- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT00003203
Carboplatin and Vincristine Plus Radiation Therapy Followed By Adjuvant Chemotherapy in Treating Young Patients With Newly Diagnosed CNS Embryonal Tumors
An Intergroup Pilot Study of Concurrent Carboplatin, Vincristine and Radiotherapy Followed by Adjuvant Chemotherapy in Patients With Newly Diagnosed High-Risk Central Nervous System Embryonal Tumors
RATIONALE: Drugs used in chemotherapy, such as carboplatin and vincristine, work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining carboplatin and vincristine with radiation therapy followed by adjuvant chemotherapy may kill more tumor cells.
PURPOSE: Randomized phase II trial to study the effectiveness of combination chemotherapy plus radiation therapy followed adjuvant chemotherapy in treating young patients who have newly diagnosed high-risk CNS embryonal tumors.
Studieöversikt
Status
Betingelser
Detaljerad beskrivning
OBJECTIVES:
- Determine the feasible dose and duration of carboplatin combined with craniospinal and local radiotherapy and adjuvant chemotherapy in children with newly diagnosed, high-risk CNS embryonal tumors (Phase I completed as of 11-25-03).
- Determine the feasibility of administering cyclophosphamide and vincristine with or without cisplatin after concurrent carboplatin, vincristine, and radiotherapy in these patients.
- Determine the overall and individual toxicity rates of this regimen in these patients.
- Determine the complete response rate in patients treated with this regimen.
- Obtain preliminary estimates of event-free survival of patients treated with this regimen.
- Determine the prognostic significance of enhancing tumor after completion of radiotherapy on event-free survival of these patients.
OUTLINE: This is a pilot, dose-escalation study of carboplatin. (Phase I completed as of 11-25-03.)
Within 31 days of definitive surgery, all patients receive vincristine IV weekly for 6 weeks and carboplatin IV over 15-20 minutes (after completion of vincristine infusion) 5 days a week for 6 weeks. Patients undergo radiotherapy (1-4 hours after carboplatin infusion) 5 days a week for 6 weeks.
Cohorts of 6-12 patients receive escalating doses of carboplatin until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose at which no more than 3 of 12 patients experience dose-limiting toxicity. (Phase I completed as of 11-25-03.)
At 6 weeks after completion of radiotherapy, patients are assigned to arm II for adjuvant/maintenance chemotherapy. (Arm I closed to accrual as of 11-25-03.)
- Arm I (closed to accrual as of 11-25-03): Patients receive cyclophosphamide IV over 1 hour on days 0 and 1, vincristine IV on days 0 and 7, and filgrastim (G-CSF) IV or subcutaneously (SC) beginning on day 2 and continuing for at least 10 days until blood counts recover.
- Arm II: Patients receive cyclophosphamide IV over 1 hour on days 1 and 2, vincristine IV on days 0 and 7, cisplatin IV over 6 hours on day 0, and G-CSF IV or SC beginning on day 3 and continuing for at least 10 days until blood counts recover.
In both arms, adjuvant/maintenance chemotherapy repeats every 4 weeks for 6 courses.
Patients are followed every 3 months for 8 months, every 4 months for 1 year, every 6 months for 2 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 162 patients will be accrued for this study.
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 2
Kontakter och platser
Studieorter
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Western Australia
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Perth, Western Australia, Australien, 6001
- Princess Margaret Hospital for Children
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California
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Long Beach, California, Förenta staterna, 90806
- Long Beach Memorial Medical Center
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Los Angeles, California, Förenta staterna, 90095-1781
- Jonsson Comprehensive Cancer Center, UCLA
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Los Angeles, California, Förenta staterna, 90027-0700
- Children's Hospital Los Angeles
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Orange, California, Förenta staterna, 92668
- Children's Hospital of Orange County
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San Francisco, California, Förenta staterna, 94115-0128
- UCSF Cancer Center and Cancer Research Institute
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Colorado
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Denver, Colorado, Förenta staterna, 80218
- Children's Hospital of Denver
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District of Columbia
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Washington, District of Columbia, Förenta staterna, 20010-2970
- Children's National Medical Center
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Illinois
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Chicago, Illinois, Förenta staterna, 60637
- University of Chicago Cancer Research Center
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Indiana
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Indianapolis, Indiana, Förenta staterna, 46202-5265
- Indiana University Cancer Center
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Iowa
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Iowa City, Iowa, Förenta staterna, 52242
- University of Iowa Hospitals and Clinics
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Michigan
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Ann Arbor, Michigan, Förenta staterna, 48109-0752
- University of Michigan Comprehensive Cancer Center
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Kalamazoo, Michigan, Förenta staterna, 49007-3731
- CCOP - Kalamazoo
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Minnesota
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Minneapolis, Minnesota, Förenta staterna, 55455
- University of Minnesota Cancer Center
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Rochester, Minnesota, Förenta staterna, 55905
- Mayo Clinic Cancer Center
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Missouri
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Kansas City, Missouri, Förenta staterna, 64108
- Children's Mercy Hospital
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Nebraska
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Omaha, Nebraska, Förenta staterna, 68198-3330
- University of Nebraska Medical Center
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New Jersey
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Paterson, New Jersey, Förenta staterna, 07503
- St. Joseph's Hospital and Medical Center
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New York
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New York, New York, Förenta staterna, 10021
- Memorial Sloan-Kettering Cancer Center
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New York, New York, Förenta staterna, 10016
- NYU School of Medicine's Kaplan Comprehensive Cancer Center
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New York, New York, Förenta staterna, 10032
- Herbert Irving Comprehensive Cancer Center
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North Carolina
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Chapel Hill, North Carolina, Förenta staterna, 27599-7295
- Lineberger Comprehensive Cancer Center, UNC
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North Dakota
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Fargo, North Dakota, Förenta staterna, 58122
- CCOP - Merit Care Hospital
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Ohio
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Cincinnati, Ohio, Förenta staterna, 45229-3039
- Children's Hospital Medical Center - Cincinnati
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Cleveland, Ohio, Förenta staterna, 44106-5065
- Ireland Cancer Center
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Columbus, Ohio, Förenta staterna, 43205-2696
- Children's Hospital of Columbus
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Oregon
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Portland, Oregon, Förenta staterna, 97201-3098
- Doernbecher Children's Hospital
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Pennsylvania
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Philadelphia, Pennsylvania, Förenta staterna, 19104
- Children's Hospital of Philadelphia
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Philadelphia, Pennsylvania, Förenta staterna, 19104
- University of Pennsylvania Cancer Center
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Pittsburgh, Pennsylvania, Förenta staterna, 15213
- Children's Hospital of Pittsburgh
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Tennessee
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Nashville, Tennessee, Förenta staterna, 37232-6838
- Vanderbilt Cancer Center
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Texas
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Houston, Texas, Förenta staterna, 77030
- University of Texas - MD Anderson Cancer Center
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Utah
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Salt Lake City, Utah, Förenta staterna, 84132
- Huntsman Cancer Institute
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Washington
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Seattle, Washington, Förenta staterna, 98109
- Fred Hutchinson Cancer Research Center
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Seattle, Washington, Förenta staterna, 98105
- Children's Hospital and Regional Medical Center - Seattle
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Wisconsin
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Madison, Wisconsin, Förenta staterna, 53792
- University of Wisconsin Comprehensive Cancer Center
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British Columbia
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Vancouver, British Columbia, Kanada, V6H 3V4
- British Columbia Children's Hospital
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Nova Scotia
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Halifax, Nova Scotia, Kanada, B3J 3G9
- IWK Grace Health Centre
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
DISEASE CHARACTERISTICS:
Histologically proven high-risk CNS embryonal tumors, including:
- Primitive neuroectodermal tumors
- Atypical teratoid/rhabdoid tumor
- Medulloblastoma
- Desmoplastic medulloblastoma
- Ependymoblastoma
- Medullomyoblastoma
- Spongioblastoma
- Spongioblastoma polare
- Primitive polar spongioblastoma
- Neuroepitheliomatous neoplasms
- Medulloepithelioma
- Neuroblastoma
- Pineoblastoma
- No bone marrow involvement or bone metastases
- No M4 disease
- M3 disease must have evidence of tumor on spinal MRI
PATIENT CHARACTERISTICS:
Age:
- 3 to 21 at diagnosis
Performance status:
- Not specified
Life expectancy:
- At least 8 weeks
Hematopoietic:
- Absolute neutrophil count greater than 1,500/mm^3
- Platelet count at least 100,000/mm^3 (transfusion independent)
- Hemoglobin at least 10.0 g/dL (packed red blood cell transfusions allowed)
Hepatic:
- Bilirubin less than 1.5 mg/dL
- SGOT/SGPT less than 2.5 times normal
Renal:
- Creatinine less than 1.5 times upper limit of normal OR
- Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- Not specified
Chemotherapy:
- No prior chemotherapy
Endocrine therapy:
- Not specified
Radiotherapy:
- No prior radiotherapy
Surgery:
- Prior definitive surgery allowed
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: N/A
- Interventionsmodell: Enskild gruppuppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
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Experimentell: Newly diagnosed cerebral PNET with histologic verification
Begin therapy within 31 days of surgery.
Radiation therapy will be given in standard fractions along with filgrastim.
The craniospinal axis will be treated first.
Patients will receive carboplatin at 35 mg/m2/day IV over 15-20 minutes Monday through Friday, 1-4 hours prior to radiation for 6 weeks (total of 30 doses).
Vincristine sulfate 1.5 mg/m2 IV will be given weekly x 6.
Following radiation, patients will receive Maintenance chemotherapy.
Patients enrolled prior to Amendment #5 will receive six cycles of cyclophosphamide and vincristine (Regimen A).
Patients enrolled after Amendment #5 will receive six cycles of cyclophosphamide, vincristine sulfate and cisplatin (Regimen B).
|
Givet IV
Andra namn:
Givet IV
Andra namn:
Givet IV
Andra namn:
Givet IV
Andra namn:
Givet IV
Andra namn:
1.8 Gy/fx x 20fx=36Gy Craniospinal XRT*
Andra namn:
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Event Free Survival
Tidsram: Length of study
|
Minimum time to disease progression or recurrence, time to death for any reason, or time to occurrence of a second malignant neoplasm (SMN).
|
Length of study
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Survival
Tidsram: Length of study
|
Time to death from any cause
|
Length of study
|
Samarbetspartners och utredare
Sponsor
Samarbetspartners
Utredare
- Studiestol: Regina Jakacki, MD, University of Pittsburgh
Publikationer och användbara länkar
Allmänna publikationer
- Jakacki RI, Burger PC, Zhou T, Holmes EJ, Kocak M, Onar A, Goldwein J, Mehta M, Packer RJ, Tarbell N, Fitz C, Vezina G, Hilden J, Pollack IF. Outcome of children with metastatic medulloblastoma treated with carboplatin during craniospinal radiotherapy: a Children's Oncology Group Phase I/II study. J Clin Oncol. 2012 Jul 20;30(21):2648-53. doi: 10.1200/JCO.2011.40.2792. Epub 2012 Jun 4.
- Jakacki R, Burger P, Zhou T, et al.: Outcome for metastatic (M+) medulloblastoma (MB) treated with carboplatin during craniospinal radiotherapy (CSRT) followed by cyclophosphamide (CPM) and vincristine (VCR): preliminary results of COG 99701. [Abstract] J Clin Oncol 25 (Suppl 18): A-2017, 2007.
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- Sjukdomar i nervsystemet
- Neoplasmer efter histologisk typ
- Neoplasmer efter plats
- Neoplasmer, körtel och epitel
- Neoplasmer, neuroepitelial
- Neuroektodermala tumörer
- Neoplasmer, könsceller och embryonala
- Neoplasmer, nervvävnad
- Neuroektodermala tumörer, primitiva
- Neuroektodermala tumörer, primitiva, perifera
- Neoplasmer
- Neoplasmer i nervsystemet
- Neoplasmer i centrala nervsystemet
- Neuroblastom
- Läkemedels fysiologiska effekter
- Molekylära mekanismer för farmakologisk verkan
- Antireumatiska medel
- Antineoplastiska medel
- Immunsuppressiva medel
- Immunologiska faktorer
- Tubulin modulatorer
- Antimitotiska medel
- Mitosmodulatorer
- Antineoplastiska medel, Alkylering
- Alkyleringsmedel
- Myeloablativa agonister
- Antineoplastiska medel, fytogena
- Cyklofosfamid
- Karboplatin
- Cisplatin
- Vincristine
Andra studie-ID-nummer
- A9971
- COG-A9971 (Annan identifierare: Children's Oncology Group)
- CCG-99701 (Annan identifierare: Children's Cancer Group)
- CDR0000066055 (Annan identifierare: Clinical Trials.gov)
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .
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