NCT00432094

Brief Summary

RATIONALE: Germ cell tumors (GCT) are highly sensitive to chemotherapy such that even with metastatic disease at diagnosis, many patients can be cured. Patients who fall into the poor risk category or others who relapse can be successfully salvaged with high dose chemotherapy and autologous stem cell transplant (AuSCT). As in other diseases such as myeloma, sequential high dose chemotherapy and AuSCT may improve overall and disease free survival. PURPOSE: Because prior investigations in GCT suggest that a subset of high risk or relapsed patients may be cured with sequential cycles of high dose chemotherapy and AuSCT, we propose investigating how well non-cross resistant conditioning regimens work in treating patients with relapsed or high risk GCT.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
23

participants targeted

Target at below P25 for phase_2

Timeline
Completed

Started Dec 2006

Longer than P75 for phase_2

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

December 19, 2006

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

February 5, 2007

Completed
2 days until next milestone

First Posted

Study publicly available on registry

February 7, 2007

Completed
14.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2021

Completed
1.2 years until next milestone

Results Posted

Study results publicly available

May 17, 2022

Completed
Last Updated

May 17, 2022

Status Verified

April 1, 2022

Enrollment Period

14.2 years

First QC Date

February 5, 2007

Results QC Date

February 25, 2022

Last Update Submit

April 22, 2022

Conditions

Keywords

childhood extragonadal germ cell tumorchildhood malignant ovarian germ cell tumorchildhood malignant testicular germ cell tumorstage III malignant testicular germ cell tumortesticular choriocarcinoma and seminomatesticular embryonal carcinoma and seminomatesticular embryonal carcinoma and teratoma with seminomatesticular embryonal carcinoma and yolk sac tumor with seminomatesticular yolk sac tumor and teratoma with seminomatesticular choriocarcinoma and embryonal carcinomatesticular choriocarcinoma and teratomatesticular choriocarcinoma and yolk sac tumortesticular choriocarcinomatesticular embryonal carcinoma and teratomatesticular embryonal carcinoma and yolk sac tumortesticular embryonal carcinomatesticular yolk sac tumor and teratomatesticular yolk sac tumortesticular seminomastage IV extragonadal non-seminomatous germ cell tumorstage IV extragonadal seminomastage I extragonadal non-seminomatous germ cell tumorstage I extragonadal seminomastage II extragonadal non-seminomatous germ cell tumorstage II extragonadal seminomastage III extragonadal non-seminomatous germ cell tumorstage III extragonadal seminomastage II ovarian germ cell tumorstage I malignant testicular germ cell tumorstage II malignant testicular germ cell tumoradult teratomachildhood teratomatesticular immature teratomatesticular mature teratomaadult central nervous system germ cell tumorchildhood central nervous system germ cell tumor

Outcome Measures

Primary Outcomes (1)

  • Overall Survival (OS)

    The percentage of people in a study or treatment group who are alive for a certain period of time after they were diagnosed with or treated for a disease, such as cancer. Also called survival rate.

    1 Year

Secondary Outcomes (4)

  • Disease-free Survival (DFS)

    1 Year

  • Engraftment of Platelets

    Day 100

  • Numbers of Patients Unable to Mobilize Peripheral Blood Stem Cells

    Pre-Transplant

  • Engraftment of Neutrophils

    Day 42

Study Arms (1)

2 Transplants/1 Transplant (Overall)

EXPERIMENTAL

2 Transplants: Patients with Germ Cell Tumors (GCT) treated with a second tandem autologous stem cell transplant (AuSCT) with non-cross-resistant conditioning regimens. 1 Transplants:Patients with Germ cell tumors who receive one transplant only.

Drug: carboplatinDrug: etoposideDrug: ifosfamideDrug: paclitaxelDrug: thiotepaProcedure: autologous hematopoietic stem cell transplantationDrug: MesnaBiological: filgrastim

Interventions

Days -6, -5, -4: 500mg/m2\^/day intravenously (IV) over 60 minutes

2 Transplants/1 Transplant (Overall)

600mg/m\^2/day intravenously (IV) over 60 minutes on Days -6 through -3.

Also known as: VP-16, Toposar
2 Transplants/1 Transplant (Overall)

2500 mg/m\^2/day continuous infusion intravenously on Days -6, -5 and -4.

Also known as: Mitoxana, Ifex
2 Transplants/1 Transplant (Overall)

225 mg/m\^2 intravenous over 3 hours on Day -7.

Also known as: Taxol
2 Transplants/1 Transplant (Overall)

150mg/m\^2/day intravenously IV over 30 minutes; Days -6, -5 and -4

Also known as: N,N'N'-triethylenethiophosphoramide
2 Transplants/1 Transplant (Overall)

Peripheral blood stem cell infusion (\< 4 x 10\^6 CD34+ cells/kg)

Also known as: PBSC
2 Transplants/1 Transplant (Overall)
MesnaDRUG

2500 mg/m\^2/day continuous infusion intravenously on Days -6, -5 and -4.

Also known as: Uromitexan®
2 Transplants/1 Transplant (Overall)
filgrastimBIOLOGICAL

Beginning Day 5, G-CSF 5 μg/kg/day until absolute neutrophil count (ANC) ≥ 1500/UL for 3 consecutive days.

Also known as: G-CSF
2 Transplants/1 Transplant (Overall)

Eligibility Criteria

Age10 Years - 69 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Diagnosis: Poor Prognosis Non-Seminomas Germ Cell Tumor in ≥ PR1/CR1 or Good or Intermediate Prognosis Seminomas and Non- Seminomas Germ Cell Tumor in ≥ PR1 or ≥ CR2 as defined by the International Germ Cell Cancer Consensus Classification. Patients with increasing tumor markers only (i.e. no imaging evidence of progressive disease) are eligible for transplant.
  • Age: ≥ 10 years and \< 70 years of age.
  • Performance status: Karnofsky ≥ 80% (subjects ≥ 16 years of age) Lansky ≥ 80% for subject 10 - 15 years of age
  • Life expectancy: Greater than 8 weeks.
  • Patients must have normal organ function as defined below:
  • Hematologic:
  • Hemoglobin \> 8 gm/dL without transfusion and off erythropoietin for 14 days or Aranesp for 21 days
  • White blood cells (WBC) \> 2.5 x 10\^9/L with an absolute neutrophile count (ANC) \> 1.5 x 10\^9/L and off G-CSF or GM-CSF for 10 days or Neulasta for 21 days
  • Platelets \> 100 x 10\^9/L without transfusion and/or a bone marrow cellularity of ≥ 20%
  • Renal: Creatinine ≤ 2.0 mg/dl or creatinine clearance \> 50 ml/min.
  • Hepatic: Total bilirubin ≤ 2.0 mg/dl, AST and alkaline phosphatase \< 5 x upper limit of normal. No history of severe prior or ongoing chronic liver disease.
  • Cardiac: Patients must be free of symptoms of uncontrolled cardiac disease including unstable angina, decompensated congestive heart failure, or arrhythmia. LVEF ≥45% by MUGA/ECHO.
  • Pulmonary: Patients must have no significant obstructive airways disease (FEV1 must be ≥ 50% of predicted) and must have acceptable diffusion capacity (corrected DLCO \> 50% of predicted).
  • Patients with a history of CNS tumor involvement are eligible if they have completed treatment for CNS disease (radiotherapy or surgery or chemotherapy), have recovered from or stabilization of the side effects associated with the therapy and have no evidence of progressive CNS disease at the time of enrollment.

You may not qualify if:

  • Patients with serious uncontrolled infections will not be eligible.
  • Male and female patients of reproductive potential must use an approved contraceptive method if appropriate (for example, intrauterine device \[IUD\], birth control pills, or barrier device) during and for the duration of study participation. The drugs used in this study are pregnancy category D - clear evidence of risk in pregnancy.
  • Pregnant and breast feeding women will not be eligible.
  • Voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care.
  • Additional Eligibility prior to Transplant Two:
  • Total Collection of ≥ 4 x 10\^6 CD34 cells/kg prior to transplant one
  • Transplant able to occur between day +30 and day +90 from transplant one
  • Recovery of blood counts as demonstrated by:
  • WBC \> 2.5 x 10\^9/L with an ANC \> 1.5 x 10\^9/L and off G-CSF for 3 days
  • Platelets \> 50 x 10\^9/L without transfusion in the prior 7 days
  • Renal: Creatinine ≤ 2.0 mg/dl or creatinine clearance \> 50 ml/min
  • Hepatic: Total bilirubin ≤ 2.0 mg/dl, AST and alkaline phosphatase \< 5 x upper limit of normal
  • Infection: Patients with serious uncontrolled infections at the time of planned transplant will be excluded
  • Patients with progressive disease by Response Evaluation Criteria in Solid Tumors (RECIST) criteria by imaging techniques are not eligible to proceed to the second transplant. Tumor marker increase alone is not sufficient to diagnose disease progression.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Masonic Cancer Center at University of Minnesota

Minneapolis, Minnesota, 55455, United States

Location

MeSH Terms

Conditions

Ovarian NeoplasmsTeratomaOvarian Germ Cell CancerTesticular NeoplasmsSeminomaEndodermal Sinus TumorCarcinoma, Embryonal

Interventions

CarboplatinEtoposideIfosfamidePaclitaxelThiotepaMesnaFilgrastimGranulocyte Colony-Stimulating Factor

Condition Hierarchy (Ancestors)

Endocrine Gland NeoplasmsNeoplasms by SiteNeoplasmsOvarian DiseasesAdnexal DiseasesGenital Diseases, FemaleFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesGenital Neoplasms, FemaleUrogenital NeoplasmsGenital DiseasesEndocrine System DiseasesGonadal DisordersNeoplasms, Germ Cell and EmbryonalNeoplasms by Histologic TypeGenital Neoplasms, MaleGenital Diseases, MaleMale Urogenital DiseasesTesticular DiseasesGerminomaMesonephroma

Intervention Hierarchy (Ancestors)

Coordination ComplexesOrganic ChemicalsPodophyllotoxinTetrahydronaphthalenesNaphthalenesPolycyclic Aromatic HydrocarbonsHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsPolycyclic CompoundsGlucosidesGlycosidesCarbohydratesCyclophosphamidePhosphoramide MustardsNitrogen Mustard CompoundsMustard CompoundsHydrocarbons, HalogenatedPhosphoramidesOrganophosphorus CompoundsOxazinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsTaxoidsCyclodecanesCycloparaffinsHydrocarbons, AlicyclicDiterpenesTerpenesTriethylenephosphoramideAziridinesAzirinesAlkanesulfonatesAlkanesulfonic AcidsAlkanesHydrocarbons, AcyclicSulfhydryl CompoundsSulfur CompoundsSulfonic AcidsSulfur AcidsColony-Stimulating FactorsGlycoproteinsGlycoconjugatesHematopoietic Cell Growth FactorsCytokinesIntercellular Signaling Peptides and ProteinsPeptidesAmino Acids, Peptides, and ProteinsProteinsBiological Factors

Results Point of Contact

Title
Dr. Najla El Jurdi
Organization
Masonic Cancer Center, University of Minnesota

Study Officials

  • Najla El Jurdi, MD

    Masonic Cancer Center, University of Minnesota

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 2
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Model Details: This trial is single arm study and it is non-randomized. Overall, if patients did not have enough cells to do two transplants then they only received one transplants.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 5, 2007

First Posted

February 7, 2007

Study Start

December 19, 2006

Primary Completion

March 1, 2021

Study Completion

March 1, 2021

Last Updated

May 17, 2022

Results First Posted

May 17, 2022

Record last verified: 2022-04

Locations