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International PPB/DICER1 Registry

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. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03382158
Recruitment Status : Recruiting
First Posted : December 22, 2017
Last Update Posted : August 17, 2022
Sponsor:
Collaborators:
Children's National Research Institute
Washington University School of Medicine
ResourcePath, LLC
Beijing Children's Hospital
University of Cambridge
Emory University
Dana-Farber Cancer Institute
Phoenix Children's Hospital
Allina Health System
University of California, San Francisco
M.D. Anderson Cancer Center
University of Texas
Kaiser Permanente
Information provided by (Responsible Party):
Children's Hospitals and Clinics of Minnesota

Tracking Information
First Submitted Date October 11, 2017
First Posted Date December 22, 2017
Last Update Posted Date August 17, 2022
Actual Study Start Date December 6, 2016
Estimated Primary Completion Date December 6, 2025   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures
 (submitted: December 18, 2017)		 Event-free survival [ Time Frame: 7 years ]
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.
Original Primary Outcome Measures Same as current
Change History
Current Secondary Outcome Measures
 (submitted: August 15, 2019)
  • Overall response to chemotherapy [ Time Frame: 7 years ]
    The investigators will assess overall response to chemotherapy among participants with radiographically measurable tumor following initial surgery or biopsy.
  • Overall survival [ Time Frame: 7 years ]
    The investigators will assess overall survival and time to death from any cause among participants.
  • Quality of life outcomes in individuals diagnosed with PPB. [ Time Frame: 7 years ]
    Chemotherapy and surgery may have adverse effects on the quality of life outcomes. Multiple factors may impact quality of life for participants.This study will allow the investigators to assess the quality of life outcomes in participants with DICER1-related tumors and will compare outcomes to those with more common childhood cancers.
  • Cardiac outcomes in individuals diagnosed with PPB. [ Time Frame: 7 years ]
    Chemotherapy and surgery may have adverse effects on cardiac outcomes. This study will allow the investigators to assess the cardiac outcomes as measured by ejection fraction and shortening fraction via echocardiogram of participants with DICER1-related tumors, and compare outcomes to those with more common childhood cancers.
  • Pulmonary function testing results in individuals diagnosed with PPB [ Time Frame: 7 years ]
    Chemotherapy and surgery may have adverse effects on pulmonary outcomes. This study will allow the investigators to assess the pulmonary outcome of participants as ascertained by pulmonary function testing (forced vital capacity (FVC), FEV1(forced expiratory volume in 1 second)/FVC) with DICER1-related tumors, and compare outcomes to those with more common childhood cancers.
  • Incidence of neoplasms in individuals with DICER1-related conditions or germline DICER1 variants. mutation. [ Time Frame: 7 years ]
    This protocol will include individuals with germline DICER1 mutations and will calculate incidence rates of specific neoplasms in this population
Original Secondary Outcome Measures
 (submitted: December 18, 2017)
  • Overall response to chemotherapy [ Time Frame: 7 years ]
    The investigators will assess overall response to chemotherapy among participants with radiographically measurable tumor following initial surgery or biopsy.
  • Overall survival [ Time Frame: 7 years ]
    The investigators will assess overall survival and time to death from any cause among participants.
  • Quality of life outcomes in individuals diagnosed with PPB. [ Time Frame: 7 years ]
    Chemotherapy and surgery may have adverse effects on the quality of life outcomes. Multiple factors including treatment, germline DICER1 mutations and familial cancer may impact quality of life for participants.This study will allow the investigators to assess the quality of life outcomes in participants with DICER1-related tumors and will compare outcomes to those with more common childhood cancers.
  • Cardiac outcomes in individuals diagnosed with PPB. [ Time Frame: 7 years ]
    Chemotherapy and surgery may have adverse effects on cardiac outcomes. This study will allow the investigators to assess the cardiac outcomes as measured by ejection fraction and shortening fraction via echocardiogram of participants with DICER1-related tumors, and compare outcomes to those with more common childhood cancers.
  • Pulmonary function testing results in individuals diagnosed with PPB [ Time Frame: 7 years ]
    Chemotherapy and surgery may have adverse effects on pulmonary outcomes. This study will allow the investigators to assess the pulmonary outcome of participants as ascertained by pulmonary function testing (FVC, FEV1/FVC) with DICER1-related tumors, and compare outcomes to those with more common childhood cancers.
  • Incidence of neoplasms in individuals with DICER1-related conditions or germline DICER1 variants. mutation. [ Time Frame: 7 years ]
    This protocol will include individuals with germline DICER1 mutations and will calculate incidence rates of specific neoplasms in this population
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title International PPB/DICER1 Registry
Official Title International Pleuropulmonary Blastoma/DICER1 Registry (for PPB, DICER1 and Associated Conditions)
Brief Summary Pleuropulmonary blastoma (PPB) is a rare malignant neoplasm of the lung presenting in early childhood. Type I PPB is a purely cystic lesion, Type II is a partially cystic, partially solid tumor, Type III is a completely solid tumor. Treatment of children with PPB is at the discretion of the treating institution. This study builds off of the 2009 study and will also seek to enroll individuals with DICER1-associated conditions, some of whom may present only with the DICER1 gene mutation, which will help the Registry understand how these tumors and conditions develop, their clinical course and the most effective treatments.
Detailed Description

PPB is a rare cancer of the lung presenting in early childhood, mostly commonly from birth to age ~72 months. PPB occurs within the lung or between the lung and the chest wall. There are three primary forms of PPB called Types I, II, and III PPB. PPB is related to an underlying change/mutation in a gene called DICER1 which impacts gene expression and cell growth. DICER1 mutations may also lead to the development of other tumors in children and adults.

The International PPB/DICER1 Registry offers information based on previous data from Registry participants and the medical literature and collaborative efforts with international rare tumor groups.

Retrospective and real-time central pathology review is encouraged. Therapy decisions remain at the discretion of the treating institution.

Children with Type I PPB require surgery and sometimes chemotherapy. Therapy decisions are the responsibility of the treating institution. Surgical guidelines are presented. It is unknown whether adjuvant chemotherapy improves cure rates for Type I PPB patients. Chemotherapy options include a 22-week regimen: 4 courses of vincristine, actinomycin D and cyclophosphamide (VAC) followed by 3 courses of vincristine and actinomycin D (VA).

Children with Types II and III PPB, require surgery, chemotherapy and sometimes radiation therapy. Many children with Types II or III PPB receive a single-arm multi-agent chemotherapy neo-adjuvant/adjuvant regimen of IVADo (ifosfamide, vincristine, actinomycin, doxorubicin) for 36 weeks. Second and possible 3rd look surgery may be considered for local control. Radiation therapy may be considered.
Study Type Observational
Study Design Observational Model: Cohort
Time Perspective: Other
Target Follow-Up Duration Not Provided
Biospecimen Retention:   Samples With DNA
Description:
Tumor tissue, blood, urine, and cerebral spinal fluid (the latter only if a lumbar puncture is performed for clinical purposes) collected from enrolled individuals.
Sampling Method Non-Probability Sample
Study Population
  1. For those with PPB: PPB primarily affects children so their participation is required.
  2. For those with DICER1-associated conditions: There's a wide array of conditions associated with DICER1, that occur at a variety of ages, from the development of cysts in utero, to lung cysts and thyroid disease noted in grandparents.
  3. The Investigators are aware that many individuals with PPB, and with conditions associated with DICER1, come from countries outside of the U.S. To exclude individuals outside the US, minority groups and non-English speaking groups would be a disservice to eligible patients and healthcare providers and would limit the sample size of this rare cancer study.
Condition
  • Pleuropulmonary Blastoma
  • Sertoli-Leydig Cell Tumor
  • DICER1 Syndrome
  • Cystic Nephroma
  • Wilms Tumor
  • Pineoblastoma
  • Renal Sarcoma
  • Nodular Hyperplasia of Thyroid
  • Nasal Chondromesenchymal Hamartoma
  • Ciliary Body Medulloepithelioma
  • Neuroblastoma
  • Pituitary Cancer
  • Embryonal Rhabdomyosarcoma
  • Ovarian Sarcoma
  • Gynandroblastoma
Intervention Not Provided
Study Groups/Cohorts
  • Type I PPB
    Type I PPB is an early manifestation of this malignant disease, cured in some cases by surgery. Surgical guidelines are presented. It is unknown whether adjuvant chemotherapy improves cure rates for individuals with Type I PPB. If the treating physicians select adjuvant chemotherapy treatment, chemotherapy options include a 22-week regimen: 4 courses of vincristine, actinomycin D and cyclophosphamide (VAC) followed by 3 courses of vincristine and actinomycin D (VA). Therapy decisions are the responsibility of the treating institution.
  • Types II and III PPB
    Types II and III PPB are aggressive sarcomas. Surgery and chemotherapy are necessary in all cases. Surgical guidelines are presented. Many children with Types II or III PPB receive a single-arm multi-agent chemotherapy neo-adjuvant/adjuvant regimen of IVADo (ifosfamide, vincristine, actinomycin, doxorubicin) for 36 weeks. Second and possible 3rd look surgery may be considered for local control. Radiation therapy may be considered. Specific therapy decisions are the responsibility of the treating institution.
  • Type Ir PPB
    Type Ir (regressed) PPB is a unique, purely cystic tumor which lacks a primitive cell component. The International PPB/DICER1 Registry will enroll and follow participants with Type Ir PPB, regardless of age.
  • DICER1 Gene or Cond Assoc with DICER1
    PPB and the associated conditions found in PPB families suggest a familial tendency to formation of tumors. The International PPB/DICER1 Registry for PPB, DICER1 and Associated Conditions study will enroll and follow participants who have the DICER1 gene mutations or conditions associated with PPB or DICER1.
Publications *

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status Recruiting
Estimated Enrollment
 (submitted: April 23, 2021)		 3400
Original Estimated Enrollment
 (submitted: December 18, 2017)		 100
Estimated Study Completion Date December 6, 2028
Estimated Primary Completion Date December 6, 2025   (Final data collection date for primary outcome measure)
Eligibility Criteria

Inclusion Criteria:

  1. Known or suspected PPB or related thoracic tumor
  2. Known or suspected sex-cord stromal tumor including Sertoli-Leydig cell tumor and gynandroblastoma (males or females)
  3. Other known or suspected DICER1-related condition including ovarian sarcoma, cystic nephroma, renal sarcoma, pineoblastoma, pituitary blastoma, nasal chondromesenchymal hamartoma, ciliary body medulloepithelioma and others
  4. Individuals with known or suspected DICER1 pathogenic variation regardless of whether they have an established DICER1-associated condition
  5. Informed consent by patient/ or parent/guardian (also, where appropriate: assent and HIPAA consent)

Exclusion criteria:

Absence of appropriate consent for Registry participation
Sex/Gender
Sexes Eligible for Study: All
Ages Child, Adult, Older Adult
Accepts Healthy Volunteers Yes
Contacts
Contact: Kris Ann P Schultz, MD 612-813-7121 krisann.schultz@childrensmn.org
Contact: Anne K Harris, MPH 612-813-5861 anne.harris@childrensmn.org
Listed Location Countries United States
Removed Location Countries  
 
Administrative Information
NCT Number NCT03382158
Other Study ID Numbers FDAAA
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement
Plan to Share IPD: No
Current Responsible Party Children's Hospitals and Clinics of Minnesota
Original Responsible Party Same as current
Current Study Sponsor Children's Hospitals and Clinics of Minnesota
Original Study Sponsor Same as current
Collaborators
  • Children's National Research Institute
  • Washington University School of Medicine
  • ResourcePath, LLC
  • Beijing Children's Hospital
  • University of Cambridge
  • Emory University
  • Dana-Farber Cancer Institute
  • Phoenix Children's Hospital
  • Allina Health System
  • University of California, San Francisco
  • M.D. Anderson Cancer Center
  • University of Texas
  • Kaiser Permanente
Investigators
Principal Investigator: Kris Ann P Schultz, MD Children's Minnesota
PRS Account Children's Hospitals and Clinics of Minnesota
Verification Date August 2022