A Phase 2 interventional study of Allogeneic Hematopoietic Stem Cell Transplantation and Cyclosporine in Desmoplastic Small Round Cell Tumor, Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor and Recurrent Desmoplastic Small Round Cell Tumor, sponsored by M.D. Anderson Cancer Center. Terminated at 1 site in United States. Open to participants aged Up to 25 Years. Per ClinicalTrials.gov, last updated 2025-06-29.
Sponsored by M.D. Anderson Cancer Center · Phase 2, Interventional, and Treatment
This phase II trial investigates side effects and how well donor stem cell transplant after chemotherapy works in treating pediatric and adolescent-young adults with high-risk solid tumor that has come back (recurrent) or does not respond to treatment (refractory). Chemotherapy drugs, such as fludarabine, thiotepa, etoposide, melphalan, and rabbit anti-thymocyte globulin work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving chemotherapy before a donor stem cell transplant helps kill cancer cells in the body and helps make room in the patient's bone marrow for new blood-forming cells (stem cells) to grow. When the healthy stem cells from a donor are infused into a patient, they may help the patient's bone marrow make more healthy cells and platelets and may help destroy any remaining cancer cells.
PRIMARY OBJECTIVE:
I. To assess tolerability of allogeneic hematopoietic stem cell transplantation (HCT) for patients with chemo-responsive recurrent/refractory solid tumors as defined by transplant-related mortality (TRM) at day 30 and the rate of grade III or higher organ toxicity (Bearman Regimen-Related Toxicities Scale) attributable to conditioning occurring within 30 days.
SECONDARY OBJECTIVES:
I. Assess median time to platelet and neutrophil engraftment. II. Assess incidence of acute graft-versus-host disease (aGVHD) by day 100. III. Assess incidence of chronic GVHD (cGVHD) at day 100 and one year. IV. Assess rate of grade II organ toxicity through day 100. V. Assess rate of graft failure (primary and secondary) through day 100. VI. Assess rate of infectious complications through day 100. VII. Assess progression free survival (PFS) at day 100,180 and 365. VIII. Assess cumulative incidence of relapse, overall survival (OS) at 100 days and 1 year.
OUTLINE:
CONDITIONING REGIMEN: Patients receive thiotepa intravenously (IV) over 2-4 hours and etoposide IV over 60 minutes on days -8 to -6, melphalan IV over 20 minutes on days -5 and -4, and fludarabine phosphate IV over 1 hour on days -5 to -3 in the absence of disease progression or unacceptable toxicity. Patients receiving umbilical cord transplant also receive rabbit anti-thymocyte globulin IV on days -4 and -3.
TRANSPLANT: Patients undergo HSCT on day 0.
GVHD PROPHYLAXIS: Beginning day -2, patients receive tacrolimus or cyclosporine IV continuously until able to receive orally (PO). Patients continue tacrolimus or cyclosporine PO to day 60 and tapered to day 100. Patients also receive mycophenolate mofetil PO or IV every 8 hours until day 40 and tapered to day 90.
After completion of HSCT, patients are followed up for up to 1 year.
Pathological criteria, including malignant recurrent/refractory solid tumors. This would include:
DONOR: Matched allogeneic umbilical cord blood (UCB): related
DONOR: Matched allogeneic umbilical cord blood: unrelated
Exclusion Criteria:
CONDITIONING REGIMEN: Patients receive thiotepa IV over 2-4 hours, etoposide IV over 60 minutes on days -8 to -6, melphalan IV over 20 minutes on days -5 and -4, and fludarabine phosphate IV over 1 hour on days -5 to -3 in the absence of disease progression or unacceptable toxicity. Patients receiving umbilical cord transplant also receive rabbit anti-thymocyte globulin IV on days -3 and -4. TRANSPLANT: Patients undergo HSCT on day 0. GVHD PROPHYLAXIS: Beginning day -2, patients receive tacrolimus or cyclosporine IV continuously until able to receive PO. Patients continue tacrolimus or cyclosporine PO to day 60 and tapered to day 100. Patients also receive mycophenolate mofetil PO or IV every 8 hours until day 40 and tapered to day 90.
Procedure: Allogeneic Hematopoietic Stem Cell Transplantation · Drug: Cyclosporine · Drug: Etoposide · Drug: Fludarabine Phosphate · Biological: Lapine T-Lymphocyte Immune Globulin · Drug: Melphalan · Drug: Mycophenolate Mofetil · Drug: Tacrolimus · Drug: Thiotepa
Undergo HSCT
Also known as: Allogeneic Hematopoietic Cell Transplantation, Allogeneic Stem Cell Transplantation, HSC, HSCT, Stem Cell Transplantation, Allogeneic
Given IV and PO
Also known as: 27-400, Ciclosporin, CsA, Cyclosporin, Cyclosporin A, Cyclosporine Modified, Gengraf, Neoral, OL 27-400, Sandimmune, SangCya
Given IV
Also known as: Demethyl Epipodophyllotoxin Ethylidine Glucoside, EPEG, Lastet, Toposar, Vepesid, VP 16, VP 16-213, VP-16, VP-16-213, VP16
Given IV
Also known as: 2-F-ara-AMP, 9H-Purin-6-amine, 2-fluoro-9-(5-O-phosphono-.beta.-D-arabinofuranosyl)-, Beneflur, Fludara, SH T 586
Given IV
Also known as: Anti-Thymocyte Globulin Rabbit, Grafalon, Rabbit Anti-Human Thymocyte Globulin (RATG), Rabbit Anti-Thymocyte Globulin, Rabbit Antithymocyte Globulin, Rabbit ATG, rATG, Thymoglobulin
Given IV
Also known as: Alanine Nitrogen Mustard, CB-3025, L-PAM, L-Phenylalanine Mustard, L-Sarcolysin, L-Sarcolysin Phenylalanine mustard, L-Sarcolysine, Melphalanum, Phenylalanine Mustard, Phenylalanine Nitrogen Mustard, Sarcoclorin, Sarkolysin, WR-19813
Given IV or PO
Also known as: CellCept, MMF
Given IV and PO
Also known as: FK 506, Fujimycin, Hecoria, Prograf, Protopic
Given IV
Also known as: 1,1'',1''''-Phosphinothioylidynetrisaziridine, Girostan, N,N'', N''''-Triethylenethiophosphoramide, Oncotiotepa, STEPA, Tepadina, TESPA, Tespamin, Tespamine, Thio-Tepa, Thiofosfamide, Thiofozil, Thiophosphamide, Thiophosphoramide, Thiotef, Tifosyl, TIO TEF, Tio-tef, Triethylene Thiophosphoramide, Triethylenethiophosphoramide, Tris(1-aziridinyl)phosphine sulfide, TSPA, WR 45312
Tolerability of Allogeneic HCT
To assess tolerability of allogeneic HCT for patients with chemo-responsive recurrent/refractory solid tumors as defined by transplant-related mortality (TRM) at day 30
Time frame: By day +30 after allogeneic HCT infusion
Rate of Organ Toxicity
The rate of grade III or higher organ toxicity (Bearman Regimen-Related Toxicities Scale)\[1\] attributable to conditioning occurring within 30 days.
Time frame: By day +30 after allogeneic HCT infusion
This study was open to accrual from 8/19/2020 to 7/23/2024. Participants were referred for the study both internally and externally.
| Milestone | Allogeneic Stem Cell Transplant in High Risk Solid Tumors |
|---|---|
| Started | 1 |
| Completed | 0 |
| Not completed | 1 |
| Withdrew: Death | 1 |
To assess tolerability of allogeneic HCT for patients with chemo-responsive recurrent/refractory solid tumors as defined by transplant-related mortality (TRM) at day 30
No measurements were reported for this outcome.
The rate of grade III or higher organ toxicity (Bearman Regimen-Related Toxicities Scale)\[1\] attributable to conditioning occurring within 30 days.
No measurements were reported for this outcome.
Collected over From the start of preparative regimen up to D+100 the collection of adverse events will reflect the onset and resolution date and maximum grade. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Allogeneic Stem Cell Transplant in High Risk Solid Tumors | 1/1 (100%) | 0/1 (0%) | 1/1 (100%) |
| Event | Allogeneic Stem Cell Transplant in High Risk Solid Tumors |
|---|---|
| Alanine aminotransferase increasedInvestigations | 1/1 |
| AnorexiaMetabolism and nutrition disorders | 1/1 |
| Aspartate aminotransferase increasedInvestigations | 1/1 |
| Blood lactate dehydrogenase increasedInvestigations | 1/1 |
| Creatinine IncreaseInvestigations | 1/1 |
| DiarrheaGastrointestinal disorders | 1/1 |
| FatigueGeneral disorders | 1/1 |
| FeverGeneral disorders | 1/1 |
| Generalized EdemaGeneral disorders | 1/1 |
| HypertensionVascular disorders | 1/1 |
| Age, Categorical(Participants) | Allogeneic Stem Cell Transplant in High Risk Solid Tumors |
|---|---|
| <=18 years | 1 |
| Between 18 and 65 years | 0 |
| >=65 years | 0 |
| Age, Continuous(years) | Allogeneic Stem Cell Transplant in High Risk Solid Tumors |
|---|---|
| Mean | 12 (12 to 12) |
| Sex: Female, Male(Participants) | Allogeneic Stem Cell Transplant in High Risk Solid Tumors |
|---|---|
| Female | 0 |
| Male | 1 |
| Ethnicity (NIH/OMB)(Participants) | Allogeneic Stem Cell Transplant in High Risk Solid Tumors |
|---|---|
| Hispanic or Latino | 0 |
| Not Hispanic or Latino | 1 |
| Unknown or Not Reported | 0 |
| Race (NIH/OMB)(Participants) | Allogeneic Stem Cell Transplant in High Risk Solid Tumors |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 0 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 0 |
| White | 1 |
| More than one race | 0 |
| Unknown or Not Reported | 0 |
| Region of Enrollment(participants) | Allogeneic Stem Cell Transplant in High Risk Solid Tumors |
|---|---|
| United States | 1 |
Documents are hosted by the registry — open the source record to download them.
This study is terminated, as verified in Jun 2025. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Desmoplastic Small Round Cell Tumor→
M.D. Anderson Cancer Center