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Childhood Germ Cell TumorPhase 2NCT00432094

Autologous Peripheral Blood Stem Cell Transplant for Germ Cell Tumors

A Phase 2 study testing carboplatin, etoposide and ifosfamide in people with Childhood Germ Cell Tumor and Ovarian Cancer, run by Masonic Cancer Center, University of Minnesota at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

RATIONALE: Germ cell tumors (GCT) are highly sensitive to chemotherapy such that even with metastatic disease at diagnosis, many patients can be cured. Patients who fall into the poor risk category or others who relapse can be successfully salvaged with high dose chemotherapy and autologous stem cell transplant… Read more about this study

Who is it for?
Ages 10 to 69 years
What is being tested?
carboplatin, etoposide and ifosfamide
Could I receive a placebo?
No, everyone receives an active treatment
How many people
23 participants
Where
1 siteUnited States
Study dates
19 Dec 2006to Mar 2021
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 10 to 69 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Diagnosis: Poor Prognosis Non-Seminomas Germ Cell Tumor in ≥ PR1/CR1 or Good or Intermediate Prognosis Seminomas and Non- Seminomas Germ Cell Tumor in ≥ PR1 or ≥ CR2 as defined by the International Germ Cell Cancer Consensus Classification. Patients with increasing tumor markers only (i.e. no imaging evidence of progressive disease) are eligible for transplant.
  • Age: ≥ 10 years and < 70 years of age.
  • Performance status: Karnofsky ≥ 80% (subjects ≥ 16 years of age) Lansky ≥ 80% for subject 10 - 15 years of age
  • Life expectancy: Greater than 8 weeks.
  • Patients must have normal organ function as defined below:
  • Hematologic:
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  • Hemoglobin > 8 gm/dL without transfusion and off erythropoietin for 14 days or Aranesp for 21 days
  • White blood cells (WBC) > 2.5 x 10^9/L with an absolute neutrophile count (ANC) > 1.5 x 10^9/L and off G-CSF or GM-CSF for 10 days or Neulasta for 21 days
  • Platelets > 100 x 10^9/L without transfusion and/or a bone marrow cellularity of ≥ 20%
  • Renal: Creatinine ≤ 2.0 mg/dl or creatinine clearance > 50 ml/min.
  • Hepatic: Total bilirubin ≤ 2.0 mg/dl, AST and alkaline phosphatase < 5 x upper limit of normal. No history of severe prior or ongoing chronic liver disease.
  • Cardiac: Patients must be free of symptoms of uncontrolled cardiac disease including unstable angina, decompensated congestive heart failure, or arrhythmia. LVEF ≥45% by MUGA/ECHO.
  • Pulmonary: Patients must have no significant obstructive airways disease (FEV1 must be ≥ 50% of predicted) and must have acceptable diffusion capacity (corrected DLCO > 50% of predicted).
  • Patients with a history of CNS tumor involvement are eligible if they have completed treatment for CNS disease (radiotherapy or surgery or chemotherapy), have recovered from or stabilization of the side effects associated with the therapy and have no evidence of progressive CNS disease at the time of enrollment.

Who cannot join

  • Patients with serious uncontrolled infections will not be eligible.
  • Male and female patients of reproductive potential must use an approved contraceptive method if appropriate (for example, intrauterine device [IUD], birth control pills, or barrier device) during and for the duration of study participation. The drugs used in this study are pregnancy category D - clear evidence of risk in pregnancy.
  • Pregnant and breast feeding women will not be eligible.
  • Voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care.
  • Additional Eligibility prior to Transplant Two:
  • Total Collection of ≥ 4 x 10^6 CD34 cells/kg prior to transplant one
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  • Transplant able to occur between day +30 and day +90 from transplant one
  • Recovery of blood counts as demonstrated by:
  • WBC > 2.5 x 10^9/L with an ANC > 1.5 x 10^9/L and off G-CSF for 3 days
  • Platelets > 50 x 10^9/L without transfusion in the prior 7 days
  • Renal: Creatinine ≤ 2.0 mg/dl or creatinine clearance > 50 ml/min
  • Hepatic: Total bilirubin ≤ 2.0 mg/dl, AST and alkaline phosphatase < 5 x upper limit of normal
  • Infection: Patients with serious uncontrolled infections at the time of planned transplant will be excluded
  • Patients with progressive disease by Response Evaluation Criteria in Solid Tumors (RECIST) criteria by imaging techniques are not eligible to proceed to the second transplant. Tumor marker increase alone is not sufficient to diagnose disease progression.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Masonic Cancer Center at University of Minnesota

    Minneapolis, Minnesota, 55455

Other trials in United States

About this study

RATIONALE: Germ cell tumors (GCT) are highly sensitive to chemotherapy such that even with metastatic disease at diagnosis, many patients can be cured. Patients who fall into the poor risk category or others who relapse can be successfully salvaged with high dose chemotherapy and autologous stem cell transplant (AuSCT). As in other diseases such as myeloma, sequential high dose chemotherapy and AuSCT may improve overall and disease free survival.

PURPOSE: Because prior investigations in GCT suggest that a subset of high risk or relapsed patients may be cured with sequential cycles of high dose chemotherapy and AuSCT, we propose investigating how well non-cross resistant conditioning regimens work in treating patients with relapsed or high risk GCT.

Read the detailed description

OBJECTIVES:

Primary

  • Determine overall survival (OS) of patients with germ cell tumors treated with tandem autologous stem cell transplantation with non-cross-resistant conditioning regimens.

Secondary

  • Determine disease-free survival (DFS) of patients treated with this regimen.
  • Determine the toxicity of tandem transplants
  • Determine the time to engraftment of neutrophils and platelets in patients treated for each transplant
  • Determine the number of patients unable to adequately mobilize sufficient peripheral blood stem cells (PBSC) for tandem transplantation.
  • Identify prognostic factors of patients unlikely to mobilize sufficient PBSC for tandem transplantation.
  • Compare OS and DFS of patients undergoing single vs tandem transplantation.

OUTLINE:

  • Peripheral blood stem cell (PBSC) mobilization with filgrastim (G-CSF): Patients receive G-CSF subcutaneously (SC) beginning on day 1 and continuing until stem cell collection is complete. Patients undergo stem cell collection beginning on day 5 of G-CSF administration and continuing for at least 3 collections until the collection goal is met.
  • Second PBSC mobilization with chemotherapy: Patients not meeting the collection goal receive cyclophosphamide IV over 2 hours on day 1 and G-CSF SC beginning on day 4 and continuing until stem cell collection is complete. Patients meeting the collection goal after PBSC mobilization via G-CSF alone or in combination with chemotherapy will undergo tandem autologous transplantation. If collection goal is not met but the patient has collected > or = 2 x 10^6 CD34 cells/kg, a single autologous transplant will be performed.
  • Single stem cell transplantation (SCT): Patients receive paclitaxel IV over 3 hours on day -7 and ifosfamide IV on days -6 to -4. Patients undergo reinfusion of stem cells on day 0. Patients also receive G-CSF SC or IV beginning on day 1 and continuing until blood counts recover.
  • Tandem SCT: Patients receive treatment as in single SCT. Beginning 30-90 days later, patients receive carboplatin IV over 60 minutes and thiotepa IV over 30 minutes on days -6 to -4 and etoposide IV over 60 minutes on days -6 to -3. Patients undergo reinfusion of stem cells on day 0. Patients also receive G-CSF SC or IV beginning on day 5 and continuing until blood counts recover.

After completion of study treatment, patients are followed at 6, 9, and 12 months and then every 6 months for up to 2 years.

PROJECTED ACCRUAL: A total of 25 patients will be accrued for this study.

Keywords
childhood extragonadal germ cell tumor, childhood malignant ovarian germ cell tumor, childhood malignant testicular germ cell tumor, stage III malignant testicular germ cell tumor, testicular choriocarcinoma and seminoma, testicular embryonal carcinoma and seminoma, testicular embryonal carcinoma and teratoma with seminoma, testicular embryonal carcinoma and yolk sac tumor with seminoma, testicular yolk sac tumor and teratoma with seminoma, testicular choriocarcinoma and embryonal carcinoma, testicular choriocarcinoma and teratoma, testicular choriocarcinoma and yolk sac tumor, testicular choriocarcinoma, testicular embryonal carcinoma and teratoma, testicular embryonal carcinoma and yolk sac tumor, testicular embryonal carcinoma, testicular yolk sac tumor and teratoma, testicular yolk sac tumor, testicular seminoma, stage IV extragonadal non-seminomatous germ cell tumor
Medical subject headings
Ovarian Neoplasms, Teratoma, Ovarian Germ Cell Cancer, Testicular Neoplasms, Seminoma, Endodermal Sinus Tumor, Carcinoma, Embryonal

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • carboplatinDrug

    Days -6, -5, -4: 500mg/m2^/day intravenously (IV) over 60 minutes

  • etoposideDrug

    Also called VP-16, Toposar

    600mg/m^2/day intravenously (IV) over 60 minutes on Days -6 through -3.

  • ifosfamideDrug

    Also called Mitoxana, Ifex

    2500 mg/m^2/day continuous infusion intravenously on Days -6, -5 and -4.

  • paclitaxelDrug

    Also called Taxol

    225 mg/m^2 intravenous over 3 hours on Day -7.

  • thiotepaDrug

    Also called N,N'N'-triethylenethiophosphoramide

    150mg/m^2/day intravenously IV over 30 minutes; Days -6, -5 and -4

  • autologous hematopoietic stem cell transplantationProcedure or surgery

    Also called PBSC

    Peripheral blood stem cell infusion (< 4 x 10^6 CD34+ cells/kg)

  • MesnaDrug

    Also called Uromitexan®

    2500 mg/m^2/day continuous infusion intravenously on Days -6, -5 and -4.

  • filgrastimBiological

    Also called G-CSF

    Beginning Day 5, G-CSF 5 μg/kg/day until absolute neutrophil count (ANC) ≥ 1500/UL for 3 consecutive days.

Study groups in NCT00432094
Study groupRoleWhat they receive
2 Transplants/1 Transplant (Overall)Experimental2 Transplants: Patients with Germ Cell Tumors (GCT) treated with a second tandem autologous stem cell transplant (AuSCT) with non-cross-resistant conditioning regimens. 1 Transplants:Patients with Germ cell tumors who receive one transplant only.
Receives: Drug: carboplatin; Drug: etoposide; Drug: ifosfamide; Drug: paclitaxel; Drug: thiotepa; Procedure: autologous hematopoietic stem cell transplantation; Drug: Mesna; Biological: filgrastim

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Survival (OS)

    The percentage of people in a study or treatment group who are alive for a certain period of time after they were diagnosed with or treated for a disease, such as cancer. Also called survival rate.

    Measured: 1 Year

Secondary outcomes (4)
  1. Disease-free Survival (DFS)

    The number of patients who survive without any signs of symptions of that cancer or any other cancer.

    Measured: 1 Year

  2. Engraftment of Platelets

    Platelet engraftment is defined as 20,000/mm^3 (20 x 10^9/L) for 3 consecutive days unsupported by a platelet transfusion.

    Measured: Day 100

  3. Numbers of Patients Unable to Mobilize Peripheral Blood Stem Cells

    Number of patients unable to achieve adequate stem cell mobilization, need to undergo one or tandem transplantation. Stem cell mobilization = A process in which certain drugs are used to cause the movement of stem cells from the bone marrow into the blood. The stem cells can be collected and stored. They may be used later to replace the bone marrow during a stem cell transplant.

    Measured: Pre-Transplant

  4. Engraftment of Neutrophils

    Neutrophil engraftment is defined as the first day of three consecutive days where the neutrophil count (absolute neutrophil count) is 500 cells/mm3 (0.5 x 109/L) or greater.

    Measured: Day 42

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Feb 2007 (estimated)
  2. Study start19 Dec 2006
  3. Primary completionMar 2021
  4. Study completionMar 2021

Resources

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
This trial is single arm study and it is non-randomized. Overall, if patients did not have enough cells to do two transplants then they only received one transplants.
Masking
None (open label)
Enrolment
23 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00432094
Sponsor's protocol ID
2006LS032
Other IDs
UMN-MT2005-21, UMN-0608M90586
Status last verified
Apr 2022
First submitted
5 Feb 2007
Last updated
17 May 2022
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing carboplatin, etoposide and ifosfamide in people with Childhood Germ Cell Tumor and Ovarian Cancer, run by Masonic Cancer Center, University of Minnesota at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 14 inclusion and 14 exclusion criteria. 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 17 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 17 May 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Overall Survival (OS) (time frame: 1 Year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 17 May 2022.

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