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Childhood Malignant Fibrous Histiocytoma of BonePhase 3NCT00334854

Ifosfamide and Doxorubicin, Radiation Therapy, and/or Surgery in Treating Young Patients With Localized Soft Tissue Sarcoma

A Phase 3 study testing doxorubicin hydrochloride, ifosfamide and adjuvant therapy in people with Childhood Malignant Fibrous Histiocytoma of Bone and Sarcoma, run by European Paediatric Soft Tissue Sarcoma Study Group at 28 sites in 9 countries.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

RATIONALE: Drugs used in chemotherapy, such as ifosfamide and doxorubicin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Read more about this study

Who is it for?
Ages Up to 20 years
What is being tested?
doxorubicin hydrochloride, ifosfamide and adjuvant therapy
Type of treatment
Surgery or procedure
How many people
250 participants
Where
28 sitesin 9 countries
Study dates
Mar 2006to May 2010
Phase
Phase 3
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 Up to 20 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

DISEASE CHARACTERISTICS:

  • Histologically confirmed synovial sarcoma or adult-type soft-tissue sarcoma
  • Adult-type soft tissue sarcoma includes any of the following:
  • Fibrosarcoma (adult-type)
  • No infantile fibrosarcoma
  • Malignant peripheral nerve sheath tumor
  • Malignant schwannoma
  • Neurofibrosarcoma
  • Epithelioid sarcoma
  • Leiomyosarcoma
  • Clear cell sarcoma
  • Liposarcoma
  • Alveolar soft-part sarcoma
  • Malignant fibrous histiocytoma
  • Hemangiopericytoma
  • Angiosarcoma
  • Dermatofibrosarcoma protuberans
  • Mesenchymal chondrosarcoma
  • No borderline tumors (e.g., hemangioendothelioma)
  • No small round cell tumors (e.g., extraosseous Ewing's sarcoma/primitive neuroectodermal tumor or desmoplastic small round cell tumor)
  • Post-irradiation soft-part sarcomas allowed
  • Diagnostic surgery performed within the past 8 weeks (for patients who require adjuvant chemotherapy)
  • No evidence of metastatic disease
  • Involved locoregional lymph nodes are allowed

PATIENT CHARACTERISTICS:

  • No prior malignancy
  • No pre-existing illness precluding study treatment*
  • Normal renal function (nephrotoxicity grade 0-1)*
  • No history of cardiac disease*
  • Normal shortening fraction (> 28%)*
  • Ejection fraction > 47%* NOTE: * For patients who require adjuvant chemotherapy

PRIOR CONCURRENT THERAPY:

  • No prior cancer treatment except primary surgery

Trial locations and contacts

28 sites in 9 countries.

28 sites in 9 countries

United Kingdom20 sites, 20 recruiting
  • Royal Aberdeen Children's Hospital

    Aberdeen, Scotland, AB25 2ZG

    Derek King, MD, 44-1224-681-818

    Recruiting
  • Royal Belfast Hospital for Sick Children

    Belfast, Northern Ireland, BT12 6BE

    Anthony McCarthy, MD, 44-289-063-3631, anthonymcarthy@royalhospital.n.i.nhs.uk

    Recruiting
  • Birmingham Children's Hospital

    Birmingham, England, B16 8ET

    David Hobin, MD, 44-121-454-4851

    Recruiting
  • Institute of Child Health at University of Bristol

    Bristol, England, BS2 8AE

    M. C. G. Stevens, MD, 44-117-342-0205, m.stevens@bristol.ac.uk

    Recruiting
  • Addenbrooke's Hospital

    Cambridge, England, CB2 2QQ

    Denise Williams, MD, 44-1223-256-298

    Recruiting
  • Childrens Hospital for Wales

    Cardiff, Wales, CF14 4XW

    Heidi Traunecker, MD, PhD, 44-29-2074-2285, heidi.traunecker@cardiffandvale.wales.nhs.uk

    Recruiting
  • Royal Hospital for Sick Children

    Edinburgh, Scotland, EH9 1LF

    W. Hamish Wallace, MD, 44-131-536-0426

    Recruiting
  • Royal Hospital for Sick Children

    Glasgow, Scotland, G3 8SJ

    Milind D. Ronghe, MD, 44-141-201-9309

    Recruiting
  • Leeds Cancer Centre at St. James's University Hospital

    Leeds, England, LS9 7TF

    Adam Glaser, MD, 44-113-206-4984, adam.glaser@leedsth.nhs.uk

    Recruiting
  • Leicester Royal Infirmary

    Leicester, England, LE1 5WW

    Johann Visser, MD, 44-116-258-5309, johannes.visser@uhl-tr.nhs.uk

    Recruiting
  • Royal Liverpool Children's Hospital, Alder Hey

    Liverpool, England, L12 2AP

    Heather P. McDowell, MD, 44-151-293-3679

    Recruiting
  • Middlesex Hospital

    London, England, W1T 3AA

    Ananth Shankar, MD, 44-20-7380-9300 ext. 9950

    Recruiting
  • Great Ormond Street Hospital for Children

    London, England, WC1N 3JH

    Julia Chisholm, MD, 44-20-7829-7924

    Recruiting
  • Royal Manchester Children's Hospital

    Manchester, England, M27 4HA

    Bernadette Brennan, MD, 44-161-922-2227, bernadette.brennan@cmmc.nhs.uk

    Recruiting
  • Sir James Spence Institute of Child Health at Royal Victoria Infirmary

    Newcastle upon Tyne, England, NE1 4LP

    Juliet Hale, MD, 44-191-282-4101, j.p.hale@ncl.ac.uk

    Recruiting
  • Queen's Medical Centre

    Nottingham, England, NG7 2UH

    Martin Hewitt, MD, BSc, FRCP, FRCPCH, 44-115-924-9924 ext. 63394, martin.hewitt@nuh.nhs.uk

    Recruiting
  • Oxford Radcliffe Hospital

    Oxford, England, 0X3 9DU

    Kate Wheeler, MD, 44-186-522-1066

    Recruiting
  • Children's Hospital - Sheffield

    Sheffield, England, S10 2TH

    Mary P. Gerrard, MBChB, FRCP, FRCPCH, 44-114-271-7366, mary.gerrard@sch.nhs.uk

    Recruiting
  • Southampton General Hospital

    Southampton, England, SO16 6YD

    Janice A. Kohler, MD, FRCP, 44-23-8079-6942

    Recruiting
  • Royal Marsden - Surrey

    Sutton, England, SM2 5PT

    Kathy Pritchard-Jones, MD, 44-20-8661-3452 ext 3498

    Recruiting

Other trials in United Kingdom

Austria1 site, 1 recruiting
  • St. Anna Children's Hospital

    Vienna, A-1090

    Ruth Ladenstein, MD, 43-1-404-700

    Recruiting

Other trials in Austria

Belgium1 site, 1 recruiting
  • Clinique de l'Esperance

    Montegnée, 4420

    Nadine Francotte, MD, 32-4-224-9111, nadine.francotte@chc.be

    Recruiting

Other trials in Belgium

Denmark1 site, 1 recruiting
  • Rigshospitalet - Copenhagen University Hospital

    Copenhagen, 2100

    Catherine Rechnitzer, MD, PhD, 45-3545-1368, rechnitzer@rh.dk

    Recruiting

Other trials in Denmark

France1 site, 1 recruiting
  • Institut Curie Hopital

    Paris, 75248

    Daniel Orbach, MD, 33-14-432-4550

    Recruiting

Other trials in France

Ireland1 site, 1 recruiting
  • Our Lady's Hospital for Sick Children Crumlin

    Dublin, 12

    Anne O'Meara, MD, 353-409-6659

    Recruiting

Other trials in Ireland

Spain1 site, 1 recruiting
  • Vall d'Hebron University Hospital

    Barcelona, 08035

    Soledad Gallego, MD, PhD, 34-93-489-3090, sgallego@vhebron.net

    Recruiting

Other trials in Spain

Sweden1 site, 1 recruiting
  • Uppsala University Hospital

    Uppsala, SE-75185

    Gustaf Ljungman, MD, 46-18-611-5586

    Recruiting

Other trials in Sweden

Switzerland1 site, 1 recruiting
  • University Children's Hospital

    Zurich, CH-8032

    Felix Niggli, MD, 41-44-266-7823

    Recruiting

Other trials in Switzerland

About this study

Official title: Localized Non-Rhabdomyosarcoma Soft Tissue Sarcomas

RATIONALE: Drugs used in chemotherapy, such as ifosfamide and doxorubicin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving combination chemotherapy with or without radiation therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving radiation therapy after surgery may kill any tumor cells that remain after surgery.

PURPOSE: This phase III trial is studying how well giving ifosfamide and doxorubicin, radiation therapy, and/or surgery works in treating young patients with localized soft tissue sarcoma.

Read the detailed description

OBJECTIVES:

Primary

  • Determine survival rates (event-free survival and overall survival [OS]) and the pattern of treatment failure in patients with synovial sarcoma or adult-type soft tissue sarcoma treated with ifosfamide and doxorubicin hydrochloride, radiotherapy, and/or surgery.
  • Determine the role of ifosfamide and doxorubicin hydrochloride in improving the response rate in patients with unresectable synovial sarcoma or adult-type soft tissue sarcoma.

Secondary

  • Evaluate clinical/pathological prognostic factors, particularly tumor grade and radiological and pathological response to neoadjuvant treatment.
  • Determine the impact of omitting adjuvant chemotherapy in patients with low-risk synovial sarcoma (tumor < 5 cm).
  • Determine the role of adjuvant chemotherapy in improving the metastases-free survival and OS in patients with adult-type soft tissue sarcoma (Intergroup Rhabdomyosarcoma Study [IRS] postsurgical grouping system I-II, tumor grade 3, tumor size > 5 cm).

OUTLINE: This is a nonrandomized, prospective, historically controlled, multicenter study. Patients with synovial sarcoma are stratified according to the Intergroup Rhabdomyosarcoma Study (IRS) postsurgical grouping system (I vs II vs III) and tumor size ( ≤ 5 cm vs > 5 cm). Patients with adult-type soft tissue sarcoma are stratified according to the IRS postsurgical grouping system (I vs II vs III), tumor size ( ≤ 5 cm vs > 5 cm), and tumor grade (G1 vs G2 vs G3). Patients are assigned to 1 of 9 treatment groups according to disease and stratification.

Synovial sarcoma

  • Group 1 (IRS group I, tumor ≤ 5 cm): Patients undergo surgical resection of tumor.
  • Group 2 (IRS group I, tumor > 5 cm): Patients receive ifosfamide IV over 3 hours on days 1-3 and doxorubicin hydrochloride IV over 4-6 hours on days 1 and 2 (IFO-DOX). Treatment repeats every 21 days for 4 courses.
  • Group 3 (IRS group II, tumor ≤ 5 cm): Patients receive 3 courses of IFO-DOX. After the completion of chemotherapy, patients undergo radiotherapy 5 days a week for 5-6 weeks.
  • Group 4 (IRS group II, tumor > 5 cm): Patients receive 3 courses of IFO-DOX. Patients then receive ifosfamide alone IV over 3 hours on days 1-3. Treatment with ifosfamide repeats every 21 days for 2 courses. Patients also receive concurrent radiotherapy (concurrently with ifosfamide) 5 days a week for 5-6 weeks. After completion of radiotherapy, patients receive 1 additional course of IFO-DOX.
  • Group 5 (IRS group III, N1): Patients receive 3 courses of IFO-DOX. Patients with no response to chemotherapy receive 1 of the following local therapies:
  • Delayed complete resection*
  • Radiotherapy (as in group 3) followed by surgery*
  • Delayed complete resection* followed by radiotherapy** (as in group 3)
  • Delayed incomplete resection* followed by radiotherapy** (as in group 3)
  • Radiotherapy (as in group 3) Patients with major or minor response to chemotherapy receive 2 courses of ifosfamide with concurrent radiotherapy followed by 1 additional course of IFO-DOX (as in group 4, above).

NOTE: * Patients undergo surgery 5 weeks after completion of chemotherapy and/or radiotherapy.

NOTE: **Patients undergo radiotherapy beginning < 21 days after surgery.

Adult-type soft tissue sarcoma

  • Group 1 (IRS group I, tumor ≤ 5 cm): Patients undergo surgical resection of tumor.
  • Group 2 (IRS group I, tumor > 5 cm): Patients receive therapy according to tumor grade:
  • G1 disease: Patients undergo surgical resection.
  • G2 disease: Patients undergo radiotherapy 5 days a week for 5-6 weeks.
  • G3 disease: Patients receive the following sequential treatment: 3 courses of IFO-DOX followed by 2 courses of ifosfamide with concurrent radiotherapy followed by 1 course of IFO-DOX.
  • Group 3 (IRS group II, N0): Patients receive therapy according to tumor grade:
  • G1 disease: Patients undergo surgical resection.
  • G2-3 disease (≤ 5 cm) and G2 disease (> 5 cm): Patients undergo radiotherapy 5 days a week for 5-6 weeks.
  • G3 disease (> 5 cm): Patients undergo sequential treatment (as in group 2, adult-type soft tissue sarcoma).
  • Group 4 (IRS group III, N1): Patients receive 3 courses of IFO-DOX. Patients with no response to chemotherapy receive local therapy (as in group 5 synovial sarcoma). Patients with major or minor response to chemotherapy receive 2 courses of ifosfamide with concurrent radiotherapy followed by 2 additional courses of IFO-DOX (as in group 4, synovial sarcoma).

After completion of study therapy, patients are followed periodically for up to 10 years.

PROJECTED ACCRUAL: A total of 250 patients will be accrued for this study.

Keywords
childhood synovial sarcoma, nonmetastatic childhood soft tissue sarcoma, childhood alveolar soft-part sarcoma, childhood angiosarcoma, childhood epithelioid sarcoma, childhood fibrosarcoma, childhood leiomyosarcoma, childhood liposarcoma, childhood neurofibrosarcoma, localized childhood malignant fibrous histiocytoma of bone, childhood malignant hemangiopericytoma, dermatofibrosarcoma protuberans, chondrosarcoma
Medical subject headings
Sarcoma, Hemangiosarcoma, Fibrosarcoma, Liposarcoma, Hemangiopericytoma, Malignant, Dermatofibrosarcoma, Chondrosarcoma

What participants receive

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

What is being measured

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

  1. Event-free survival

  2. Local relapse-free survival

  3. Metastases-free survival

  4. Overall survival

  5. Response rate (complete response, very good partial response [PR], PR, minor PR, and stable disease)

Timeline

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

  1. First posted8 Jun 2006 (estimated)
  2. Study startMar 2006
  3. Primary completionMay 2010 (estimated)

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 3
Primary purpose
Treatment
Allocation
Non-randomised
Enrolment
250 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00334854
Sponsor's protocol ID
CCLG-EPSSG-NRSTS-2005
Other IDs
CDR0000482277, EU-20620, EUDRACT-2005-001139-31, UKCCSG-CTA-21275/0215/001/0001, CCLG-EpSSG-STS-2006-03
Status last verified
Jul 2009
First submitted
7 Jun 2006
Last updated
12 Aug 2013
Results posted
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing doxorubicin hydrochloride, ifosfamide and adjuvant therapy in people with Childhood Malignant Fibrous Histiocytoma of Bone and Sarcoma, run by European Paediatric Soft Tissue Sarcoma Study Group at 28 sites in 9 countries.

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

Who may be eligible to take part?

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: status not confirmed, as of the sponsor's last update on 12 Aug 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 28 sites in United Kingdom, Austria, Belgium, Denmark, France and 4 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.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

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

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Event-free survival. The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 12 Aug 2013.

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