This is an international open-label, randomized, multicenter phase II study of VIT and VI for the treatment of patients with recurrent or refractory rhabdomyosarcoma. The study will evaluate the safety and efficacy of these combinations in patients with recurrent or refractory rhabdomyosarcoma.
The dose of vincristine will be 1.5 mg/m² or 0.05 mg/kg for patient ≤ 10 kg (maximum 2 mg) and will be administered by direct intravenous infusion on day 1 and 8 of each course, before irinotecan. The dose of irinotecan will be 50 mg/m²/d. Irinotecan will be given intravenously over 1 hour on days 1-5 of each course, one hour following the administration of temozolomide. In the absence of any contraindication (ie known allergies), treatment with oral cefixime 8 mg/kg once daily (maximum daily dose 400 mg) is recommended and will be started 2 days before chemotherapy until day 7. Temozolomide will be given according to the randomization. The starting dose of temozolomide will be 125 mg/m²/d. The dose of temozolomide will be escalated to 150 mg/m²/day at cycle 2 for patients who do not experience \> grade 3 toxicity of any kind. Temozolomide will be given orally, on an empty stomach, on days 1 through 5 of each course. Dose reductions and/or administration delays will be performed using specific predefined rules to accommodate individual patient tolerance of treatment and to maintain optimal dose intensity.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
120
* D1 and D8: Vincristine 1.5 mg/m² (max 2mg) direct IV infusion (0.05 mg/kg for patient ≤ 10 kg) * D1 to D5: Irinotecan 50 mg/m²/d, IV 1. cycle / 21 days
* D1 to D5: Temozolomide 125 mg/m²/d, PO (the dose will be escalated to 150 mg/m²/day at cycle 2 for patients who do not experience \> grade 3 toxicity of any kind) * D1 and D8: Vincristine 1.5 mg/m² (maximum 2mg) direct IV infusion (0.05 mg/kg for patient ≤ 10 kg) * D1 to D5: Irinotecan 50 mg/m²/d, IV 1. cycle / 21 days
CHU d'Amiens Picardie Site Sud
Amiens, France
Hôpital des Enfants, Groupe Hospitalier Pellegrin
Bordeaux, France
Centre Oscar Lambret
Lille, France
Objective tumour response and progression in each treatment arm.
The primary efficacy endpoint is defined as the proportion of patients who had a documented complete or partial tumour response occurring after the first 2 cycles of treatment which must be confirmed by a follow-up objective tumour assessment obtained within 4-5 weeks after the initial documentation.
Time frame: at least 6 weeks (two cycles of treatment)
To assess the duration of tumor response in each treatment arm
The duration of tumour response is defined as the time from first documentation of objective tumour response to the first objective or clinical documentation of progression
Time frame: During all the study
To determine the time to tumor progression in each treatment arm
The time to tumor progression: the time from the date of first treatment administration to the date of first objective or clinical documentation of tumour progression or death due to any cause
Time frame: During all the study
To assess the time to treatment failure in each treatment arm
The time to treatment failure is defined as the time from the date of first treatment administration to the first documentation of tumour progression, discontinuation of study treatment before one year, or death, whichever occurs first
Time frame: Before 1 year
To assess the overall survival in each treament arm
The overall survival is defined as the time from the date of first treatment administration to date of death
Time frame: During all the study
To assess the safety profile and tolerability in each treatment arm
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Centre Léon Bérard
Lyon, France
CHU, Hôpital d'Enfants de la Timone
Marseille, France
Hôpital Arnaud de Villeneuve - CHU
Montpellier, France
CHU, Hôpital Mère enfants
Nantes, France
Hôpital Armand Trousseau
Paris, France
Institut Curie
Paris, France
Hôpital Jean Bernard
Poitiers, France
...and 6 more locations
Safety parameters include adverse events and haematology and blood chemistry assays. Safety evaluations will include characterization of the frequency and severity of adverse events, complete blood cell counts with differential, serum chemistries and electrolytes, and change in weight and body surface area (BSA).
Time frame: During all the study