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Metronomic Chemotherapy in Wilms Tumor (MetroWilms-1906) (MetroWilms)

Primary Purpose

Wilms Tumor

Status
Recruiting
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
Vincristine
Irinotecan
Temozolomide
Etoposide
Cis-Retinoic acid
Sponsored by
Centre Oscar Lambret
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Wilms Tumor focused on measuring Multidrug chemotherapy, metronomic chemotherapy, Wilms Tumor, Renal cancer

Eligibility Criteria

18 Months - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patient ≥18 months old and ≤ 35 years old
  • Relapsed or refractory Wilms tumor, histologically proven at diagnosis
  • After at least 2 lines of chemotherapy (conventional or high dose, which may include the study molecules) or after 1 line for high risk relapse for which there would not be any curative therapy. If 1 line for high risk relapse, the enrolment should be confirmed by coordinators.
  • Radiologically measurable or evaluable disease (visible, target or non-target-lesion on MRI or CT-scan)
  • Performance status: Karnofsky performance status (for patients >16 years of age) or Lansky Play score (for patients ≤16 years of age) ≥ 70%.
  • Able to take oral medication or nasal gastric tube or authorized gastrostomy
  • Adequate biological criteria:

    • Neutrophils > 1000/mm3 ; Platelets > 75 000/mm3
    • Transaminases (ALT/ AST) ≤ 3 times ULN (or ≤ 6 times ULN if liver metastasis); total bilirubin ≤ 2 ULN (except in case of Gilbert's disease)
  • Creatinine ≤ 1,5 ULN or clearance ≥ 60 mL/ min/ 1,73m2 (In case of doubt, to be confirm by assessment of cystatin )
  • Females of childbearing potential must have a negative seric pregnancy test within 7 days prior to initiation of treatment.
  • Sexually active patients must agree to use adequate and appropriate contraception (at least one highly effective contraception or two complementary methods of contraception), 1 month before beginning of treatment while on study drug and for 6 months after stopping the study drug for both female and male patients.
  • Written informed consent from parents/legal representative, patient, and age-appropriate assent before any study-specific screening procedures according to national guidelines.
  • Patient covered by the French "Social Security" regime

Exclusion Criteria:

  • Prior history of other cancer within 5 years
  • Chemotherapy or radiotherapy of target lesion within 3 weeks prior to inclusion
  • Target therapy within less than 5 * half-life of the substance prior to inclusion
  • Major surgery within 15 days prior to inclusion
  • Presence of any NCI-CTCAE v5 grade ≥ 2 cardiac, hepatic, pulmonary or renal toxicity
  • Severe myelosuppression
  • Severe peripheral neuropathy (grade ≥ 2)
  • Fructose intolerance
  • Inflammatory bowel chronic disease and/or intestinal obstruction
  • Patients with demyelinating form of Charcot-Marie-Tooth disease
  • Known active viral hepatitis or known human immunodeficiency virus (HIV) infection or any other uncontrolled infection.
  • Known hypersensitivity to dacarbazine (DTIC), isotretinoin or to any of the study drugs, study drug classes, excipients in the formulation
  • Hyperlipidemia and hypervitaminosis A
  • Vaccination with a live attenuated vaccine within 1 month prior to inclusion
  • Pregnant or breastfeeding patients
  • Inability to comply with medical follow-up of the trial (geographical, social or psychological reasons)

Sites / Locations

  • CHU Amiens Picardie
  • CHRU de Bordeaux Hôpital des EnfantsRecruiting
  • CHU GRENOBLE ALPES - Hôpital COUPLE ENFANTRecruiting
  • Centre Oscar LambretRecruiting
  • Centre Léon BérardRecruiting
  • Hôpital pour Enfants " La Timone " AP-HMRecruiting
  • CHU de MONTPELLIER - Hôpital Arnaud de Villeneuve
  • CHU NantesRecruiting
  • CHU de Nice - Hôpital Archet 2Recruiting
  • Hôpital Armand-TROUSSEAURecruiting
  • CHU Hôpital SudRecruiting
  • Chu RouenRecruiting
  • CHRU Strasbourg - Hôpital de HautepierreRecruiting
  • CHU Toulouse - Hôpital des Enfants
  • CHRU NANCY - Hôpital d'EnfantsRecruiting
  • Gustave ROUSSYRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single Arm - Vincristine + Irinotécan + Témozolomide + Etoposide + Cis-Retinoic acid

Arm Description

Metronomic chemotherapy : Vincristine + Irinotécan + Témozolomide + Etoposide + Cis-Retinoic acid

Outcomes

Primary Outcome Measures

Disease control
Complete response, partial response or stable disease after 2 cycles of treatment, measured by the progression-free survival (PFS).

Secondary Outcome Measures

Progression-free survival
The time interval between study entry and date of progression (using RECIST 1.1)
Overall survival
The time interval between study entry and death from any cause
Tumor response
Using CT-scan or MRI imaging (using RECIST 1.1)
Adverse events
The adverse events (AE) are collected to evaluate the safety of the study treatment.
The feasibility of evaluated therapy
assessed in terms of frequency of dose reductions or temporary stops of treatment
Quality of life of the patient (KindL)
Ravens-Sieberer and Bullinger Quality of Life Questionnaire will be used to measure the quality of life of the patients. The score can go from 0 to 100, and the higher score corresponds to a higher health-related quality of life

Full Information

First Posted
November 8, 2021
Last Updated
October 13, 2023
Sponsor
Centre Oscar Lambret
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1. Study Identification

Unique Protocol Identification Number
NCT05384821
Brief Title
Metronomic Chemotherapy in Wilms Tumor (MetroWilms-1906)
Acronym
MetroWilms
Official Title
Phase 1-2 Trial Evaluating Metronomic Chemotherapy in Patients With a Relapsed or Refractory Wilms Tumor
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 14, 2022 (Actual)
Primary Completion Date
May 2028 (Anticipated)
Study Completion Date
October 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre Oscar Lambret

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a multicenter, interventional, non-randomized study among patients with a relapsed or refractory Wilms tumor. The study will aim to assess efficacy of metronomic chemotherapy, in terms of disease control after two cycles of metronomic chemotherapy.
Detailed Description
The main aim of this study is to assess efficacy of metronomic chemotherapy, in terms of disease control after two cycles of metronomic chemotherapy . Other objectives of the study include: To evaluate disease control obtained with metronomic chemotherapy, in terms of progression-free survival (PFS) and overall survival (OS). Evaluating early response after one cycle of treatment of metronomic treatment; Evaluating best tumor response over the whole metronomic treatment duration; Evaluating safety of the proposed metronomic chemotherapy; Evaluating the feasibility of the proposed metronomic chemotherapy. To evaluate quality of life using Kindl® Quality of Life questionnaire at baseline (before start of treatment), and approximately at weeks 7 and 13 of treatment

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Wilms Tumor
Keywords
Multidrug chemotherapy, metronomic chemotherapy, Wilms Tumor, Renal cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
28 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Single Arm - Vincristine + Irinotécan + Témozolomide + Etoposide + Cis-Retinoic acid
Arm Type
Experimental
Arm Description
Metronomic chemotherapy : Vincristine + Irinotécan + Témozolomide + Etoposide + Cis-Retinoic acid
Intervention Type
Drug
Intervention Name(s)
Vincristine
Intervention Description
IV, D1-D22-D43 and D64
Intervention Type
Drug
Intervention Name(s)
Irinotecan
Intervention Description
Oral, 5 days/week during W1,W2,W7 and W8 (D1 to D5, D8 to D12, D43 to D47, D50 to D54)
Intervention Type
Drug
Intervention Name(s)
Temozolomide
Intervention Description
Oral,3 weeks in a row, twice per cycle (D1 to D21, D43 to D63)
Intervention Type
Drug
Intervention Name(s)
Etoposide
Intervention Description
Oral, 3 weeks in a row, twice per cycle (D22 to D42, D64 to D84)
Intervention Type
Drug
Intervention Name(s)
Cis-Retinoic acid
Intervention Description
Oral, 2 weeks in a row, thrice per cycle (D15 to D28, D43 to D56, D71 to D84)
Primary Outcome Measure Information:
Title
Disease control
Description
Complete response, partial response or stable disease after 2 cycles of treatment, measured by the progression-free survival (PFS).
Time Frame
6 months after inclusion
Secondary Outcome Measure Information:
Title
Progression-free survival
Description
The time interval between study entry and date of progression (using RECIST 1.1)
Time Frame
Up to progression, an average of 1 year
Title
Overall survival
Description
The time interval between study entry and death from any cause
Time Frame
Through study completion, an average of 12 months
Title
Tumor response
Description
Using CT-scan or MRI imaging (using RECIST 1.1)
Time Frame
Immediately after each cycle of treatment, up to progression, an average of 1 year
Title
Adverse events
Description
The adverse events (AE) are collected to evaluate the safety of the study treatment.
Time Frame
Through study completion, an average of 12 months (plus 30 days)
Title
The feasibility of evaluated therapy
Description
assessed in terms of frequency of dose reductions or temporary stops of treatment
Time Frame
Through study completion, an average of 12 months
Title
Quality of life of the patient (KindL)
Description
Ravens-Sieberer and Bullinger Quality of Life Questionnaire will be used to measure the quality of life of the patients. The score can go from 0 to 100, and the higher score corresponds to a higher health-related quality of life
Time Frame
Baseline, week 7 and week 13

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Months
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient ≥18 months old and ≤ 17 years old Relapsed or refractory Wilms tumor, histologically proven at diagnosis After at least 2 lines of chemotherapy (conventional or high dose, which may include the study molecules) or after 1 line for high risk relapse for which there would not be any curative therapy. If 1 line for high risk relapse, the enrolment should be confirmed by coordinators. Radiologically measurable or evaluable disease (visible, target or non-target-lesion on MRI or CT-scan) Performance status: Karnofsky performance status (for patients >16 years of age) or Lansky Play score (for patients ≤16 years of age) ≥ 70%. Able to take oral medication or nasal gastric tube or authorized gastrostomy Adequate biological criteria: Neutrophils > 1000/mm3 ; Platelets > 75 000/mm3 Transaminases (ALT/ AST) ≤ 3 times ULN (or ≤ 6 times ULN if liver metastasis); total bilirubin ≤ 2 ULN (except in case of Gilbert's disease) Creatinine ≤ 1,5 ULN or clearance ≥ 60 mL/ min/ 1,73m2 (In case of doubt, to be confirm by assessment of cystatin ) Females of childbearing potential must have a negative seric pregnancy test within 7 days prior to initiation of treatment. Sexually active patients must agree to use adequate and appropriate contraception (at least one highly effective contraception or two complementary methods of contraception), 1 month before beginning of treatment while on study drug and for 6 months after stopping the study drug for both female and male patients. Written informed consent from parents/legal representative, patient, and age-appropriate assent before any study-specific screening procedures according to national guidelines. Patient covered by the French "Social Security" regime Exclusion Criteria: Prior history of other cancer within 5 years Chemotherapy or radiotherapy of target lesion within 3 weeks prior to inclusion Target therapy within less than 5 * half-life of the substance prior to inclusion Major surgery within 15 days prior to inclusion Presence of any NCI-CTCAE v5 grade ≥ 2 cardiac, hepatic, pulmonary or renal toxicity Severe myelosuppression Severe peripheral neuropathy (grade ≥ 2) Fructose intolerance Inflammatory bowel chronic disease and/or intestinal obstruction Patients with demyelinating form of Charcot-Marie-Tooth disease Known active viral hepatitis or known human immunodeficiency virus (HIV) infection or any other uncontrolled infection. Known hypersensitivity to dacarbazine (DTIC), isotretinoin or to any of the study drugs, study drug classes, excipients in the formulation Hyperlipidemia and hypervitaminosis A Vaccination with a live attenuated vaccine within 1 month prior to inclusion Pregnant or breastfeeding patients Inability to comply with medical follow-up of the trial (geographical, social or psychological reasons)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Emilie Heyman - Decoupigny
Phone
+33 (0)3 20 29 59 18
Email
promotion@o-lambret.fr
First Name & Middle Initial & Last Name or Official Title & Degree
Marie Vanseymortier
Phone
+33 (0)3 20 29 59 18
Email
promotion@o-lambret.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hélène SUDOUR-BONNANGE, MD
Organizational Affiliation
Centre Oscar Lambret
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Arnauld VERSCHUUR, MD, PhD
Organizational Affiliation
CHU La Timone
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHU Amiens Picardie
City
Amiens
ZIP/Postal Code
80054
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Leslie ANDRY, MD
Phone
+33 3 22 08 76 44
Email
andry.leslie@chu-amiens.fr
First Name & Middle Initial & Last Name & Degree
Leslie ANDRY, MD
Facility Name
CHRU de Bordeaux Hôpital des Enfants
City
Bordeaux
ZIP/Postal Code
33076
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anne NOTZ- CARRERE, MD
Phone
+33 5 57 82 04 34
Email
anne.notz-carrere@chu-bordeaux.fr
First Name & Middle Initial & Last Name & Degree
Anne NOTZ- CARRERE, MD
Facility Name
CHU GRENOBLE ALPES - Hôpital COUPLE ENFANT
City
Grenoble
ZIP/Postal Code
38043
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dominique PLANTAZ, MD
Phone
+33 4 76 76 59 11
Email
DPlantaz@chu-grenoble.fr
First Name & Middle Initial & Last Name & Degree
Dominique PLANTAZ, MD
Facility Name
Centre Oscar Lambret
City
Lille
ZIP/Postal Code
59020
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hélène SUDOUR-BONNANGE, MD
Phone
+33 3 20 29 59 56
Email
h-sudour@o-lambret.fr
First Name & Middle Initial & Last Name & Degree
Cyril LERVAT, MD
Phone
+33 3 20 29 59 56
Email
c-lervat@o-lambret.fr
First Name & Middle Initial & Last Name & Degree
Hélène SUDOUR-BONNANGE, MD
First Name & Middle Initial & Last Name & Degree
Cyril LERVAT, MD
Facility Name
Centre Léon Bérard
City
Lyon
ZIP/Postal Code
69373
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Benoit DUMONT, MD
Phone
+33 4 69 16 65 74
Email
Benoit.DUMONT@ihope.fr
First Name & Middle Initial & Last Name & Degree
Benoit DUMONT, MD
Facility Name
Hôpital pour Enfants " La Timone " AP-HM
City
Marseille
ZIP/Postal Code
13005
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Arnauld VERSCHUUR, MD
Phone
+33 4 91 38 86 21
Email
arnauld.verschuur@ap-hm.fr
First Name & Middle Initial & Last Name & Degree
Arnauld Verschuur, MD
Facility Name
CHU de MONTPELLIER - Hôpital Arnaud de Villeneuve
City
Montpellier
ZIP/Postal Code
34295
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stéphanie HAOUY, MD
Phone
+33 4 67 33 65 19
Email
s-haouy@chu-montpellier.fr
First Name & Middle Initial & Last Name & Degree
Stéphanie HAOUY, MD
Facility Name
CHU Nantes
City
Nantes
ZIP/Postal Code
44093
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Estelle THEBAUD, MD
Phone
+33 2 40 08 36 10
Email
Estelle.THEBAUD@chu-nantes.fr
First Name & Middle Initial & Last Name & Degree
Estelle THEBAUD, MD
Facility Name
CHU de Nice - Hôpital Archet 2
City
Nice
ZIP/Postal Code
06202
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Joy BENADIBA, MD
Phone
+33 4 92 03 92 68
Email
benadiba.j@chu-nice.fr
First Name & Middle Initial & Last Name & Degree
Joy BENADIBA, MD
Facility Name
Hôpital Armand-TROUSSEAU
City
Paris
ZIP/Postal Code
75012
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marie Dominique TABONE, MD
Phone
+33 1 44 73 68 46
Email
marie-dominique.tabone@aphp.fr
First Name & Middle Initial & Last Name & Degree
Marie Dominique TABONE, MD
Facility Name
CHU Hôpital Sud
City
Rennes
ZIP/Postal Code
35203
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jacinthe BONNEAU-LAGACHERIE, MD
Phone
+33 2 99 26 59 17
Email
Jacinthe.BONNEAU-LAGACHERIE@chu-rennes.fr
First Name & Middle Initial & Last Name & Degree
Jacinthe BONNEAU-LAGACHERIE, MD
Facility Name
Chu Rouen
City
Rouen
ZIP/Postal Code
76000
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aude MARIE-CARDINE, MD
Phone
+33 2 32 88 81 91
Email
Aude.Marie-Cardine@chu-rouen.fr
First Name & Middle Initial & Last Name & Degree
Aude MARIE-CARDINE, MD
Facility Name
CHRU Strasbourg - Hôpital de Hautepierre
City
Strasbourg
ZIP/Postal Code
67098
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sarah JANNIER, MD
Phone
+33 3 88 12 87 94
Email
sarah.jannier@chru-strasbourg.fr
First Name & Middle Initial & Last Name & Degree
Sarah JANNIER, MD
Facility Name
CHU Toulouse - Hôpital des Enfants
City
Toulouse
ZIP/Postal Code
70034
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cécile BOULANGER, MD
Phone
+33 5 34 55 75 66
Email
boulanger.c@chu-toulouse.fr
First Name & Middle Initial & Last Name & Degree
Cécile BOULANGER, MD
Facility Name
CHRU NANCY - Hôpital d'Enfants
City
Vandœuvre-lès-Nancy
ZIP/Postal Code
54500
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ludovic MANSUY, MD
Phone
+33 3 83 15 47 34
Email
lu.mansuy@chru-nancy.fr
First Name & Middle Initial & Last Name & Degree
Ludovic MANSUY, MD
Facility Name
Gustave ROUSSY
City
Villejuif
ZIP/Postal Code
94805
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Claudia PASQUALINI, MD
Phone
+33 1 42 11 42 11
Email
Claudia.pasqualini@gustaveroussy.fr
First Name & Middle Initial & Last Name & Degree
Claudia PASQUALINI, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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Metronomic Chemotherapy in Wilms Tumor (MetroWilms-1906)

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