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Primary Central Nervous System NeoplasmsSIOP-LGG-2004NCT00276640

Radiation Therapy or Combination Chemotherapy in Treating Patients With Clinically or Radiologically Progressive Low-Grade Gliomas

A study testing vincristine, carboplatin, vincristine, carboplatin, etoposide and radiation therapy in people with Primary Central Nervous System Neoplasms, run by Societe Internationale d'Oncologie Pediatrique at 13 sites in 12 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Read more about this study

Who is it for?
Ages 1 day to 18 years
Conditions the study is for
Primary Central Nervous System Neoplasms
What is being tested?
vincristine, carboplatin, vincristine, carboplatin, etoposide and radiation therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
3,417 participants
Where
13 sitesin 12 countries
Study dates
1 Apr 2004to 31 May 2017
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 day to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Age: children and adolescents up to the completion of the 18th year of life.
  • Histology: low grade glioma according to ICD O Code Children with chiasmatic-hypothalamic tumors may be eligible without histological diagnosis, if neuroradiologic findings meet unequivocal criteria for the presence of a low grade glioma.
  • Primary tumor localization: intracranial and/or spinal cord.
  • Dissemination: Children presenting with disseminated low grade glioma will be eligible for the study.
  • Associated conditions: Children are eligible for the trial regardless of the presence of associated genetic disease: Neurofibromatosis NF I will be the prominent one, all children with NF I are entered into the study arm III in case of an indication for non-surgical therapy. Other conditions like Tuberous Sclerosis etc. should be registered and their impact on the course of disease and/or therapy be followed.
  • Primary tumor diagnosis: The tumor should not be pretreated with chemotherapy or radiotherapy.
  • Informed consent: The patient and/or his legal guardian ( parents ) have to have declared their written informed consent to the study.
  • Randomization: All eligible patients without Neurofibromatosis NF I receiving chemotherapy as their fist non-surgical therapy are eligible for randomization.

Who cannot join

  • Primary tumor localization: diffuse intrinsic tumors of the pons, even if histologically an Astrocytoma I° or II° is diagnosed.
  • Exception: pontine glioma II° in NF I patients may be entered into the study.
  • Special diagnosis: Patients presenting with rare intracranial neoplasms of low grade malignancy, but non-glial origin may be followed according to the low grade glioma strategy but they are not subject of this therapy trial. Their data may be registered however, to learn about those therapeutic interventions which may prove useful to these patients and to develop separate strategies in the future. Choroid plexus papilloma should be entered into the SIOP-CPT study.
  • Pretreatment: Children treated with chemo- or radiotherapy prior to entering the study will be evaluated separately. (Previous treatment with steroids is not considered a chemotherapeutic treatment.)
  • Preexisting impairments of health status, making the conduct of the study impossible or ethically unwise.
  • Evidence of pregnancy or lactation period.
  • Participation in another clinical study: In case the patient participates in another clinical study simultaneously to being enrolled in the study SIOP-LGG 2004, which is not interfering with the present treatment strategy ( e.g. endocrinologic study ), this should be known to the national study chairmen.
  • Medication: Concomitant medication for associated or other conditions ( e.g. hormone replacement, anticonvulsants ), not containing cytostatic drugs, should be recorded, but is no exclusion criteria.

Trial locations and contacts

13 sites in 12 countries.

13 sites in 12 countries

United Kingdom2 sites
  • Leeds Cancer Centre at St. James's University Hospital

    Leeds, England, LS9 7TF

  • Queen's Medical Centre

    Nottingham, England, NG7 2UH

Other trials in United Kingdom

Austria1 site
  • Allg. Krankenhaus der Stadt Wien Universitaets-Kinderklinik

    Vienna, 1090

Other trials in Austria

Belgium1 site
  • Universitair Ziekenhuis Gent

    Ghent, B-9000

Other trials in Belgium

Croatia1 site
  • Children's Hospital Zagreb

    Zagreb, 10000

Other trials in Croatia

Denmark1 site
  • Aalborg Hospital

    Aalborg, 9100

Other trials in Denmark

France1 site
  • Institut Gustave Roussy

    Villejuif, F-94805

Other trials in France

Germany1 site
  • Klinikum Augsburg

    Augsburg, DOH-86156

Other trials in Germany

Italy1 site
  • Azienda Ospedaliera di Padova

    Padova, 35128

Other trials in Italy

Norway1 site
  • University of Tromso

    Tromsø, N-9037

Other trials in Norway

Poland1 site
  • Children's Memorial Health Institute

    Warsaw, 04-736

Other trials in Poland

Portugal1 site
  • Hospital San Joao

    Porto, 4200

Other trials in Portugal

Switzerland1 site
  • University Children's Hospital

    Zurich, CH-8032

Other trials in Switzerland

About this study

Official title: Cooperative Multicenter Study for Children and Adolescents With Low Grade Glioma

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.

PURPOSE: This clinical trial is studying giving radiation therapy or combination chemotherapy to see how well it works in treating patients with clinically or radiologically progressive low-grade gliomas.

Read the detailed description

OBJECTIVES:

  • Provide a comprehensive treatment strategy for children and adolescents with low-grade glioma of all tumour locations and histologies.
  • Provide standardized treatment indication and treatment recommendations for non-surgical therapy in children and adolescents with low grade glioma without and with associated neurofibrosis-type 1 (NF1) at diagnosis or after observation.
  • Determine overall, event-free, and progression-free survival.
  • Radiotherapy arm: a. Determine progression free survival in older children without NF1 treated with radiotherapy using modern techniques for planning and treatment. b. Determine the reduction of the rate and intensity of possible late effects of therapy to the organs at risk by optimized planning and treatment.
  • Chemotherapy arm: a. Determine progression free survival for younger children without NF1 treated with chemotherapy and randomized to either the 2-drug or the 3-drug induction regimen. b. Determine the distribution of response at week 24 (after induction) for younger children without NF1 treated with chemotherapy and randomized to either the 2-drug or the 3-drug induction regimen. c. Determine progression free survival for children with NF1treated with chemotherapy.
  • Determine the influence of clinical and histological findings on overall survival, progression-free and event-free survival in these patients.
  • Determine prospectively the late effects of tumor and therapy in these patients.

OUTLINE: This is a partially randomized, open-label, multicenter study.

Children with completely resected tumors, incompletely resected tumors, or those with clinically/neuroradiologically diagnosed tumors, who do not have severe symptoms at diagnosis, are only observed during follow-up.

Children with unresectable/incompletely-resectable tumors, or those with relapsed disease and those observed following incomplete initial resection or neuroradiologic diagnosis and clinical and/or neuro-radiologic progression receive non-surgical therapy. This non-surgical therapy is either chemotherapy (for children younger than 8 years and those with neurofibrosis-type 1 [NF1]) or radiotherapy (for children older than 8 years).

  • Chemotherapy: Within the chemotherapy arm, patients without NF1 are randomized to receive 1 of 2 induction chemotherapy regimens. Patients with NF1 receive the two-drug induction therapy as in arm I.
  • Arm I (two-drug induction therapy [vincristine-carboplatin] ): Patients receive induction therapy comprising vincristine IV on day 1 of weeks 1-10 and weeks 13, 17, and 21 and carboplatin IV over 1 hour on day 1 of weeks 1, 4, 7, 10, 13, 17, and 21.
  • Arm II (three-drug induction therapy [vincristine-carboplatin-etoposide]): Patients receive vincristine and carboplatin as in two-drug induction therapy. Patients also receive etoposide IV over 1 hour on days 1-3 of weeks 1, 4, 7, and 10.

Beginning in week 25, all patients in the chemotherapy arm receive consolidation therapy comprising vincristine IV on days 1, 8, and 15 and carboplatin IV over 1 hour on day 1. Treatment repeats every 6 weeks for 9 courses. Patients experiencing disease progression or an allergic reaction to carboplatin receive vincristine IV on days 1, 8, and 15 and either cyclophosphamide IV over 1 hour on day 1 or cisplatin IV over 3 hours on days 1 and 2. Treatment repeats every 6 weeks for 5 courses. All patients in the chemotherapy arm receive a total of 18 months of treatment.

  • Radiotherapy: Conventional external beam fractionated radiotherapy is given at standard doses for children receiving radiotherapy. Brachytherapy can be given, if tumors are suitable for this type of treatment.

After completion of study treatment, patients are followed periodically for 10 years.

PROJECTED ACCRUAL: A total of 520 patients will be accrued for the randomized arm of this study.

Being tested
vincristine, carboplatin, vincristine, carboplatin, etoposide, radiation therapy
Keywords
recurrent childhood brain stem glioma, untreated childhood brain stem glioma, recurrent childhood cerebellar astrocytoma, untreated childhood cerebellar astrocytoma, childhood low-grade cerebral astrocytoma, recurrent childhood cerebral astrocytoma, childhood oligodendroglioma, recurrent childhood visual pathway and hypothalamic glioma, untreated childhood visual pathway and hypothalamic glioma, childhood spinal cord neoplasm
Medical subject headings
Central Nervous System Neoplasms, Astrocytoma, Oligodendroglioma, Optic Nerve Glioma, Spinal Cord Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • vincristine, carboplatinDrug

    vincristine: 1,5 mg/m² i.v., week 1,2,3,4,5,6,7,8,9,10,13,17,21

    carboplatin: 550 mg/m² i.v., week 1,4,7,10,13,17,21

  • vincristine, carboplatin, etoposideDrug

    vincristine: 1,5 mg/m² i.v., week 1,2,3,4,5,6,7,8,9,10,13,17,21

    carboplatin: 550 mg/m² i.v., week 1,4,7,10,13,17,21

    etoposide: 100 mg/m² i.v., week 1,4,7,10

  • radiation therapyRadiation

    intracranial tumor site: 30 fractions, dose per fraction: 1.8 Gy, total dose: 54 Gy, duration 6 weeks

    spinal tumor site: 28 fractions, dose per fraction: 1.8 Gy, total dose: 50.4 Gy duration 5 1/2 weeks

Study groups in NCT00276640
Study groupRoleWhat they receive
vincristine, carboplatinActive comparatorstandard chemotherapy group
Receives: Drug: vincristine, carboplatin
vincristine, carboplatin, etoposideActive comparatorintensified induction chemotherapy group
Receives: Drug: vincristine, carboplatin, etoposide
radiationActive comparatorradiation therapy group
Receives: Radiation: radiation therapy
ControlNo interventionControl group: wait and see strategy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression-free survival

    Measured: week 24, and at 1, 3, and 5 years

  2. Event-free survival

    Measured: week 24 and at 1, 3, and 5 years

  3. Overall survival

    Measured: week 24 and at 1, 3, and 5 years

Secondary outcomes (1)
  1. Response week 24

    radiological response to therapy (chemotherapy or radiation therapy)

    Measured: week 24

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Jan 2006 (estimated)
  2. Study start1 Apr 2004
  3. Primary completion31 Dec 2015
  4. Study completion31 May 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
3,417 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00276640
Sponsor's protocol ID
CDR0000454506
Other IDs
2005-005377-29, 2005
Acronym
SIOP-LGG-2004
Status last verified
Apr 2018
First submitted
12 Jan 2006
Last updated
20 Apr 2018
Results posted
No
Data monitoring committee
Yes

Publications

  • Gnekow AK, Walker DA, Kandels D, Picton S, Giorgio Perilongo, Grill J, Stokland T, Sandstrom PE, Warmuth-Metz M, Pietsch T, Giangaspero F, Schmidt R, Faldum A, Kilmartin D, De Paoli A, De Salvo GL; of the Low Grade Glioma Consortium and the participating centers. A European randomised controlled trial of the addition of etoposide to standard vincristine and carboplatin induction as part of an 18-month treatment programme for childhood (</=16 years) low grade glioma - A final report. Eur J Cancer. 2017 Aug;81:206-225. doi: 10.1016/j.ejca.2017.04.019. Epub 2017 Jun 22.

    PubMed 28649001
  • Weiss S, Thomale UW, Schulz M, Kandels D, Schuhmann MU, El Damaty A, Krauss J, Driever PH, Witt O, Bison B, Pietsch T, Gnekow A, Simon M. Neurosurgical morbidity in pediatric supratentorial midline low-grade glioma: Results from the German LGG studies. Int J Cancer. 2023 Oct 15;153(8):1487-1500. doi: 10.1002/ijc.34615. Epub 2023 Jun 1.

    PubMed 37260252
  • Kandels D, Pietsch T, Bison B, Warmuth-Metz M, Thomale UW, Kortmann RD, Timmermann B, Hernaiz Driever P, Witt O, Schmidt R, Gnekow AK. Loss of efficacy of subsequent nonsurgical therapy after primary treatment failure in pediatric low-grade glioma patients-Report from the German SIOP-LGG 2004 cohort. Int J Cancer. 2020 Dec 15;147(12):3471-3489. doi: 10.1002/ijc.33170. Epub 2020 Jul 11.

    PubMed 32580249

Questions about this trial

What is this clinical trial studying?

A study testing vincristine, carboplatin, vincristine, carboplatin, etoposide and radiation therapy in people with Primary Central Nervous System Neoplasms, run by Societe Internationale d'Oncologie Pediatrique at 13 sites in 12 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Apr 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in United Kingdom, Austria, Belgium, Croatia, Denmark and 7 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression-free survival (time frame: week 24, and at 1, 3, and 5 years). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00276640, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Apr 2018.

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