International Pleuropulmonary Blastoma (PPB) Treatment and Biology Registry

Overview[ - collapse ][ - ]

Purpose Pleuropulmonary Blastoma (PPB) is very rare and there is no established "standard" or "best" therapy. For many years, children with PPB around the world have been treated according to decisions made case-by-case in many different hospitals by many different physicians. No treatment has been tested in a large group of PPB patients. The goal is to treat many children with one treatment program and to learn the results of the treatment.
ConditionPleuropulmonary Blastoma
InterventionDrug: Vincristine
Drug: Dactinomycin
Drug: Cyclophosphamide
Drug: Ifosfamide
Drug: Doxorubicin
PhaseN/A
SponsorChildren's Hospitals and Clinics of Minnesota
Responsible PartyChildren's Hospitals and Clinics of Minnesota
ClinicalTrials.gov IdentifierNCT01464606
First ReceivedSeptember 29, 2011
Last UpdatedAugust 16, 2013
Last verifiedAugust 2013

Tracking Information[ + expand ][ + ]

First Received DateSeptember 29, 2011
Last Updated DateAugust 16, 2013
Start DateSeptember 2011
Estimated Primary Completion DateSeptember 2018
Current Primary Outcome MeasuresEvent-free survival [Time Frame: 5 years] [Designated as safety issue: No]The primary endpoint for statistical analysis will be time from start treatment to an event, defined as the occurrence of progression or recurrence of PPB, occurrence of a second malignant neoplasm, or death from any cause that is at least possibly related to the original disease or treatment.
Current Secondary Outcome MeasuresOverall response to chemotherapy, and survival [Time Frame: 5 years] [Designated as safety issue: No]Secondary endpoints will the best overall response to chemotherapy among patients with radiographically measurable tumor following initial surgery or biopsy, and time to death from any cause.

Descriptive Information[ + expand ][ + ]

Brief TitleInternational Pleuropulmonary Blastoma (PPB) Treatment and Biology Registry
Official TitleInternational Pleuropulmonary Blastoma (PPB) Treatment and Biology Registry Protocol
Brief Summary
Pleuropulmonary Blastoma (PPB) is very rare and there is no established "standard" or "best"
therapy. For many years, children with PPB around the world have been treated according to
decisions made case-by-case in many different hospitals by many different physicians. No
treatment has been tested in a large group of PPB patients.

The goal is to treat many children with one treatment program and to learn the results of
the treatment.
Detailed Description
This Registry will collect family medical history and establishes a collection of specimens
from PPB patients and their parents for future research. Primary goals of the biology
research are (1) to identify new scientific ways to learn about PPB and the best way to
treat it in the future and (2) to establish a collection of PPB biologic specimens for
future research.

Background: PPB is a rare cancer of the lung presenting in early childhood, mostly from
birth to age ~72 months. PPB occurs within the lung or between the lung and the chest wall.
There are three forms of PPB called Types I, II, and III PPB. Children with Type I PPB
require surgery and sometimes chemotherapy. Children with Types II and III PPB, require
surgery, chemotherapy and sometimes radiation therapy. Because there has never been a
consensus as to the best treatment for PPB, the Registry will provide treatment guidelines.
It is the goal of the Treatment and Biology Registry that by offering specific regimens the
Registry will be able to prospectively review and analyze the regimen for the first time.

Design:

- Diagnostic central pathology review will be required for patients who will be
prospectively evaluated.

- This Treatment Registry will offer surgery and chemotherapy regimen guidelines, and
optional radiation therapy guidelines for prospectively enrolled patients.

- The Treatment and Biology Registry will create a PPB biologic specimens reference bank
for tumor.

Methods:

- For Type I PPB, surgery is necessary. Some doctors use chemotherapy after surgery. If
chemotherapy is used the Registry will suggest that it be combination chemotherapy with
VAC (vincristine, dactinomycin, cyclophosphamide).

- For Types II and III PPB patients surgery is necessary, followed by chemotherapy. The
Registry will suggest that subjects receive combination chemotherapy with Ifosphamide,
Vincristine, Actinomycin-D and Doxorubicin ("IVADo"). Second look and possible 3rd look
surgery may be required. Radiation therapy is recommended only for residual disease
after maximum surgery.

Analysis: Statistical data analysis will include only centrally confirmed cases.
Additionally only patients with PPB Type II or Type III who were enrolled and treated with
IVADo as per the regimen will be compared to historical controls. No statistical analysis is
planned for patients with Type I PPB. Future treatment will be compared to the IVADo regimen
in order to measure improvements.
Study TypeInterventional
Study PhaseN/A
Study DesignAllocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
ConditionPleuropulmonary Blastoma
InterventionDrug: Vincristine
≥ 3 years: 1.5 mg/m2 IV x 1 (maximum dose 2 mg)
Other Names:
Vincristine; OncovinDrug: Dactinomycin
≥ 3 years: 0.045 mg/kg (maximum dose 2.5 mg) IV X 1
Other Names:
Actinomycin-DDrug: Cyclophosphamide
≥ 3 year: 1.2 gm/m2/dose IV as 1 hr infusion with IV fluids
Other Names:
CytoxanDrug: Ifosfamide
≥ 3 years: 3 g/m2/dose IV over 3 hours on Days 1, 2, (6 g/m2/cycle)
Drug: Doxorubicin
≥ 3 years: 30 mg/m2/dose IV over 30 min, Days 1, 2 (60 mg/m2/cycle)
Other Names:
Adriamycin
Study Arm (s)
  • Experimental: Type I PPB therapy
    PPB Type I therapy: All patients will be treated with surgery. Chemotherapy after surgery is per the treating physician(s) discretion. If chemotherapy is used the Registry will suggest that it be combination chemotherapy with VAC (Vincristine, Actinomycin-D, Cyclophosphamide).
  • Experimental: Types II and III PPB therapy
    Combination chemotherapy with Ifosphamide, Vincristine, Actinomycin-D and Doxorubicin ("IVADo"). Second look and possible 3rd look surgery may be required. Radiation therapy is recommended only for residual disease after maximum surgery.

Recruitment Information[ + expand ][ + ]

Recruitment StatusRecruiting
Estimated Enrollment125
Estimated Completion DateSeptember 2018
Estimated Primary Completion DateSeptember 2016
Eligibility Criteria
Inclusion Criteria:

1. Age : Patients from birth to < 21 years of age at the time of diagnosis.

2. Pathology Diagnosis: Patients with newly-diagnosed PPB Types I, II or III. Diagnosis
is made by the local pathologist.

All cases must be submitted for central pathology review. Only centrally-reviewed
cases confirmed as PPB will be analyzed prospectively.

Cases in which the initial diagnosis is "suggestive" or "supportive" of PPB, but not
diagnostic, and in which later resection specimens, including resections following
chemotherapy, confirm a PPB diagnosis will be included. Patients diagnosed by fine
needle aspiration biopsy will be included only if a later resection specimen,
including resections following chemotherapy, is diagnostic of PPB.

3. Prior Therapy: PPB Type I: All patients are eligible and will be followed in the
study.

PPB Types II or III: Newly-diagnosed Types II and III PPB patients will be included
in the Treatment and Biology Registry.

4. Prior corticosteroid therapy is allowed.

5. Patients who have received other chemotherapy regimens or radiation therapy will not
be statistical analysis.

6. Types II and III PPB patients with PRIOR Type I PPB diagnosis: Types II and III PPB
cases which are recurrences of an earlier Type I PPB are included if no chemotherapy
was used for the Type I disease.

7. Informed consent by parent/guardian. (also, where appropriate: assent and HIPPA
consent)
GenderBoth
AgesN/A
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesUnited States

Administrative Information[ + expand ][ + ]

NCT Number NCT01464606
Other Study ID NumbersPPB Reg Tx-Biol-001
Has Data Monitoring CommitteeNo
Information Provided ByChildren's Hospitals and Clinics of Minnesota
Study SponsorChildren's Hospitals and Clinics of Minnesota
CollaboratorsNot Provided
Investigators Principal Investigator: Yoav H Messinger, MD Children's Hospitals and Clinics of Minensota
Verification DateAugust 2013

Locations[ + expand ][ + ]

Children's Hospitals and Clinics of Minnesota
Minneapolis, Minnesota, United States, 55404
Contact: Gretchen M Williams, BS | 612-813-7115 | gretchen.williams@childrensmn.org
Principal Investigator: Yoav H Messinger, M.D.
Recruiting