Surgery and Combination Chemotherapy in Treating Children With Extracranial Germ Cell Tumors
Childhood Embryonal Tumor, Childhood Extracranial Germ Cell Tumor, Childhood Extragonadal Germ Cell Tumor
About this trial
This is an interventional treatment trial for Childhood Embryonal Tumor
Eligibility Criteria
Inclusion Criteria: Extracranial germ cell tumor that contains 1 of the following malignant histologies: NOTE: Mixed germ cell tumors that include mature/immature teratoma are eligible provided 1 of the 3 histologies listed above is also present in the tumor. Yolk sac tumor Embryonal carcinoma Choriocarcinoma Low-risk disease (closed to accrual as of 01/20/10) Stage I gonadal tumors (ovarian and testicular) Must have undergone complete surgical and radiologic staging to exclude the possibility of > stage I disease Intermediate-risk disease Stage II, III, or IV malignant testicular GCT Stage II or III malignant ovarian GCT Stage I or II malignant extragonadal GCT Previously stage I gonadal patients who have relapsed on the low-risk (observation) stratum of this study(closed to accrual as of 01/20/10) Patients with immature teratoma or mature teratoma who relapse with a malignant component No patients with any of the following diagnoses: Stage IV ovarian and stage III-IV extragonadal GCT Intracranial GCT Pure mature or immature teratoma, pure dysgerminoma, or seminoma Patients with a non-germ cell component in their GCT (e.g., primitive neuroectodermal tumors or rhabdomyosarcoma) Alpha-fetoprotein and beta human chorionic gonadotropin tumor markers known If > 5 days have elapsed from the time of obtaining original markers, tumor markers must be repeated before enrollment of low-risk patients and before initiating therapy in intermediate-risk patients (the results of the repeated tumor markers do not have to be known at the time of study enrollment) Must be enrolled within 6 weeks of original diagnostic surgery Creatinine clearance or radioisotope GFR ≥ 70 mL/min OR a serum creatinine based on age/gender as follows: ≤ 0.4 mg/dL (for patients 1 to 5 months of age) ≤ 0.5 mg/dL (for patients 6 to 11 months of age) ≤ 0.6 mg/dL (for patients 1 year of age) ≤ 0.8 mg/dL (for patients 2 to 5 years of age) ≤ 1.0 mg/dL (for patients 6 to 9 years of age) ≤ 1.2 mg/dL (for patients 10 to 12 years of age) ≤ 1.4 mg/dL (for female patients ≥ 13 years of age) ≤ 1.5 mg/dL (for male patients 13 to 15 years of age) ≤ 1.7 mg/dL (for male patients ≥ 16 years of age) No prior chemotherapy No prior radiotherapy
Sites / Locations
- University of Alabama at Birmingham
- Phoenix Childrens Hospital
- University of Arkansas for Medical Sciences
- Southern California Permanente Medical Group
- Loma Linda University Medical Center
- Miller Children's Hospital
- Children's Hospital Los Angeles
- Children's Hospital Central California
- Children's Hospital and Research Center at Oakland
- Kaiser Permanente-Oakland
- Childrens Hospital of Orange County
- Lucile Packard Children's Hospital Stanford University
- Sutter General Hospital
- Rady Children's Hospital - San Diego
- University of California San Francisco Medical Center-Parnassus
- Children's Hospital Colorado
- Connecticut Children's Medical Center
- Yale University
- Alfred I duPont Hospital for Children
- Children's National Medical Center
- Broward Health Medical Center
- Lee Memorial Health System
- University of Florida
- Memorial Healthcare System - Joe DiMaggio Children's Hospital
- University of Miami Miller School of Medicine-Sylvester Cancer Center
- Miami Children's Hospital
- All Children's Hospital
- Children's Healthcare of Atlanta - Egleston
- Memorial Health University Medical Center
- University of Hawaii
- Saint Luke's Mountain States Tumor Institute
- Childrens Memorial Hospital
- Loyola University Medical Center
- Advocate Hope Children's Hospital
- Saint Jude Midwest Affiliate
- Southern Illinois University
- University of Kentucky
- Kosair Children's Hospital
- Massachusetts General Hospital Cancer Center
- Dana-Farber Cancer Institute
- Baystate Medical Center
- C S Mott Children's Hospital
- Wayne State University
- Saint John Hospital and Medical Center
- Hurley Medical Center
- Helen DeVos Children's Hospital at Spectrum Health
- Michigan State University - Breslin Cancer Center
- Children's Hospitals and Clinics of Minnesota - Minneapolis
- University of Minnesota Medical Center-Fairview
- Mayo Clinic
- The Childrens Mercy Hospital
- Washington University School of Medicine
- Dartmouth Hitchcock Medical Center
- Hackensack University Medical Center
- Saint Peter's University Hospital
- UMDNJ - Robert Wood Johnson University Hospital
- Newark Beth Israel Medical Center
- Albany Medical Center
- Montefiore Medical Center
- Brooklyn Hospital Center
- Roswell Park Cancer Institute
- The Steven and Alexandra Cohen Children's Medical Center of New York
- New York University Langone Medical Center
- Columbia University Medical Center
- University of Rochester
- State University of New York Upstate Medical University
- New York Medical College
- Mission Hospitals Inc
- Duke University Medical Center
- Wake Forest University Health Sciences
- Sanford Medical Center-Fargo
- Children's Hospital Medical Center of Akron
- Cincinnati Children's Hospital Medical Center
- Rainbow Babies and Childrens Hospital
- Nationwide Children's Hospital
- The Children's Medical Center of Dayton
- Mercy Children's Hospital
- University of Oklahoma Health Sciences Center
- Legacy Emanuel Hospital and Health Center
- Oregon Health and Science University
- Geisinger Medical Center
- Penn State Hershey Children's Hospital
- Children's Hospital of Philadelphia
- Saint Christopher's Hospital for Children
- Children's Hospital of Pittsburgh of UPMC
- Medical University of South Carolina
- Palmetto Health Richland
- T C Thompson Children's Hospital
- East Tennessee Childrens Hospital
- St. Jude Children's Research Hospital
- Vanderbilt-Ingram Cancer Center
- Texas Tech University Health Science Center-Amarillo
- Dell Children's Medical Center of Central Texas
- Driscoll Children's Hospital
- University of Texas Southwestern Medical Center
- Cook Children's Medical Center
- Baylor College of Medicine
- M D Anderson Cancer Center
- Covenant Children's Hospital
- University of Texas Health Science Center at San Antonio
- Methodist Children's Hospital of South Texas
- Scott and White Memorial Hospital
- Primary Children's Medical Center
- University of Vermont
- Childrens Hospital-King's Daughters
- Carilion Clinic Children's Hospital
- Seattle Children's Hospital
- West Virginia University Charleston
- Saint Vincent Hospital
- University of Wisconsin Hospital and Clinics
- Marshfield Clinic
- Midwest Children's Cancer Center
- The Children's Hospital at Westmead
- Princess Margaret Hospital for Children
- Alberta Children's Hospital
- University of Alberta Hospital
- British Columbia Children's Hospital
- Chedoke-McMaster Hospitals
- Cancer Centre of Southeastern Ontario at Kingston General Hospital
- Hospital for Sick Children
- Hospital Sainte-Justine
- Centre Hospitalier Universitaire de Quebec
- Allan Blair Cancer Centre
- Starship Children's Hospital
- San Jorge Children's Hospital
- Swiss Pediatric Oncology Group - Geneva
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Arm I
Arm 2
Patients enrolled with gonadal tumors of stage II or greater or extragonadal tumors of any stage receive cisplatin IV over 90 minutes & etoposide IV over 90 minutes days 1-3 and bleomycin sulfate IV over ≥ 10 minutes day 1. Treatment repeats every 3 weeks, 3 courses (weeks 0,3 & 6). After completion of compressed induction chemotherapy, patients with no change in disease status or disease progression are removed from study. Patients with no evidence of disease receive no further therapy. Patients with a partial response or abnormal tumor markers proceed to conventional surgery (second-look) and/or 3 more courses of compressed consolidation chemotherapy. After surgery, patients with pathologic complete response and have normal tumor markers receive no further therapy. Patients who remain with a partial response after surgery receive compressed consolidation chemotherapy. Patients receive cisplatin, etoposide, and bleomycin as induction chemotherapy in weeks 10,13, & 16.
Patients who are enrolled with stage I gonadal tumors receive no further anticancer therapy until evidence of tumor recurrence or the diagnosis of a second malignant neoplasm. Observation only for recurrence or development of an SMN