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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00078988
Registration number
NCT00078988
Ethics application status
Date submitted
8/03/2004
Date registered
9/03/2004
Date last updated
7/05/2015
Titles & IDs
Public title
High-Dose Chemotherapy Plus Autologous Stem Cell Transplantation Compared With Intermediate-Dose Chemotherapy Plus Autologous Stem Cell Transplantation With or Without Isotretinoin in Treating Young Patients With Recurrent High-Grade Gliomas
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Scientific title
A Phase III Randomized Trial for the Treatment of Pediatric High Grade Gliomas at First Recurrence With a Single High Dose Chemotherapy and Autologous Stem Cell Transplant Versus Three Courses of Intermediate Dose Chemotherapy With Peripheral Blood Stem Cell (PBSC) Support
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Secondary ID [1]
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COG-ACNS0231
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Secondary ID [2]
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ACNS0231
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Brain Tumor
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Central Nervous System Tumor
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Condition category
Condition code
Cancer
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Neuroendocrine tumour (NET)
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Cancer
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Brain
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Cancer
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Children's - Brain
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - filgrastim
Treatment: Drugs - carboplatin
Treatment: Drugs - etoposide
Treatment: Drugs - isotretinoin
Treatment: Drugs - thiotepa
Treatment: Surgery - autologous bone marrow transplantation
Treatment: Surgery - peripheral blood stem cell transplantation
Experimental: Arm I (high-dose chemotherapy and ASCR) - Patients receive high-dose chemotherapy comprising carboplatin IV over 4 hours on days -8 to -6; thiotepa IV over 3 hours and etoposide IV over 3 hours on days -5 to -3; and filgrastim (G-CSF) IV or SC once daily beginning on day 1 and continuing until blood counts recover. Autologous PBSC or bone marrow are reinfused on day 0.
Experimental: Arm II (intermediate-dose chemotherapy and ASCR) - Patients receive intermediate-dose chemotherapy comprising carboplatin IV over 4 hours and thiotepa IV over 3 hours on days 1-2 and G-CSF IV or SC once daily beginning on day 4 and continuing until blood counts recover. Autologous PBSC or bone marrow are reinfused on day 3. Treatment repeats every 28 days for a total of 3 courses.
Experimental: Arm III (isotretinoin) - Patients receive oral isotretinoin twice daily on days 1-14. Treatment repeats every 28 days for a total of 6 courses.
No intervention: Arm IV (no isotretinoin) - Patients do not receive maintenance therapy.
Treatment: Other: filgrastim
Given IV
Treatment: Drugs: carboplatin
Given IV
Treatment: Drugs: etoposide
Given IV
Treatment: Drugs: isotretinoin
Given IV
Treatment: Drugs: thiotepa
Given IV
Treatment: Surgery: autologous bone marrow transplantation
Peripheral blood stem cells or bone marrow will be reinfused about 72 hours following completion of the last dose of chemotherapy (Day 0)
Treatment: Surgery: peripheral blood stem cell transplantation
Filgrastim is to be given daily in the afternoon for 4 days prior to the first harvest and continued until the completion of the daily harvests. The daily PBSC harvesting should be started prior to the fifth dose of filgrastim.
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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Treatment: Drugs
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Intervention code [3]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Event-free survival
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Assessment method [1]
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The primary endpoint for the evaluation of treatment efficacy will be event-free survival (EFS)
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Timepoint [1]
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om study entry to disease progression, disease relapse, occurrence of a second malignant neoplasm, or death from any cause. assessed up to 4 years
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Primary outcome [2]
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Toxic death attributable to complications of treatment in the absence of tumor progression as assessed by NCI Common Toxicity Criteria for Adverse Events (CTCAE) version 3.0
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Assessment method [2]
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Toxic death will be monitored separately in each of the two chemotherapy groups
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Timepoint [2]
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Up to 4 years after completion of study treatment
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Secondary outcome [1]
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Overall survival (OS)
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Assessment method [1]
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Secondary endpoints include overall survival (OS), which is defined as the time from study entry to death from any cause, assessed up to 4 years
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Timepoint [1]
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ondary e ndpoints include overall survival (OS), which is defined as the time from study entry to death from any cause assessed up to 4 years
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Eligibility
Key inclusion criteria
DISEASE CHARACTERISTICS:
* Histologically confirmed diagnosis of 1 of the following high-grade gliomas:
* Glioblastoma multiforme
* Anaplastic astrocytoma
* Gliosarcoma
* Disease in first relapse
* No primary brainstem or spinal cord gliomas
* No secondary glioblastomas arising after prior treatment for a non-glial tumor
* Prior local radiotherapy of 5,000-6,000 cGy required
* Less than 1.5 cm of residual gadolinium-enhancing tumor in maximal cross-sectional diameter by MRI
* No metastatic tumor by spinal MRI
PATIENT CHARACTERISTICS:
Age
* Under 21 at diagnosis
Performance status
* Lansky 50-100% OR
* Karnofsky 50-100%
Life expectancy
* Not specified
Hematopoietic
* Absolute neutrophil count = 500/mm^3
* Platelet count = 100,000/mm^3 (transfusion independent)
Hepatic
* Bilirubin = 1.5 times upper limit of normal (ULN)
* AST or ALT < 2.5 times ULN
Renal
* Glomerular filtration rate = 60 mL/min AND/OR
* Creatinine clearance = 60 mL/min
Cardiovascular
* Shortening fraction = 27% by echocardiogram OR
* Ejection fraction = 50% by MUGA
Pulmonary
* No dyspnea at rest
* No exercise intolerance
* Pulse oximetry > 94%
Other
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy
* Not specified
Chemotherapy
* More than 4 weeks since prior chemotherapy
* No prior thiotepa
* No prior myeloablative chemotherapy
Endocrine therapy
* No concurrent corticosteroids
Radiotherapy
* See Disease Characteristics
* More than 8 weeks since prior radiotherapy
* No prior craniospinal radiotherapy
Surgery
* Not specified
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Minimum age
No limit
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Maximum age
20
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/10/2004
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/09/2006
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Sample size
Target
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Final
1
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Princess Margaret Hospital for Children - Perth
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Recruitment postcode(s) [1]
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6001 - Perth
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Recruitment outside Australia
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United States of America
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Arkansas
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California
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Colorado
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Ontario
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Canada
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Quebec
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Funding & Sponsors
Primary sponsor type
Other
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Name
Children's Oncology Group
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Address
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Other collaborator category [1]
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Government body
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Name [1]
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National Cancer Institute (NCI)
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Ethics approval
Ethics application status
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Summary
Brief summary
RATIONALE: Drugs used in chemotherapy, such as carboplatin, thiotepa, and etoposide, work in different ways to stop tumor cells from dividing so they stop growing or die. Combining chemotherapy with autologous stem cell transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells. Isotretinoin may be effective in preventing recurrence of glioma. It is not yet known which regimen of chemotherapy plus autologous stem cell transplantation with or without isotretinoin is more effective in treating recurrent high-grade glioma. PURPOSE: This randomized phase III trial is studying high-dose chemotherapy or intermediate-dose chemotherapy followed by autologous stem cell transplantation to see how well it works compared to high-dose chemotherapy or intermediate-dose chemotherapy followed by autologous stem cell transplantation and isotretinoin in treating young patients with recurrent high-grade glioma.
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Trial website
https://clinicaltrials.gov/study/NCT00078988
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Ziad Khatib, MD
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Address
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Nicklaus Children's Hospital f/k/a Miami Children's Hospital
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT00078988
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