ClinicalTrials.gg
Not yet recruitingNCT06485908MEPENDAXUpdated Jul 3, 2024

Axitinib and Oral Metronomic Etoposide for Pediatric Children and AYA Refractory/Relapsing Medulloblastoma and Ependymoma

A Phase 1/2 interventional study of administration of axitinib in combination with etoposide in Medulloblastoma and Ependymoma, sponsored by Assistance Publique Hopitaux De Marseille. Not yet recruiting. Open to participants aged 4 Years to 25 Years. Per ClinicalTrials.gov, last updated 2024-07-03.

Sponsored by Assistance Publique Hopitaux De Marseille · Phase 1/2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Apr 2026, 7 months ago, but the record still lists the study as not yet recruiting.
Phase
Phase 1/2
Study type
Interventional
Enrollment
40
Allocation
Not applicable
Ages
4 Years to 25 Years
Sex
All
01

Study summary

It is an open multicentric phase I/II trial with axitinib (Inlyta®) and metronomic delivery of etoposide for children, adolescent and young adults (AYA) with refractory/ relapsing solid tumors. It is a two-stage trial:

First stage: To determine the Maximum Tolerated Dose (MTD) of the combination of axitinib and oral metronomic etoposide for patient with medulloblastoma or ependymoma Second stage: Extension cohort evaluating the preliminary efficacy at the recommended dose for the phase II (RDP2) of the combination. The 2nd stage will start after a meeting of independent data monitoring committee (IDMC). Two cohorts of 9 patients with ependymoma and medulloblastoma Patients treated at first stage won't be included in the second stage.

02

Conditions studied

  • Medulloblastoma
  • Ependymoma
03

In context

Medulloblastoma

317 studies on the registry are indexed under Medulloblastoma; 51 are open to participants now.

This study's planned enrollment of 40 is above the median of 31 across 255 interventional studies indexed under Medulloblastoma.

Browse Medulloblastoma studies →

Lead sponsor

Assistance Publique Hopitaux De Marseille is the lead sponsor of 702 studies on the registry; 139 are open to participants now.

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

04

Who can participate

Ages eligible
4 Years to 25 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

  • proven diagnosis of ependymoma or medulloblastoma
  • Methyloma classification performed or available material for methyloma analysis
  • Confirmed progressive or disease despite standard therapy, or for which no effective standard therapy exists
  • Male and female subjects with > 4 to ≤ 25 years of age at inclusion
  • Weight > 20 kg
  • Evaluable target lesion(s) according to RAPNO
  • Performance status: performance status (for patients >12 years of age) or Lansky Play score (for patients ≤12 years of age) ≥ 70%. Patients who are unable to walk because of paralysis or stable neurological disability, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score
  • ≥ 3 months
  • No known allergy to any of the compounds in the experimental treatment
  • Able to take oral treatments
  • Adequate organ function:

Hematologic criteria

  • Peripheral (ANC) ≥ 1000/mm3 (unsupported)
  • count ≥ 100,000/mm3 (unsupported)
  • ≥ 8.0 g/dL (transfusion is allowed) Cardiac function
  • Shortening fraction (SF) >29% and (LVEF) ≥50% at baseline, as determined by echocardiography (mandatory only for patients who have received cardiotoxic therapy).

Renal and hepatic function

  • Serum creatinine \< 1.5 x (ULN) for age
  • Total \< 1.5 x ULN
  • (ALT)/ Aspartate aminotransferase (AST)/ \< 2.5 x ULN

    • Able to comply with scheduled follow-up and with management of toxicity.
    • Females of child bearing potential must have a negative serum pregnancy test within 7 days prior to initiation of treatment.
    • Sexually active patients must agree to use adequate and appropriate (in accordance with Clinical Trials Facilitation and Coordination Group (CTFG) recommendations) while on study drug and for 6 months after stopping the study drug.
    • Patient able to comfortably swallow capsules.
    • Written from parents/legal representative, patient, and age-appropriate assent before any study-specific screening procedures are conducted according to local, regional or national guidelines.
    • Patient affiliated to a social security regimen or beneficiary of the same according to local requirements.

Non-inclusion Criteria

  • Chemotherapy within 21 days of day 1 from the start of study treatment. This period can be shortened in the case of treatment with vincristine (2 weeks) and extended to 6 weeks in the case of treatment with nitrosureas. The period is set to 5 half-lives in the case of targeted therapies or metronomic chemotherapy. The period is set to 2 weeks after bevacizumab administration. Evidence of > Grade 1 recent CNS hemorrhage on the baseline MRI or scan.
  • Impairment of gastrointestinal (GI) function or GI disease that may significantly alter drug absorption of oral drugs (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, or malabsorption syndrome).
  • , uncontrolled heart disease (including history of any cardiac arrhythmias, e.g., ventricular, supraventricular, nodal arrhythmias, or conduction abnormality within 12 months of screening).
  • Known active viral hepatitis or known (HIV) infection or any other uncontrolled infection.
  • Presence of any v5 grade ≥ 2 treatment-related extra-hematological toxicity with the exception of alopecia, ototoxicity or peripheral neuropathy.
  • Known congenital immunodeficiency.
  • Radiotherapy within the 2 months preceding D1 of the start of study treatment. Palliative RT on a non-target lesion is allowed up to 1 weeks before beginning of treatment.
  • Major surgery within 21 days of the first dose. Gastrostomy, ventriculo-peritoneal shunt, endoscopic ventriculostomy, tumor and insertion of central venous access devices are not considered major surgery, but for these procedures, a 48 hour interval must be maintained before the first dose of the drug is administered.
  • Bleeding disorder.
  • Clinically significant, uncontrolled heart disease (including history of any cardiac arrhythmias, e.g., ventricular, supraventricular, nodal arrhythmias, or conduction abnormality within 12 months of screening).
  • Known to any study drug or component of the formulation.
  • Absence of effective contraception in patients of childbearing age (see appendix 3)
  • Pregnant or nursing (lactating) females.
  • Patients with galactose intolerance, lactase deficiency or glucose or galactose malabsorption syndrome (rare hereditary diseases).
  • Severe infections requiring parenteral antibiotic therapy.
  • Inability to undergo medical monitoring of the trial for geographic, social or psychological reasons.
Terms in these criteria, in plain language(19)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
40 participants (estimated)

Study arms

  • Experimental
    Patients receiving axitinib in combination with etoposide

    1. st stage: Dose escalation The first patient will be included at the level of 1.6 mg/m²/day of axitinib. Patients will be included by cohort of a maximum of 6 patients evaluable for DLT. In the absence of more than 2 patients with DLT during the first 28-day cycle, escalation to the next level will be allowed. Intra-patient dose escalation is not permitted. Non evaluable patients for DLT will be replaced. Six evaluable patients will be enrolled at the last dose level. RP2D will be the DMT or in the absence of DLT the maximum dose evaluated. Treatment will be continued until progression, or unacceptable toxicity for a period of 1 year. Depending on the number of DLTs observed, a maximum of 18 patients should be included. 2. nd stage: extension cohort For the second phase of the study, at RP2D, 2 cohorts of 9 patients (ependymoma, medulloblastoma) will be considered in the study. Treatment will be continued until progression, or unacceptable toxicity for a period of 1 year.

    Drug: administration of axitinib in combination with etoposide

Interventions

  • Drugadministration of axitinib in combination with etoposide

    1. st stage: * Axitinib (Inlyta®) PO, in the morning and in the evening every day * Level -1 : Dose 1.2 mg/m² * Level 1: Dose 1.6 mg/m² * Level 2: Dose 2.0 mg/m² * Level 3: Dose 2.4 mg /m² (equivalent to 4 mg in adults) * Etoposide (50 mg capsules or in the form of etoposide phosphate if required): 25 mg/m²/day in the evening orally every day fasting (capped to a maximum of 50 mg/day) First patient will be enrolled at dose level 1 2. nd stage: * Axitinib (Inlyta®) dosing as selected at the 1st stage * Etoposide (50 mg capsules or in the form of etoposide phosphate if required): 25 mg/m2/ day in the evening orally every day fasting(capped to a maximum of 50 mg/day)

06

What researchers measure

Primary outcomes

  1. Dose-limiting toxicity (DLT)

    During first stage

    Time frame: During the first 28 days (cycle 1)

  2. Progression-free survival (PFS)

    During second stage, progression-free survival (PFS) computed as the time interval from the beginning of treatment to the date of centrally-assessed with RAPNO criteria. A central review of all imaging is planned at the end of phase 1 and at the end of phase expansion to evaluate tumor response and progressions. PFS-duration of patients alive free of progression at last follow-up will be censored at the date of last visit.

    Time frame: 3 years (from start of treatment to last follow-up visit)

07

Study locations

No study locations are listed for this record.

08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Oct 2024; primary completion for Apr 2026, 18 months later.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 25, 2024
First posted
Jul 3, 2024
StartEst.
Oct 2024
Primary completionEst.
Apr 2026
CompletionEst.
Jan 2030
Last update
Jul 3, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 3, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06485908
Responsible party
Sponsor
First posted
Jul 3, 2024
Start date
Oct 2024 (estimated)
Primary completion
Apr 2026 (estimated)
Completion
Jan 2030 (estimated)
Last update
Jul 3, 2024

Study contacts

Nicolas ANDRE
Contact
nicolas.andre@ap-hm.fr
0491386792
Nicolas ANDRE
principal investigator · Assistance Publique - Hôpitaux de Marseille

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jun 2024. You cannot join it, but the record below documents what was studied.

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