This proof-of-concept platform trial is designed to cover the targeting of several survival pathways in oncogenesis that are currently not adequately employed for pediatric patients in Europe (Geoerger 2017; Geoerger 2019). The aims of the trial are: 1. To determine the recommended phase II dose (RP2D) of a specific anticancer agent and/or a relevant combination in a pediatric population, to document its tolerability and 2. To explore first signals of activity in a molecularly enriched study population.
The first molecular profiling protocols have been launched in Europe (MOSCATO-01 (Geoerger 2014), MAPPYACTS, INFORM, iTHER, SM-PAEDS, etc.) determining multiple actionable alterations in pediatric recurrent cancers. Increasingly, stratified approaches are being implemented to enrich clinical trials of molecularly targeted agents and possibly improve outcomes in specific populations i.e. a molecularly enriched/predictive biomarker-driven approach. The diversity and heterogeneity of the detected molecular alterations and the low number of pediatric patients mandate an adapted, innovative trial design for the attributed treatment options in order to satisfy the current unmet medical need. This basket trial is designed to cover the targeting of several survival pathways in oncogenesis that are currently not adequately employed for pediatric patients in Europe.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
472
Rigshospitalet
Copenhagen, Denmark
RECRUITINGGustave Roussy
Villejuif, Val de Marne, France
RECRUITINGCHU Angers
Angers, France
RECRUITINGCHU Pellegrin
Bordeaux, France
RECRUITINGCentre Oscar Lambret
Lille, France
RECRUITINGCentre Léon Bérard
Lyon, France
RECRUITINGHôpital de La Timone
Marseille, France
RECRUITINGCHU Nantes
Nantes, France
RECRUITINGInstitut Curie
Paris, France
RECRUITINGHôpital Armand Trousseau
Paris, France
RECRUITING...and 13 more locations
Recommended phase II dose (RP2D)
Defined as the adult recommended dose (adjusted for weight or BSA) if toxicity and/or PK profiling are similar in children and in adults, or a higher dose, providing it is below or equal to the maximum tolerated dose (MTD)
Time frame: During the first cycle
Maximum Tolerated Dose (MTD)
The MTD will be defined as the dose associated with or closest to 25% of Dose Limiting Toxicities (DLTs)
Time frame: During the first cycle
Objective Response Rate (ORR)
Defined as the proportion of participants who achieved a confirmed complete response (CR) or partial response (PR) assessed by investigators. In patients with leukemia, ORR is defined as the percentage of patients attaining CR, CRi or CRp.
Time frame: During treatment period
Pharmacokinetics (PK)
To characterize single or multiple-dose PK of the agent(s)
Time frame: Depending on the treatment arm
Progression Free Survival (PFS)
Defined as the time from treatment initiation until the date of first documented progression (clinically or radiologically) or death from any cause. Patients alive and free of progression at the cut-off date will be censored at the last assessment date.
Time frame: From treatment initiation until the date of first documented progression or death
Evaluation of duration of response (DoR)
Defined as the time period between the first documented response (complete response (CR) or partial response (PR)) and the time of progression, according to RECIST v1.1, RANO criteria for patients with HGG, INRC criteria for patients with NB, etc.
Time frame: Between the first document response and the time of first documented progression
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