NeuroblastomaNCT00526318
Combination Chemotherapy Followed by Stem Cell Transplant and Isotretinoin in Treating Young Patients With High-Risk Neuroblastoma
A study testing filgrastim, carboplatin and cisplatin in people with Neuroblastoma, run by German Society for Pediatric Oncology and Hematology GPOH gGmbH at 68 sites in 2 countries.
Trial summary
RATIONALE: Giving chemotherapy before an autologous stem cell transplant stops the growth of tumor cells by stopping them from dividing or by killing them. It also prepares the patient's bone marrow for the stem cell transplant. Read more about this study
- Who is it for?
- Ages Up to 21 years
- Conditions the study is for
- Neuroblastoma
- What is being tested?
- filgrastim, carboplatin and cisplatin
- Type of treatment
- Surgery or procedure
- How many people
- 360 participants
- Where
- 68 sitesin 2 countries
- Study dates
- Jan 2007to Dec 2016
- 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 Up to 21 years
- All sexes
- No healthy volunteers
- Child, Adult
DISEASE CHARACTERISTICS:
- Diagnosis of neuroblastoma according to any of the following criteria:
- Histological diagnosis from tumor tissue
- Presence of distinct neuroblastoma cells in the bone marrow and elevated catecholamine metabolites (HVA, VMA) in blood or urine
- High-risk disease, meeting 1 of the following criteria:
- Stage 4 disease, regardless of the MYCN status (1-21 years of age)
- Stage 1-3 or 4S disease with MYCN amplification (6 months -21 years of age)
PATIENT CHARACTERISTICS:
- Not pregnant or nursing
- Fertile patients must use effective contraception (hormonal contraception or intra-uterine device [IUD])
PRIOR CONCURRENT THERAPY:
- No concurrent participation in another clinical trial that would preclude the interventions or outcome assessment of this clinical trial
- No other concurrent anticancer therapy
Trial locations and contacts
68 sites in 2 countries.
68 sites in 2 countries
Germany63 sites, 63 recruiting
- Recruiting
Kinderklinik - Universitaetsklinikum Aachen
Aachen, D-52074
R. Mertens, MD, PhD, 49-241-808-9902, rmertens@ukaachen.de
- Recruiting
Klinikum Augsburg
Augsburg, DOH-86156
Astrid Gnekow, 49-821-400-3603
- Recruiting
Klinikum Bayreuth
Bayreuth, D-95445
T. Rupprecht, 49-921-400-1400
- Recruiting
Helios Klinikum Berlin
Berlin, 13125
Lothar Schweigerer, MD, 49-30-9401-2345
- Recruiting
Charite University Hospital - Campus Virchow Klinikum
Berlin, D-13353
Gunter Henze, 49-30-450-660-31
- Recruiting
Evangelisches Krankenhauus Bielfeld
Biefeld, 33617
N. Jorch, MD, 49-52-177-278-050
- Recruiting
Kinderklinik der Universitaet Bonn
Bonn, D-53113
Udo Bode, MD, 49-228-2873-3215, udo.bode@ukb.uni-bonn.de
- Recruiting
Staedtisches Klinikum - Howedestrase
Braunschweig, 38118
Wolfgang Eberl, MD, 49-531-595-1222, w.eberl@kliniklum-braunschweig.de
- Recruiting
Klinikum Bremen-Mitte
Bremen, D-28205
Arnulf Pekrun, MD, PhD, 49-421-497-3656, arnulf.pekrun@klinikum-bremen-mitte.de
- Recruiting
Klinikum Chemnitz gGmbH
Chemnitz, D-09116
Krause, MD, 49-371-3332-4124
- Recruiting
Klinikum Coburg
Coburg, 96450
Roland Frank, MD, 49-9561-22-5547
- Recruiting
Children's Hospital
Cologne, D-50924
Frank Berthold, MD, 49-221-478-4380, frank.berthold@uk-koeln.de
- Recruiting
Carl - Thiem - Klinkum Cottbus
Cottbus, D-03048
D Mobius, MD, 49-355-462336
- Recruiting
Vestische Kinderklinik
Datteln, 45704
W. Andler, MD, 49-023-63-9750, w.andler@kinderklinik-datteln.de
- Recruiting
Klinikum Lippe - Detmold
Detmold, D-32756
Klaus Wesseler, MD, 49-523-172-4511
- Recruiting
Klinikum Dortmund
Dortmund, D-44137
Dominik T. Schneider, MD, 49-231-953-2-1670, dominik.schneider@klinikumdo.de
- Recruiting
Universitatsklinikum Carl Gustav Carus
Dresden, D-01307
M. Suttorp, MD, 49-351-458-0, meinolf.suttorp@uniklinikum-dresden.de
- Recruiting
Klinikum Duisburg
Duisburg, D-47055
Ruef, MD, 49-203-733-2421
- Recruiting
Universitaetsklinikum Duesseldorf
Düsseldorf, D-40225
Arndt Borkhardt, 49-211-311-7990
- Recruiting
Helios Klinikum Erfurt
Erfurt, 99089
Axel Sauerbrey, MD, 49-361-781-3729, asauerbrey@erfurt.helios-kliniken.de
- Recruiting
Universitaets - Kinderklinik
Erlangen, 91054
W. Holter, MD, 49-9131-853-3118
- Recruiting
Universitaetsklinikum Essen
Essen, D-45147
Bernhard Kremens, MD, 49-201-723-2453
- Recruiting
Klinikum der J.W. Goethe Universitaet
Frankfurt, D-60590
Thomas Klingebiel, MD, 49-69-6301-5094, thomas.klingebiel@kgu.de
- Recruiting
Universitaetskinderklinik - Universitaetsklinikum Freiburg
Freiburg im Breisgau, D-79106
Charlotte Niemeyer, MD, 49-761-270-4506, charlotte.niemeyer@uniklinik-freiburg.de
- Recruiting
Kinderklinik
Giessen, D-35385
Alfred Reiter, MD, 49-641-994-3420
- Recruiting
Universitaetsklinikum Goettingen
Göttingen, D-37075
M. Lakomek, MD, 49-551-398-600
- Recruiting
Universitats - Kinderklinik
Greiswald, 17487
James F. Beck, MD, 49-383-486-6325, beck@uni-greifswald.de
- Recruiting
Universitaetsklinikum Halle
Halle, D-06097
Dieter Koerholz, MD, 49-345-557-2387
- Recruiting
Krankenhaus St. Elisabeth und St. Barbara
Halle, D-06110
G. Guenther, MD, 49-345-482-50
- Recruiting
University Medical Center Hamburg - Eppendorf
Hamburg, D-20246
Rudolf Erttmann, MD, 49-40-4717-4270, erttmann@uke.uni-hamburg.de
- Recruiting
Medizinische Hochschule Hannover
Hanover, D-30625
Karl Welte, MD, 49-511-532-6710, welte.karl.h@mh-hannover.de
- Recruiting
Universitaets-Kinderklinik Heidelberg
Heidelberg, D-69120
Andreas E. Kulozik, MD, PhD, 49-6221-564-555, andreas.kulozik@med.uni-heidelberg.de
- Recruiting
Gemeinschaftskrankenhaus
Herdecke, 58313
Christoph Tautz, MD, 49-2330-62-3914, ctautz@yahoo.de
- Recruiting
Universitaetsklinikum des Saarlandes
Homburg, 66421
Norbert Graf, 49-6841-162-4000
- Recruiting
Universitaets - Kinderklinik
Jena, D-07745
Felix Zintl, MD, 49-3641-938-270
- Recruiting
Staedtisches Klinikum Karlsruhe gGmbH
Karlsruhe, 76133
A. Leipold, 49-721-974-3311
- Recruiting
Klinikum Kassel
Kassel, D-34125
Martina Rodehueser, MD, 49-561-980-3066
- Recruiting
University Hospital Schleswig-Holstein - Kiel Campus
Kiel, D-24105
A. Claviez, MD, 49-431-597-1622, a.claviez@pediatrics.uni-kiel.de
- Recruiting
Klinikum Kemperhof Koblenz
Koblenz, D-56065
M. Rister, MD, 49-261-499-2602
- Recruiting
Klinikum Krefeld GmbH
Krefeld, D-47805
S. Volpel, MD, 49-2151-32-2375
- Recruiting
Universitaets - Kinderklinik - Luebeck
Lübeck, D-23538
Peter P. Bucsky, MD, 49-451-500-2956, bucsky@paedia.ukl.mu-luebeck.de
- Recruiting
St. Annastift Krankenhaus
Ludwigshafen, 67065
Barbara Selle, MD, 49-621-5702-4449
- Recruiting
Universitaetsklinkum Magdeburg der Otto-von-Guericke-Universitaet Magdeburg
Magdeburg, D-39120
P. Vorwerk, MD, 49-394-672-791
- Recruiting
Johannes Gutenberg University
Mainz, D-55101
P. Gutjahr, MD, 49-6131-17-2112
- Recruiting
Staedtisches Klinik - Kinderklinik
Mannheim, D-68167
M. Duerken, 49-621-383-2243
- Recruiting
Universitaetsklinikum Giessen und Marburg GmbH - Marburg
Marburg, D-35043
H. Christiansen, MD, 49-6421-286-2671
- Recruiting
Klinikum Minden
Minden, D-32423
Bernhard Erdlenbruch, MD, 49-57-1801-4601, bernhard.erdlenbruch@klinikum-minden.de
- Recruiting
Krankenhaus Muenchen Schwabing
Munich, 80804
Stefan Burdach, MD, PhD, 49-89-3068-2352
- Recruiting
Dr. von Haunersches Kinderspital der Universitaet Muenchen
Munich, D-80337
Irene Schmid, MD, 49-89-5160-7978
- Recruiting
Klinik und Poliklinik fuer Kinder und Jugendmedizin - Universitaetsklinikum Muenster
Münster, D-48149
Heribert F. Juergens, MD, 49-251-834-7742, jurgh@uni-muenster.de
- Recruiting
Klinikum Neubrandenburg
Neubrandenburg, 17036
H. J. Feickert, MD, PhD, 49-395-775-2901, feickerthj@dbk-nb.de
- Recruiting
Cnopf'sche Kinderklinik
Nuremberg, 90419
W. Scheurlen, 49-911-334-002
- Recruiting
Klinikum Oldenburg
Oldenburg, 26133
Hermann Mueller, MD, 49-441-403-2013, mueller.hermann@klinikum-oldenburg.de
- Recruiting
Klinik St. Hedwig-Kinderklinik
Regensburg, 93049
Ove Peters, 49-941-369-5404
- Recruiting
Kinderklinik - Universitaetsklinikum Rostock
Rostock, D-18057
Carl Friedrich Classen, MD, PD, 49-381-494-0, carl-friedrich.classen@med.uni-rostock.de
- Recruiting
Johanniter-Kinderklinik
Sankt Augustin, 53757
Roswitha Dickerhoff, MD, 49-22-41-2491, roswitha.dickerhoft@uni-bonn.de
- Recruiting
Kinderklink Siegen Deutsches Rotes Kreuz
Siegen, D-57072
Rainer Burghard, MD, 49-271-2345-0, rainer.burghard@drk-kinderklinik.de
- Recruiting
Olgahospital
Stuttgart, D-70176
Stefan Bielack, MD, 49-711-99-24-61, st.bielack@olgahospital.de
- Recruiting
Krankenanstalt Mutterhaus der Borromaerinnen
Trier, D-54290
Wolfgang Rauh, MD, 49-651-947-2654
- Recruiting
Universitaetsklinikum Tuebingen
Tübingen, D-72076
Rupert Handgretinger, MD, 49-7071-298-2087
- Recruiting
Comprehensive Cancer Center Ulm at Universitaetsklinikum Ulm
Ulm, D-89075
Klaus M. Debatin, MD, 49-731-5002-7790, klaus-michael.debatin@medizin.uni-ulm.de
- Recruiting
Helios Kliniken Wuppertal University Hospital
Wuppertal, D-42283
K. Sinha, MD, 49-202-896-2441
- Recruiting
Universitaets - Kinderklinik Wuerzburg
Würzburg, D-97080
P. G. Schlegel, MD, 49-931-201-27-831, schlegel@mail.uni-wuerzburg.de
Switzerland5 sites, 5 recruiting
- Recruiting
Kantonsspital Aarau
Aarau, CH-5001
R. Angst, 41-62-838-4906
- Recruiting
Universitaets-Kinderspital beider Basel
Basel, CH-4005
Thomas Kuhne, MD, 41-61-685-6565, thomas.kuehne@ukbb.ch
- Recruiting
Kinderspital Luzern
Lucerne, CH-6000
U. Caflisch, MD, 41-41-205-11-11
- Recruiting
Ostschweizer Kinderspital
Sankt Gallen, CH-9006
Jeanette Greiner, MD, 41-71-243-13-60, jeanette.greiner@kispisg.ch
- Recruiting
University Children's Hospital
Zurich, CH-8032
Felix Niggli, MD, 41-44-266-7823
About this study
Official title: Trial Protocol for the Treatment of Children With High Risk Neuroblastoma (NB2004-HR)
RATIONALE: Giving chemotherapy before an autologous stem cell transplant stops the growth of tumor cells by stopping them from dividing or by killing them. It also prepares the patient's bone marrow for the stem cell transplant. The stem cells are given to the patient to replace the blood-forming cells that were destroyed by the chemotherapy. Giving isotretinoin after transplant may kill any remaining tumor cells. It is not yet known which combination chemotherapy regimen is more effective when given before a stem cell transplant and isotretinoin in treating neuroblastoma.
PURPOSE: This randomized clinical trial is studying two different combination chemotherapy regimens to compare how well they work when given before a stem cell transplant and isotretinoin in treating young patients with high-risk neuroblastoma.
Read the detailed description
OBJECTIVES:
Primary
- Compare the event-free survival of pediatric patients with high-risk neuroblastoma treated with standard induction chemotherapy vs topotecan hydrochloride-containing induction chemotherapy followed by myeloablative autologous stem cell transplantation and consolidation therapy with isotretinoin.
Secondary
- Compare the overall survival of patients treated with these regimens.
- Compare early response (complete response, very good partial response, partial response, mixed response, stable disease, and progression/relapse) after 2 courses of standard vs experimental induction chemotherapy (or after 60 days if the second course is not yet finished).
- Compare response to standard vs experimental induction chemotherapy before autologous stem cell transplantation (or after 280 days if induction chemotherapy is not yet finished).
- Compare the toxicity of standard vs experimental induction chemotherapy during courses 1 and 2 and the frequency of ≥ grade 3 toxicity during the last 6 courses of induction chemotherapy.
- Compare the extent of initial surgery and best surgery (biopsy vs incomplete resection vs macroscopic complete resection) and the frequency of complications related to surgery (e.g., nephrectomy, bleeding, infection, or intestinal obstruction).
- Compare the acute and long-term side effects of external-beam radiotherapy.
- Correlate the activity of MIBG and whole-body radiation dose.
- Collect and store tumor material in the tumor bank for future evaluation of other molecular markers (MYCN and status of chromosome 1p and 11q) and prognostic significant gene signatures.
OUTLINE: This is a multicenter study. Patients are stratified according to disease stage, lactate dehydrogenase (LDH) status, MYCN status, and age at diagnosis (stage 4 disease; LDH not elevated; any MYCN status; age at diagnosis 1-21 years vs stage 4 disease; LDH elevated; any MYCN status; age at diagnosis ≥ 1 but < 2 years vs stage 4 disease; LDH elevated; any MYCN status; age at diagnosis 2-21 years vs localized disease; MYCN amplification; age at diagnosis ≥ 6 months)
- Induction chemotherapy: Patients are randomized to 1 of 2 induction chemotherapy arms.
- Arm I (standard): Patients receive N5 chemotherapy comprising cisplatin IV continuously over 96 hours and etoposide phosphate IV continuously over 96 hours on days 1-4 and vindesine IV over 1 hour on day 1. Patients also receive filgrastim (G-CSF) subcutaneously (SC) once daily beginning on day 9 and continuing until blood counts recover. Patients then receive N6 chemotherapy comprising vincristine IV over 1 hour on days 1 and 8, dacarbazine IV over 1 hour on days 1-5, ifosfamide IV continuously over 120 hours on days 1-5, and doxorubicin hydrochloride IV over 4 hours on days 6 and 7. Patients also receive G-CSF SC once daily beginning on day 10 and continuing until blood counts recover. Treatment with N5 and N6 chemotherapy alternates every 21 days for 6 courses (N5 chemotherapy is given in courses 1, 3, and 5 and N6 chemotherapy is given in courses 2, 4, and 6).
- Arm II (experimental): Patients receive N8 chemotherapy comprising cyclophosphamide IV over 1 hour on days 1-7, topotecan hydrochloride IV continuously over 168 hours on days 1-7, and etoposide phosphate IV over 1 hour on days 8-10. Patients also receive G-CSF SC once daily beginning on day 12 and continuing until blood counts recover. Treatment with N8 chemotherapy repeats every 21 days for 2 courses. Patients then receive N5 chemotherapy alternating with N6 chemotherapy as in arm I.
- Surgery: Patients may undergo secondary surgery after completion of 4 or 6 courses of induction chemotherapy but prior to radiotherapy.
- Radiotherapy (131I-MIBG therapy and external-beam radiotherapy [EBRT]): Patients with active residual primary tumor after the completion of induction chemotherapy undergo ^131I-MIBG therapy* prior to autologous stem cell transplantation (ASCT) and EBRT after ASCT.
NOTE: *Patients with MIBG negative neuroblastoma at initial diagnosis will only receive EBRT.
- Myeloablative ASCT: Patients receive melphalan IV over 30 minutes on days -8 to -5, etoposide phosphate IV over 4 hours on day -4, and carboplatin IV over 1 hour on days -4 to -2. Patients undergo reinfusion of CD34+ stem cells on day 0. Patients also receive G-CSF SC or IV over 4 hours once daily beginning on day 2 and continuing until blood counts recover.
- Consolidation therapy (isotretinoin)*: Beginning 30 days after ASCT, patients receive oral isotretinoin once daily on days 1-14. Treatment repeats every 28 days for up to 6 courses. Beginning 3 months later, patients receive an additional 3 courses of isotretinoin.
NOTE: *Isotretinoin must not be given concurrently with radiotherapy
After completion of study treatment, patients are followed every 6 weeks for 1 year, every 3 months for 4 years, and then every 6 months thereafter.
- Conditions
- Neuroblastoma
- Being tested
- filgrastim, carboplatin, cisplatin, cyclophosphamide, dacarbazine
- Keywords
- localized resectable neuroblastoma, localized unresectable neuroblastoma, regional neuroblastoma, stage 4S neuroblastoma, disseminated neuroblastoma
- Medical subject headings
- Neuroblastoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
filgrastimBiological
carboplatinDrug
cisplatinDrug
cyclophosphamideDrug
dacarbazineDrug
etoposide phosphateDrug
ifosfamideDrug
isotretinoinDrug
melphalanDrug
topotecan hydrochlorideDrug
vindesineDrug
autologous hematopoietic stem cell transplantationProcedure or surgery
iobenguane I 131Radiation
radiation therapyRadiation
What is being measured
The primary outcome is the main question the study is designed to answer.
Event-free survival (EFS)
Secondary outcomes (9)
Overall survival (OS)
Impact of well established clinical and molecular risk factors on EFS and OS
Early response, measured after 2 courses of induction chemotherapy
Response to induction therapy, measured before autologous stem cell transplantation
Toxicity during the first 2 courses and the last 6 courses of induction chemotherapy
Impact of the extent of initial and best surgery on outcome and frequency of complications
Acute and late toxicity of radiotherapy
Correlation of MIBG activity with whole-body radiation dose
Molecular markers (MYCN and status of chromosome 1p and 11q)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Sep 2007 (estimated)
- Study startJan 2007
- Primary completionDec 2016 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for NeuroblastomaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Randomised
- Enrolment
- 360 participants (estimated)
Sponsor and investigators
- Lead sponsor
- German Society for Pediatric Oncology and Hematology GPOH gGmbH
- Sponsor type
- University, hospital or other
- Investigators
- Frank Berthold, MD, Study chair, Children's Hospital Medical Center, Cincinnati
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00526318
- Sponsor's protocol ID
- GPOH-NB2004-HR
- Other IDs
- CDR0000564820, UNI-KOELN-161, EU-20661
- Status last verified
- Jul 2015
- First submitted
- 5 Sep 2007
- Last updated
- 16 Jul 2015
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 16 Jul 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Trial Protocol for the Treatment of Children With High Risk Neuroblastoma (NB2004-HR)
- ClinicalTrials.gov ID
- NCT00526318
- Acronym / sponsor ID
- GPOH-NB2004-HR
- Conditions
- Neuroblastoma
- Keywords
- localized resectable neuroblastoma, localized unresectable neuroblastoma, regional neuroblastoma, stage 4S neuroblastoma, disseminated neuroblastoma
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 360 participants (estimated)
- Lead sponsor
- German Society for Pediatric Oncology and Hematology GPOH gGmbHUniversity, hospital or other
- Study start
- Jan 2007
- Primary completion
- Dec 2016 (estimated)
- First posted
- 10 Sep 2007 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Giving chemotherapy before an autologous stem cell transplant stops the growth of tumor cells by stopping them from dividing or by killing them. It also prepares the patient's bone marrow for the stem cell transplant. The stem cells are given to the patient to replace the blood-forming cells that were destroyed by the chemotherapy. Giving isotretinoin after transplant may kill any remaining tumor cells. It is not yet known which combination chemotherapy regimen is more effective when given before a stem cell transplant and isotretinoin in treating neuroblastoma.
PURPOSE: This randomized clinical trial is studying two different combination chemotherapy regimens to compare how well they work when given before a stem cell transplant and isotretinoin in treating young patients with high-risk neuroblastoma.
Detailed description
OBJECTIVES:
Primary
- Compare the event-free survival of pediatric patients with high-risk neuroblastoma treated with standard induction chemotherapy vs topotecan hydrochloride-containing induction chemotherapy followed by myeloablative autologous stem cell transplantation and consolidation therapy with isotretinoin.
Secondary
- Compare the overall survival of patients treated with these regimens.
- Compare early response (complete response, very good partial response, partial response, mixed response, stable disease, and progression/relapse) after 2 courses of standard vs experimental induction chemotherapy (or after 60 days if the second course is not yet finished).
- Compare response to standard vs experimental induction chemotherapy before autologous stem cell transplantation (or after 280 days if induction chemotherapy is not yet finished).
- Compare the toxicity of standard vs experimental induction chemotherapy during courses 1 and 2 and the frequency of ≥ grade 3 toxicity during the last 6 courses of induction chemotherapy.
- Compare the extent of initial surgery and best surgery (biopsy vs incomplete resection vs macroscopic complete resection) and the frequency of complications related to surgery (e.g., nephrectomy, bleeding, infection, or intestinal obstruction).
- Compare the acute and long-term side effects of external-beam radiotherapy.
- Correlate the activity of MIBG and whole-body radiation dose.
- Collect and store tumor material in the tumor bank for future evaluation of other molecular markers (MYCN and status of chromosome 1p and 11q) and prognostic significant gene signatures.
OUTLINE: This is a multicenter study. Patients are stratified according to disease stage, lactate dehydrogenase (LDH) status, MYCN status, and age at diagnosis (stage 4 disease; LDH not elevated; any MYCN status; age at diagnosis 1-21 years vs stage 4 disease; LDH elevated; any MYCN status; age at diagnosis ≥ 1 but < 2 years vs stage 4 disease; LDH elevated; any MYCN status; age at diagnosis 2-21 years vs localized disease; MYCN amplification; age at diagnosis ≥ 6 months)
- Induction chemotherapy: Patients are randomized to 1 of 2 induction chemotherapy arms.
- Arm I (standard): Patients receive N5 chemotherapy comprising cisplatin IV continuously over 96 hours and etoposide phosphate IV continuously over 96 hours on days 1-4 and vindesine IV over 1 hour on day 1. Patients also receive filgrastim (G-CSF) subcutaneously (SC) once daily beginning on day 9 and continuing until blood counts recover. Patients then receive N6 chemotherapy comprising vincristine IV over 1 hour on days 1 and 8, dacarbazine IV over 1 hour on days 1-5, ifosfamide IV continuously over 120 hours on days 1-5, and doxorubicin hydrochloride IV over 4 hours on days 6 and 7. Patients also receive G-CSF SC once daily beginning on day 10 and continuing until blood counts recover. Treatment with N5 and N6 chemotherapy alternates every 21 days for 6 courses (N5 chemotherapy is given in courses 1, 3, and 5 and N6 chemotherapy is given in courses 2, 4, and 6).
- Arm II (experimental): Patients receive N8 chemotherapy comprising cyclophosphamide IV over 1 hour on days 1-7, topotecan hydrochloride IV continuously over 168 hours on days 1-7, and etoposide phosphate IV over 1 hour on days 8-10. Patients also receive G-CSF SC once daily beginning on day 12 and continuing until blood counts recover. Treatment with N8 chemotherapy repeats every 21 days for 2 courses. Patients then receive N5 chemotherapy alternating with N6 chemotherapy as in arm I.
- Surgery: Patients may undergo secondary surgery after completion of 4 or 6 courses of induction chemotherapy but prior to radiotherapy.
- Radiotherapy (131I-MIBG therapy and external-beam radiotherapy [EBRT]): Patients with active residual primary tumor after the completion of induction chemotherapy undergo ^131I-MIBG therapy* prior to autologous stem cell transplantation (ASCT) and EBRT after ASCT.
NOTE: *Patients with MIBG negative neuroblastoma at initial diagnosis will only receive EBRT.
- Myeloablative ASCT: Patients receive melphalan IV over 30 minutes on days -8 to -5, etoposide phosphate IV over 4 hours on day -4, and carboplatin IV over 1 hour on days -4 to -2. Patients undergo reinfusion of CD34+ stem cells on day 0. Patients also receive G-CSF SC or IV over 4 hours once daily beginning on day 2 and continuing until blood counts recover.
- Consolidation therapy (isotretinoin)*: Beginning 30 days after ASCT, patients receive oral isotretinoin once daily on days 1-14. Treatment repeats every 28 days for up to 6 courses. Beginning 3 months later, patients receive an additional 3 courses of isotretinoin.
NOTE: *Isotretinoin must not be given concurrently with radiotherapy
After completion of study treatment, patients are followed every 6 weeks for 1 year, every 3 months for 4 years, and then every 6 months thereafter.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
Who may qualify
- Ages
- Up to 21 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| filgrastim | Biological | – |
| carboplatin | Drug | – |
| cisplatin | Drug | – |
| cyclophosphamide | Drug | – |
| dacarbazine | Drug | – |
| doxorubicin hydrochloride | Drug | – |
| etoposide phosphate | Drug | – |
| ifosfamide | Drug | – |
| isotretinoin | Drug | – |
| melphalan | Drug | – |
| topotecan hydrochloride | Drug | – |
| vincristine sulfate | Drug | – |
| vindesine | Drug | – |
| autologous hematopoietic stem cell transplantation | Procedure or surgery | – |
| iobenguane I 131 | Radiation | – |
| radiation therapy | Radiation | – |
Primary outcome
Event-free survival (EFS)
9 secondary outcomes
Overall survival (OS)
Impact of well established clinical and molecular risk factors on EFS and OS
Early response, measured after 2 courses of induction chemotherapy
Response to induction therapy, measured before autologous stem cell transplantation
Toxicity during the first 2 courses and the last 6 courses of induction chemotherapy
Impact of the extent of initial and best surgery on outcome and frequency of complications
Acute and late toxicity of radiotherapy
Correlation of MIBG activity with whole-body radiation dose
Molecular markers (MYCN and status of chromosome 1p and 11q)
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Jul 2015.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Frank Berthold, MD study chair
Children's Hospital Medical Center, Cincinnati
68 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing filgrastim, carboplatin and cisplatin in people with Neuroblastoma, run by German Society for Pediatric Oncology and Hematology GPOH gGmbH at 68 sites in 2 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 16 Jul 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 68 sites in Germany, Switzerland. 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?
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 (EFS). 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 16 Jul 2015.