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Kombinasjonskjemoterapi med eller uten Ganitumab ved behandling av pasienter med nylig diagnostisert metastatisk Ewing-sarkom

21. oktober 2026 oppdatert av: National Cancer Institute (NCI)

Randomisert fase 3-studie som evaluerer tillegget av det monoklonale IGF-1R-antistoffet Ganitumab (AMG 479, NSC# 750008) til multiagent kjemoterapi for pasienter med nylig diagnostisert metastatisk Ewing-sarkom

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

Studieoversikt

Status

Aktiv, ikke rekrutterende

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Faktiske)

312

Fase

  • Fase 3

Kontakter og plasseringer

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Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

Ikke eldre enn 50 år (Barn, Voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Regimen A (VDC/IE)

See Design Details.
Legemiddel: Cyclophosphamide

Given IV

Andre navn:
  • Cytoksan
  • CTX
  • (-)-cyklofosfamid
  • 2H-1,3,2-oksazafosforin, 2-[bis(2-kloretyl)amino]tetrahydro-, 2-oksid, monohydrat
  • Carloxan
  • Ciclofosfamida
  • Ciklofosfamid
  • Cicloxal
  • Clafen
  • Claphene
  • CP monohydrat
  • CYCLO-celle
  • Sykloblastin
  • Cyclofosfam
  • Cyklofosfamid monohydrat
  • Cyclophosphamidum
  • Syklofosfan
  • Cyclophosphanum
  • Syklostin
  • Cytofosfan
  • Fosfaseron
  • Genoxal
  • Genuxal
  • Ledoxina
  • Mitoxan
  • Neosar
  • Revimmune
  • Syklofosfamid
  • WR- 138719
  • Asta B 518
  • B-518
  • WR-138719
  • B 518
  • B518
  • WR 138719
  • WR138719
  • Frindovyx
Legemiddel: Doxorubicin Hydrochloride

Given IV

Andre navn:
  • Adriamycin
  • 5,12-naftacendion, 10-[(3-amino-2,3,6-trideoksy-alfa-L-lyxo-heksopyranosyl)oksy]-7,8, 9,10-tetrahydro-6,8,11-trihydroksy -8-(hydroksyacetyl)-1-metoksy-, hydroklorid, (8S-cis)- (9Cl)
  • ADM
  • Adriacin
  • Adriamycin hydroklorid
  • Adriamycin PFS
  • Adriamycin RDF
  • ADRIAMYCIN, HYDROKLORID
  • Adriblastina
  • Adriblastin
  • Adrimedac
  • Chloridrato de Doxorrubicina
  • DOX
  • DOXO-CELL
  • Doxolem
  • Doxorubicin HCl
  • Doxorubicin.HCl
  • Doxorubin
  • Farmiblastina
  • FI 106
  • FI-106
  • hydroksydaunorubicin
  • Rubex
  • FI106
Legemiddel: Doxorubicin

Given IV

Andre navn:
  • Adriablastin
  • Hydroxydaunomycin
  • Hydroxyl Daunorubicin
  • Hydroxyldaunorubicin
Legemiddel: Vincristine

Given IV

Andre navn:
  • VCR
  • Leurocristine
  • Vincrystine
  • LCR
Legemiddel: Vincristine Sulfate

Given IV

Andre navn:
  • Oncovin
  • Kyocristine
  • Leurocristine Sulfate
  • Leurocristine, sulfat
  • Vincasar
  • Vincosid
  • Vincrex
  • Vinkristin, sulfat
Legemiddel: Etoposide

Given IV

Andre navn:
  • Demetyl Epipodofyllotoksin Ethylidin Glucoside
  • EPEG
  • Lastet
  • Toposar
  • Vepesid
  • VP 16
  • VP 16-213
  • VP-16
  • VP-16-213
  • VP16
  • VP 16213
  • VP-16213
  • VP16213
Legemiddel: Etoposide Phosphate

Given IV

Andre navn:
  • Etopophos
Stråling: External Beam Radiation Therapy

Undergo EBRT

Andre navn:
  • EBRT
  • Definitiv strålebehandling
  • Ekstern strålestråling
  • Ekstern strålebehandling
  • Ekstern Beam RT
  • ekstern stråling
  • ekstern strålestråling
  • Stråling, ekstern stråle
  • Teleradioterapi
  • Teleterapi
  • Teleterapi stråling
  • Ekstern strålebehandling (konvensjonell)
Legemiddel: Ifosfamide

Given IV

Andre navn:
  • Asta Z 4942
  • Asta Z-4942
  • Cyfos
  • Holoxan
  • Holoksan
  • Ifex
  • IFO
  • IFO-celle
  • Ifolem
  • Ifomida
  • Ifomide
  • Ifosfamidum
  • Ifoxan
  • IFX
  • Iphosphamid
  • Ifosfamid
  • Iso-endoxan
  • Isoendoksan
  • Isofosfamid
  • Mitoxana
  • MJF 9325
  • MJF-9325
  • Naxamid
  • Seromida
  • Tronoxal
  • Z 4942
  • Z-4942
Stråling: Stereotactic Radiosurgery

Undergo SBRT

Andre navn:
  • Stereotaktisk ekstern strålebestråling
  • stereotaktisk ekstern strålebehandling
  • Stereotaktisk strålebehandling
  • stereotaksisk strålebehandling
  • stereotaksisk radiokirurgi
  • SRS
Fremgangsmåte: Therapeutic Surgical Procedure

Undergo surgery
Eksperimentell: 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.
Legemiddel: Cyclophosphamide

Given IV

Andre navn:
  • Cytoksan
  • CTX
  • (-)-cyklofosfamid
  • 2H-1,3,2-oksazafosforin, 2-[bis(2-kloretyl)amino]tetrahydro-, 2-oksid, monohydrat
  • Carloxan
  • Ciclofosfamida
  • Ciklofosfamid
  • Cicloxal
  • Clafen
  • Claphene
  • CP monohydrat
  • CYCLO-celle
  • Sykloblastin
  • Cyclofosfam
  • Cyklofosfamid monohydrat
  • Cyclophosphamidum
  • Syklofosfan
  • Cyclophosphanum
  • Syklostin
  • Cytofosfan
  • Fosfaseron
  • Genoxal
  • Genuxal
  • Ledoxina
  • Mitoxan
  • Neosar
  • Revimmune
  • Syklofosfamid
  • WR- 138719
  • Asta B 518
  • B-518
  • WR-138719
  • B 518
  • B518
  • WR 138719
  • WR138719
  • Frindovyx
Legemiddel: Doxorubicin Hydrochloride

Given IV

Andre navn:
  • Adriamycin
  • 5,12-naftacendion, 10-[(3-amino-2,3,6-trideoksy-alfa-L-lyxo-heksopyranosyl)oksy]-7,8, 9,10-tetrahydro-6,8,11-trihydroksy -8-(hydroksyacetyl)-1-metoksy-, hydroklorid, (8S-cis)- (9Cl)
  • ADM
  • Adriacin
  • Adriamycin hydroklorid
  • Adriamycin PFS
  • Adriamycin RDF
  • ADRIAMYCIN, HYDROKLORID
  • Adriblastina
  • Adriblastin
  • Adrimedac
  • Chloridrato de Doxorrubicina
  • DOX
  • DOXO-CELL
  • Doxolem
  • Doxorubicin HCl
  • Doxorubicin.HCl
  • Doxorubin
  • Farmiblastina
  • FI 106
  • FI-106
  • hydroksydaunorubicin
  • Rubex
  • FI106
Legemiddel: Doxorubicin

Given IV

Andre navn:
  • Adriablastin
  • Hydroxydaunomycin
  • Hydroxyl Daunorubicin
  • Hydroxyldaunorubicin
Legemiddel: Vincristine

Given IV

Andre navn:
  • VCR
  • Leurocristine
  • Vincrystine
  • LCR
Legemiddel: Vincristine Sulfate

Given IV

Andre navn:
  • Oncovin
  • Kyocristine
  • Leurocristine Sulfate
  • Leurocristine, sulfat
  • Vincasar
  • Vincosid
  • Vincrex
  • Vinkristin, sulfat
Legemiddel: Etoposide

Given IV

Andre navn:
  • Demetyl Epipodofyllotoksin Ethylidin Glucoside
  • EPEG
  • Lastet
  • Toposar
  • Vepesid
  • VP 16
  • VP 16-213
  • VP-16
  • VP-16-213
  • VP16
  • VP 16213
  • VP-16213
  • VP16213
Legemiddel: Etoposide Phosphate

Given IV

Andre navn:
  • Etopophos
Stråling: External Beam Radiation Therapy

Undergo EBRT

Andre navn:
  • EBRT
  • Definitiv strålebehandling
  • Ekstern strålestråling
  • Ekstern strålebehandling
  • Ekstern Beam RT
  • ekstern stråling
  • ekstern strålestråling
  • Stråling, ekstern stråle
  • Teleradioterapi
  • Teleterapi
  • Teleterapi stråling
  • Ekstern strålebehandling (konvensjonell)
Legemiddel: Ifosfamide

Given IV

Andre navn:
  • Asta Z 4942
  • Asta Z-4942
  • Cyfos
  • Holoxan
  • Holoksan
  • Ifex
  • IFO
  • IFO-celle
  • Ifolem
  • Ifomida
  • Ifomide
  • Ifosfamidum
  • Ifoxan
  • IFX
  • Iphosphamid
  • Ifosfamid
  • Iso-endoxan
  • Isoendoksan
  • Isofosfamid
  • Mitoxana
  • MJF 9325
  • MJF-9325
  • Naxamid
  • Seromida
  • Tronoxal
  • Z 4942
  • Z-4942
Stråling: Stereotactic Radiosurgery

Undergo SBRT

Andre navn:
  • Stereotaktisk ekstern strålebestråling
  • stereotaktisk ekstern strålebehandling
  • Stereotaktisk strålebehandling
  • stereotaksisk strålebehandling
  • stereotaksisk radiokirurgi
  • SRS
Fremgangsmåte: Therapeutic Surgical Procedure

Undergo surgery

Biologisk: Ganitumab

Given IV

Andre navn:
  • AMG 479
  • Anti-IGF-1R humant monoklonalt antistoff AMG-479
  • AMG-479
  • AMG479

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Event-free Survival
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Overall Survival
Tidsramme: 5 years after enrollment

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

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Serum IGF Pathway Component and Tissue Protein, Deoxyribonucleic Acid (DNA), and Ribonucleic Acid Markers
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

National Cancer Institute (NCI)

Etterforskere

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

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Hjelpsomme linker

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

12. desember 2014

Primær fullføring (Faktiske)

31. mars 2021

Studiet fullført (Antatt)

16. september 2027

Datoer for studieregistrering

Først innsendt

1. desember 2014

Først innsendt som oppfylte QC-kriteriene

1. desember 2014

Først lagt ut (Antatt)

3. desember 2014

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

22. oktober 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

21. oktober 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • NCI-2014-02380
  • U10CA180886 (U.S. NIH-stipend/kontrakt)
  • U10CA098543 (U.S. NIH-stipend/kontrakt)
  • NCI-2014-02380 (Registeridentifikator: CTRP (Clinical Trial Reporting Program))
  • AEWS1221 (Annen identifikator: CTEP)
  • s15-00442
  • AEWS1221
  • AEWS1221 (Annen identifikator: Children's Oncology Group)

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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