CClinicalTrials.gg
CompletedNCT00028795Updated Feb 21, 2014

Chemotherapy and Radiation Therapy After Surgery in Treating Children With Newly Diagnosed Astrocytoma, Glioblastoma Multiforme, Gliosarcoma, or Diffuse Intrinsic Pontine Glioma

A Phase 2 interventional study of temozolomide and adjuvant therapy in Brain and Central Nervous System Tumors, sponsored by Children's Oncology Group. Completed at 230 sites in 7 countries. Open to participants aged 3 Years to 21 Years. Per ClinicalTrials.gov, last updated 2014-02-21.

Sponsored by Children's Oncology Group · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
170
Allocation
Not applicable
Ages
3 Years to 21 Years
Sex
All
01

Study summary

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Giving chemotherapy together with radiation therapy may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving chemotherapy together with radiation therapy after surgery followed by chemotherapy alone works in children with newly diagnosed astrocytoma, glioblastoma multiforme, gliosarcoma, or diffuse intrinsic pontine glioma.

Read the detailed description

OBJECTIVES:

  • Compare the event-free survival of patients with newly diagnosed anaplastic astrocytoma, glioblastoma multiforme, gliosarcoma, or diffuse intrinsic pontine glioma (DIPG) treated with adjuvant temozolomide administered concurrently with postoperative radiotherapy and then alone as maintenance therapy vs historical control cohorts treated in prior Pediatric Oncology Group and Children's Cancer Group studies.
  • Determine the toxicity of this regimen in these patients.
  • Determine the efficacy of this regimen in patients with DIPG.
  • Determine the toxicity of this regimen in patients with DIPG.

OUTLINE: This is a multicenter study.

  • Adjuvant chemoradiotherapy: Beginning within 6 weeks after surgical resection or diagnosis*, patients without gross residual disease undergo cranial irradiation 5 days a week for 6 weeks. Beginning within 6 weeks after surgical resection, patients with gross residual disease undergo radiotherapy as above followed by boost radiotherapy for 1 week. All patients receive oral temozolomide once daily beginning within 5 days after initiation of radiotherapy and continuing for a total of 6 weeks in the absence of disease progression or unacceptable toxicity.
  • Adjuvant maintenance therapy: Beginning 4 weeks after completion of adjuvant chemoradiotherapy, patients receive oral temozolomide on days 1-5. Treatment repeats every 28 days for a total of 10 courses in the absence of disease progression or unacceptable toxicity.

NOTE: *For patients with diffuse intrinsic pontine glioma only

Patients are followed every 3-6 months for 4 years and then annually thereafter.

PROJECTED ACCRUAL: A total of 50-60 patients will be accrued for this study within 12-14 months.

02

Conditions studied

  • Brain and Central Nervous System Tumors

Keywords

  • childhood brain stem glioma
  • childhood high-grade cerebral astrocytoma
  • childhood spinal cord neoplasm
  • untreated childhood brain stem glioma
03

In context

Glioma

1,397 studies on the registry are indexed under Glioma; 351 are open to participants now.

This study's enrollment of 170 is above the median of 32 across 1,065 interventional studies indexed under Glioma.

Browse Glioma studies →

Lead sponsor

Children's Oncology Group is the lead sponsor of 436 studies on the registry; 34 are open to participants now.

Of its 12 completed or terminated interventional studies of FDA-regulated products, 11 (92%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
3 Years to 21 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed newly diagnosed CNS tumor of the following types:

    • High grade glioma (HGG) of one of the following histologies:

      • Anaplastic astrocytoma (grade III)
      • Glioblastoma multiforme (grade IV)
      • Gliosarcoma
      • Primary spinal cord malignant glioma
    • Diffuse intrinsic pontine glioma (DIPG)

      • Diagnosed by gadolinium-enhanced MRI
      • At least 2/3 of tumor situated in the pons AND tumor clearly originated in the pons
      • No diffuse leptomeningeal disease
      • No tumors with features not typical of diffuse intrinsic brainstem glioma, including any of the following:

        • Dorsally exophytic brainstem glioma
        • Cervico-medullary junction tumor
        • Focal low-grade glioma of the midbrain or brainstem
      • No diffuse brainstem enlargement due to neurofibromatosis
  • No primary brain stem malignant glioma
  • No M+ disease (CSF positive for tumor or metastatic disease)
  • Must begin study radiotherapy within 6 weeks after surgical resection (for HGG patients) or diagnosis (for DIPG patients)

PATIENT CHARACTERISTICS:

Age:

  • 3 to 21

Performance status:

  • Karnofsky 50-100% OR
  • Lansky 50-100%

Life expectancy:

  • At least 2 months

Hematopoietic:

  • Absolute neutrophil count at least 1,000/mm\^3
  • Platelet count at least 100,000/mm\^3*
  • Hemoglobin at least 10.0 g/dL* NOTE: *Transfusion independent

Hepatic:

  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)
  • SGOT or SGPT less than 2.5 times ULN

Renal:

  • Creatinine no greater than 1.5 times ULN

Other:

  • No other concurrent malignancy
  • Concurrent seizure disorder allowed if well controlled on anticonvulsants
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 2 months after completion of study treatment

PRIOR CONCURRENT THERAPY:

Biologic:

  • No concurrent routine cytokine support

Chemotherapy:

  • Not specified

Endocrine therapy:

  • No concurrent corticosteroids except for increased intracranial pressure in patients with CNS tumors

Radiotherapy:

  • See Disease Characteristics

Surgery:

  • See Disease Characteristics

Other:

  • No prior therapy for HGG or DIPG
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
170 participants (actual)

Study arms

  • Experimental
    Chemoradiotherapy

    Drug: temozolomide · Procedure: adjuvant therapy · Radiation: radiation therapy

Interventions

  • Drugtemozolomide
  • Procedureadjuvant therapy
  • Radiationradiation therapy
06

What researchers measure

Primary outcomes

  1. Improved outcome

  2. Toxicity as assessed by NCI CTCAE v. 2.0

07

Study locations

230 sites
  • Comprehensive Cancer Center at University of Alabama at Birmingham
    Birmingham, Alabama 35233, United States
  • University of South Alabama Cancer Research Institute
    Mobile, Alabama 36604, United States
  • Phoenix Children's Hospital
    Phoenix, Arizona 85016, United States
  • Arizona Cancer Center at University of Arizona Health Sciences Center
    Tucson, Arizona 85724, United States
  • Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
    Little Rock, Arkansas 72205, United States
  • Southern California Permanente Medical Group
    Downey, California 90242, United States
  • City of Hope Comprehensive Cancer Center
    Duarte, California 91010-3000, United States
  • Rebecca and John Moores UCSD Cancer Center
    La Jolla, California 92093-0658, United States
  • Loma Linda University Cancer Institute at Loma Linda University Medical Center
    Loma Linda, California 92354, United States
  • Jonathan Jaques Children's Cancer Center at Miller Children's Hospital
    Long Beach, California 90801-1428, United States
  • Children's Hospital Los Angeles
    Los Angeles, California 90027-0700, United States
  • Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center
    Los Angeles, California 90048, United States
  • Jonsson Comprehensive Cancer Center at UCLA
    Los Angeles, California 90095-1781, United States
  • Children's Hospital Central California
    Madera, California 93638-8762, United States
  • Children's Hospital and Research Center at Oakland
    Oakland, California 94609-1809, United States
  • Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center
    Orange, California 92868, United States
  • Children's Hospital of Orange County
    Orange, California 92868, United States
  • Lucile Packard Children's Hospital at Stanford University Medical Center
    Palo Alto, California 94304, United States
  • Sutter Cancer Center
    Sacramento, California 95816, United States
  • University of California Davis Cancer Center
    Sacramento, California 95817, United States
  • Kaiser Permanente Medical Center - Sacramento
    Sacramento, California 95825, United States
  • Kaiser Permanente Medical Center/Kaiser Foundation Hospital - San Diego
    San Diego, California 92120, United States
  • Children's Hospital and Health Center - San Diego
    San Diego, California 92123-4282, United States
  • UCSF Comprehensive Cancer Center
    San Francisco, California 94143, United States
  • Santa Barbara Cottage Hospital
    Santa Barbara, California 93102, United States
  • Kaiser Permanente Medical Center - Santa Clara Kiely Campus
    Santa Clara, California 95051-5386, United States
  • General Robert Huyser Cancer Center at David Grant Medical Center
    Travis Air Force Base, California 94535, United States
  • Children's Hospital Cancer Center
    Denver, Colorado 80218, United States
  • Presbyterian - St. Luke's Medical Center
    Denver, Colorado 80218, United States
  • Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center
    Farmington, Connecticut 06360-7106, United States
  • Yale Comprehensive Cancer Center
    New Haven, Connecticut 06520-8064, United States
  • Alfred I. duPont Hospital for Children
    Wilmington, Delaware 19899, United States
  • Lombardi Cancer Center at Georgetown University Medical Center
    Washington, District of Columbia 20007, United States
  • Children's National Medical Center
    Washington, District of Columbia 20010-2970, United States
  • Broward General Medical Center
    Fort Lauderdale, Florida 33316, United States
  • Children's Hospital of Southwest Florida
    Fort Myers, Florida 33908, United States
  • University of Florida Shands Cancer Center
    Gainesville, Florida 32610-0296, United States
  • Joe DiMaggio Children's Hospital at Memorial
    Hollywood, Florida 33021, United States
  • Nemours Children's Clinic
    Jacksonville, Florida 32207, United States
  • Jackson Memorial Hospital
    Miami, Florida 33136, United States
  • Miami Children's Hospital
    Miami, Florida 33155, United States
  • Baptist-South Miami Regional Cancer Program
    Miami, Florida 33176-2197, United States
  • Florida Hospital Cancer Institute
    Orlando, Florida 32804, United States
  • Nemours Children's Clinic-Orlando
    Orlando, Florida 32806, United States
  • Sacred Heart Children's Hospital
    Pensacola, Florida 32504, United States
  • All Children's Hospital
    St. Petersburg, Florida 33701, United States
  • St. Joseph's Children's Hospital of Tampa
    Tampa, Florida 33677-4227, United States
  • Kaplan Cancer Center at St. Mary's Medical Center
    West Palm Beach, Florida 33407, United States
  • AFLAC Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta - Scottish Rite Campus
    Atlanta, Georgia 30342, United States
  • MBCCOP-Medical College of Georgia Cancer Center
    Augusta, Georgia 30912-4000, United States
  • Medical Center of Central Georgia
    Macon, Georgia 31201, United States
  • Curtis & Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center
    Savannah, Georgia 31405, United States
  • Cancer Research Center of Hawaii
    Honolulu, Hawaii 96813, United States
  • Tripler Army Medical Center
    Honolulu, Hawaii 96859-5000, United States
  • St. Luke's Mountain States Tumor Institute - Boise
    Boise, Idaho 83712, United States
  • University of Chicago Cancer Research Center
    Chicago, Illinois 60601, United States
  • Rush University Medical Center
    Chicago, Illinois 60612, United States
  • University of Illinois Medical Center
    Chicago, Illinois 60612, United States
  • Children's Memorial Hospital - Chicago
    Chicago, Illinois 60614, United States
  • Advocate Hope Children's Hospital
    Oak Lawn, Illinois 60453, United States
  • Lutheran General Cancer Care Center
    Park Ridge, Illinois 60068-1174, United States
  • Saint Jude Midwest Affiliate
    Peoria, Illinois 61637, United States
  • Southern Illinois University School of Medicine
    Springfield, Illinois 62794-9658, United States
  • Riley Children Cancer Center at Riley Hospital for Children
    Indianapolis, Indiana 46202-5225, United States
  • St. Vincent Hospitals and Health Care Centers
    Indianapolis, Indiana 46260, United States
  • Blank Children's Hospital
    Des Moines, Iowa 50309, United States
  • Holden Comprehensive Cancer Center at University of Iowa
    Iowa City, Iowa 52242-1009, United States
  • Wesley Medical Center
    Wichita, Kansas 67214, United States
  • Markey Cancer Center at University of Kentucky Chandler Medical Center
    Lexington, Kentucky 40536-0284, United States
  • Kosair Children's Hospital
    Louisville, Kentucky 40202-3830, United States
  • MBCCOP - LSU Health Sciences Center
    New Orleans, Louisiana 70112, United States
  • Tulane Cancer Center at Tulane University Hospital and Clinic
    New Orleans, Louisiana 70112, United States
  • Children's Hospital of New Orleans
    New Orleans, Louisiana 70118, United States
  • Ochsner Cancer Institute at Ochsner Clinic Foundation
    New Orleans, Louisiana 70121, United States
  • Pediatric Specialty Clinic at Eastern Maine Medical Center
    Bangor, Maine 04401, United States
  • Maine Children's Cancer Program
    Scarborough, Maine 04074-9308, United States
  • Greenebaum Cancer Center at University of Maryland Medical Center
    Baltimore, Maryland 21201-1595, United States
  • Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
    Baltimore, Maryland 21215, United States
  • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
    Baltimore, Maryland 21231-7223, United States
  • Walter Reed Army Medical Center
    Silver Spring, Maryland 20910, United States
  • Floating Hospital for Children
    Boston, Massachusetts 02111, United States
  • Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
    Boston, Massachusetts 02115, United States
  • Baystate Regional Cancer Program at D'Amour Center for Cancer Care
    Springfield, Massachusetts 01107, United States
  • UMASS Memorial Cancer Center - University Campus
    Worcester, Massachusetts 01655, United States
  • University of Michigan Comprehensive Cancer Center
    Ann Arbor, Michigan 48109-0914, United States
  • Children's Hospital of Michigan
    Detroit, Michigan 48201, United States
  • Van Elslander Cancer Center at St. John Hospital and Medical Center
    Detroit, Michigan 48236, United States
  • Hurley Medical Center
    Flint, Michigan 48503, United States
  • DeVos Children's Hospital
    Grand Rapids, Michigan 49503, United States
  • Bronson Methodist Hospital
    Kalamazoo, Michigan 49007-5364, United States
  • Breslin Cancer Center at Ingham Regional Medical Center
    Lansing, Michigan 48910, United States
  • William Beaumont Hospital - Royal Oak Campus
    Royal Oak, Michigan 48073-6769, United States
  • St. Mary's - Duluth Clinic Cancer Center
    Duluth, Minnesota 55805, United States
  • Children's Hospitals and Clinics - Minneapolis/St. Paul
    Minneapolis, Minnesota 55404, United States
  • Mayo Clinic Cancer Center
    Rochester, Minnesota 55905, United States
  • University of Mississippi Medical Center
    Jackson, Mississippi 39216-4505, United States
  • University of Missouri - Columbia
    Columbia, Missouri 65203, United States
  • Children's Mercy Hospital
    Kansas City, Missouri 64108, United States
  • Cardinal Glennon Children's Hospital
    Saint Louis, Missouri 63104, United States
  • St. Louis Children's Hospital
    Saint Louis, Missouri 63110, United States

Showing the first 100 of 230 sites across 7 countries.

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References and documents

Publications

  • Pollack IF, Hamilton RL, Burger PC, Brat DJ, Rosenblum MK, Murdoch GH, Nikiforova MN, Holmes EJ, Zhou T, Cohen KJ, Jakacki RI; Children's Oncology Group. Akt activation is a common event in pediatric malignant gliomas and a potential adverse prognostic marker: a report from the Children's Oncology Group. J Neurooncol. 2010 Sep;99(2):155-63. doi: 10.1007/s11060-010-0297-3. Epub 2010 Jul 4. PubMed 20607350 ↗
  • Pollack IF, Hamilton RL, Sobol RW, Nikiforova MN, Nikiforov YE, Lyons-Weiler MA, LaFramboise WA, Burger PC, Brat DJ, Rosenblum MK, Gilles FH, Yates AJ, Zhou T, Cohen KJ, Finlay JL, Jakacki RI; Children's Oncology Group. Mismatch repair deficiency is an uncommon mechanism of alkylator resistance in pediatric malignant gliomas: a report from the Children's Oncology Group. Pediatr Blood Cancer. 2010 Dec 1;55(6):1066-71. doi: 10.1002/pbc.22634. PubMed 20589656 ↗
  • Cohen KJ, Heideman RL, Zhou T, Holmes EJ, Lavey RS, Bouffet E, Pollack IF. Temozolomide in the treatment of children with newly diagnosed diffuse intrinsic pontine gliomas: a report from the Children's Oncology Group. Neuro Oncol. 2011 Apr;13(4):410-6. doi: 10.1093/neuonc/noq205. Epub 2011 Feb 22. PubMed 21345842 ↗
  • Cohen KJ, Pollack IF, Zhou T, Buxton A, Holmes EJ, Burger PC, Brat DJ, Rosenblum MK, Hamilton RL, Lavey RS, Heideman RL. Temozolomide in the treatment of high-grade gliomas in children: a report from the Children's Oncology Group. Neuro Oncol. 2011 Mar;13(3):317-23. doi: 10.1093/neuonc/noq191. PubMed 21339192 ↗
  • Nicholson HS, Kretschmar CS, Krailo M, Bernstein M, Kadota R, Fort D, Friedman H, Harris MB, Tedeschi-Blok N, Mazewski C, Sato J, Reaman GH. Phase 2 study of temozolomide in children and adolescents with recurrent central nervous system tumors: a report from the Children's Oncology Group. Cancer. 2007 Oct 1;110(7):1542-50. doi: 10.1002/cncr.22961. PubMed 17705175 ↗
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 21, 2014, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00028795
Lead sponsor
Children's Oncology Group
Collaborators
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
Jan 27, 2003
Start date
Dec 2002
Primary completion
Sep 2007
Completion
Mar 2012
Last update
Feb 21, 2014

Study contacts

Kenneth J. Cohen, MD, MBA
study chair · Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

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