Study Assessing the Feasibility of a Surgery and Chemotherapy-Only in Children With Wnt Positive Medulloblastoma

NCT ID: NCT02212574

Last Updated: 2021-11-05

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

EARLY_PHASE1

Total Enrollment

6 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-04-04

Study Completion Date

2018-11-09

Brief Summary

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Participants enrolling on this study will receive standard of care chemotherapy for Wnt positive medulloblastoma without the radiation therapy or the weekly chemotherapy that is given during radiation therapy.

Detailed Description

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There will be 9 cycles of chemotherapy. There are two different kinds of cycles given. They are referred to as A and B.

Cycle A lasts for 6 weeks and Cycle B lasts for 4 weeks. B cycles are given after the completion of two A cycles.

Below are the details of the drugs and schedules for A and B cycles.

Cycle A (This cycle lasts 42 days)

* Lomustine (CCNU) is given by mouth on Day 1.
* Vincristine is given directly into a vein (IV) over one minute or using a minibag over several minutes by some institutions on Days 1, 8, and 15.
* Cisplatin is given directly into a vein over 8 hours on Day 1

Cycle B (This cycle lasts 28 days)

* Cyclophosphamide is given into a vein over 1 hour on Days 1 and 2.
* MESNA, a drug to protect the bladder from the effects of cyclophosphamide, will be given 15 minutes before each dose of cyclophosphamide and repeated at 3 and 6 hours.
* Vincristine is given directly into a vein directly into the vein (IV) over one minute or using a minibag over several minutes by some institutions on Days 1 and 8.

You may also get a supportive care drug called a myeloid growth factor (filgrastim or pegfilgrastim). This drug will help your blood counts recover after the chemotherapy is given.

Conditions

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Medulloblastoma

Keywords

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Wnt Medulloblastoma Chemotherapy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Chemotherapy

Chemotherapy Cycle A Lomustine (CCNU) is given by mouth on Day 1. Vincristine is given directly into a vein (IV) over one minute or using a minibag over several minutes by some institutions on Days 1, 8, and 15. Cisplatin is given directly into a vein over 8 hours on Day 1. This cycle lasts 42 days.

Chemotherapy Cycle B Cyclophosphamide is given into a vein over 1 hour on Days 1 and 2. MESNA, a drug to protect the bladder from the effects of cyclophosphamide, will be given 15 minutes before each dose of cyclophosphamide and repeated at 3 and 6 hours. Vincristine is given directly into a vein directly into the vein (IV) over one minute or using a minibag over several minutes by some institutions on Days 1 and 8.This cycle lasts 28 days

Group Type OTHER

Lomustine

Intervention Type DRUG

Chemotherapy Cycle A Lomustine (CCNU) is given by mouth on Day 1.

Vincristine

Intervention Type DRUG

Chemotherapy Cycle A Vincristine is given directly into a vein (IV) over one minute or using a minibag over several minutes by some institutions on Days 1, 8, and 15.

Cisplatin

Intervention Type DRUG

Chemotherapy Cycle A Cisplatin is given directly into a vein over 8 hours on Day 1.

Cyclophosphamide

Intervention Type DRUG

Chemotherapy Cycle B Cyclophosphamide is given into a vein over 1 hour on Days 1 and 2.

Mesna

Intervention Type DRUG

Chemotherapy Cycle B MESNA, a drug to protect the bladder from the effects of cyclophosphamide, will be given 15 minutes before each dose of cyclophosphamide and repeated at 3 and 6 hours.

Vincristine

Intervention Type DRUG

Chemotherapy Cycle B Vincristine is given directly into a vein directly into the vein (IV) over one minute or using a minibag over several minutes by some institutions on Days 1 and 8.

Interventions

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Lomustine

Chemotherapy Cycle A Lomustine (CCNU) is given by mouth on Day 1.

Intervention Type DRUG

Vincristine

Chemotherapy Cycle A Vincristine is given directly into a vein (IV) over one minute or using a minibag over several minutes by some institutions on Days 1, 8, and 15.

Intervention Type DRUG

Cisplatin

Chemotherapy Cycle A Cisplatin is given directly into a vein over 8 hours on Day 1.

Intervention Type DRUG

Cyclophosphamide

Chemotherapy Cycle B Cyclophosphamide is given into a vein over 1 hour on Days 1 and 2.

Intervention Type DRUG

Mesna

Chemotherapy Cycle B MESNA, a drug to protect the bladder from the effects of cyclophosphamide, will be given 15 minutes before each dose of cyclophosphamide and repeated at 3 and 6 hours.

Intervention Type DRUG

Vincristine

Chemotherapy Cycle B Vincristine is given directly into a vein directly into the vein (IV) over one minute or using a minibag over several minutes by some institutions on Days 1 and 8.

Intervention Type DRUG

Other Intervention Names

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CCNU Oncovin Cisplatinum Cytoxan Mesnex Oncovin

Eligibility Criteria

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Inclusion Criteria

* Participants must have classical histology posterior fossa medulloblastoma as determined by institutional neuro-pathological evaluation.
* Sufficient pathologic material must be available for central analysis and review
* Tumors will be deemed Wnt positive if, at the time of central analysis, there is:
* Monosomy 6 as determined by array CGH
* Gene transcript detection by NanoString supporting Wnt+ medulloblastoma
* Absence of large-cell, anaplastic histology
* Nuclear b-catenin IHC will be determined, but not required for the diagnosis
* Absence of residual or disseminated disease as defined by the following criteria: Minimal residual disease as determined by post-operative imaging preferably performed within 48 hours of resection (and at most 28 days post-surgery), i.e. gross total resection or residual disease of \<1.5cm2 on post-operative imaging.

No evidence of metastatic disease in the brain, spine or cerebral spinal fluid (CSF). Assessments must include MRI imaging of the brain and spine with and without contrast and a lumbar puncture for CSF cytology

* Diagnostic imaging (pre and post contrast) must be forwarded to Dana-Farber Cancer Institute (DFCI) for central review to confirm eligibility
* Patients must not have had any radiation therapy or chemotherapy for medulloblastoma prior to study enrollment
* Patients must have a Lansky performance status of \>/=30 for children \</=10 years of age or a Karnofsky performance status of \> 30 for children \> 10 years of age.
* Participants must have normal organ and marrow function as defined below:
* Hemoglobin greater than 10 g/dL (can be transfused). Hemoglobin \<10 g/dL due to operative blood loss is permitted.
* Absolute neutrophil count \> 1.0x109/L
* Platelets \> 100,000/uL (non-transfused)
* Total bilirubin \<1.5 x upper limit normal
* SGOT (AST) or SGPT (ALT) \<2.5 x upper limit normal (ULN) for age
* Creatinine clearance or radioisotope GFR \>70 ml/min/1.73m2 or normal serum creatinine for patient's age and gender
* All females of child-bearing age must have a negative pregnancy test before being enrolled on study. All patients of child-bearing age must practice an effective method of birth control whilst undergoing chemotherapy on study.
* No history of allergic reactions attributed to compounds of similar chemical or biologic composition to cisplatin, lomustine, vincristine or cyclophosphamide.
Minimum Eligible Age

3 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Matthew Larson Foundation for Pediatric Brain Tumors

OTHER

Sponsor Role collaborator

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kenneth Cohen, MD

Role: STUDY_CHAIR

Johns Hopkins University

Locations

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Phoenix Childrens Hospital Hematology/Oncology

Phoenix, Arizona, United States

Site Status

Children's Hospital Colorado Center for Cancer & Blood Disorders

Aurora, Colorado, United States

Site Status

M D Anderson Cancer Center-Orlando Pediatric Hematology/Oncology

Orlando, Florida, United States

Site Status

All Children's Hospital Pediatric Hematology/Oncology

St. Petersburg, Florida, United States

Site Status

Children's Healthcare of Atlanta- Egleston Pediatric Neuro-Oncology

Atlanta, Georgia, United States

Site Status

Ann and Robert H Lurie Children's Hospital of Chicago Hematology/Oncology

Chicago, Illinois, United States

Site Status

Johns Hopkins University

Baltimore, Maryland, United States

Site Status

Dana-Farber Cancer Institute

Boston, Massachusetts, United States

Site Status

Washington University School of Medicine Pediatric Hematology/Oncology

St Louis, Missouri, United States

Site Status

Hackensack University Medical Center

Hackensack, New Jersey, United States

Site Status

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Nationwide Children's Hospital

Columbus, Ohio, United States

Site Status

Oregon Health and Science University Pediatric Hematology/Oncology

Portland, Oregon, United States

Site Status

Seattle Children's Hospital Hematology/Oncology

Seattle, Washington, United States

Site Status

Childrens Hospital of Wisconsin (Medical College of Wisconsin)

Milwaukee, Wisconsin, United States

Site Status

Countries

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Canada Spain United Kingdom United States

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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NA_00091840

Identifier Type: OTHER

Identifier Source: secondary_id

J1403

Identifier Type: -

Identifier Source: org_study_id