Rhabdomyosarcoma Clinical Trial
Official title:
A Randomized Trial of Filgrastim-SD/01 vs. Filgrastim in Newly Diagnosed Children and Young Adults With Sarcoma Treated With Dose-Intensive Chemotherapy
Verified date | January 27, 2016 |
Source | National Institutes of Health Clinical Center (CC) |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Filgrastim (granulocyte colony-stimulating factor), which is administered by daily
subcutaneous injection after cytotoxic chemotherapy, shortens the duration of
chemotherapy-induced neutropenia and lowers the risk of infection. In children treated with
dose-intensive chemotherapy, filgrastim reduces the duration of severe neutropenia and, as a
result, has become a standard component of the treatment regimen. Filgrastim-SD/01 (AMGEN),
which is produced by PEGylation of the amino-terminus of filgrastim, is a sustained duration
form of granulocyte colony-stimulating factor. In phase I and phase II trials in adults, a
single dose of Filgrastim-SD/01 appears to be equivalent to daily dosing of filgrastim in
enhancing neutrophil recovery and has a comparable adverse event profile.
Dose-intensive vincristine/cyclophosphamide/doxorubicin (VDoxC) alternating with
ifosfamide/etoposide (IE) has become standard therapy for children and adolescents with
Ewing's sarcoma and other sarcomas treated at the POB/NCI and other cancer centers within the
US. Supportive care measures used in children who are treated with this regimen include mesna
to prevent oxazaphosphorine urotoxicity, dexrazoxane to reduce doxorubicin cardiotoxicity,
and filgrastim to shorten the duration of neutropenia. The purpose of this randomized open
label trial is to compare the tolerance, toxicity, and therapeutic effects of
Filgrastim-SD/01 given as a single injection after chemotherapy to daily subcutaneous
filgrastim in patients with newly diagnosed sarcoma. The pharmacokinetics of Filgrastim-SD/01
will also be compared to the pharmacokinetics of filgrastim. This trial will also be a
platform for performing biological studies of these tumors and for detailed cardiac studies.
High-risk patients who are treated on this front line trial and respond will also be
candidates for a planned transplant protocol. A total of 34 patients (17 patients per
treatment arm) will be entered onto the trial.
Status | Completed |
Enrollment | 34 |
Est. completion date | May 20, 2009 |
Est. primary completion date | May 20, 2009 |
Accepts healthy volunteers | No |
Gender | All |
Age group | N/A to 25 Years |
Eligibility |
- INCLUSION CRITERIA: - Newly diagnosed histologically proven: - Ewing's sarcoma family of tumors, including peripheral neuroectodermal tumors; - Alveolar rhabdomyosarcoma; - Stage 3 or 4 embryonal rhabdomyosarcoma; - Malignant peripheral nerve sheath tumor that is unresectable, incompletely resected with bulk residual disease or metastatic; - Synovial cell sarcoma that is unresectable, incompletely resected with bulk residual disease, or metastatic. - Age equal to or less than 25 years at the time of diagnosis. - Normal cardiac function (ejection fraction by MUGA or ECHO that is within the institutional normal range). - Normal serum creatinine for age or creatinine clearance greater than 60 ml/min/1.73m(2). - Normal liver function (SGPT less than 5 times the upper limit of normal and bilirubin less than 2.5 times the upper limit of normal). - Normal hematologic function (absolute neutrophil count equal to or greater than 1500/microL, hemoglobin equal to or greater than 9.0 g/dl and platelet count equal to or greater than 100,000/microL). - Subjects of childbearing or child-fathering potential must be willing to use a medically acceptable form of birth control, which includes abstinence, while being treated on this study. EXCLUSION CRITERIA: - Previous chemotherapy or radiotherapy. - Pregnant or breast feeding females because the chemotherapy administered on this trial could have a detrimental effect on the developing fetus or newborn. - Histological evidence of tumor infiltration of bone marrow. - Stage 1 or 2 embryonal rhabdomyosarcomas. |
Country | Name | City | State |
---|---|---|---|
United States | National Institutes of Health Clinical Center, 9000 Rockville Pike | Bethesda | Maryland |
Lead Sponsor | Collaborator |
---|---|
National Cancer Institute (NCI) |
United States,
Delgado C, Francis GE, Fisher D. The uses and properties of PEG-linked proteins. Crit Rev Ther Drug Carrier Syst. 1992;9(3-4):249-304. Review. — View Citation
Layton JE, Hockman H, Sheridan WP, Morstyn G. Evidence for a novel in vivo control mechanism of granulopoiesis: mature cell-related control of a regulatory growth factor. Blood. 1989 Sep;74(4):1303-7. — View Citation
Welte K, Gabrilove J, Bronchud MH, Platzer E, Morstyn G. Filgrastim (r-metHuG-CSF): the first 10 years. Blood. 1996 Sep 15;88(6):1907-29. Review. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Tolerance and toxicity | 1 year | ||
Primary | PKs | 1 year | ||
Secondary | Compare neutrophil function | |||
Secondary | Compare CD34 positive stem cell mobilization | |||
Secondary | Compare days of febrile neutropenia, days on antibiotics, and inpatient days resulting from neutropenia | |||
Secondary | Evaluate the role of functional cardiac MRI and serum troponin T levels in detecting early doxorubicin cardiotoxicity | |||
Secondary | Assess methods of detecting minimal residual disease | |||
Secondary | cDNA microarray analysis of gene expression, development of cell lines and xenotransplantation models, and exploration of apoptotic pathways |
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