Combination Chemotherapy Before and After Surgery in Treating Patients With Osteosarcoma

Sarcoma Clinical Trial

Official title:

Osteosarcoma: Outcome of Therapy Based on Histologic Response. A Collaborative Effort of the POB/NCI, Texas Children's Hospital and University of Oklahoma.

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT00019864
• Other study ID #: CDR0000067263
• Secondary ID: NCI-99-C-0125I
• Status: Terminated
• Phase: Phase 2
• First received: July 11, 2001
• Last updated: June 4, 2015
• Start date: March 2000
• Est. completion date: October 2011

Study information

• Verified date: October 2007
• Source: National Cancer Institute (NCI)
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Federal Government
• Study type: Interventional

Clinical Trial Summary

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Giving chemotherapy before surgery may shrink the tumor so that it can be removed during surgery. Giving chemotherapy after surgery may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving chemotherapy before and after surgery works in treating patients with osteosarcoma.

Description:

OBJECTIVES:

• Determine the rate of in vivo histologic response in patients with osteosarcoma treated with neoadjuvant cisplatin, methotrexate, and doxorubicin with dexrazoxane (as cardioprotection).

• Determine the event-free and overall survival of patients with nonmetastatic disease who show good response to neoadjuvant therapy and receive adjuvant therapy with the same regimen.

• Determine the event-free survival of patients with nonmetastatic disease who show poor response to neoadjuvant therapy and receive adjuvant therapy with the same regimen.

• Determine the event-free survival and overall survival of patients with metastatic disease who receive neoadjuvant therapy.

OUTLINE: This is a multicenter study.

• Neoadjuvant therapy: Patients receive neoadjuvant chemotherapy comprising dexrazoxane IV over 15 minutes, doxorubicin IV over 15 minutes, and cisplatin IV over 4 hours on days 1 and 2 in week 0. Patients also receive methotrexate IV over 4 hours followed by leucovorin calcium in weeks 3 and 4. Patients then receive filgrastim (G-CSF) subcutaneously (SC) once daily beginning 24 hours after completion of chemotherapy and continuing until blood counts recover. Treatment repeats every 5 weeks for 2 courses in the absence of disease progression or unacceptable toxicity.

• Surgical resection: Patients undergo definitive surgery in week 11.

• Adjuvant therapy: Patients receive dexrazoxane, doxorubicin, cisplatin, methotrexate, and leucovorin calcium as in neoadjuvant therapy*. Treatment repeats every 5 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity.

NOTE: *Cisplatin is not administered in courses 3 and 4 of adjuvant therapy

Patients are followed within 4 weeks, every 3 months for 2 years, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: Approximately 100 patients will be accrued for this study.

Other known NCT identifiers

• NCT00001821

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 100
• Est. completion date: October 2011
• Est. primary completion date: December 2006
• Accepts healthy volunteers: No
• Gender: Both
• Age group: N/A to 25 Years

Eligibility

DISEASE CHARACTERISTICS:

• Histologically confirmed newly diagnosed osteosarcoma

• No more than 1 month since prior diagnostic biopsy

• Nonmetastatic malignant high-grade osteosarcoma of bone

• Histologically confirmed metastatic disease allowed

• Unresectable primary disease allowed

• No low-grade, parosteal, or periosteal osteosarcoma

PATIENT CHARACTERISTICS:

Age:

• 25 and under

Performance status:

• Not specified

Life expectancy:

• Not specified

Hematopoietic:

• Absolute neutrophil count at least 1,000/mm^3

• Platelet count at least 100,000/mm^3

• Hemoglobin at least 8.0 g/dL

Hepatic:

• Bilirubin no greater than 2.0 mg/dL

• ALT less than 5 times normal

Renal:

• Creatinine no greater than 1.5 times normal

• Creatinine clearance or radioisotope glomerular filtration rate greater than 70 mL/min

Cardiovascular:

• Shortening fraction at least 27% by echocardiogram or MUGA

• Ejection fraction at least 45% by echocardiogram or MUGA

Other:

• Not pregnant

• Negative pregnancy test

• Fertile patients must use effective contraception during and for 6 months after study

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• See Disease Characteristics

• No other concurrent chemotherapy

Endocrine therapy:

• Not specified

Radiotherapy:

• See Disease Characteristics

Surgery:

• Not specified

Other:

• No other concurrent therapy with no evidence of progressive disease

Study Design

Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Cardiac Toxicity
• Osteosarcoma
• Sarcoma

Intervention

Biological:
• filgrastim

Drug:
• cisplatin

• dexrazoxane hydrochloride

• doxorubicin hydrochloride

• leucovorin calcium

• methotrexate

Procedure:
• adjuvant therapy

• conventional surgery

• neoadjuvant therapy

Locations

Country	Name	City	State
United States	Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office	Bethesda	Maryland
United States	Cook Children's Medical Center - Fort Worth	Fort Worth	Texas
United States	Texas Children's Cancer Center and Hematology Service at Texas Children's Hospital	Houston	Texas
United States	Oklahoma University Cancer Institute	Oklahoma City	Oklahoma

Sponsors (1)

Lead Sponsor	Collaborator
National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Rate of in vivo histologic response			No
Primary	Event-free survival			No
Primary	Overall survival			No