International Pleuropulmonary Blastoma (PPB) Treatment and Biology Registry
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Purpose
Pleuropulmonary Blastoma (PPB) is very rare and there is no established "standard" or "best" therapy. For many years, children with PPB around the world have been treated according to decisions made case-by-case in many different hospitals by many different physicians. No treatment has been tested in a large group of PPB patients.
The goal is to treat many children with one treatment program and to learn the results of the treatment.
| Condition | Intervention |
|---|---|
|
Pleuropulmonary Blastoma |
Drug: Vincristine Drug: Dactinomycin Drug: Cyclophosphamide Drug: Ifosfamide Drug: Doxorubicin |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | International Pleuropulmonary Blastoma (PPB) Treatment and Biology Registry Protocol |
- Event-free survival [ Time Frame: 5 years ] [ Designated as safety issue: No ]The primary endpoint for statistical analysis will be time from start treatment to an event, defined as the occurrence of progression or recurrence of PPB, occurrence of a second malignant neoplasm, or death from any cause that is at least possibly related to the original disease or treatment.
- Overall response to chemotherapy, and survival [ Time Frame: 5 years ] [ Designated as safety issue: No ]Secondary endpoints will the best overall response to chemotherapy among patients with radiographically measurable tumor following initial surgery or biopsy, and time to death from any cause.
| Estimated Enrollment: | 125 |
| Study Start Date: | September 2011 |
| Estimated Study Completion Date: | September 2018 |
| Estimated Primary Completion Date: | September 2016 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Type I PPB therapy
PPB Type I therapy: All patients will be treated with surgery. Chemotherapy after surgery is per the treating physician(s) discretion. If chemotherapy is used the Registry will suggest that it be combination chemotherapy with VAC (Vincristine, Actinomycin-D, Cyclophosphamide).
|
Drug: Vincristine
≥ 3 years: 1.5 mg/m2 IV x 1 (maximum dose 2 mg)
Other Name: Vincristine; Oncovin
Drug: Dactinomycin
≥ 3 years: 0.045 mg/kg (maximum dose 2.5 mg) IV X 1
Other Name: Actinomycin-D
Drug: Cyclophosphamide
≥ 3 year: 1.2 gm/m2/dose IV as 1 hr infusion with IV fluids
Other Name: Cytoxan
|
|
Experimental: Types II and III PPB therapy
Combination chemotherapy with Ifosphamide, Vincristine, Actinomycin-D and Doxorubicin ("IVADo"). Second look and possible 3rd look surgery may be required. Radiation therapy is recommended only for residual disease after maximum surgery.
|
Drug: Vincristine
≥ 3 years: 1.5 mg/m2 IV x 1 (maximum dose 2 mg)
Other Name: Vincristine; Oncovin
Drug: Dactinomycin
≥ 3 years: 0.045 mg/kg (maximum dose 2.5 mg) IV X 1
Other Name: Actinomycin-D
Drug: Cyclophosphamide
≥ 3 year: 1.2 gm/m2/dose IV as 1 hr infusion with IV fluids
Other Name: Cytoxan
Drug: Ifosfamide
≥ 3 years: 3 g/m2/dose IV over 3 hours on Days 1, 2, (6 g/m2/cycle)
Drug: Doxorubicin
≥ 3 years: 30 mg/m2/dose IV over 30 min, Days 1, 2 (60 mg/m2/cycle)
Other Name: Adriamycin
|
Detailed Description:
This Registry will collect family medical history and establishes a collection of specimens from PPB patients and their parents for future research. Primary goals of the biology research are (1) to identify new scientific ways to learn about PPB and the best way to treat it in the future and (2) to establish a collection of PPB biologic specimens for future research.
Background: PPB is a rare cancer of the lung presenting in early childhood, mostly from birth to age ~72 months. PPB occurs within the lung or between the lung and the chest wall. There are three forms of PPB called Types I, II, and III PPB. Children with Type I PPB require surgery and sometimes chemotherapy. Children with Types II and III PPB, require surgery, chemotherapy and sometimes radiation therapy. Because there has never been a consensus as to the best treatment for PPB, the Registry will provide treatment guidelines. It is the goal of the Treatment and Biology Registry that by offering specific regimens the Registry will be able to prospectively review and analyze the regimen for the first time.
Design:
- Diagnostic central pathology review will be required for patients who will be prospectively evaluated.
- This Treatment Registry will offer surgery and chemotherapy regimen guidelines, and optional radiation therapy guidelines for prospectively enrolled patients.
- The Treatment and Biology Registry will create a PPB biologic specimens reference bank for tumor.
Methods:
- For Type I PPB, surgery is necessary. Some doctors use chemotherapy after surgery. If chemotherapy is used the Registry will suggest that it be combination chemotherapy with VAC (vincristine, dactinomycin, cyclophosphamide).
- For Types II and III PPB patients surgery is necessary, followed by chemotherapy. The Registry will suggest that subjects receive combination chemotherapy with Ifosphamide, Vincristine, Actinomycin-D and Doxorubicin ("IVADo"). Second look and possible 3rd look surgery may be required. Radiation therapy is recommended only for residual disease after maximum surgery.
Analysis: Statistical data analysis will include only centrally confirmed cases. Additionally only patients with PPB Type II or Type III who were enrolled and treated with IVADo as per the regimen will be compared to historical controls. No statistical analysis is planned for patients with Type I PPB. Future treatment will be compared to the IVADo regimen in order to measure improvements.
Eligibility| Ages Eligible for Study: | up to 21 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age : Patients from birth to < 21 years of age at the time of diagnosis.
Pathology Diagnosis: Patients with newly-diagnosed PPB Types I, II or III. Diagnosis is made by the local pathologist.
All cases must be submitted for central pathology review. Only centrally-reviewed cases confirmed as PPB will be analyzed prospectively.
Cases in which the initial diagnosis is "suggestive" or "supportive" of PPB, but not diagnostic, and in which later resection specimens, including resections following chemotherapy, confirm a PPB diagnosis will be included. Patients diagnosed by fine needle aspiration biopsy will be included only if a later resection specimen, including resections following chemotherapy, is diagnostic of PPB.
Prior Therapy: PPB Type I: All patients are eligible and will be followed in the study.
PPB Types II or III: Newly-diagnosed Types II and III PPB patients will be included in the Treatment and Biology Registry.
- Prior corticosteroid therapy is allowed.
- Patients who have received other chemotherapy regimens or radiation therapy will not be statistical analysis.
- Types II and III PPB patients with PRIOR Type I PPB diagnosis: Types II and III PPB cases which are recurrences of an earlier Type I PPB are included if no chemotherapy was used for the Type I disease.
- Informed consent by parent/guardian. (also, where appropriate: assent and HIPPA consent)
Contacts and Locations| United States, Minnesota | |
| Children's Hospitals and Clinics of Minnesota | Recruiting |
| Minneapolis, Minnesota, United States, 55404 | |
| Contact: Gretchen M Williams, BS 612-813-7115 gretchen.williams@childrensmn.org | |
| Contact: Yoav H Messinger, MD 612-813-7115 yoav.messinger@childrensmn.org | |
| Principal Investigator: Yoav H Messinger, M.D. | |
| Principal Investigator: | Yoav H Messinger, MD | Children's Hospitals and Clinics of Minensota |
More Information
Additional Information:
Publications:
| Responsible Party: | Yoav Messinger, M.D., Children's Hospitals and Clinics of Minnesota |
| ClinicalTrials.gov Identifier: | NCT01464606 History of Changes |
| Other Study ID Numbers: | PPB Reg Tx-Biol-001 |
| Study First Received: | September 29, 2011 |
| Last Updated: | June 14, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Children's Hospitals and Clinics of Minnesota:
|
pleuropulmonary blastoma pediatric lung cysts |
Additional relevant MeSH terms:
|
Pulmonary Blastoma Neoplasms, Complex and Mixed Neoplasms by Histologic Type Neoplasms Lung Neoplasms Respiratory Tract Neoplasms Thoracic Neoplasms Neoplasms by Site Dactinomycin Doxorubicin Isophosphamide mustard Cyclophosphamide Ifosfamide Vincristine Antibiotics, Antineoplastic |
Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Protein Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Nucleic Acid Synthesis Inhibitors Anti-Bacterial Agents Anti-Infective Agents Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Antirheumatic Agents Antineoplastic Agents, Alkylating Alkylating Agents |
ClinicalTrials.gov processed this record on May 21, 2013