Irinotecan and Temozolomide for Ewing Sarcoma

NCT ID: NCT03359005

Last Updated: 2022-11-01

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: PHASE2
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-02-07
• Study Completion Date: 2025-02-28

Brief Summary

The investigators explored the activity of vincristine and irinotecan combined with temozolomide (VIT) in patients with relapsed and metastatic Ewing Sarcoma.

Detailed Description

After standard multimodal therapy, the prognosis of relapsed and metastatic Ewing Sarcoma is dismal and unchanged over the last decades. The anti-tumor activity of VIT was demonstrated by several studies in the past. However, the detailed schedule of VIT was not decided. Thus, the investigators explored the activity of 5-d shorter schedule of VIT and 5-d x2w longer schedule of VIT in patients with relapsed and metastatic Ewing Sarcoma after the failure of first-line chemotherapy with doxorubicin, vincristine, cyclophosphamide, ifosphamide and etoposide.

Conditions

Ewing Sarcoma

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

5d VIT (irinotecan, temozolomide and vincristine)

Irinotecan 50mg/m2/d IV over 60 minutes on days 1-5.

Treatment repeats every 3 weeks for at least 2 courses in the absence of disease progression or unacceptable toxicity.

Group Type: EXPERIMENTAL

Vincristine

Intervention Type: DRUG

vincristine 1.5mg/m2 iv D1,D8

Temozolomide

Intervention Type: DRUG

Temozolomide 100mg/m2/d iv on days 1-5.

5d x 2 VIT (irinotecan, temozolomide and vincristine)

Irinotecan 20mg/m2/d IV over 60 minutes on days 1-5 and 8-12.

Treatment repeats every 3 weeks for at least 2 courses in the absence of disease progression or unacceptable toxicity.

Group Type: ACTIVE_COMPARATOR

Vincristine

Intervention Type: DRUG

vincristine 1.5mg/m2 iv D1,D8

Temozolomide

Intervention Type: DRUG

Temozolomide 100mg/m2/d iv on days 1-5.

Interventions

Vincristine

vincristine 1.5mg/m2 iv D1,D8

Intervention Type: DRUG

Temozolomide

Temozolomide 100mg/m2/d iv on days 1-5.

Intervention Type: DRUG

Other Intervention Names

VCR; Temodar

Eligibility Criteria

Inclusion Criteria

• Histologically confirmed Ewing sarcoma.
• Evidence of Ewing sarcoma translocation by fluorescence in situ hybridization (FISH) or real-time polymerase chain reaction (RT-PCT).
• Recurrent or refractory tumors with no known curative treatment options according to the judgment of the investigator.
• Prior treatment consisted of standard Ewing Sarcoma chemotherapy agents including doxorubicin, vincristine, cyclophosphamide, ifosfamide and etoposide; metastatic relapsed and unresectable progressive disease (PD);
• Life expectancy of ≥ 3 months.
• Eastern Cooperative Oncology Group performance status 0-1
• Measurable disease on CT or MRI by RECIST 1.1.
• Adequate organ function.
• Time elapsed from previous therapy must be ≥ 3 weeks for systemic therapy, ≥ 2 weeks for radiation therapy or major surgery.
• Patients who have undergone autologous hematopoietic stem cell transplantation are eligible once they have recovered from all toxicities from therapy.
• Patients who have received allogeneic hematopoietic stem cell transplantation will be eligible 6 months after the procedure provided there is no evidence of active graft-versus-host disease and immunosuppressive treatment has been discontinued for at least 30 days.
• Patients with central nervous system disease are eligible for enrollment if they have received prior radiotherapy or surgery to sites of central nervous system metastatic disease, have been off glucocorticoids for at least 4 weeks, have no overt evidence of neurological deficit and are ≥ 6 weeks from completion of brain irradiation.
• Females of childbearing potential as well as males and their partners must agree to use an effective form of contraception during the study and for 6 months following the last dose of study medication.

Exclusion Criteria

• Clinically significant unrelated illness which would, in the judgment of the treating physician, compromise the patient's ability to tolerate the investigational agent or be likely to interfere with the study procedures or results.
• Patients with baseline corrected QT interval(QTc) > 480 msec.
• Known hypersensitivity to any of the components of niraparib or prior hypersensitivity reactions to that class of drugs.
• Known hypersensitivity reaction to temozolomide or any of its components, or dacarbazine (DTIC) or any of its components, and irinotecan or any of its components.
• Concomitant use of any other investigational or anticancer agent(s).
• Pregnant patients or patients who are breast feeding. Subjects capable of pregnancy (post menarche and not post-menopausal, defined as over 12 months since final menstrual period) must have a negative pregnancy test within 7 days prior to first dose.
• Inability to swallow capsules.
• Other clinically significant malignant disease diagnosed within the previous 5 years, excluding intra-epithelial cervical neoplasia or non-melanoma skin cancer.
• Known persistent (> 4 weeks) ≥ Grade 2 neutropenia, ≥ Grade 2 thrombocytopenia or > Grade 3 anemia from prior cancer therapy.
• Other kinds of malignant tumors at the same time.

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Peking University People's Hospital

OTHER

Sponsor Role: lead

Responsible Party

GUO WEI

Musculoskeletal Tumor Center

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Wei Guo, Ph.D, M.D.

Role: PRINCIPAL_INVESTIGATOR

Peking University People's Hospital

Locations

Peking University People's Hospital

Beijing, Beijing Municipality, China

Site Status: RECRUITING

Countries

China

Central Contacts

Jie Xu, M.D.

Role: CONTACT

xujie_pkuph@sina.com

86-15901040835

Lu Xie, M.D.

Role: CONTACT

sweetdoctor@163.com

86-13401044719

Facility Contacts

Jie Xu

Role: primary

xujie_pkuph@sina.com

86 15901040835

Other Identifiers

PKUPH-EWS-01

Identifier Type: -

Identifier Source: org_study_id