NeuroblastomaPhase 3NCT00003119
Surgery in Treating Children With Neuroblastoma
A Phase 3 study testing filgrastim, sargramostim and carboplatin in people with Neuroblastoma, run by Children's Oncology Group at 235 sites in 7 countries.
Trial summary
RATIONALE: Surgery alone may be effective in treating children with neuroblastoma. PURPOSE: Phase III trial to study the effectiveness of surgery alone in treating children who have neuroblastoma. 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, sargramostim and carboplatin
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 968 participants
- Where
- 235 sitesin 7 countries
- Study dates
- Mar 1998to Mar 2006
- Phase
- Phase 3
- 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:
- Histologically proven low-risk neuroblastoma (excluding ganglioneuroma)
- International Neuroblastoma Staging System (INSS) stage 1 in all patients
- INSS stage 2A or 2B in patients less than 365 days of age
- INSS stage 2A or 2B tumor with nonamplified MYCN with any Shimada histology in patients ages 1 to 20 years
- INSS stage 2A or 2B tumor with amplified MYCN with Shimada favorable histology in patients ages 1 to 20 years
- INSS stage 4S tumors with nonamplified MYCN, Shimada favorable histology, and a DNA index not equal to 1 in patients less than 365 days of age
- Immediate chemotherapy allowed prior to biopsy for patients with intradural extension and/or emergent paresis if biopsy performed within 96 hours
- Must have no abnormal organ function unless due to neuroblastoma
- Concurrent registration on companion biology study (protocol COG-ANBL00B1) or its successor
PATIENT CHARACTERISTICS:
Age:
- Under 21
Performance status:
- Not specified
Life expectancy:
- Not specified
Hematopoietic:
- Not specified
Hepatic:
- Bilirubin less than 1.5 times normal
- SGOT or SGPT less than 2.5 times normal
Renal:
- Creatinine less than 1.5 times normal
Cardiovascular:
- Shortening fraction greater than 27% by echocardiogram OR
- Ejection fraction greater than 47% by radionuclide angiogram
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- No prior immunotherapy
Chemotherapy:
- See Disease Characteristics
Endocrine therapy:
- No prior hormonal therapy
Radiotherapy:
- No prior radiotherapy
Surgery:
- Prior surgery allowed
Other:
- No other prior therapy
Trial locations and contacts
235 sites in 7 countries.
235 sites in 7 countries
United States207 sites
Children's Hospital Medical Center of Akron
Akron, Ohio, 44308-1062
Cancer Center of Albany Medical Center
Albany, New York, 12208
University of New Mexico Cancer Research and Treatment Center
Albuquerque, New Mexico, 87131
Texas Tech University Health Sciences Center School of Medicine
Amarillo, Texas, 79106
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, 48109-0914
Mission Hospitals
Asheville, North Carolina, 28801
AFLAC Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta - Scottish Rite Campus
Atlanta, Georgia, 30342
MBCCOP-Medical College of Georgia Cancer Center
Augusta, Georgia, 30912-4000
Children's Hospital of Austin
Austin, Texas, 78701
Greenebaum Cancer Center at University of Maryland Medical Center
Baltimore, Maryland, 21201-1595
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
Baltimore, Maryland, 21225
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Baltimore, Maryland, 21231-2410
Eastern Maine Medical Center
Bangor, Maine, 04401
University of Alabama at Birmingham Comprehensive Cancer Center
Birmingham, Alabama, 35233
Mountain States Tumor Institute - Boise
Boise, Idaho, 83712
Floating Hospital for Children
Boston, Massachusetts, 02111
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
Boston, Massachusetts, 02115
Brooklyn Hospital Center
Brooklyn, New York, 11201-5493
SUNY Downstate Medical Center
Brooklyn, New York, 11203
Brookdale University Hospital and Medical Center
Brooklyn, New York, 11212
Comprehensive Cancer Center at Maimonides Medical Center
Brooklyn, New York, 11219
Vermont Cancer Center at University of Vermont
Burlington, Vermont, 05401-3498
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
Chapel Hill, North Carolina, 27599-7295
Hollings Cancer Center at Medical University of South Carolina
Charleston, South Carolina, 29425-0721
West Virginia University - Robert C. Byrd Health Sciences Center - Charleston Division
Charleston, West Virginia, 25302
Blumenthal Cancer Center at Carolinas Medical Center
Charlotte, North Carolina, 28232-2861
Presbyterian Healthcare
Charlotte, North Carolina, 28233
Cancer Center at the University of Virginia
Charlottesville, Virginia, 22908
University of Chicago Cancer Research Center
Chicago, Illinois, 60601
Rush University Medical Center
Chicago, Illinois, 60612
University of Illinois Medical Center
Chicago, Illinois, 60612
Children's Memorial Hospital - Chicago
Chicago, Illinois, 60614
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229-3039
Ireland Cancer Center at University Hospitals of Cleveland and Case Western Reserve University
Cleveland, Ohio, 44106-5065
Cleveland Clinic Taussig Cancer Center
Cleveland, Ohio, 44195
Palmetto Health South Carolina Cancer Center
Columbia, South Carolina, 29203
Columbus Children's Hospital
Columbus, Ohio, 43205-2696
Medical City Dallas Hospital
Dallas, Texas, 75230
Simmons Cancer Center at University of Texas Southwestern Medical Center - Dallas
Dallas, Texas, 75390-9063
Geisinger Medical Center
Danville, Pennsylvania, 17822-1320
Children's Medical Center - Dayton
Dayton, Ohio, 45404
Children's Hospital of Denver
Denver, Colorado, 80218-1088
Presbyterian - St. Luke's Medical Center
Denver, Colorado, 80218
Blank Children's Hospital
Des Moines, Iowa, 50308
John Stoddard Cancer Center at Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Children's Hospital of Michigan
Detroit, Michigan, 48201
Josephine Ford Cancer Center at Henry Ford Health System
Detroit, Michigan, 48202
Van Elslander Cancer Center at St. John Hospital and Medical Center
Detroit, Michigan, 48236
Southern California Permanente Medical Group
Downey, California, 90242
City of Hope Comprehensive Cancer Center
Duarte, California, 91010-3000
St. Mary's - Duluth Clinic Cancer Center
Duluth, Minnesota, 55805
Duke Comprehensive Cancer Center
Durham, North Carolina, 27710
Inova Fairfax Hospital
Falls Church, Virginia, 22042-3300
Dakota Cancer Institute at Innovis Health - Dakota Clinic
Fargo, North Dakota, 58103-4940
University of Connecticut Comprehensive Cancer Center at University of Connecticut Health Center
Farmington, Connecticut, 06360-7106
Hurley Medical Center
Flint, Michigan, 48503
Broward General Medical Center
Fort Lauderdale, Florida, 33316
Children's Hospital of Southwest Florida
Fort Myers, Florida, 33908
Cook Children's Medical Center - Fort Worth
Fort Worth, Texas, 76104
Shands Cancer Center at the University of Florida Health Science Center
Gainesville, Florida, 32610-0296
University of Texas Medical Branch
Galveston, Texas, 77555-0361
Spectrum Health and DeVos Children's Hospital
Grand Rapids, Michigan, 49503
Bellin Memorial Hospital
Green Bay, Wisconsin, 54301
CCOP - St. Vincent Hospital Cancer Center, Green Bay
Green Bay, Wisconsin, 54301
St. Vincent Hospital
Green Bay, Wisconsin, 54307-9070
Leo W. Jenkins Cancer Center of University Health Systems of Eastern Carolina
Greenville, North Carolina, 27858-4354
Children's Hospital of Greenville Hospital System
Greenville, South Carolina, 29605
Cancer Center at Hackensack University Medical Center
Hackensack, New Jersey, 07601
Penn State Cancer Institute at Milton S. Hershey Medical Center
Hershey, Pennsylvania, 17033
Joe DiMaggio Children's Hospital at Memorial
Hollywood, Florida, 33021
Cancer Research Center of Hawaii
Honolulu, Hawaii, 96813
MBCCOP - Hawaii
Honolulu, Hawaii, 96813
Tripler Army Medical Center
Honolulu, Hawaii, 96859-5000
University of Texas - MD Anderson Cancer Center
Houston, Texas, 77030-4009
Baylor College of Medicine
Houston, Texas, 77030
Cabell Huntington Hospital
Huntington, West Virginia, 25701
Riley Children Cancer Center at Riley Hospital for Children
Indianapolis, Indiana, 46202-5225
St. Vincent Hospitals and Health Care Centers
Indianapolis, Indiana, 46260
Holden Comprehensive Cancer Center at University of Iowa
Iowa City, Iowa, 52242-1009
University of Mississippi Medical Center
Jackson, Mississippi, 39216-4505
Nemours Children's Clinic
Jacksonville, Florida, 32207
East Tennessee State University Cancer Center at Johnson City Medical Center
Johnson City, Tennessee, 37614-0622
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007-5364
Children's Mercy Hospital
Kansas City, Missouri, 64108
East Tennessee Children's Hospital
Knoxville, Tennessee, 37901
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
Rebecca and John Moores UCSD Cancer Center
La Jolla, California, 92093-0658
San Antonio Military Pediatric Cancer and Blood Disorders Center
Lackland Air Force Base, Texas, 78236
Breslin Cancer Center at Ingham Regional Medical Center
Lansing, Michigan, 48910
Sunrise Hospital and Medical Center
Las Vegas, Nevada, 89109
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, 03756
Markey Cancer Center at University of Kentucky Chandler Medical Center
Lexington, Kentucky, 40536-0284
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
Loma Linda University Cancer Institute at Loma Linda University Medical Center
Loma Linda, California, 92354
Jonathan Jaques Children's Cancer Center at Miller Children's Hospital
Long Beach, California, 90801-1428
Children's Hospital Los Angeles
Los Angeles, California, 90027-0700
Cedars-Sinai Comprehensive Cancer Center at Cedars-Sinai Medical Center
Los Angeles, California, 90048
Jonsson Comprehensive Cancer Center, UCLA
Los Angeles, California, 90095-1781
Kosair Children's Hospital
Louisville, Kentucky, 40202-3830
Covenant Children's Hospital
Lubbock, Texas, 79410
Medical Center of Central Georgia
Macon, Georgia, 31201
Children's Hospital Central California
Madera, California, 93638-8762
University of Wisconsin Comprehensive Cancer Center
Madison, Wisconsin, 53792-6164
Marshfield Clinic
Marshfield, Wisconsin, 54449-5772
CCOP - Marshfield Clinic Research Foundation
Marshfield, Wisconsin, 54449
St. Jude Children's Research Hospital
Memphis, Tennessee, 38105-2794
Jackson Memorial Hospital
Miami, Florida, 33136
Miami Children's Hospital
Miami, Florida, 33155
Baptist-South Miami Regional Cancer Program
Miami, Florida, 33176-2197
Midwest Children's Cancer Center
Milwaukee, Wisconsin, 53226
Children's Hospitals and Clinics - Minneapolis
Minneapolis, Minnesota, 55404
University of South Alabama Cancer Research Institute
Mobile, Alabama, 36604
West Virginia University Hospitals
Morgantown, West Virginia, 26506-9300
Vanderbilt Children's Hospital
Nashville, Tennessee, 37232-6310
Cancer Institute of New Jersey at Robert Wood Johnson University Hospital
New Brunswick, New Jersey, 08903
Yale Comprehensive Cancer Center
New Haven, Connecticut, 06520-8028
Schneider Children's Hospital
New Hyde Park, New York, 11042
MBCCOP - LSU Health Sciences Center
New Orleans, Louisiana, 70112
Tulane Cancer Center at Tulane University Hospital and Clinic
New Orleans, Louisiana, 70112
Children's Hospital of New Orleans
New Orleans, Louisiana, 70118
Ochsner Clinic Foundation
New Orleans, Louisiana, 70121
Memorial Sloan-Kettering Cancer Center
New York, New York, 10021
New York Weill Cornell Cancer Center at Cornell University
New York, New York, 10021
Mount Sinai School of Medicine
New York, New York, 10029
Herbert Irving Comprehensive Cancer Center at Columbia University
New York, New York, 10032
Newark Beth Israel Medical Center
Newark, New Jersey, 07112-2094
Children's Hospital of the King's Daughters
Norfolk, Virginia, 23507
Advocate Hope Children's Hospital
Oak Lawn, Illinois, 60453
Children's Hospital and Research Center at Oakland
Oakland, California, 94609-1809
Children's Hospital at Oklahoma University Medical Center
Oklahoma City, Oklahoma, 73104
Children's Hospital of Omaha
Omaha, Nebraska, 68114
UNMC Eppley Cancer Center at the University of Nebraska Medical Center
Omaha, Nebraska, 68198-2168
Chao Family Comprehensive Cancer Center at University of California Irvine Cancer Center
Orange, California, 92868
Children's Hospital of Orange County
Orange, California, 92868
Florida Hospital Cancer Institute
Orlando, Florida, 32804
Nemours Children's Clinic-Orlando
Orlando, Florida, 32806
Lucile Packard Children's Hospital at Stanford University Medical Center
Palo Alto, California, 94304
Lutheran General Cancer Care Center
Park Ridge, Illinois, 60068-1174
St. Joseph's Hospital and Medical Center
Paterson, New Jersey, 07503
Sacred Heart Children's Hospital
Pensacola, Florida, 32504
Saint Jude Midwest Affiliate
Peoria, Illinois, 61637
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
St. Christopher's Hospital for Children
Philadelphia, Pennsylvania, 19134-1095
Phoenix Children's Hospital
Phoenix, Arizona, 85016
Children's Hospital of Pittsburgh
Pittsburgh, Pennsylvania, 15213-2583
CCOP - Columbia River Oncology Program
Portland, Oregon, 97225
Legacy Emanuel Hospital and Health Center & Children's Hospital
Portland, Oregon, 97227
Doernbecher Children's Hospital at Oregon Health & Science University
Portland, Oregon, 97239-3098
Naval Medical Center, Portsmouth
Portsmouth, Virginia, 23708-5100
Rhode Island Hospital
Providence, Rhode Island, 02903
Massey Cancer Center at Virginia Commonwealth University
Richmond, Virginia, 23298-0121
Carilion Medical Center for Children
Roanoke, Virginia, 24029
Mayo Clinic Cancer Center
Rochester, Minnesota, 55905
James P. Wilmot Cancer Center at University of Rochester Medical Center
Rochester, New York, 14642
CCOP - Beaumont
Royal Oak, Michigan, 48073-6769
William Beaumont Hospital - Royal Oak
Royal Oak, Michigan, 48073-6769
Sutter Cancer Center
Sacramento, California, 95816
University of California Davis Cancer Center
Sacramento, California, 95817
Kaiser Permanente Medical Center - Sacramento
Sacramento, California, 95825
Children's Hospitals and Clinics - Minnesota
Saint Paul, Minnesota, 55102
Huntsman Cancer Institute
Salt Lake City, Utah, 84112
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78207
MBCCOP - South Texas Pediatrics
San Antonio, Texas, 78229-3900
Methodist Cancer Center at Methodist Specialty and Transplant Hospital
San Antonio, Texas, 78229-3902
Kaiser Permanente Medical Center/Kaiser Foundation Hospital - San Diego
San Diego, California, 92120
Children's Hospital and Health Center, San Diego
San Diego, California, 92123-4282
UCSF Comprehensive Cancer Center
San Francisco, California, 94143
Santa Barbara Cottage Hospital
Santa Barbara, California, 93102
Kaiser Permanente Medical Center - Santa Clara
Santa Clara, California, 95051-5386
Curtis & Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center
Savannah, Georgia, 31405
Maine Children's Cancer Program
Scarborough, Maine, 04074-9308
Children's Hospital and Regional Medical Center - Seattle
Seattle, Washington, 98105
Fred Hutchinson Cancer Research Center
Seattle, Washington, 98109-1024
Group Health Central Hospital
Seattle, Washington, 98112
Walter Reed Army Medical Center
Silver Spring, Maryland, 20910
Avera Cancer Institute
Sioux Falls, South Dakota, 57105-1080
Sioux Valley Hospital at University of South Dakota Medical Center
Sioux Falls, South Dakota, 57117-5039
Deaconess Medical Center
Spokane, Washington, 99210-0248
Southern Illinois University School of Medicine
Springfield, Illinois, 62794-9658
Baystate Regional Cancer Program at Baystate Medical Center
Springfield, Massachusetts, 01107
Cardinal Glennon Children's Hospital
St Louis, Missouri, 63104
St. Louis Children's Hospital
St Louis, Missouri, 63110
All Children's Hospital
St. Petersburg, Florida, 33701
Long Island Cancer Center at Stony Brook University Hospital
Stony Brook, New York, 11794
Valerie Fund Children's Center at Atlantic Health
Summit, New Jersey, 07901
SUNY Upstate Medical University Hospital
Syracuse, New York, 13210
Mary Bridge Children's Hospital and Health Center
Tacoma, Washington, 98415-0299
Madigan Army Medical Center
Tacoma, Washington, 98431-5000
St. Joseph's Children's Hospital
Tampa, Florida, 33677-4227
CCOP - Scott and White Hospital
Temple, Texas, 76508
Center for Cancer Prevention and Care at Scott and White Clinic
Temple, Texas, 76508
Albert Einstein Clinical Cancer Center
The Bronx, New York, 10461
Toledo Children's Hospital
Toledo, Ohio, 43601
St. Vincent Mercy Medical Center
Toledo, Ohio, 43608
David Grant Medical Center
Travis Air Force Base, California, 94535
Arizona Cancer Center at University of Arizona Health Sciences Center
Tucson, Arizona, 85724
CCOP - Oklahoma
Tulsa, Oklahoma, 74136
Natalie Warren Bryant Cancer Center
Tulsa, Oklahoma, 74136
New York Medical College
Valhalla, New York, 10595
Lombardi Cancer Center at Georgetown University Medical Center
Washington D.C., District of Columbia, 20007
Children's National Medical Center
Washington D.C., District of Columbia, 20010-2970
St. Mary's Hospital
West Palm Beach, Florida, 33407
Wesley Medical Center
Wichita, Kansas, 67214
Alfred I. duPont Hospital for Children
Wilmington, Delaware, 19899
Comprehensive Cancer Center at Wake Forest University
Winston-Salem, North Carolina, 27157-1081
UMASS Memorial Cancer Center - University Campus
Worcester, Massachusetts, 01655
Forum Health-Tod Childrens Hospital
Youngstown, Ohio, 44501
Canada15 sites
Alberta Children's Hospital
Calgary, Alberta, T2T 5C7
Cross Cancer Institute
Edmonton, Alberta, T6G 1Z2
IWK Health Centre
Halifax, Nova Scotia, B3J 3G9
McMaster Children's Hospital at Hamilton Health Sciences
Hamilton, Ontario, L8S 4J9
Children's Hospital of Western Ontario
London, Ontario, N6C 2V5
Montreal Children's Hospital at McGill University Health Center
Montreal, Quebec, H3G 1A4
Hopital Sainte Justine
Montreal, Quebec, H3T 1C5
Children's Hospital of Eastern Ontario
Ottawa, Ontario, K1H 8L1
Allan Blair Cancer Centre at Pasqua Hospital
Regina, Saskatchewan, S4T 7T1
Centre de Recherche du Centre Hospitalier de l'Universite Laval
Sainte-Foy, Quebec, GIV 4G2
Saskatoon Cancer Centre
Saskatoon, Saskatchewan, S7N 4H4
Janeway Children's Health and Rehabilitation Centre
St. John's, Newfoundland and Labrador, A1B 3V6
Hospital for Sick Children
Toronto, Ontario, M5G 1X8
British Columbia Children's Hospital
Vancouver, British Columbia, V6H 3V4
CancerCare Manitoba
Winnipeg, Manitoba, R3E 0V9
Australia6 sites
Royal Children's Hospital
Brisbane, Queensland, 4029
Women's and Children's Hospital
North Adelaide, South Australia, 5006
Royal Children's Hospital
Parkville, Victoria, 3052
Princess Margaret Hospital for Children
Perth, Western Australia, 6001
Sydney Children's Hospital
Randwick, New South Wales, 2031
Children's Hospital at Westmead
Westmead, New South Wales, 2145
Switzerland3 sites
Swiss Pediatric Oncology Group Bern
Bern, CH 3010
Swiss Pediatric Oncology Group Geneva
Geneva, CH 1211
Swiss Pediatric Oncology Group Lausanne
Lausanne, CH 1011
Puerto Rico2 sites
Puerto Rico Cancer Center at University of Puerto Rico - Medical Sciences Campus
San Juan, 00936-5067
San Jorge Childrens Hospital
Santurce, 00912
About this study
Official title: Primary Surgical Therapy for Biologically Defined Low-Risk Neuroblastoma: A Pediatric Oncology Group/Children's Cancer Group Intergroup Study
RATIONALE: Surgery alone may be effective in treating children with neuroblastoma.
PURPOSE: Phase III trial to study the effectiveness of surgery alone in treating children who have neuroblastoma.
Read the detailed description
OBJECTIVES:
- To determine if asymptomatic patients with low-risk neuroblastoma treated with surgery alone will have a 3-year survival rate of 95%.
- Estimate the response and 3-year event-free survival rates of symptomatic patients treated with chemotherapy.
- Estimate the event-free survival and overall survival rates in patients who relapse or progress after initial treatment with surgery alone.
- Determine the acute and chronic toxic effects associated with treating low-risk neuroblastoma with surgery alone or surgery and chemotherapy.
OUTLINE: This is a multicenter study. Patients are stratified according to disease stage, MYCN status, age, and histology.
Patients undergo primary tumor resection and biopsy of regional nodes. Patients with at least 50% of the tumor resected are followed monthly for 3 months, every 3 months for 9 months, every 6 months for one year, and then annually thereafter.
Regimen I
- Patients with clinically symptomatic (e.g., respiratory distress, spinal cord compromise with or without neurologic deficit, inferior vena cava compression with renal or bowel ischemia, intractable vomiting due to gastrointestinal obstruction, genitourinary obstruction, or coagulopathy) low-risk neuroblastoma or who have less than 50% of the primary tumor resected receive 4 different courses of chemotherapy.
- Course 1: Patients receive carboplatin IV over 1 hour followed by etoposide IV over 2 hours on day 0 and etoposide only on days 1 and 2.
- Course 2: Patients receive carboplatin IV over 1 hour, cyclophosphamide IV over 1 hour, and doxorubicin IV over 15-60 minutes on day 1.
- Course 3: Patients receive cyclophosphamide IV over 1 hour followed by etoposide IV over 2 hours on day 0 and etoposide only on days 1 and 2.
- Course 4: Patients receive carboplatin IV over 1 hour and etoposide IV over 2 hours followed by doxorubicin IV over 15-60 minutes on day 0 and etoposide only on days 1 and 2.
Regimen II
- Patients who progress to or recur with unfavorable biology intermediate-risk disease receive an additional 4 courses of chemotherapy.
- Course 5: Patients receive treatment as in course 3 above.
- Course 6: Patients receive treatment as in course 2 above.
- Course 7: Patients receive treatment as in course 1 above.
- Course 8: Patients receive cyclophosphamide IV over 1 hour followed by doxorubicin IV over 15-60 minutes on day 1.
All infants under 60 days of age receive filgrastim (G-CSF) or sargramostim (GM-CSF) subcutaneously beginning 24 to 36 hours after chemotherapy and continuing until blood counts recover.
Courses in both regimens repeat every 3 weeks in the absence of unacceptable toxicity.
Patients at risk for symptomatic spinal cord compression may also receive chemotherapy. Patients experiencing progressive or recurrent disease after observation undergo repeat surgery and/or chemotherapy as above. Patients with clinically symptomatic disease may also undergo radiotherapy if response to chemotherapy is not rapid.
Patients are followed every 2 months for 1 year, every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter.
PROJECTED ACCRUAL: A total of 820 patients will be accrued for this study within 4 years.
- Conditions
- Neuroblastoma
- Being tested
- filgrastim, sargramostim, carboplatin, cyclophosphamide, doxorubicin hydrochloride
- Keywords
- localized resectable neuroblastoma, stage 4S 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
sargramostimBiological
carboplatinDrug
cyclophosphamideDrug
etoposideDrug
adjuvant therapyProcedure or surgery
conventional surgeryProcedure or surgery
radiation therapyRadiation
| Study group | Role | What they receive |
|---|---|---|
| Treatment 1 - Asymptomatic - no immediate chemotherapy | Experimental | Not described Receives: Procedure: conventional surgery; Radiation: radiation therapy |
| Symptomatic - immediate chemotherapy | Experimental | Not described Receives: Biological: filgrastim; Biological: sargramostim; Drug: carboplatin; Drug: cyclophosphamide; Drug: doxorubicin hydrochloride; Drug: etoposide; Procedure: adjuvant therapy; Procedure: conventional surgery; Radiation: radiation therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Estimate the 3 year survival rate for low risk asymptomatic stage 2A/2B patients who are treated with surgery alone
The primary objective is to estimate the 3 year survival rate for low risk asymptomatic stage 2A/2B patients who are treated with surgery alone. Under the assumption that about 90% of the low risk 2A/2B patients will be asymptomatic, and 10% of these will be lost to follow up, the projected sample size will enable estimation of the survival rate with a standard error less than .03. This sample size will also provide sufficient power for the sequential monitoring plan (see below) for this subgroup of patients.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jan 2003 (estimated)
- Study startMar 1998
- Primary completionMar 2006
- Study completionMar 2006
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for NeuroblastomaStudies of the same condition, open and under way.
- More trials run by Children's Oncology GroupThe sponsor's other registered studies.
- 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 3
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 968 participants (actual)
Sponsor and investigators
- Lead sponsor
- Children's Oncology Group
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Douglas R. Strother, MD, Study chair, Alberta Children's Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00003119
- Sponsor's protocol ID
- P9641
- Other IDs
- COG-P9641, POG-P9641, CCG-P9641, CDR0000065874
- Status last verified
- Mar 2017
- First submitted
- 1 Nov 1999
- Last updated
- 13 Mar 2017
- Results posted
- No
- Data monitoring committee
- No
Publications
Meany HJ, Attiyeh EF, Naranjo A, et al.: Outcome analysis of non-high-risk neuroblastoma patients enrolled on Children's Oncology Group trials P9641 and A3961. [Abstract] J Clin Oncol 30 (Suppl 15): A-9533, 2012.
Attiyeh EF, Mosse YP, Diskin S, et al.: Identification of genomic DNA signatures predicting relapse in low- and intermediate- risk neuroblastoma using a case control design and high-density SNP genotyping: a Children's Oncology Group (COG) study. [Abstract] J Clin Oncol 25 (Suppl 18): A-9500, 526s, 2007.
Strother DR, London WB, Schmidt ML, Brodeur GM, Shimada H, Thorner P, Collins MH, Tagge E, Adkins S, Reynolds CP, Murray K, Lavey RS, Matthay KK, Castleberry R, Maris JM, Cohn SL. Outcome after surgery alone or with restricted use of chemotherapy for patients with low-risk neuroblastoma: results of Children's Oncology Group study P9641. J Clin Oncol. 2012 May 20;30(15):1842-8. doi: 10.1200/JCO.2011.37.9990. Epub 2012 Apr 23.
PubMed 22529259
Study at a glance
From the registry record, last updated by the sponsor on 13 Mar 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Primary Surgical Therapy for Biologically Defined Low-Risk Neuroblastoma: A Pediatric Oncology Group/Children's Cancer Group Intergroup Study
- ClinicalTrials.gov ID
- NCT00003119
- Acronym / sponsor ID
- P9641
- Conditions
- Neuroblastoma
- Keywords
- localized resectable neuroblastoma, stage 4S neuroblastoma
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 968 participants (actual)
- Lead sponsor
- Children's Oncology GroupResearch network
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Mar 1998
- Primary completion
- Mar 2006 (actual)
- Study completion
- Mar 2006 (actual)
- First posted
- 27 Jan 2003 (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: Surgery alone may be effective in treating children with neuroblastoma.
PURPOSE: Phase III trial to study the effectiveness of surgery alone in treating children who have neuroblastoma.
Detailed description
OBJECTIVES:
- To determine if asymptomatic patients with low-risk neuroblastoma treated with surgery alone will have a 3-year survival rate of 95%.
- Estimate the response and 3-year event-free survival rates of symptomatic patients treated with chemotherapy.
- Estimate the event-free survival and overall survival rates in patients who relapse or progress after initial treatment with surgery alone.
- Determine the acute and chronic toxic effects associated with treating low-risk neuroblastoma with surgery alone or surgery and chemotherapy.
OUTLINE: This is a multicenter study. Patients are stratified according to disease stage, MYCN status, age, and histology.
Patients undergo primary tumor resection and biopsy of regional nodes. Patients with at least 50% of the tumor resected are followed monthly for 3 months, every 3 months for 9 months, every 6 months for one year, and then annually thereafter.
Regimen I
- Patients with clinically symptomatic (e.g., respiratory distress, spinal cord compromise with or without neurologic deficit, inferior vena cava compression with renal or bowel ischemia, intractable vomiting due to gastrointestinal obstruction, genitourinary obstruction, or coagulopathy) low-risk neuroblastoma or who have less than 50% of the primary tumor resected receive 4 different courses of chemotherapy.
- Course 1: Patients receive carboplatin IV over 1 hour followed by etoposide IV over 2 hours on day 0 and etoposide only on days 1 and 2.
- Course 2: Patients receive carboplatin IV over 1 hour, cyclophosphamide IV over 1 hour, and doxorubicin IV over 15-60 minutes on day 1.
- Course 3: Patients receive cyclophosphamide IV over 1 hour followed by etoposide IV over 2 hours on day 0 and etoposide only on days 1 and 2.
- Course 4: Patients receive carboplatin IV over 1 hour and etoposide IV over 2 hours followed by doxorubicin IV over 15-60 minutes on day 0 and etoposide only on days 1 and 2.
Regimen II
- Patients who progress to or recur with unfavorable biology intermediate-risk disease receive an additional 4 courses of chemotherapy.
- Course 5: Patients receive treatment as in course 3 above.
- Course 6: Patients receive treatment as in course 2 above.
- Course 7: Patients receive treatment as in course 1 above.
- Course 8: Patients receive cyclophosphamide IV over 1 hour followed by doxorubicin IV over 15-60 minutes on day 1.
All infants under 60 days of age receive filgrastim (G-CSF) or sargramostim (GM-CSF) subcutaneously beginning 24 to 36 hours after chemotherapy and continuing until blood counts recover.
Courses in both regimens repeat every 3 weeks in the absence of unacceptable toxicity.
Patients at risk for symptomatic spinal cord compression may also receive chemotherapy. Patients experiencing progressive or recurrent disease after observation undergo repeat surgery and/or chemotherapy as above. Patients with clinically symptomatic disease may also undergo radiotherapy if response to chemotherapy is not rapid.
Patients are followed every 2 months for 1 year, every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter.
PROJECTED ACCRUAL: A total of 820 patients will be accrued for this study within 4 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Treatment 1 - Asymptomatic - no immediate chemotherapy | Experimental | Procedure: conventional surgery, Radiation: radiation therapy |
| Symptomatic - immediate chemotherapy | Experimental | Biological: filgrastim, Biological: sargramostim, Drug: carboplatin, Drug: cyclophosphamide, Drug: doxorubicin hydrochloride, Drug: etoposide, Procedure: adjuvant therapy, Procedure: conventional surgery, Radiation: radiation therapy |
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 | Symptomatic - immediate chemotherapy |
| sargramostim | Biological | Symptomatic - immediate chemotherapy |
| carboplatin | Drug | Symptomatic - immediate chemotherapy |
| cyclophosphamide | Drug | Symptomatic - immediate chemotherapy |
| doxorubicin hydrochloride | Drug | Symptomatic - immediate chemotherapy |
| etoposide | Drug | Symptomatic - immediate chemotherapy |
| adjuvant therapy | Procedure or surgery | Symptomatic - immediate chemotherapy |
| conventional surgery | Procedure or surgery | Symptomatic - immediate chemotherapy, Treatment 1 - Asymptomatic - no immediate chemotherapy |
| radiation therapy | Radiation | Symptomatic - immediate chemotherapy, Treatment 1 - Asymptomatic - no immediate chemotherapy |
Primary outcome
Estimate the 3 year survival rate for low risk asymptomatic stage 2A/2B patients who are treated with surgery alone
The primary objective is to estimate the 3 year survival rate for low risk asymptomatic stage 2A/2B patients who are treated with surgery alone. Under the assumption that about 90% of the low risk 2A/2B patients will be asymptomatic, and 10% of these will be lost to follow up, the projected sample size will enable estimation of the survival rate with a standard error less than .03. This sample size will also provide sufficient power for the sequential monitoring plan (see below) for this subgroup of patients.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Mar 2017.
- BackgroundMeany HJ, Attiyeh EF, Naranjo A, et al.: Outcome analysis of non-high-risk neuroblastoma patients enrolled on Children's Oncology Group trials P9641 and A3961. [Abstract] J Clin Oncol 30 (Suppl 15): A-9533, 2012.
- BackgroundAttiyeh EF, Mosse YP, Diskin S, et al.: Identification of genomic DNA signatures predicting relapse in low- and intermediate- risk neuroblastoma using a case control design and high-density SNP genotyping: a Children's Oncology Group (COG) study. [Abstract] J Clin Oncol 25 (Suppl 18): A-9500, 526s, 2007.
- Results publication: PubMed 22529259Strother DR, London WB, Schmidt ML, Brodeur GM, Shimada H, Thorner P, Collins MH, Tagge E, Adkins S, Reynolds CP, Murray K, Lavey RS, Matthay KK, Castleberry R, Maris JM, Cohn SL. Outcome after surgery alone or with restricted use of chemotherapy for patients with low-risk neuroblastoma: results of Children's Oncology Group study P9641. J Clin Oncol. 2012 May 20;30(15):1842-8. doi: 10.1200/JCO.2011.37.9990. Epub 2012 Apr 23.
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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.
Douglas R. Strother, MD study chair
Alberta Children's Hospital
235 sites in 7 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing filgrastim, sargramostim and carboplatin in people with Neuroblastoma, run by Children's Oncology Group at 235 sites in 7 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: finished, as of the sponsor's last update on 13 Mar 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 235 sites in United States, Canada, Australia, Switzerland, Puerto Rico and 2 more countries. 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.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Estimate the 3 year survival rate for low risk asymptomatic stage 2A/2B patients who are treated with surgery alone. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00003119, which also lists 3 linked publications.
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 13 Mar 2017.