International PPB/DICER1 Registry
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|ClinicalTrials.gov Identifier: NCT03382158|
Recruitment Status : Recruiting
First Posted : December 22, 2017
Last Update Posted : August 17, 2022
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|Condition or disease|
|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|
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|
|Estimated Enrollment :||3400 participants|
|Official Title:||International Pleuropulmonary Blastoma/DICER1 Registry (for PPB, DICER1 and Associated Conditions)|
|Actual Study Start Date :||December 6, 2016|
|Estimated Primary Completion Date :||December 6, 2025|
|Estimated Study Completion Date :||December 6, 2028|
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.
- 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.
- 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
Biospecimen Retention: Samples With DNA
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|Ages Eligible for Study:||Child, Adult, Older Adult|
|Sexes Eligible for Study:||All|
|Accepts Healthy Volunteers:||Yes|
|Sampling Method:||Non-Probability Sample|
- For those with PPB: PPB primarily affects children so their participation is required.
- 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.
- 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.
- Known or suspected PPB or related thoracic tumor
- Known or suspected sex-cord stromal tumor including Sertoli-Leydig cell tumor and gynandroblastoma (males or females)
- 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
- Individuals with known or suspected DICER1 pathogenic variation regardless of whether they have an established DICER1-associated condition
- Informed consent by patient/ or parent/guardian (also, where appropriate: assent and HIPAA consent)
Absence of appropriate consent for Registry participation
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): NCT03382158
|Contact: Kris Ann P Schultz, MDemail@example.com|
|Contact: Anne K Harris, MPHfirstname.lastname@example.org|
|United States, Minnesota|
|Minneapolis, Minnesota, United States, 55404|
|Contact: Anne Harris, MPH 612-813-5861 email@example.com|
|Contact: Paige R Mallinger, MS 6128137121 firstname.lastname@example.org|
|Principal Investigator:||Kris Ann P Schultz, MD||Children's Minnesota|
Publications of Results:
|Responsible Party:||Children's Hospitals and Clinics of Minnesota|
|Other Study ID Numbers:||
|First Posted:||December 22, 2017 Key Record Dates|
|Last Update Posted:||August 17, 2022|
|Last Verified:||August 2022|
|Individual Participant Data (IPD) Sharing Statement:|
|Plan to Share IPD:||No|
|Studies a U.S. FDA-regulated Drug Product:||No|
|Studies a U.S. FDA-regulated Device Product:||No|
Sertoli-Leydig cell tumor
Neuroectodermal Tumors, Primitive
Leydig Cell Tumor
Sertoli-Leydig Cell Tumor
Sex Cord-Gonadal Stromal Tumors
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Neuroectodermal Tumors, Primitive, Peripheral
Neoplasms, Germ Cell and Embryonal
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Central Nervous System Diseases
Nervous System Diseases