PNOC031: Protocol for Embryonal Tumor With Multilayered Rosettes (ETMR)
Summary
This is an open-label, comprehensive, iterative investigation of evaluating the use of induction chemotherapy, high-dose chemotherapy, and focal radiation therapy in children with newly diagnosed Embryonal Tumor With Multilayered Rosettes (ETMR).
Detailed description
PRIMARY OBJECTIVES I. To determine the six-month progression-free survival (PFS6) of participants with newly diagnosed, gross-totally resected, non-metastatic ETMR, treated using a regimen of induction chemotherapy and early focal radiotherapy (Cohort 1) SECONDARY OBJECTIVES I. To determine the two-year progression-free survival (PFS) and overall survival (OS) of participants with newly diagnosed, gross-totally resected, non-metastatic ETMR (Cohort 1). II. To determine the two-year progression-free survival (PFS) and overall survival (OS) of participants with newly diagnosed, gross-totally resected, non-metastatic ETMR (Cohort 2). III. To determine the two-year progression-free survival (PFS), overall survival (OS) and objective response rate of participants with newly diagnosed, incompletely resected and/or metastatic ETMR (Cohort 3A and 3B) EXPLORATORY OBJECTIVES: I. To validate the utility of a liquid miRNA biomarker in blood and Cerebral spinal fluid (CSF) as a correlative marker of a participant's disease status. II. To better define the genomic landscape of ETMR. OUTLINE: Participants with newly diagnosed ETMR will obtain either gross total, or sub-total resection surgery prior to enrollment. After surgery, participants will be assigned to 1 of 4 possible cohorts: Cohorts 1 and 2: Participants with newly diagnosed, gross-totally resected, non-metastatic ETMR. Cohorts 3A and 3B: Participants with newly diagnosed, incompletely resected and/or metastatic ETMR. Participants will be assessed for survival outcomes for up to 2 years. Follow-up procedures are to be captured under the PNOC COMP protocol. Participants will be followed under the Pediatric Neuro-Oncology Consortium (PNOC) COMP protocol until death or withdrawal from study.
Arms & interventions
- RadiationRadiotherapy (RT)
Undergo RT
- DrugChemotherapy Drug, Cancer - Physician's Choice
One or more of the following may be assigned by the physician (physician's choice) per standard of care guidelines upon study enrollment following surgery: Cytarabine, Carboplatin, Cisplatin, Vincristine Sulfate injection (Vincristine PFS), Topotecan Hydrochloride, Dactinomycin, Thiotepa, Filgrastim, Cyclophosphamide, or Doxorubicin Hydrochloride. Not all participants will receive all possible drug regimens.
- ProcedureNon-Investigational Surgical Resection
Undergo surgery directly before study enrollment as part of planned care.
- DrugTemozolomide
Participants assigned to or whom receive optional RT will receive concurrent temozolomide
- ProcedureTumor Tissue Sample
Tumor tissue will be collected for correlative studies
- ProcedureBlood Sample
Blood samples will be collected for correlative studies
- ProcedureCerebrospinal Fluid (CSF) Sample
CSF samples will be collected for correlative studies
Outcome measures
Primary
Median Progression-free survival at 6 months (PFS6) (Cohort 1)
The median PFS6 is defined as the median number of months for participants in Cohort 1 who have remained progression-free from the date of initial surgical resection until 6 months.
Time frame: Up to 6 months
Secondary
Median Progression-free survival at 2 years progression-free survival (PFS)
Time frame: Up to 2 years
Median Overall Survival at 2 years (OS)
Time frame: Up to 2 years
Eligibility criteria
Study locations (7)
University of Alabama at Birmingham
Birmingham, Alabama, 35233
University of California, San Francisco
San Francisco, California, 94143
Riley Hospital for Children at Indiana University Health
Indianapolis, Indiana, 46202
Johns Hopkins University
Baltimore, Maryland, 21218
Washington University in St. Louis
St Louis, Missouri, 63130
Hackensack University Medical Center
Hackensack, New Jersey, 07601
St. Jude Children's Research Hospital
Memphis, Tennessee, 38105