Status:

COMPLETED

Combination Chemotherapy in Treating Young Patients With Recurrent or Resistant Malignant Germ Cell Tumors

Lead Sponsor:

Children's Oncology Group

Collaborating Sponsors:

National Cancer Institute (NCI)

Conditions:

Childhood Extracranial Germ Cell Tumor

Childhood Extragonadal Malignant Germ Cell Tumor

Eligibility:

All Genders

Up to 21 years

Phase:

PHASE2

Brief Summary

This phase II trial is studying how well giving combination chemotherapy works in treating young patients with recurrent or resistant malignant germ cell tumors. Drugs used in chemotherapy, such as pa...

Detailed Description

PRIMARY OBJECTIVES: I. Determine the response rate in pediatric patients with recurrent or resistant malignant germ cell tumors (GCT) treated with paclitaxel, ifosfamide, and carboplatin. SECONDARY ...

Eligibility Criteria

Inclusion

  • Inclusion Criteria:
  • Histologically confirmed (at original diagnosis) extracranial germ cell tumor (GCT) containing 1 of the following malignant elements:
  • Yolk sac tumor (endodermal sinus tumor)
  • Choriocarcinoma
  • Embryonal carcinoma
  • Meets 1 of the following disease criteria:
  • Recurrent malignant disease
  • Chemotherapy-resistant disease
  • Relapsed disease
  • Disease refractory to conventional therapy
  • Measurable disease
  • Must have received a prior first-line chemotherapy regimen that included cisplatin
  • Patients with tumor marker (AFP and/or BHCG) elevation alone or bone scan findings alone are not eligible\*
  • Patients with immature teratoma (any grade), germinoma, sex-cord stromal tumors, or recurrent GCT previously treated with surgery alone are not eligible
  • Karnofsky performance status (PS) 50-100% (age \> 16 years) OR Lansky PS 50-100% (age ≤ 16 years) OR ECOG PS 0-2
  • Life expectancy ≥ 8 weeks
  • Absolute neutrophil count ≥ 750/mm³
  • Platelet count ≥ 75,000/mm³ (transfusion independent)
  • Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min OR creatinine normal based on age/gender, as defined by the following:
  • ≤ 0.4 mg/dL (1 month to \< 6 months of age)
  • ≤ 0.5 mg/dL (6 months to \< 1 year of age)
  • ≤ 0.6 mg/dL (1 to \< 2 years of age)
  • ≤ 0.8 mg/dL (2 to \< 6 years of age)
  • ≤ 1.0 mg/dL (6 to \< 10 years of age)
  • ≤ 1.2 mg/dL (10 to \< 13 years of age)
  • ≤ 1.4 mg/dL (13 to ≥ 16 years of age) (female)
  • ≤ 1.5 mg/dL (13 to \< 16 years of age) (male)
  • ≤ 1.7 mg/dL (≥ 16 years of age) (male)
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN) for age
  • ALT \< 2.5 times ULN for age
  • Shortening fraction ≥ 27% by echocardiogram OR ejection fraction ≥ 50% by gated radionuclide study
  • No dyspnea at rest
  • No exercise intolerance
  • Pulse oximetry \> 94% (if there is clinical indication for determination)
  • Patients with seizure disorder are eligible provided they are on non-enzyme inducing anticonvulsants and seizures are well controlled
  • No CNS toxicity \> grade 2
  • No active graft-versus-host disease
  • No allergy to Cremophor EL or castor oil
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No other concurrent chemotherapy or immunomodulating agents
  • Recovered from prior chemotherapy, immunotherapy, or radiotherapy
  • At least 1 week since prior growth factors (2 weeks for pegfilgrastim)
  • At least 1 week since prior biologic therapy
  • At least 2 weeks since prior myelosuppressive chemotherapy (4 weeks for nitrosourea)
  • At least 2 weeks since prior local palliative radiotherapy (i.e., small port)
  • At least 6 months since prior craniospinal radiotherapy or radiotherapy to ≥ 50% of pelvis
  • At least 6 weeks since other prior substantial bone marrow radiotherapy
  • At least 6 months since prior allogeneic stem cell transplantation
  • Concurrent radiotherapy to localized painful lesions allowed provided at least 1 measurable lesion is not irradiated

Exclusion

    Key Trial Info

    Start Date :

    November 5 2007

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    June 30 2018

    Estimated Enrollment :

    20 Patients enrolled

    Trial Details

    Trial ID

    NCT00467051

    Start Date

    November 5 2007

    End Date

    June 30 2018

    Last Update

    August 29 2018

    Active Locations (95)

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    Page 1 of 24 (95 locations)

    1

    The University of Arizona Medical Center-University Campus

    Tucson, Arizona, United States, 85724

    2

    University of Arkansas for Medical Sciences

    Little Rock, Arkansas, United States, 72205

    3

    Kaiser Permanente Downey Medical Center

    Downey, California, United States, 90242

    4

    Miller Children's and Women's Hospital Long Beach

    Long Beach, California, United States, 90806