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Irinotecan in Combination With Cisplatin in Pediatric Patients With Unfavorable Prognosis Gliomas

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT01574092
Recruitment Status : Completed
First Posted : April 10, 2012
Last Update Posted : August 24, 2015
Sponsor:
Collaborators:
Fundació Sant Joan de Déu
Spanish National Health System
Information provided by (Responsible Party):
Hospital Sant Joan de Deu

Brief Summary:

Tumours of the brain and of the central nervous system (CNS) are the most common solid tumours in children. Amongst these, gliomas are the most frequent, although this term covers different histological subtypes, the most frequent being astrocytoma. However, they are rare diseases of low prevalence.

The interest in the cisplatin/irinotecan combination in brain tumours motivated a previous pilot study at our hospital, with encouraging results. This experience, together with the need for new strategies for high-risk pediatric gliomas has motivated the conduct of this study.


Condition or disease Intervention/treatment Phase
Pediatric High Risk Gliomas Drug: Combination of two marketed drugs (irinotecan and cisplatin) Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 39 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase II, Single Arm, Open Label Clinical Trial With Irinotecan in Combination With Cisplatin in Pediatric Patients With Unfavorable Prognosis Gliomas
Study Start Date : November 2009
Actual Primary Completion Date : June 2014
Actual Study Completion Date : March 2015


Arm Intervention/treatment
Experimental: Irinotecan plus Cisplatin combination
This is a open-label study with only one treatment experimental arm. The patients will be treated, in a weekly basis, with 30 mg/m2 of cisplatino plus 65 mg/m2 of irinotecán (one cycle), until a total of 16 cycles.
Drug: Combination of two marketed drugs (irinotecan and cisplatin)
Irinotecan and Cisplatin will be administered weekly ambulatory, intravenous (iv), until to reach a total of 16 cycles. Cisplatin is administered first and then Irinotecan. Cisplatin 30 mg/m2/d (iv) in one hour,followed by Irinotecan 65 mg/m2/d iv in one hour. There is a one-week rest period every 4 cycles. The total treatment length including 16 cycles + rest weeks is 19 weeks.
Other Names:
  • Irinotecan Hospira (20mg/ml)
  • Cisplating Ferrer Farma(10mg or 50mg presentations)




Primary Outcome Measures :
  1. The primary objective of this study is to determine the safety and objective response rate (ORR). [ Time Frame: Clinical signs, AEs, SAEs, ARs, SARs, Imaging and Audiometry changes: from baseline to FUP month 12. ]
    The primary objective is to determine the safety and objective response rate (ORR), defined according to the criteria given in the CPMP/EWP/205/95/Rev.3/Corr.2, of irinotecan + cisplatin in pediatric patients with gliomas, through clinical signs and MR. The primary variable is the ORR.


Secondary Outcome Measures :
  1. Duration of the response. [ Time Frame: Clinical signs: baseline and every week (w1to21)+FUP month 3,6,9,12. Imaging (RM Baseline+w10&20+FUP month 3,6,9,12/PET: Baseline+w20). ]
    The secondary variable has the aim to assess the duration of response by measuring the time to progression (TP), the time to treatment failure (TF) and overall survival (OS).

  2. Safety of the combined Irinotecan+Cisplatin therapy [ Time Frame: Clinical signs, AEs, SAEs, ARs, SARs: baseline and every week (w1to21)+FUP month 3,6,9,12.Blood (hemo/chem):baseline&every week (w 1 to 21, except w10). Audiometry: baseline+w20+m6+m12. ]
    The secondary variable aims to assess the safety of combined Irinotecan+Cisplatin therapy in study population (children and teens. Treatment safety will be assessed according to the Common Terminology Criteria for Adverse Events v3.0, (CTCAE).

  3. Possible associations of gene MGMT promoter and microsatellites instability with reference to response to study treatment [ Time Frame: Clinical signs: baseline and every week (w1to21)+FUP month 3,6,9,12. Imaging (RM Baseline+w10&20+FUP month 3,6,9,12/PET: Baseline+w20). Genomic study: baseline (week-14 to-9) ]
    The secondary variable aims to search if there could be any possible association between silent MGMT and the inestability of microsatellites with refernce to the response reached with the combined Irinotecan plus Cisplatin therapy in paediatrics glioma.

  4. To assess the applicability and efficacy of volumetric measurements as a treatment tumor-response indicator. [ Time Frame: Clinical signs: baseline (day-14to-9) and every week (w1to21)+FUP month 3,6,9,12. Imaging (RM Baseline day-14to -9 +w10&20+FUP month 3,6,9,12. ]
    The aim of this secondary outcome measure is to assess the applicability and efficacy of the volumetric study measurement during the radiology assessment with reference to the tumour response to the study treatment.

  5. To assess the applicability and efficacy of metabolic study by PET-methionine [ Time Frame: Clinical signs: baseline (day-14to-9) and every week (w1to21)+FUP month 3,6,9,12. PET: Baseline day-14to -9 + w20). ]
    The aim of this secondary outcome measure is to assess the applicability and efficacy of the metabolic study by PET-methionine



Information from the National Library of Medicine

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Ages Eligible for Study:   6 Months to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria:

  1. Histological confirmation of neoplasia, except for intrinsic brain stem tumour and optic pathway glioma in one patient with neurofibromatosis type 1 (NF1).
  2. Pertaining to one of the diagnostic groups: Cohort 1: Recently diagnosed high grade glioma. Cohort 2: Recurrent high grade glioma. Cohort 3: Intrinsic brain stem tumour. Cohort 4: High risk low grade glioma.
  3. Measurable primary or metastatic tumours with at least one 10 mm diameter lesion in two MR dimensions.
  4. Absence of prior treatment with cisplatin or irinotecan.
  5. Aged between 6 months to 18 years.
  6. Lansky/Karnofsky performance status ≥ 70% (Appendix 6.1). Neurological deficits secondary to the tumour should be stable before entering the trial.
  7. Patients receiving dexamethasone should be on a stable or decreasing regimen before inclusion.
  8. Life expectancy ≥ 3 months.
  9. Adequate organic function, including haematological, renal and hepatic function.
  10. Wash-out period of at least 3 weeks after chemotherapy and 6 weeks after nitrosoureas or radiotherapy. Recovery from all toxic effects of previous treatments.
  11. Subjects of fertile age should use an effective birth control method throughout the entire study. Women of child-bearing age will be included after a negative pregnancy test result.
  12. Informed consent of the parents or legal representative, and informed consent of the mature minor.

Exclusion criteria:

  1. Concurrent administration of any other anti-cancer treatment.
  2. Pre-existing, non-controlled diarrhoea
  3. Pregnancy or lactation
  4. Treatment in another clinical trial.
  5. Serious concomitant disease that could compromise the completion of the trial. -

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01574092


Locations
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Spain
Hospital Sant Joan De Déu
Esplugues de Llobregat, Barcelona, Spain, 08950
Sponsors and Collaborators
Hospital Sant Joan de Deu
Fundació Sant Joan de Déu
Spanish National Health System
Investigators
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Principal Investigator: OFELIA CRUZ, MD, PhD HOSPITAL DE SANT JOAN DE DÈU
Publications:

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Responsible Party: Hospital Sant Joan de Deu
ClinicalTrials.gov Identifier: NCT01574092    
Other Study ID Numbers: HSJD-GLIOMAS-IC
First Posted: April 10, 2012    Key Record Dates
Last Update Posted: August 24, 2015
Last Verified: August 2015
Keywords provided by Hospital Sant Joan de Deu:
Pediatric
Pediatrics
Gliomas
Glioma
Brain tumor
Brain cancer
Cisplatin
Cisplatino
Irinotecan
Brain stem tumor
Brainstem gliomas
Intrinsic brain stem tumor
PAEDIATRIC HIGH GRADE GLIOMA
Childhood brain stem glioma
Additional relevant MeSH terms:
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Glioma
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Irinotecan
Antineoplastic Agents
Topoisomerase I Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action