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No longer recruiting (closed or complete)Last updated: 15 January 2024

SIOPEN: This phase III trial is assessing the different types of treatment available for patients with Neuroblastoma, to which patients will be randomisedHigh Risk Neuroblastoma Study 1 of SIOP-Europe (SIOPEN)

Trial purpose

Medical clipboardCancer treatment

Tumor type

Brain and Spinal Cancers Brain and Spinal

Age

People0 - 21

Trial acronym

SIOPEN

Clinical summary

Summary

This is a randomised study of the European SIOP Neuroblastoma Group (SIOPEN) in high-risk neuroblastoma (stages 2, 3, 4 and 4s MYCN-amplified neuroblastoma, stage 4 MYCN non amplified > 12 months at diagnosis). The protocol consists of a rapid, dose intensive induction chemotherapy (R3 randomisation - Rapid COJEC vs modified N7), peripheral blood stem cell harvest, attempted complete excision of the primary tumour, myeloablative therapy (BuMel) followed by peripheral blood stem cell rescue, radiotherapy to the site of the primary tumour and immunotherapy (R4 randomisation - isotretinoin and ch14.18/CHO, with or without aldesleukin (IL-2). In the induction phase, all patients with stage 4 neuroblastoma and those with stage 4s MYCN-amplified neuroblastoma will be randomised (R3) to Rapid COJEC or modified N7; localised patients receive Rapid COJEC (Rapid COJEC is given with G-CSF support based on the results of the R0 randomisation running between 2002 and 2005). Following induction treatment peripheral blood stem cell harvest (PBSCH) will be performed and complete excision of the primary tumour will be attempted. Patients with an inadequate metastatic response to allow BuMel MAT followed by PBSCR at the end of induction should receive 2 TVD (Topotecan, Vincristine, Doxorubicin) cycles. After Rapid COJEC induction, localised patients will proceed to consolidation. Patients aged 12-18 months at diagnosis, with stage 4 neuroblastoma, no MYCN amplification and without segmental chromosomal alterations (SCA) are thought to have a good prognosis and will stop treatment after induction therapy and surgery to the primary tumour. Consolidation consists of BuMel MAT (following the results of the R1 randomisation) followed by peripheral blood stem cell rescue (PBSCR) and radiotherapy to the site of the primary tumour. During the immunotherapy phase, patients will be randomised (R4) to immunotherapy with isotretinoin (13-cis-RA) and ch14.18/CHO, with or without aldesleukin (IL-2).

Conditions

This trial is treating people with Neuroblastoma

Eligibility

Inclusion

  • • Established diagnosis of neuroblastoma according to the International Neuroblastoma Staging System (INSS).

    • Age below 21 years.
    • High risk neuroblastoma defined as either:

      1. INSS stage 2, 3, 4, and 4s with MYCN amplification, or
      2. INSS stage 4 without MYCN amplification aged > 12 months at diagnosis
    • Patients who have received no previous chemotherapy except for one cycle of etoposide and carboplatin (VP16/Carbo). In this situation patients will receive Rapid COJEC induction and the first Rapid COJEC cycle may be replaced by the first cycle VP16/Carbo (etoposide / carboplatin).
    • Written informed consent, including agreement of parents or legal guardian for minors, to enter a randomised study if the criteria for randomisation are met.
    • Tumour cell material available for determination of biological prognostic factors.
    • Females of childbearing potential must have a negative pregnancy test. Patients of childbearing potential must agree to use an effective birth control method. Female patients who are lactating must agree to stop breast-feeding.
    • Registration of all eligibility criteria with the data centre within 6 weeks from diagnosis.
    • Provisional follow up of 5 years.
    • National and local ethical committee approval.

Exclusion

Any negative answer concerning the inclusion criteria of the study

Exclusion

  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
Message

Clinical trials have complex eligibility criteria, and other criteria may apply for this trial. Ask your doctor about whether this trial could be right for you.

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More information

Trial Identifiers

Information on this page is partially produced from ClinicalTrials.gov *. View further details about this trial on the registry via the links below:

Trial sponsor

St. Anna Kinderkrebsforschung

Scientific Title

High Risk Neuroblastoma Study 1 of SIOP-Europe (SIOPEN)

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