Detail Article

Informations générales (source: ClinicalTrials.gov)

Numéro NCT

NCT02265770 En recrutement IDF

Titre

An International Clinical Program for the Diagnosis and Treatment of Children, Adolescents and Young Adults With Ependymoma (SIOP-EP-II)

Type

Interventional

Pathologie

Épendymome

Phase

Phase 2/Phase 3

Promoteur

Centre Leon Berard (Voir sur ClinicalTrials)

Date de début

juin 2015

Date de fin

août 2031

Dernière mise à jour

29 juin 2024

Résumé

The overall aim of this project is to improve the outcome of patients diagnosed with ependymoma by improving and harmonising the staging and the standard of care of this patient population and to improve the investigators understanding of the underlying biology thereby informing future treatment. The program will evaluate new strategies for diagnosis (centralized reviews of pathology and imaging) and new therapeutic strategies in order to develop treatment recommendations. Patients will be stratified into different treatment subgroups according to their age, the tumour location and the outcome of the initial surgery. Each subgroup will be studied in a specific randomised study to evaluate the proposed therapeutic strategies. Stratum 1: The aim of the stratum 1 is to evaluate the clinical impact of 16-week chemotherapy regimen with VEC-CDDP following surgical resection and conformal radiotherapy in terms of progression free survival in patients who are > 12 months and < 22 years at diagnosis, with completely removed intra cranial Ependymoma. Stratum 2: This stratum is designed as a phase II trial for patients who are > 12 months and < 22 years at diagnosis, with residual disease to investigate the possible activity of HD-MTX by giving to all patients the benefit of VEC chemotherapy whilst randomising half of patients to receive additional HD-MTX. Patients will receive conformal radiotherapy (cRT). For patients who remain with a residual inoperable disease after induction chemotherapy and cRT, an 8 Gy boost of radiotherapy to the residual tumour will be delivered immediately after the end of the cRT. Stratum 3 This stratum is designed as a phase II trial to evaluate the benefit of postoperative dose intense chemotherapy administered alone or in combination with valproate in children <12 months of age or those not eligible to receive radiotherapy .

Détail

Voir le détail The Ependymoma Program is a comprehensive program to improve the accuracy of the primary diagnosis of ependymoma and explore different therapeutic strategies in children, adolescents and young adults, accordingly. This program is opened to all patients diagnosed with ependymoma below the age of 22 years. It will include a centralised review of pre and post-operative imaging to assess the completeness of the resection. It will also include a central review of pathology to confirm the histological diagnosis. The biological markers 1q and 6q gain, Tenascin C status, NELL2 and LAMA2, RELA-fusion and molecular subgroup by methylation array will be prospectively assessed for prospective evaluation of disease subgroups. Further biological evaluations will be coordinated within the linked BIOMECA study. After surgery and central review of imaging and pathology, patients will be offered the opportunity to undergo second look surgery, if possible. Patients will be enrolled in one of 3 different strata according to the outcome of the initial surgical resection (residual disease vs no residual disease), their age or eligibility / suitability to receive radiotherapy. These 3 different strata correspond to 3 therapeutic strategies according to the patient status. 1. Stratum 1 is designed as a randomised phase III study for patients who have had a complete resection, with no measurable residual disease (as confirmed by centrally reviewed MRI) and are > 12 months and < 22 years at diagnosis. Those patients will be randomised to receive conformal radiotherapy followed by either 16 weeks of chemotherapy with VEC-CDDP, or observation. 2. Stratum 2 is designed as a randomised phase II study for patients who have inoperable measurable residual disease and who are > 12 months and < 22 years at diagnosis. Those patients will be randomised to two different treatment schedules of chemotherapy either with VEC or VEC+ high dose methotrexate (VEC +HD-MTX). After completion of the frontline chemotherapy, patients will be assessed for response (MRI) and will receive second look surgery when feasible. For those patients who remain unresectable with residual disease despite frontline chemotherapy and for whom second line surgery is not feasible, there will be a study of the safety of a radiotherapy boost of 8 Gy that will be administered to the residual tumour immediately after the completion of the conformal radiotherapy. Patients without evidence of residual disease after the chemotherapy and/or a second look surgery are not eligible for radiotherapy boost. All patients who have not shown progression under chemotherapy will receive, as maintenance therapy, a 16 week course of VEC -CDDP following completion of radiotherapy. 3. Stratum 3 is designed as a randomised phase II chemotherapy study in children <12 months of age or those not eligible to receive radiotherapy. These patients will be randomised to receive a dose dense chemotherapy alternating myelosuppressive and relatively non-myelosuppressive drugs at 2 weekly intervals, with or without, the addition of the histone deacetylase inhibitor, valproate. Registry: Patients that do not fulfil the inclusion criteria of one of the interventional strata will be enrolled and followed up via an observational study which will be analysed descriptively. Fermer le détail

Etablissements

Les établissements d'Île-de-France ayant mis à jour leurs données Origine et niveau de fiabilité des données
CLCC INSTITUT CURIE		En recrutement IDF	04/09/2024 13:49:51	Contacter
CLCC INSTITUT GUSTAVE ROUSSY	L�a GUERRINI-ROUSSEAU	En recrutement IDF	04/06/2024 14:34:52	Contacter
Les établissements sans correspondance certaine dans le répertoire FINESS dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données
AP-HM - Hôpital d'Enfants de La Timone - 13385 - Marseille - Bouches-du-Rhône - France	Nicolas André, MD, PhD	En recrutement		Contact (sur clinicalTrials)
Centre LEON BERARD - 69473 - Lyon - Rhône - France	Pierre LEBLOND, MD	En recrutement		Contact (sur clinicalTrials)
Centre OSCAR LAMBRET - 59000 - Lille - Nord - France	Hélène SUDOUR, MD	En recrutement		Contact (sur clinicalTrials)
CHRU BESANCON - Hôpital Jean Minjoz - 25030 - Besançon - Doubs - France	Véronique Laithier, MD	En recrutement		Contact (sur clinicalTrials)
CHRU BREST - Hôpital Morvan - 29609 - Brest - Finistère - France	Liana-Stefania Carausu, MD	En recrutement		Contact (sur clinicalTrials)
CHRU MONTPELLIER - Hôpital Arnaud de Villeneuve - 34295 - Montpellier - Herault - France	Nicolas Sirvent, MD	En recrutement		Contact (sur clinicalTrials)
CHRU Saint-Etienne - 42055 - Saint-Etienne - Loire - France	Sandrine Thouvenin, MD	En recrutement		Contact (sur clinicalTrials)
CHRU STRASBOURG - Hôpital de Hautepierre - 67098 - Strasbourg - Bas-Rhin - France	Natacha Entz-Werle, MD	En recrutement		Contact (sur clinicalTrials)
CHRU Tours - Hôpital Clocheville - 37044 - Tours - Indre-et-Loire - France	Pascale Blouin, MD	En recrutement		Contact (sur clinicalTrials)
CHU AMIENS-PICARDIE - Hôpital Nord - 80054 - Amiens - Somme - France	Antoine Gourmel, MD	En recrutement		Contact (sur clinicalTrials)
Chu Angers - 49100 - Angers - Maine-et-Loire - France	Emilie De Carli, MD	En recrutement		Contact (sur clinicalTrials)
CHU Clermont- Ferrand - Hôpital Estaing - 63003 - Clermont-Ferrand - Puy-de-Dôme - France	Catherine Paillard, MD	En recrutement		Contact (sur clinicalTrials)
CHU de Bordeaux-Hôpital des enfants Pellegrin - 33000 - Bordeaux - Gironde - France	Céline Icher, MD	En recrutement		Contact (sur clinicalTrials)
CHU de RENNES - Hôpital Sud - 35203 - Rennes - Ille-et-Vilaine - France	Charline Normand, MD	En recrutement		Contact (sur clinicalTrials)
CHU de TOULOUSE - Hôpital des Enfants - 31059 - Toulouse - Haute-Garonne - France	Anne-Isabelle Bertozzi-Salamon, MD	En recrutement		Contact (sur clinicalTrials)
CHU Dijon - Hôpital des Enfants - 21079 - Dijon - Côte d'Or - France	Claire Briandet, MD	En recrutement		Contact (sur clinicalTrials)
CHU GRENOBLE - Hôpital Couple-Enfant - 38700 - La Tronche - Isère - France	Anne Pagnier, MD	En recrutement		Contact (sur clinicalTrials)
CHU La Réunion - 97400 - Saint-Denis - France	Yves REGUERRE, MD	En recrutement		Contact (sur clinicalTrials)
CHU Limoges - Limoges - France	Christophe Piguet, MD	En recrutement		Contact (sur clinicalTrials)
CHU NANCY - Brabois Hôpital d'Enfants - 54511 - Vandoeuvre-les-Nancy - Meurthe-et-Moselle - France	Pascal Chastagner, MD	En recrutement		Contact (sur clinicalTrials)
CHU Nice - Hôpital de l'Archet 2 - 06202 - Nice - France	Gwénaëlle DUHIL DE BENAZE, MD	En recrutement		Contact (sur clinicalTrials)
CHU POITIERS - Hôpital de la Milétrie - 86021 - Poitiers - Vienne - France	Frédéric Millot, MD	En recrutement		Contact (sur clinicalTrials)
CHU REIMS - American Memorial Hospital - 51092 - Reims - Marne - France	Claire Pluchart, MD	En recrutement		Contact (sur clinicalTrials)
CHU Rouen - Hôpital Charles Nicolle - 76031 - Rouen - Seine Maritime - France	Pascale Schneider, MD	En recrutement		Contact (sur clinicalTrials)

Critères

Genre

Tous

Nombre d'inclusion

Critère d'inclusion

After Initial surgery, patients will be enrolled in one of 3 different interventional
strata where they will be offered a set of therapeutic interventions based on the outcome
of the intervention (no measurable residue vs residual inoperable disease), their age
and/or their eligibility /suitability to receive radiotherapy.

Patients with centrally and histologically confirmed intracranial ependymoma meeting the
following criteria will be enrolled into one of interventional stratum:

- Age < 22 years old at diagnosis

- Newly diagnosed intracranial ependymoma of WHO grade II-III confirmed by central
pathological review

- Post-menarchal female not pregnant or nursing (breast feeding) and with a negative
beta-HCG pregnancy test prior to commencing the trial

- Males and females of reproductive age and childbearing potential with effective
contraception for the duration of their treatment and 6 months after the completion
of their treatment

- No contraindication to the use if one of the study drugs proposed by the protocol

- Patients and/or their parents or legal guardians willing and able to comply with
scheduled visits, treatment plan, laboratory tests and other study procedure

- No co-existent unrelated disease at the time of study entry that would render the
patient unable to receive chemotherapy

- No signs of infection.

Common inclusion criteria for Strata 1 and 2:

- Age > 12 months and < 22 years at time of study entry

- No metastasis on spinal MRI and on CSF cytology assessments

- No previous radiotherapy

- No previous chemotherapy (except steroids)

- No medical contraindication to radiotherapy and chemotherapy

- Adequate bone marrow, liver and renal functions

Specific inclusion criteria for Stratum 1:

• No residual measurable ependymoma based on the central neuroradiological review
(R0-1-2)

Specific inclusion criteria for Stratum 2:

• Residual non reoperable measurable ependymoma based on the central neuroradiological
review (R3-4)

Inclusion criteria for Stratum 3:

- Children younger than 12 months at time of entry to study or any children ineligible
to receive radiotherapy due to age at diagnosis, tumour location or clinician /
parent decision and according to national criteria

- Adequate bone marrow, liver and renal functions

- No previous chemotherapy and radiotherapy

- No contraindication to chemotherapy Patients that do not fulfill the inclusion
criteria of one of the interventional strata will be enrolled and followed up into
an observational study and descriptive analysis will be performed.

EXCLUSION CRITERIA for all interventional strata:

- Tumour entity other than primary intracranial ependymoma

- Primary diagnosis predating the opening of SIOP Ependymoma II

- Patients with WHO grade I ependymoma including ependymoma variants: myxopapillary
ependymomas and subependymomas,patients with spinal cord location of the primary
tumour

- Participation within a different trial for treatment of ependymoma

- Contraindication to one of the IMP used according to the SmPCs

- Concurrent treatment with any anti-tumour agents

- Inability to tolerate chemotherapy

- Unable to tolerate intravenous hydration

- Pre-existing mucositis, peptic ulcer, inflammatory bowel disease ascites, or pleural
effusion.

Strata 1 and 2:

- Ineligible to receive radiotherapy

- Patient for whom imaging remains RX despite all effort to clarify the MRI conclusion

Stratum 3:

- Pre-existing severe hepatic and/or renal damage

- Family history of severe epilepsy

- Presence of previously undiagnosed mitochondrial disorder detected by screening as
part of trial

- Elevated blood ammonium and lactate level ≥ 1.5 x upper limit of the normal

Critère de non inclusion

NCT02265770 - An International Clinical Program for the Diagnosis and Treatment of Children, Adolescents and Young Adults With Ependymoma (SIOP-EP-II)

Informations générales
Etablissements
Critères
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