ACTIVE_NOT_RECRUITING

A Study of the Drugs Selumetinib Versus Carboplatin/Vincristine in Patients With Neurofibromatosis and Low-Grade Glioma

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This phase III trial studies if selumetinib works just as well as the standard treatment with carboplatin/vincristine (CV) for subjects with NF1-associated low grade glioma (LGG), and to see if selumetinib is better than CV in improving vision in subjects with LGG of the optic pathway (vision nerves). Selumetinib is a drug that works by blocking some enzymes that low-grade glioma tumor cells need for their growth. This results in killing tumor cells. Chemotherapy drugs, such as carboplatin and vincristine, 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. It is not yet known whether selumetinib works better in treating patients with NF1-associated low-grade glioma compared to standard therapy with carboplatin and vincristine.

Official Title

A Phase 3 Randomized Study of Selumetinib Versus Carboplatin/Vincristine in Newly Diagnosed or Previously Untreated Neurofibromatosis Type 1 (NF1) Associated Low-Grade Glioma (LGG)

Quick Facts

Study Start:2020-01-15
Study Completion:2030-12-31
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:ACTIVE_NOT_RECRUITING

Study ID

NCT03871257

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:2 Years to 21 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD, ADULT
Inclusion CriteriaExclusion Criteria
  1. * Patients must be \>= 2 years and =\< 21 years at the time of enrollment
  2. * Patients must have a body surface area (BSA) of \>= 0.5 m\^2 at enrollment
  3. * Patients must have neurofibromatosis type 1 (NF1) based on clinical criteria and/or germline genetic testing
  4. * Patients must be newly diagnosed or have previously diagnosed NF-1 associated LGG that has not been treated with any modality other than surgery
  5. * For patients with optic pathway gliomas (OPGs):
  6. * Newly-diagnosed patients with OPG are eligible if there are neurologic symptoms (including visual dysfunction, as defined below) or other exam findings associated with the tumor
  7. * Previously-diagnosed patients with OPG are eligible if they have new or worsening neurologic symptoms (including visual dysfunction, as defined below) or have tumor growth
  8. * For both newly-diagnosed and previously-diagnosed OPG, the patient may be eligible, irrespective of whether there has been tumor growth or other neurological symptoms or worsening, if they meet at least one of the following visual criteria:
  9. * Visual worsening, defined as worsening of visual acuity (VA) or visual fields (VF) documented within the past year (by examination or history); OR
  10. * Significant visual dysfunction (defined as VA worse than normal for age by 0.6 logMAR \[20/80, 6/24, or 2.5/10\] or more in one or both eyes)
  11. * For patients with LGG in other locations (i.e., not OPGs):
  12. * Newly-diagnosed patients with LGG are eligible if there are neurologic symptoms or other exam findings associated with the tumor
  13. * NOTE: Newly-diagnosed patients with LGG without associated neurologic symptoms or exam findings are not eligible
  14. * Previously-diagnosed patients with LGG are eligible if they have new or worsening neurologic symptoms or have tumor growth
  15. * Although not required, if a biopsy/tumor resection is performed, eligible histologies will include all tumors considered LGG or low-grade astrocytoma (World Health Organization \[WHO\] grade I and II) by 5th edition WHO classification of central nervous system (CNS) tumors with the exception of subependymal giant cell astrocytoma
  16. * Patients must have two-dimensional measurable tumor \>= 1 cm\^2
  17. * Patients with metastatic disease or multiple independent primary LGGs are allowed on study
  18. * Creatinine clearance or radioisotope glomerular filtration Rate (GFR) \>= 70 mL/min/1.73 m\^2 OR a serum creatinine based on age/sex (within 7 days prior to enrollment) as follows:
  19. * Age; maximum serum creatinine (mg/dL)
  20. * 2 to \< 6 years; 0.8 (male) and 0.8 (female)
  21. * 6 to \< 10 years; 1 (male) and 1 (female)
  22. * 10 to \< 13 years; 1.2 (male) and 1.2 (female)
  23. * 13 to \< 16 years; 1.5 (male) and 1.4 (female)
  24. * \>= 16 years; 1.7 (male) and 1.4 (female)
  25. * Total bilirubin =\< 1.5 x upper limit of normal (ULN) for age (within 7 days prior to enrollment) (children with a diagnosis of Gilbert's syndrome will be allowed on study regardless of their total and indirect \[unconjugated\] bilirubin levels as long as their direct \[conjugated\] bilirubin is \< 3.1 mg/dL)
  26. * Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\]) =\< 3 x upper limit of normal (ULN) = 135 U/L (within 7 days prior to enrollment). For the purpose of this study, the ULN for SGPT is 45 U/L
  27. * Albumin \>= 2 g/dL (within 7 days prior to enrollment)
  28. * Left ventricular ejection fraction (LVEF) \>= 53% (or institutional normal; if the LVEF result is given as a range of values, then the upper value of the range will be used) by echocardiogram (within 4 weeks prior to enrollment)
  29. * Corrected QT (QTc) interval =\< 450 msec by electrocardiography (EKG) (within 4 weeks prior to enrollment)
  30. * Absolute neutrophil count \>= 1,000/uL (unsupported) (within 7 days prior to enrollment)
  31. * Platelets \>= 100,000/uL (unsupported) (within 7 days prior to enrollment)
  32. * Hemoglobin \>= 8 g/dL (may be supported) (within 7 days prior to enrollment)
  33. * Patients with a known seizure disorder should be stable and should have not experienced a significant increase in seizure frequency within 2 weeks prior to enrollment
  34. * Patients 2-17 years of age must have a blood pressure that is =\< 95th percentile for age, height, and sex at the time of enrollment. Patients \>= 18 years of age must have a blood pressure =\< 130/80 mmHg at the time of enrollment (with or without the use of antihypertensive medications).
  35. * Note: Adequate blood pressure can be achieved using medication for the treatment of hypertension
  36. * All patients must have ophthalmology toxicity assessments performed within 8 weeks prior to enrollment
  37. * For all patients, an MRI of the brain (with orbital cuts for optic pathway tumors) and/or spine (depending on the site(s) of primary disease) with and without contrast must be performed within 8 weeks prior to enrollment
  38. * For patients who undergo a surgery on the target tumor (not required), a pre- and post-operative\* MRI of the brain (with orbital cuts for optic pathway tumors) or spine (depending on the site(s) of primary disease) with and without contrast must also be performed. The post-operative MRI must be performed within 4 weeks prior to enrollment. If only a biopsy is performed, a post-operative MRI is not required and the pre-operative (op) MRI within 8 weeks of enrollment will be used as the baseline scan
  39. * The post-operative MRIs should be performed ideally within 48 hours after surgery if possible
  40. * Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1, or 2. Use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age
  41. * Patients must have the ability to swallow whole capsules
  42. * Patients must have receptive and expressive language skills in English, Spanish or French to complete the quality of life (QOL) and neurocognitive assessments
  43. * All patients and/or their parents or legal guardians must sign a written informed consent.
  44. * All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met.
  1. * Patients must not have received any prior tumor-directed therapy including chemotherapy, radiation therapy, immunotherapy, or bone marrow transplant. Prior surgical intervention is permitted
  2. * Patients with a concurrent malignancy or history of treatment (other than surgery) for another tumor within the last year are ineligible
  3. * Patients may not be receiving any other investigational agents
  4. * Patients with any serious medical or psychiatric illness/ condition, including substance use disorders likely in the judgement of the investigator to interfere or limit compliance with study requirements/treatment are not eligible
  5. * Patients who, in the opinion of the investigator, are not able to comply with the study procedures are not eligible
  6. * Female patients who are pregnant are not eligible since fetal toxicities and teratogenic effects have been noted for several of the study drugs. A pregnancy test is required for female patients of childbearing potential
  7. * Lactating females who plan to breastfeed their infants are not eligible
  8. * Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation and for 12 weeks after stopping study therapy are not eligible
  9. * Note: Women of child-bearing potential and males with sexual partners who are pregnant or who could become pregnant (i.e., women of child-bearing potential) should use effective methods of contraception for the duration of the study and for 12 weeks after stopping study therapy to avoid pregnancy and/or potential adverse effects on the developing embryo
  10. * Cardiac conditions:
  11. * Known genetic disorder that increases risk for coronary artery disease. Note: The presence of dyslipidemia in a family with a history of myocardial infarction is not in itself an exclusion unless there is a known genetic disorder documented
  12. * Symptomatic heart failure
  13. * New York Heart Association (NYHA) class II-IV prior or current cardiomyopathy
  14. * Severe valvular heart disease
  15. * History of atrial fibrillation
  16. * Ophthalmologic conditions:
  17. * Current or past history of central serous retinopathy
  18. * Current or past history of retinal vein occlusion or retinal detachment
  19. * Patients with uncontrolled glaucoma
  20. * If checking pressure is clinically indicated, patients with intraocular pressure (IOP) \> 22 mmHg or ULN adjusted by age are not eligible
  21. * Ophthalmological findings secondary to long-standing optic pathway glioma (such as visual loss, optic nerve pallor, or strabismus) or longstanding orbito-temporal plexiform neurofibroma (PN), such as visual loss, strabismus) will NOT be considered a significant abnormality for the purposes of the study
  22. * Treatments and/or medications patient is receiving that would make her/him ineligible, such as:
  23. * Supplementation with vitamin E greater than 100% of the daily recommended dose. Any multivitamin containing vitamin E must be stopped prior to study enrollment even if less than 100% of the daily recommended dosing for vitamin E
  24. * Surgery within 2 weeks prior to enrollment, with the exception of surgical placement for vascular access or cerebrospinal fluid (CSF) diverting procedures such as endoscopic third ventriculostomy (ETV) and ventriculo-peritoneal (VP) shunt.
  25. * Note: Patients must have healed from any prior surgery prior to enrollment
  26. * Patients who have an uncontrolled infection are not eligible

Contacts and Locations

Principal Investigator

Jason R Fangusaro
PRINCIPAL_INVESTIGATOR
Children's Oncology Group

Study Locations (Sites)

Children's Hospital of Alabama
Birmingham, Alabama, 35233
United States
Banner Children's at Desert
Mesa, Arizona, 85202
United States
Phoenix Childrens Hospital
Phoenix, Arizona, 85016
United States
Arkansas Children's Hospital
Little Rock, Arkansas, 72202-3591
United States
Loma Linda University Medical Center
Loma Linda, California, 92354
United States
Children's Hospital Los Angeles
Los Angeles, California, 90027
United States
Kaiser Permanente-Oakland
Oakland, California, 94611
United States
Children's Hospital of Orange County
Orange, California, 92868
United States
Lucile Packard Children's Hospital Stanford University
Palo Alto, California, 94304
United States
Rady Children's Hospital - San Diego
San Diego, California, 92123
United States
Naval Medical Center -San Diego
San Diego, California, 92134
United States
UCSF Medical Center-Mission Bay
San Francisco, California, 94158
United States
Children's Hospital Colorado
Aurora, Colorado, 80045
United States
Connecticut Children's Medical Center
Hartford, Connecticut, 06106
United States
Yale University
New Haven, Connecticut, 06520
United States
Alfred I duPont Hospital for Children
Wilmington, Delaware, 19803
United States
Children's National Medical Center
Washington, District of Columbia, 20010
United States
Golisano Children's Hospital of Southwest Florida
Fort Myers, Florida, 33908
United States
University of Florida Health Science Center - Gainesville
Gainesville, Florida, 32610
United States
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood, Florida, 33021
United States
Nemours Children's Clinic-Jacksonville
Jacksonville, Florida, 32207
United States
Nicklaus Children's Hospital
Miami, Florida, 33155
United States
AdventHealth Orlando
Orlando, Florida, 32803
United States
Arnold Palmer Hospital for Children
Orlando, Florida, 32806
United States
Nemours Children's Hospital
Orlando, Florida, 32827
United States
Sacred Heart Hospital
Pensacola, Florida, 32504
United States
Johns Hopkins All Children's Hospital
Saint Petersburg, Florida, 33701
United States
Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa, Florida, 33607
United States
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta, Georgia, 30329
United States
Kapiolani Medical Center for Women and Children
Honolulu, Hawaii, 96826
United States
Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
United States
Lurie Children's Hospital-Chicago
Chicago, Illinois, 60611
United States
University of Illinois
Chicago, Illinois, 60612
United States
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
United States
Southern Illinois University School of Medicine
Springfield, Illinois, 62702
United States
Riley Hospital for Children
Indianapolis, Indiana, 46202
United States
Ascension Saint Vincent Indianapolis Hospital
Indianapolis, Indiana, 46260
United States
Blank Children's Hospital
Des Moines, Iowa, 50309
United States
University of Iowa/Holden Comprehensive Cancer Center
Iowa City, Iowa, 52242
United States
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
United States
Norton Children's Hospital
Louisville, Kentucky, 40202
United States
Children's Hospital New Orleans
New Orleans, Louisiana, 70118
United States
Ochsner Medical Center Jefferson
New Orleans, Louisiana, 70121
United States
Eastern Maine Medical Center
Bangor, Maine, 04401
United States
Maine Children's Cancer Program
Scarborough, Maine, 04074
United States
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
United States
Walter Reed National Military Medical Center
Bethesda, Maryland, 20889-5600
United States
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, 02114
United States
Dana-Farber Cancer Institute
Boston, Massachusetts, 02215
United States
C S Mott Children's Hospital
Ann Arbor, Michigan, 48109
United States
Children's Hospital of Michigan
Detroit, Michigan, 48201
United States
Wayne State University/Karmanos Cancer Institute
Detroit, Michigan, 48201
United States
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids, Michigan, 49503
United States
Corewell Health Children's
Royal Oak, Michigan, 48073
United States
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis, Minnesota, 55404
United States
University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, 55455
United States
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
United States
University of Mississippi Medical Center
Jackson, Mississippi, 39216
United States
University of Missouri Children's Hospital
Columbia, Missouri, 65212
United States
Children's Mercy Hospitals and Clinics
Kansas City, Missouri, 64108
United States
Cardinal Glennon Children's Medical Center
Saint Louis, Missouri, 63104
United States
Washington University School of Medicine
Saint Louis, Missouri, 63110
United States
Children's Hospital and Medical Center of Omaha
Omaha, Nebraska, 68114
United States
University of Nebraska Medical Center
Omaha, Nebraska, 68198
United States
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
United States
Morristown Medical Center
Morristown, New Jersey, 07960
United States
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick, New Jersey, 08903
United States
Presbyterian Hospital
Albuquerque, New Mexico, 87106
United States
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
United States
Albany Medical Center
Albany, New York, 12208
United States
Roswell Park Cancer Institute
Buffalo, New York, 14263
United States
The Steven and Alexandra Cohen Children's Medical Center of New York
New Hyde Park, New York, 11040
United States
Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York, New York, 10016
United States
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
United States
University of Rochester
Rochester, New York, 14642
United States
State University of New York Upstate Medical University
Syracuse, New York, 13210
United States
New York Medical College
Valhalla, New York, 10595
United States
UNC Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina, 27599
United States
Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina, 28203
United States
Duke University Medical Center
Durham, North Carolina, 27710
United States
East Carolina University
Greenville, North Carolina, 27834
United States
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
United States
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
United States
Children's Hospital Medical Center of Akron
Akron, Ohio, 44308
United States
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229
United States
Rainbow Babies and Childrens Hospital
Cleveland, Ohio, 44106
United States
Nationwide Children's Hospital
Columbus, Ohio, 43205
United States
Dayton Children's Hospital
Dayton, Ohio, 45404
United States
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
United States
Legacy Emanuel Children's Hospital
Portland, Oregon, 97227
United States
Oregon Health and Science University
Portland, Oregon, 97239
United States
Geisinger Medical Center
Danville, Pennsylvania, 17822
United States
Penn State Children's Hospital
Hershey, Pennsylvania, 17033
United States
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
United States
Saint Christopher's Hospital for Children
Philadelphia, Pennsylvania, 19134
United States
Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, 15224
United States
Rhode Island Hospital
Providence, Rhode Island, 02903
United States
Medical University of South Carolina
Charleston, South Carolina, 29425
United States
Prisma Health Richland Hospital
Columbia, South Carolina, 29203
United States
BI-LO Charities Children's Cancer Center
Greenville, South Carolina, 29605
United States
East Tennessee Childrens Hospital
Knoxville, Tennessee, 37916
United States
Saint Jude Children's Research Hospital
Memphis, Tennessee, 38105
United States
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, 37232
United States
Dell Children's Medical Center of Central Texas
Austin, Texas, 78723
United States
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
United States
El Paso Children's Hospital
El Paso, Texas, 79905
United States
Cook Children's Medical Center
Fort Worth, Texas, 76104
United States
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston, Texas, 77030
United States
M D Anderson Cancer Center
Houston, Texas, 77030
United States
Covenant Children's Hospital
Lubbock, Texas, 79410
United States
UMC Cancer Center / UMC Health System
Lubbock, Texas, 79415
United States
Children's Hospital of San Antonio
San Antonio, Texas, 78207
United States
Methodist Children's Hospital of South Texas
San Antonio, Texas, 78229
United States
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
United States
Primary Children's Hospital
Salt Lake City, Utah, 84113
United States
University of Vermont and State Agricultural College
Burlington, Vermont, 05405
United States
Children's Hospital of The King's Daughters
Norfolk, Virginia, 23507
United States
Virginia Commonwealth University/Massey Cancer Center
Richmond, Virginia, 23298
United States
Carilion Children's
Roanoke, Virginia, 24014
United States
Seattle Children's Hospital
Seattle, Washington, 98105
United States
Providence Sacred Heart Medical Center and Children's Hospital
Spokane, Washington, 99204
United States
Mary Bridge Children's Hospital and Health Center
Tacoma, Washington, 98405
United States
Madigan Army Medical Center
Tacoma, Washington, 98431
United States
University of Wisconsin Carbone Cancer Center - University Hospital
Madison, Wisconsin, 53792
United States
Children's Hospital of Wisconsin
Milwaukee, Wisconsin, 53226
United States

Collaborators and Investigators

Sponsor: National Cancer Institute (NCI)

  • Jason R Fangusaro, PRINCIPAL_INVESTIGATOR, Children's Oncology Group

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2020-01-15
Study Completion Date2030-12-31

Study Record Updates

Study Start Date2020-01-15
Study Completion Date2030-12-31

Terms related to this study

Additional Relevant MeSH Terms

  • Low Grade Glioma
  • Neurofibromatosis Type 1
  • Visual Pathway Glioma