ICONIC: Improving Outcomes Through Collaboration in OsteosarComa

NCT ID: NCT04132895

Last Updated: 2024-08-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-10-25

Study Completion Date

2027-01-31

Brief Summary

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There has been little improvement in outcome for patients with osteosarcoma (OS) over the last 20 years. There have been only a few clinical trials of new treatments and no major new therapies introduced recently. This is in part because there is no good understanding of the biology of osteosarcoma, but also trials have only included subgroups of patients. The more that is understood about how and why osteosarcoma arises and grows the better clinicians will be able to decide what treatments are most likely to work best.

The purpose of this project is to collect high quality clinical data about patients of all ages with osteosarcoma, such as information about the size of the disease, how it was diagnosed and where it is at diagnosis, what treatments were given and how the disease responded the treatments.

Blood and tissue samples will also be collected for analysis in research laboratories. By looking at the results of the laboratory findings and the clinical data together, the questions will start to be answered about why osteosarcomas arise and grow, what makes it spread, and why some patients respond to treatment better than others. As time goes on, this information is planned to be used to develop clinical trials of new treatments.

Alongside this, the aim is to find out more about how osteosarcoma and its treatments affect the lives of those living with this disease. This information will help provide the most appropriate care and support that will meet the needs of each patient.

Ultimately, the aim is to improve the care and treatment of osteosarcoma patients so that they may live longer and better lives.

Detailed Description

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Osteosarcoma is the most common bone sarcoma, accounting for approximately 30% of all bone sarcoma diagnoses. In England, it accounts for approximately 130 cases per year across all ages.

Generally osteosarcoma has an early peak in adolescent patients, with a second peak in patients over 60 years of age. There are differing treatments, including chemotherapy with more than one drug and surgery to the primary site - and for metastases where these occur.

Outcome, however, has improved little over the past 25 years with the proportion of patients surviving to 5 years remaining at about 42% for all ages and stages in the UK. Patients under 40 years of age (52%) are more likely to survive for 5 years than patients over 40 years (25%).

Survival also depends on the primary site of the osteosarcoma. It is poor for patients with tumours that are not in the limbs, at 36% for patients under the age of 40 years and as low as 6% for patients over 40 years. Also patients with metastatic disease at diagnosis still have a poor outcome.

The use of chemotherapy and surgery depends on factors such as age, the site of the osteosarcoma, how far spread it is and how well the patient is generally, with approximately two thirds of patients currently receiving chemotherapy, radiotherapy and surgery in England each year.

The most recent randomised trial for osteosarcoma, EURAMOS-1 \[A randomized trial of the European and American Osteosarcoma Study Group to optimize treatment strategies for resectable osteosarcoma based on histological response to pre-operative chemotherapy\], was an excellent example of an international effort to seek improved treatments for a rare cancer. Despite the participation of over 2000 patients, there were no changes to the standard of care for osteosarcoma.

There is still an unmet need to find new approaches, including biomarkers and new, targeted patient specific therapeutic approaches to improve outcomes for this group. This includes searching for improved systemic treatments and better approaches to management of the osteosarcoma. The ICONIC Study will provide a dataset for translational research into osteosarcoma.

Osteosarcoma clinical trials to date have focussed on a limited number of outcomes, usually in the younger patients with a tumour in a limb. So addressing complex inter-related questions has not been possible and several subpopulations of patients have not been studied. This limits opportunities to improve the standard of care. These groups include:

* patients with widely spread (metastatic) disease;
* patients with tumours in the less common locations such as the pelvis, spine and skull;
* patients with osteosarcoma with a background of skeletal abnormalities or an underlying genetic predisposition;
* the 50% of osteosarcoma arising in patients over 40 years.

Little is currently known about factors influencing treatment decisions in these groups and how consistently a standard of care is applied. The effect of treatments on quality of life, patient reported outcomes and other performance assessments is also not well described or understood. As osteosarcoma is quite rare it can be difficult for General Practitioners (GPs) to identify symptoms and patients often wait a long time before tests for osteosarcoma are carried out. How this affects outcomes is not known.

Overall, there is a need to broaden the ambition and scope of osteosarcoma research while improving access for all patients.

Conditions

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Osteosarcoma

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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observational only, no interventions are prescribed in protocol.

* Treatment will be given as per usual standard of care.
* No treatments are specified by this protocol.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* New histological diagnosis of osteosarcoma or in the absence of osteoid seen on biopsy, pathology and imaging supportive of a diagnosis of osteosarcoma. (It is well recognised that some patients may present with features suggestive of osteosarcoma (under 40 years, radiological abnormality compatible) but in whom no osteoid is detected in needle biopsy. Although categorised as spindle cell tumour of bone, such patients are usually treated in an identical approach to osteosarcoma. A definite diagnosis of osteosarcoma is then often possible after surgery when the entire resection specimen is available.)
* Written informed consent of patient and/or parent/legal guardian.

Exclusion Criteria

• Diagnosis more than four months prior to registration.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bone Cancer Research Trust

UNKNOWN

Sponsor Role collaborator

University College, London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sandra Strauss, MD

Role: PRINCIPAL_INVESTIGATOR

University College Hospitals London

Locations

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University College Hospitals London NHS Foundation Trust

London, Greater London, United Kingdom

Site Status RECRUITING

NHS Grampian Health Board

Aberdeen, , United Kingdom

Site Status RECRUITING

Birmingham Women's and Childrens NHS Foundation Trust

Birmingham, , United Kingdom

Site Status RECRUITING

The Royal Orthopaedic Hospital NHS Foundation Trust

Birmingham, , United Kingdom

Site Status RECRUITING

University Hospitals Birmingham NHS Foundation Trust

Birmingham, , United Kingdom

Site Status RECRUITING

Cambridge University Hospitals NHS Foundation Trust

Cambridge, , United Kingdom

Site Status RECRUITING

Cardiff and Vale University LHB

Cardiff, , United Kingdom

Site Status RECRUITING

NHS Lothian Health Board

Edinburgh, , United Kingdom

Site Status RECRUITING

NHS Greater Glasgow and Clyde Health Board

Glasgow, , United Kingdom

Site Status RECRUITING

Leeds Teaching Hospitals NHS Trust

Leeds, , United Kingdom

Site Status RECRUITING

University Hospitals of Leicester NHS Trust

Leicester, , United Kingdom

Site Status RECRUITING

Alder Hey Children's NHS Foundation Trust

Liverpool, , United Kingdom

Site Status RECRUITING

The Clatterbridge Cancer Centre NHS Foundation Trust

Liverpool, , United Kingdom

Site Status RECRUITING

Manchester University NHS Foundation Trust

Manchester, , United Kingdom

Site Status RECRUITING

The Christie NHS Foundation Trust

Manchester, , United Kingdom

Site Status RECRUITING

The Newcastle upon Tyne Hospitals NHS Foundation Trust

Newcastle, , United Kingdom

Site Status RECRUITING

Nottingham University Hospitals NHS Trust

Nottingham, , United Kingdom

Site Status RECRUITING

The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust

Oswestry, , United Kingdom

Site Status RECRUITING

Oxford University Hospitals NHS Foundation Trust

Oxford, , United Kingdom

Site Status RECRUITING

Sheffield Children's NHS Foundation Trust

Sheffield, , United Kingdom

Site Status RECRUITING

Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield, , United Kingdom

Site Status RECRUITING

University Hospital Southampton NHS Foundation Trust

Southampton, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Krystyna Reczko

Role: CONTACT

020 7679 9878

Rubina Begum

Role: CONTACT

020 7679 9514

Facility Contacts

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The Chief Investigator

Role: primary

Courtney Willis

Role: primary

Suzanne Gatz

Role: primary

Michael Parry

Role: primary

Jenny Sherriff

Role: primary

Han Wong

Role: primary

Cathy Morley-Jacob

Role: primary

Angela Jesudason

Role: primary

Ioanna Nixon

Role: primary

Diana McIntosh

Role: backup

Dan Stark

Role: primary

Simone Wilkins

Role: backup

Sunita Dhir

Role: primary

Colin Thorbinson

Role: primary

Nasim Ali

Role: primary

Bernadette Brennan

Role: primary

Martin McCabe

Role: primary

Kenneth Rankin

Role: primary

Ivo Hennig

Role: primary

Paul Cool

Role: primary

Sarah Pratap

Role: primary

Daniel Yeomanson

Role: primary

Robin Young

Role: primary

Peter Simmonds

Role: primary

Other Identifiers

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UCL/18/0248

Identifier Type: -

Identifier Source: org_study_id

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