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새로 진단된 전이성 유잉 육종 환자 치료에서 가니투맙을 병용하거나 사용하지 않는 병용 화학 요법

2026년 10월 21일 업데이트: National Cancer Institute (NCI)

새로 진단된 전이성 유잉 육종 환자를 위한 다제제 화학요법에 대한 IGF-1R 단클론 항체 가니투맙(AMG 479, NSC# 750008)의 추가를 평가하는 무작위 3상 시험

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.

연구 개요

상태

모집하지 않고 적극적으로

정황

개입 / 치료

상세 설명

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.

연구 유형

중재적

등록 (실제)

312

단계

  • 3단계

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연구 장소

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

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

50년 이하 (어린이, 성인)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

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

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Regimen A (VDC/IE)

See Design Details.
의약품: Cyclophosphamide

Given IV

다른 이름들:
  • 사이톡산
  • CTX
  • (-)-시클로포스파미드
  • 2H-1,3,2-옥사자포스포린, 2-[비스(2-클로로에틸)아미노]테트라하이드로-, 2-옥사이드, 일수화물
  • 칼록산
  • 시클로포스파미다
  • 시클로포스파마이드
  • 시클록살
  • 클라펜
  • CP 일수화물
  • CYCLO 셀
  • 사이클로블라스틴
  • 사이클로포스팜
  • 사이클로포스파미드 일수화물
  • 사이클로포스파미둠
  • 시클로포스판
  • 사이클로포스판
  • 시클로포스파늄
  • 사이클로스틴
  • 사이토포스판
  • 포스파세론
  • 제녹살
  • 제눅살
  • 레독시나
  • 미톡산
  • 네오사르
  • 리바이뮨
  • 실클로포스파미드
  • WR-138719
  • 아스타 B 518
  • B-518
  • B518
  • WR 138719
  • WR138719
  • 프린도빅스
의약품: Doxorubicin Hydrochloride

Given IV

다른 이름들:
  • 아드리아마이신
  • 5,12-나프타세네디온, 10-[(3-아미노-2,3,6-트리데옥시-알파-L-릭소-헥소피라노실)옥시]-7,8,9,10-테트라히드로-6,8,11-트리히드록시 -8-(히드록시아세틸)-1-메톡시-, 염산염, (8S-cis)-(9CI)
  • ADM
  • 아드리아신
  • 아드리아마이신 염산염
  • 아드리아마이신 PFS
  • 아드리아마이신 RDF
  • 아드리아마이신, 염화수소
  • 아드리블라스티나
  • 아드리블라스틴
  • 아드리메닥
  • 클로리드라토 데 독소루비시나
  • DOX
  • 독소셀
  • 독소렘
  • 독소루비신 HCl
  • 독소루비신.HCl
  • 독소루빈
  • 파미블라스티나
  • FI 106
  • FI-106
  • 하이드록시다우노루비신
  • 루벡스
  • FI106
의약품: Doxorubicin

Given IV

다른 이름들:
  • 아드리아블라스틴
  • 하이드록시다우노마이신
  • 하이드록실 다우노루비신
  • 하이드록실다우노루비신
의약품: Vincristine

Given IV

다른 이름들:
  • VCR
  • 류로크리스틴
  • 빈크리스틴
  • LCR
의약품: Vincristine Sulfate

Given IV

다른 이름들:
  • 온코빈
  • 교크리스틴
  • 류로크리스틴 황산염
  • 류로크리스틴, 설페이트
  • 빈카사르
  • 빈코시드
  • 빈크렉스
  • 빈크리스틴, 설페이트
의약품: Etoposide

Given IV

다른 이름들:
  • 데메틸 에피포도필로톡신 에틸리딘 글루코사이드
  • 에펙
  • 라셋
  • 토포사르
  • 베페시드
  • 부사장 16
  • 부사장 16-213
  • VP-16
  • VP-16-213
  • VP16
  • VP 16213
  • VP-16213
  • VP16213
의약품: Etoposide Phosphate

Given IV

다른 이름들:
  • 에토포포스
방사능: External Beam Radiation Therapy

Undergo EBRT

다른 이름들:
  • EBRT
  • 확실한 방사선 치료
  • 외부 빔 방사
  • 외부 빔 방사선 요법
  • 외부 빔 RT
  • 외부 방사선
  • 외부 방사선 치료
  • 외부 빔 방사선
  • 방사선, 외부 빔
  • 원격방사선 요법
  • 텔레테라피
  • 텔레테라피 방사선
  • 외부 빔 방사선 요법(기존)
의약품: Ifosfamide

Given IV

다른 이름들:
  • 아스타 Z 4942
  • 아스타 Z-4942
  • 싸이포스
  • 홀로산
  • 홀로세인
  • 아이펙스
  • IFO
  • IFO-셀
  • 이폴렘
  • 이포미다
  • 이포마이드
  • 이포스파미둠
  • 이폭산
  • IFX
  • 이포스파미드
  • 이포스파마이드
  • 이소엔독산
  • 이소포스파마이드
  • 미톡사나
  • 엠제이프 9325
  • MJF-9325
  • 낙사마이드
  • 세로미다
  • 트로녹살
  • Z 4942
  • Z-4942
방사능: Stereotactic Radiosurgery

Undergo SBRT

다른 이름들:
  • 정위 외부 빔 조사
  • 정위 외부 빔 방사선 요법
  • 정위 방사선 요법
  • 정위 방사선 수술
  • 정위방사선치료
  • SRS
절차: Therapeutic Surgical Procedure

Undergo surgery
실험적: 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.
의약품: Cyclophosphamide

Given IV

다른 이름들:
  • 사이톡산
  • CTX
  • (-)-시클로포스파미드
  • 2H-1,3,2-옥사자포스포린, 2-[비스(2-클로로에틸)아미노]테트라하이드로-, 2-옥사이드, 일수화물
  • 칼록산
  • 시클로포스파미다
  • 시클로포스파마이드
  • 시클록살
  • 클라펜
  • CP 일수화물
  • CYCLO 셀
  • 사이클로블라스틴
  • 사이클로포스팜
  • 사이클로포스파미드 일수화물
  • 사이클로포스파미둠
  • 시클로포스판
  • 사이클로포스판
  • 시클로포스파늄
  • 사이클로스틴
  • 사이토포스판
  • 포스파세론
  • 제녹살
  • 제눅살
  • 레독시나
  • 미톡산
  • 네오사르
  • 리바이뮨
  • 실클로포스파미드
  • WR-138719
  • 아스타 B 518
  • B-518
  • B518
  • WR 138719
  • WR138719
  • 프린도빅스
의약품: Doxorubicin Hydrochloride

Given IV

다른 이름들:
  • 아드리아마이신
  • 5,12-나프타세네디온, 10-[(3-아미노-2,3,6-트리데옥시-알파-L-릭소-헥소피라노실)옥시]-7,8,9,10-테트라히드로-6,8,11-트리히드록시 -8-(히드록시아세틸)-1-메톡시-, 염산염, (8S-cis)-(9CI)
  • ADM
  • 아드리아신
  • 아드리아마이신 염산염
  • 아드리아마이신 PFS
  • 아드리아마이신 RDF
  • 아드리아마이신, 염화수소
  • 아드리블라스티나
  • 아드리블라스틴
  • 아드리메닥
  • 클로리드라토 데 독소루비시나
  • DOX
  • 독소셀
  • 독소렘
  • 독소루비신 HCl
  • 독소루비신.HCl
  • 독소루빈
  • 파미블라스티나
  • FI 106
  • FI-106
  • 하이드록시다우노루비신
  • 루벡스
  • FI106
의약품: Doxorubicin

Given IV

다른 이름들:
  • 아드리아블라스틴
  • 하이드록시다우노마이신
  • 하이드록실 다우노루비신
  • 하이드록실다우노루비신
의약품: Vincristine

Given IV

다른 이름들:
  • VCR
  • 류로크리스틴
  • 빈크리스틴
  • LCR
의약품: Vincristine Sulfate

Given IV

다른 이름들:
  • 온코빈
  • 교크리스틴
  • 류로크리스틴 황산염
  • 류로크리스틴, 설페이트
  • 빈카사르
  • 빈코시드
  • 빈크렉스
  • 빈크리스틴, 설페이트
의약품: Etoposide

Given IV

다른 이름들:
  • 데메틸 에피포도필로톡신 에틸리딘 글루코사이드
  • 에펙
  • 라셋
  • 토포사르
  • 베페시드
  • 부사장 16
  • 부사장 16-213
  • VP-16
  • VP-16-213
  • VP16
  • VP 16213
  • VP-16213
  • VP16213
의약품: Etoposide Phosphate

Given IV

다른 이름들:
  • 에토포포스
방사능: External Beam Radiation Therapy

Undergo EBRT

다른 이름들:
  • EBRT
  • 확실한 방사선 치료
  • 외부 빔 방사
  • 외부 빔 방사선 요법
  • 외부 빔 RT
  • 외부 방사선
  • 외부 방사선 치료
  • 외부 빔 방사선
  • 방사선, 외부 빔
  • 원격방사선 요법
  • 텔레테라피
  • 텔레테라피 방사선
  • 외부 빔 방사선 요법(기존)
의약품: Ifosfamide

Given IV

다른 이름들:
  • 아스타 Z 4942
  • 아스타 Z-4942
  • 싸이포스
  • 홀로산
  • 홀로세인
  • 아이펙스
  • IFO
  • IFO-셀
  • 이폴렘
  • 이포미다
  • 이포마이드
  • 이포스파미둠
  • 이폭산
  • IFX
  • 이포스파미드
  • 이포스파마이드
  • 이소엔독산
  • 이소포스파마이드
  • 미톡사나
  • 엠제이프 9325
  • MJF-9325
  • 낙사마이드
  • 세로미다
  • 트로녹살
  • Z 4942
  • Z-4942
방사능: Stereotactic Radiosurgery

Undergo SBRT

다른 이름들:
  • 정위 외부 빔 조사
  • 정위 외부 빔 방사선 요법
  • 정위 방사선 요법
  • 정위 방사선 수술
  • 정위방사선치료
  • SRS
절차: Therapeutic Surgical Procedure

Undergo surgery

생물학적: Ganitumab

Given IV

다른 이름들:
  • AMG479
  • 항-IGF-1R 인간 단클론 항체 AMG-479
  • AMG-479

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Event-free Survival
기간: 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

2차 결과 측정

결과 측정
측정값 설명
기간
Overall Survival
기간: 5 years after enrollment

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

기타 결과 측정

결과 측정
측정값 설명
기간
Serum IGF Pathway Component and Tissue Protein, Deoxyribonucleic Acid (DNA), and Ribonucleic Acid Markers
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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)
기간: 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

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

National Cancer Institute (NCI)

수사관

  • 수석 연구원: Steven G DuBois, Children's Oncology Group

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

일반 간행물

유용한 링크

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2014년 12월 12일

기본 완료 (실제)

2021년 3월 31일

연구 완료 (추정된)

2027년 9월 16일

연구 등록 날짜

최초 제출

2014년 12월 1일

QC 기준을 충족하는 최초 제출

2014년 12월 1일

처음 게시됨 (추정된)

2014년 12월 3일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 10월 22일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 10월 21일

마지막으로 확인됨

2026년 9월 1일

추가 정보

이 연구와 관련된 용어

추가 관련 MeSH 약관

기타 연구 ID 번호

  • NCI-2014-02380
  • U10CA180886 (미국 NIH 보조금/계약)
  • U10CA098543 (미국 NIH 보조금/계약)
  • NCI-2014-02380 (레지스트리 식별자: CTRP (Clinical Trial Reporting Program))
  • AEWS1221 (기타 식별자: CTEP)
  • s15-00442
  • AEWS1221
  • AEWS1221 (기타 식별자: Children's Oncology Group)

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

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