osteosarcoma as a second malignancy is eligible if no prior exposure to systemic chemotherapies.
- Feasibility Phase (NOTE: as of Amendment #2B, the feasibility phase has been completed) Patients must have metastatic disease and a resectable primary tumor. Designation of a primary tumor as resectable will be determined at the time of diagnosis by the institutional multidisciplinary team.
For 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.
-
Lung metastases: defined as biopsy-proven metastasis or the presence of one or more pulmonary lesions >= 5 mm, OR multiple pulmonary lesions >= 3 mm or greater in size.
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Bone metastases: Areas suspicious for bone metastasis based on fludeoxyglucose F-18 (18F-FDG)-positron emission tomography (PET) scan (or whole body technetium-99 bone scan if 18F-FDG-PET is unavailable at the treating institution) require confirmatory biopsy or supportive anatomic imaging of at least one suspicious site with either magnetic resonance imaging (MRI) or computed tomography (CT) (whole body 18F-FDG-PET/CT or 18F-FDG-PET/MR scans are acceptable).
- Efficacy Phases (Phase 2/3) NOTE: as of Amendment #2B, the efficacy phase is open for enrollment.
Patients with both localized and metastatic disease are eligible for the efficacy phase, regardless of resectability. Patients will be enrolled to two separate cohorts:
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Cohort 1 (Standard Risk): Patients with non-pelvic primary osteosarcoma deemed to be resectable at the time of diagnosis by the institutional multidisciplinary team, without evidence of metastatic lesions.
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Cohort 2 (High-Risk): Patients with a primary pelvic tumor, a primary tumor designated as unresectable by the institutional multidisciplinary team, AND/OR radiographic evidence of metastatic lesions.
- A serum creatinine based on age/sex as follows (within 7 days prior to enrollment unless otherwise indicated):
-
(Age: Maximum Serum Creatinine [mg/dL]; Sex)
- 1 month to < 6 months: 0.4 (male); 0.4 (female)
- 6 months to < 1 year: 0.5 (male); 0.5 (female)
- 1 to < 2 years: 0.6 (male); 0.6 (female)
- 2 to < 6 years: 0.8 (male); 0.8 (female)
- 6 to < 10 years: 1 (male); 1 (female)
- 10 to < 13 years: 1.2 (male); 1.2 (female)
- 13 to < 16 years: 1.5 (male); 1.4 (female)
- >= 16 years: 1.7 (male); 1.4 (female)
-
OR - a 24 hour urine creatinine clearance >= 70 mL/min/1.73 m^2
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OR - a glomerular filtration rate (GFR) >= 70 mL/min/1.73 m^2. GFR must be performed using direct measurement with a nuclear blood sampling method OR direct small molecule clearance method (iothalamate or other molecule per institutional standard).
-
Note: Estimated GFR (eGFR) from serum creatinine, cystatin C or other estimates are not acceptable for determining eligibility.
- Total bilirubin =< 1.5 x upper limit of normal (ULN) for age (within 7 days prior to enrollment unless otherwise indicated)
- Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 135 U/L (within 7 days prior to enrollment unless otherwise indicated)
-
-
Note: For the purpose of this study, the ULN for SGPT (ALT) has been set to the value of 45 U/L
- No history of congenital prolonged corrected QT (QTc) syndrome, New York Heart Association (NYHA) Class III or IV congestive heart failure, unstable angina pectoris, serious cardiac arrhythmias
-
Shortening fraction of >= 27%, or
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Ejection fraction of >= 50%
-
Corrected QT interval by Fridericia (QTcF) < 480 msec on electrocardiogram. Patients with Grade 1 prolonged QTc (450-480 msec) at time of study enrollment should have correctable causes of prolonged QTc addressed if possible (i.e., electrolytes, medications).
- Peripheral absolute neutrophil count (ANC) >= 1000/uL (within 7 days prior to enrollment unless otherwise indicated)
- Platelet count >= 100,000/uL (transfusion independent, defined as not receiving platelet transfusions within a 7-day period prior to enrollment) (within 7 days prior to enrollment unless otherwise indicated)
- Hemoglobin >= 8.0 g/dL (within 7 days prior to enrollment unless otherwise indicated)
- International normalized ratio (INR) =< 1.5 (within 7 days prior to enrollment unless otherwise indicated)
- Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible as long as they are NOT receiving anti-retroviral agents that are strong inhibitors or inducers of CYP3A4, CYP2D6, and/or MRP2 transporter protein.
- 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 who have received previous systemic therapy for osteosarcoma or a prior oncologic diagnosis.
- Patients who have central nervous system metastases.
- Patients with central cavitating pulmonary lesions invading or encasing any major blood vessels in the lung.
- Patients who are unable to swallow tablets. Tablets cannot be crushed or chewed.
- Patients with gastrointestinal disorders including active disorders associated with a high risk of perforation or fistula formation. Specifically, no clinically significant gastrointestinal (GI) bleeding, GI perforation, bowel obstruction, intra-abdominal abscess or fistula for 6 months prior to enrollment, no hemoptysis or other signs of pulmonary hemorrhage for 3 months prior to enrollment.
- Patients with active bleeding or bleeding diathesis. No clinically significant hematuria, hematemesis, or hemoptysis or other history of significant bleeding within 3 months prior to enrollment.
- Patients with uncompensated or symptomatic hypothyroidism. Patients who have hypothyroidism controlled with thyroid replacement hormone are eligible.
- Patients with moderate to severe hepatic impairment (Child-Pugh B or C).
- Patients who have had primary tumor resection or attempted curative resection of metastases prior to enrollment.
- Patients who have undergone other major surgical procedure (eg, laparotomy) within 14 days prior to enrollment. Thoracoscopic procedures for diagnostic purposes (biopsy of lung nodule) and central access such as port-a-cath placement are allowed.
- Patients with a history of serious or non-healing wound or bone fracture (pathologic fracture of primary tumor is not considered exclusion).
- Patients with any medical or surgical conditions that would interfere with gastrointestinal absorption of cabozantinib.
- Patients with previously identify allergy or hypersensitivity to components of the study treatment formulations.
- Patients who are receiving any other investigational agent not defined within this protocol are not eligible.
- Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study are not eligible.
- Patients who received enzyme-inducing anticonvulsants within 14 days prior to enrollment.
- Patients with a prior history of hypertension (> 95th percentile for age, height, and sex for patients < 18 years and > 140/90 mmHg for patients >= 18 years requiring medication for blood pressure control.
- Patients who are receiving drugs that prolong QTc.
- Patients receiving anticoagulation with oral coumarin agents (eg warfarin), direct thrombin inhibitors (eg dabigatran), direct factor Xa inhibitor betrixaban, or platelet inhibitors (eg, clopidogrel). Low dose aspirin for cardioprotection (per local applicable guidelines) and low dose, low molecular weight heparins (LMWH) are permitted. Anticoagulation with therapeutic doses of LMWH and direct factor Xa inhibitors rivaroxaban or apixaban are allowed in subjects who are on a stable dose for at least 6 weeks before the first dose of study treatment, and who have had no complications from a thromboembolic event or the anticoagulation regimen.
- Patients receiving strong CYP3A4 inducers or strong CYP3A4 inhibitors.
- 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 protocol therapy.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:順次割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
アクティブコンパレータ:Efficacy Phase Arm A (MAP)
Standard risk patients receive methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day "induction" cycles, followed by appropriate local control. Patients then receive "consolidation" with methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day cycles and methotrexate IV and doxorubicin IV for two additional 35-day cycles. Patients also undergo X-ray, CT, MRI, and PET or bone scintigraphy at diagnosis and additional time points throughout the trial. All patients also undergo collection of blood samples during screening and on study. |
Given IV
他の名前:
Given IV
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Given IV
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Undergo CT
他の名前:
Undergo MRI
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Undergo surgery
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Undergo bone scintography
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実験的:Efficacy Phase Arm B (cabozantinib, MAP)
Standard risk patients receive cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day "induction" cycles, followed by appropriate local control. Patients then receive one 35-day "consolidation" cycle with methotrexate IV, doxorubicin IV, and cisplatin IV, then a second 35-day "consolidation" cycle with cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV, followed by two additional 35-day "consolidation" cycles with cabozantinib PO, methotrexate IV, and doxorubicin IV. Patients then receive cabozantinib PO for six 28-day "maintenance" cycles. Patients also undergo X-ray, CT, MRI, and PET or bone scintigraphy at diagnosis and additional time points throughout the trial. All patients also undergo collection of blood samples during screening and on study. |
Given IV
他の名前:
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Given PO
他の名前:
Undergo surgery
他の名前:
Undergo bone scintography
他の名前:
Undergo X-ray
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アクティブコンパレータ:Efficacy Phase Arm C (MAP)
High risk patients receive methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day "induction" cycles, followed by appropriate local control. Patients then receive "consolidation" with methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day cycles and methotrexate IV and doxorubicin IV for two additional 35-day cycles. Patients also undergo X-ray, CT, MRI, and PET or bone scintigraphy at diagnosis and additional time points throughout the trial. All patients also undergo collection of blood samples during screening and on study. |
Given IV
他の名前:
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Undergo surgery
他の名前:
Undergo bone scintography
他の名前:
Undergo X-ray
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実験的:Efficacy Phase Arm D (cabozantinib, MAP)
High risk patients receive cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day "induction" cycles, followed by appropriate local control. Patients then receive one 35-day "consolidation" cycle with methotrexate IV, doxorubicin IV, and cisplatin IV, then a second 35-day "consolidation" cycle with cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV, followed by two additional 35-day "consolidation" cycles with cabozantinib PO, methotrexate IV, and doxorubicin IV. Patients then receive cabozantinib PO for six 28-day "maintenance" cycles. Patients also undergo X-ray, CT, MRI, and PET or bone scintigraphy at diagnosis and additional time points throughout the trial. All patients also undergo collection of blood samples during screening and on study. |
Given IV
他の名前:
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Given PO
他の名前:
Undergo bone scintography
他の名前:
Undergo X-ray
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実験的:Feasibility phase (cabozantinib, MAP)
(CLOSED TO ACCRUAL 05/09/2025): Patients receive cabozantinib orally (PO), methotrexate intravenously (IV), doxorubicin IV, and cisplatin IV for two 35-day "induction" cycles. Patients are then considered for appropriate local control. Then they receive "consolidation" with methotrexate IV, doxorubicin IV, and cisplatin IV for one 35-day cycle, followed by cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV for one 35-day cycle, and cabozantinib PO, methotrexate IV, and doxorubicin IV for two 35-day cycles. Patients then receive cabozantinib PO for six 28-day "maintenance" cycles. |
Given IV
他の名前:
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Given PO
他の名前:
Undergo surgery
他の名前:
Undergo bone scintography
他の名前:
Undergo X-ray
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Occurrence of dose-limiting toxicity (Feasibility)
時間枠:Baseline up to 6 weeks
|
Only patients with high risk osteosarcoma who have a primary tumor considered resectable at the time of enrollment will be enrolled to this part of the trial. If a feasible dose cannot be established, the study committee will consult with Children's Oncology Group leadership and National Cancer Institute Cancer Therapy Evaluation Program regarding possible modifications of the regimen and subsequent protocol amendment. |
Baseline up to 6 weeks
|
|
Event-free survival (EFS) (Phase II)
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
The randomization and analysis will be stratified according to risk group. An assessment of the reduction in risk for EFS-event at the designated landmark time will be used to determine whether the trial continues to part 3. If the study proceeds to part 3, patients enrolled to part 2 of the trial will contribute to the primary analyses for part 3 of the study. If the interim criterion for continuation is not obtained, accrual will be closed with the conclusion that cabozantinib does not reduce sufficiently the risk for EFS-event for patients with newly-diagnosed osteosarcoma. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
|
EFS (Phase III)
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
Will consist of two randomized phase 3 sub-studies ('Phase 3'). One will be conducted in standard risk patients and one will be conducted in high risk patients. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
|
Overall survival
時間枠:From randomization until death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
The one-sided logrank test will be the primary statistical methodology for assessing the null statistical hypothesis. The assessment of the reduction in risk of EFS-event will be conducted in standard risk patients and high risk patients separately. |
From randomization until death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
Will validate whether elevated circulating tumor deoxyribonucleic acid (ctDNA) levels greater than or equal to 5% at the time of diagnosis are associated with increased risk of EFS-event in patients with localized, resectable osteosarcoma. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
Will validate whether elevated ctDNA levels greater than or equal to 5% at the time of diagnosis are associated with increased risk of EFS-event in patients with metastatic, pelvic and unresectable osteosarcoma. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
Will validate whether elevated ctDNA levels greater than or equal to 3% after initiation of therapy and prior to definitive surgery are associated with increased risk of EFS-event in patients with localized, resectable osteosarcoma. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
Will validate whether elevated ctDNA levels greater than or equal to 3% after initiation of therapy and prior to definitive surgery are associated with increased risk of EFS-event in patients with metastatic, pelvic and unresectable osteosarcoma. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
|
Change in symptom burden and tolerability
時間枠:Up to 5 years after completion of study treatment
|
Will determine whether methotrexate, doxorubicin, and cisplatin (MAP) chemotherapy plus cabozantinib results in increased symptom burden and decreased tolerability to patients as measured by patient reported therapy-specific acute toxicities (Patient-Reported Outcomes-Common Terminology Criteria for Adverse Events [PRO-CTCAE]). |
Up to 5 years after completion of study treatment
|
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
Will determine whether ctDNA at diagnosis and early on-treatment, as a continuous measurement of ctDNA burden, is associated with an increased risk of EFS-event in patients with newly diagnosed osteosarcoma. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
Will evaluate whether the magnitude of change in ctDNA levels from diagnosis to planned surgical procedure is associated with risk of EFS-event in patients with newly diagnosed osteosarcoma. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
Will determine whether ctDNA levels greater than or equal to 3% after planned surgical procedures are associated with increased risk of EFS-event. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
Will describe the presence of specific copy-number alterations, including MYC amplifications, detected in ctDNA and matched diagnostic tumor samples in patients with newly diagnosed osteosarcoma and determine whether frequently occurring copy-number alterations are associated with increased risk of EFS-event. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 5 years after completion of study treatment
|
|
ctDNA burden
時間枠:Up to 5 years after completion of study treatment
|
Will determine whether ctDNA burden is predictive of response to the experimental therapy in patients with newly diagnosed osteosarcoma. |
Up to 5 years after completion of study treatment
|
|
Impact of combination therapy on symptom bother
時間枠:Up to 5 years after completion of study treatment
|
Will prospectively compare the impact of combination therapy on symptom bother as measured by the Functional Assessment of Cancer Therapy-General Questionnaire item GP5 in patients with osteosarcoma receiving MAP chemotherapy with or without cabozantinib, and to assess the relationship between symptom bother and number of patient-reported acute toxicities (as measured by the PRO-CTCAE). |
Up to 5 years after completion of study treatment
|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 1 year after completion of study treatment
|
Estimates of 1-year EFS for standard risk (SR) and high risk (HR) patients on each Arm MAP and Arm cabozantinib (CABO)-MAP and the corresponding 95% confidence intervals (CIs) by sex. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 1 year after completion of study treatment
|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 1 year after completion of study treatment
|
Estimates of 1-year EFS for SR and HR patients on each Arm MAP and Arm CABO-MAP and the corresponding 95% CIs by race. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 1 year after completion of study treatment
|
|
EFS
時間枠:From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 1 year after completion of study treatment
|
Estimates of 1-year EFS for SR and HR patients on each Arm MAP and Arm CABO-MAP and the corresponding 95% CIs by ethnicity. |
From randomization until disease progression, relapse, diagnosis of a second malignant neoplasm, death or last contact, whichever occurs first, assessed up to 1 year after completion of study treatment
|
協力者と研究者
捜査官
- 主任研究者:Michael W Bishop、Children's Oncology Group
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
- 新生物
- 組織型別の新生物
- 肉腫
- 新生物、結合組織および軟部組織
- 新生物、骨組織
- 新生物、結合組織
- 骨肉腫
- 有機化学物質
- 複素環化化合物
- 複素環化化合物、2リング
- 複素環化化合物、融合リング
- 調査手法
- 炭化水素
- 炭化水素、周期的
- 炭水化物
- 物理現象
- 多環芳香族炭化水素
- 炭化水素、芳香
- 多環式化合物
- グリコシド
- 機器と消耗品
- 無機化学物質
- 塩素化合物
- 窒素化合物
- 要素
- 金属
- 化学技術、分析
- スペクトル分析
- 羽毛
- プテリジン
- 金属、重い
- アミノプテリン
- アントラサイクリン
- ナフテセン
- アミノグリコシド
- プラチナ化合物
- 電磁現象
- 磁気現象
- ダウノルビシン
- 遷移要素
- 電磁放射
- 放射線
- 放射、イオン化
- メトトレキサート
- ドキソルビシン
- シスプラチン
- クエン酸1,2-ジアミノシクロヘキサン白金II
- 磁気共鳴分光法
- 外科的処置、手術
- 白金
- X線
- カボザンチニブ
- メルフォス
- ファントム、イメージング
その他の研究ID番号
- NCI-2022-08567
- U10CA180886 (米国 NIH グラント/契約)
- AOST2032 (その他の識別子:CTEP)
- NCI-2022-08567 (レジストリ識別子:CTRP (Clinical Trial Reporting Program))
- AOST2032 (その他の識別子:Children's Oncology Group)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。