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Combination of Irinotecan and Temozolomide in Children With Brain Tumors.

Phase 2 Single-Arm, Open Label Study Of Irinotecan In Combination With Temozolomide In Children With Recurrent Or Refractory Medulloblastoma And In Children With Newly Diagnosed High-Grade Glioma.

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00404495
Enrollment
83
Registered
2006-11-28
Start date
2007-04-30
Completion date
2011-12-31
Last updated
2012-04-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Glioma, Medulloblastoma

Brief summary

This study will assess the rate of objective confirmed tumor response of irinotecan in combination with temozolomide in children with recurrent or refractory medulloblastoma and in children with newly diagnosed high-grade glioma.

Interventions

DRUGIrinotecan

Irinotecan 10 mg/m\^2 per day on days 1-5 and days 8-12 in repeated 3 week cycles

DRUGTemozolomide

Temozolomide 100-125 mg/m\^2 daily on days 1-5 in repeated 3 week cycles

Sponsors

Pfizer
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
6 Months to 18 Years
Healthy volunteers
No

Inclusion criteria

* Cohort 1: Recurrent or refractory medulloblastoma in which current standard treatment approaches have failed; biopsy is not required for recurrent disease. * Cohort 2: Newly-diagnosed high-grade glioma (World Health Organization \[WHO\] grade 3 or 4) * Life expectancy ≥ 3 months

Exclusion criteria

* Diagnosis of brainstem glioma * Concurrent administration of any other anti-tumor therapy * Pre-existing uncontrolled diarrhea

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With Objective Response of Complete Response or Partial ResponseBaseline to 1 Year (medulloblastoma), Baseline to 6 Weeks (high-grade glioma)Percentage of participants with objective response based assessment of confirmed complete response (CR) or confirmed partial response (PR). CR persisted on repeat imaging study at least (≥) 4 weeks after initial documentation of response. PR, for bidimensionally measurable disease, was a decrease by ≥50% of the sum of the products of the largest perpendicular diameters of all measurable lesions as determined by 2 observations not less than 4 weeks apart. Best overall response recorded any time while the participant was receiving treatment. External Response Review Committee (ERRC) assessment.

Secondary

MeasureTime frameDescription
Percentage of Participants With Objective Response of Complete Response or Partial Response, Investigator's AssessmentBaseline to 1 Year (medulloblastoma), Baseline to 6 Weeks (high-grade glioma)Percentage of participants with objective response based assessment of confirmed CR or confirmed PR. CR persisted on repeat imaging study ≥4 weeks after initial documentation of response. PR, in case of bidimensionally measurable disease, was a decrease by ≥50% of the sum of the products of the largest perpendicular diameters of all measurable lesions as determined by 2 observations not less than 4 weeks apart. Best overall response could be recorded any time while the participant was receiving treatment. Investigator's assessment.
Duration of ResponseBaseline to Date of Tumor Response (Up to 1 Year)Median duration (50%) of tumor response for participants with objective disease response: who have not progressed or died due to any cause; with a response and subsequent progression or death due to any cause for duration of response (DR). DR was defined as time from start of first documented objective tumor response (CR or PR) to first documented objective tumor progression or death due to any cause, whichever occurred first. DR (calculated in Weeks) = (the end date for DR minus first subsequent confirmed CR or PR plus 1) divided by 7. Investigator's assessment.
Time to Treatment Failure (TTF)Baseline to Date of Treatment Failure (Up to 1 Year)TTF was defined as the time from the date of first dose of study treatment to the date of the first documentation of progressive disease (PD), the date of treatment discontinuation except completion of treatment, or date of death due to cancer. Investigator's assessment.
Time to Tumor Progression (TTP)Baseline to Date of Progression (Up to 1 Year)TTP was defined as the time in months from start of study treatment to first documentation of objective tumor progression or death due to cancer, whichever came first. TTP was calculated as (first event date minus the date of first dose of study medication plus 1) divided by 7 multiplied by 4.33. Tumor progression was determined from oncologic assessment data (where data met the criteria for PD). Investigator's assessment.
Overall Survival (OS)Baseline to Date of Death (Up to 1 Year After Treatment)Time in months from the start of study treatment to date of death due to any cause. OS was calculated as (the death date minus the date of first dose of study medication plus 1) divided by 7 multiplied by 4.33. Death was determined from adverse event data (where outcome was death) or from follow-up contact data (where the participant current status was death). Investigator's assessment.

Countries

Australia, Belgium, Denmark, France, Italy, Poland, Spain, United Kingdom

Participant flow

Participants by arm

ArmCount
Temozolomide + Irinotecan for Medulloblastoma
For participants with medulloblastoma: Irinotecan 10 mg/m\^2/day on Days 1-5 and Days 8-12 in repeated 3-week cycles. Temozolomide 100-125 mg/m\^2 daily on Days 1-5 in repeated 3-week cycles; treatment duration: up to 1 year or until progression.
66
Temozolomide + Irinotecan for High-Grade Glioma
For participants with high-grade glioma: Irinotecan 10 mg/m\^2/day on Days 1-5 and Days 8-12 in repeated 3-week cycles. Temozolomide 100-125 mg/m\^2 daily on Days 1-5 in repeated 3-week cycles; treatment duration: 2 cycles as a window phase before starting standard therapy.
17
Total83

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath3711
Overall StudyLost to Follow-up50
Overall StudyOther10
Overall StudyWithdrawal by Subject10

Baseline characteristics

CharacteristicTemozolomide + Irinotecan for MedulloblastomaTemozolomide + Irinotecan for High-Grade GliomaTotal
Age, Customized
>12 years to 18 years
17 participants5 participants22 participants
Age, Customized
2 years to 12 years
49 participants12 participants61 participants
Sex: Female, Male
Female
21 Participants3 Participants24 Participants
Sex: Female, Male
Male
45 Participants14 Participants59 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
64 / 6617 / 17
serious
Total, serious adverse events
31 / 665 / 17

Outcome results

Primary

Percentage of Participants With Objective Response of Complete Response or Partial Response

Percentage of participants with objective response based assessment of confirmed complete response (CR) or confirmed partial response (PR). CR persisted on repeat imaging study at least (≥) 4 weeks after initial documentation of response. PR, for bidimensionally measurable disease, was a decrease by ≥50% of the sum of the products of the largest perpendicular diameters of all measurable lesions as determined by 2 observations not less than 4 weeks apart. Best overall response recorded any time while the participant was receiving treatment. External Response Review Committee (ERRC) assessment.

Time frame: Baseline to 1 Year (medulloblastoma), Baseline to 6 Weeks (high-grade glioma)

Population: Primary Evaluable Population: subset of evaluable population predetermined by 2-stage Optimum Simon design. Medulloblastoma cohort: n=consecutive evaluable participants up to 46 if 6 responses obtained in first 15 evaluable participants. Glioma cohort: n=consecutive evaluable participants up to 29 if 1 response in first 10 evaluable participants.

ArmMeasureValue (NUMBER)
Temozolomide + Irinotecan for MedulloblastomaPercentage of Participants With Objective Response of Complete Response or Partial Response32.6 percentage of participants
Temozolomide + Irinotecan for High-Grade GliomaPercentage of Participants With Objective Response of Complete Response or Partial Response0 percentage of participants
Secondary

Duration of Response

Median duration (50%) of tumor response for participants with objective disease response: who have not progressed or died due to any cause; with a response and subsequent progression or death due to any cause for duration of response (DR). DR was defined as time from start of first documented objective tumor response (CR or PR) to first documented objective tumor progression or death due to any cause, whichever occurred first. DR (calculated in Weeks) = (the end date for DR minus first subsequent confirmed CR or PR plus 1) divided by 7. Investigator's assessment.

Time frame: Baseline to Date of Tumor Response (Up to 1 Year)

Population: Evaluable local population. Number of participants analyzed=number of participants who responded.

ArmMeasureValue (MEDIAN)
Temozolomide + Irinotecan for MedulloblastomaDuration of Response22.4 weeks
Temozolomide + Irinotecan for High-Grade GliomaDuration of Response36.3 weeks
Secondary

Overall Survival (OS)

Time in months from the start of study treatment to date of death due to any cause. OS was calculated as (the death date minus the date of first dose of study medication plus 1) divided by 7 multiplied by 4.33. Death was determined from adverse event data (where outcome was death) or from follow-up contact data (where the participant current status was death). Investigator's assessment.

Time frame: Baseline to Date of Death (Up to 1 Year After Treatment)

Population: All participants. One participant in the Temozolomide + Irinotecan for Medulloblastoma cohort did not have recurrent or refractory medulloblastoma and 3 participants in the Temozolomide + Irinotecan for High-Grade Glioma cohort did not have high-grade glioma, and were not considered evaluable for survival.

ArmMeasureValue (MEDIAN)
Temozolomide + Irinotecan for MedulloblastomaOverall Survival (OS)16.7 months
Temozolomide + Irinotecan for High-Grade GliomaOverall Survival (OS)9.4 months
Secondary

Percentage of Participants With Objective Response of Complete Response or Partial Response, Investigator's Assessment

Percentage of participants with objective response based assessment of confirmed CR or confirmed PR. CR persisted on repeat imaging study ≥4 weeks after initial documentation of response. PR, in case of bidimensionally measurable disease, was a decrease by ≥50% of the sum of the products of the largest perpendicular diameters of all measurable lesions as determined by 2 observations not less than 4 weeks apart. Best overall response could be recorded any time while the participant was receiving treatment. Investigator's assessment.

Time frame: Baseline to 1 Year (medulloblastoma), Baseline to 6 Weeks (high-grade glioma)

Population: Evaluable local population: Participants received at least 1 dose of study medication, had measurable disease under study, at least 1 on-study objective tumor assessment, completed at least 2 cycles of study treatment or progressed. Based on investigator's assessment.

ArmMeasureValue (NUMBER)
Temozolomide + Irinotecan for MedulloblastomaPercentage of Participants With Objective Response of Complete Response or Partial Response, Investigator's Assessment34.9 percentage of participants
Temozolomide + Irinotecan for High-Grade GliomaPercentage of Participants With Objective Response of Complete Response or Partial Response, Investigator's Assessment11.8 percentage of participants
Secondary

Time to Treatment Failure (TTF)

TTF was defined as the time from the date of first dose of study treatment to the date of the first documentation of progressive disease (PD), the date of treatment discontinuation except completion of treatment, or date of death due to cancer. Investigator's assessment.

Time frame: Baseline to Date of Treatment Failure (Up to 1 Year)

Population: Evaluable local population

ArmMeasureValue (MEDIAN)
Temozolomide + Irinotecan for MedulloblastomaTime to Treatment Failure (TTF)3.8 months
Temozolomide + Irinotecan for High-Grade GliomaTime to Treatment Failure (TTF)1.6 months
Secondary

Time to Tumor Progression (TTP)

TTP was defined as the time in months from start of study treatment to first documentation of objective tumor progression or death due to cancer, whichever came first. TTP was calculated as (first event date minus the date of first dose of study medication plus 1) divided by 7 multiplied by 4.33. Tumor progression was determined from oncologic assessment data (where data met the criteria for PD). Investigator's assessment.

Time frame: Baseline to Date of Progression (Up to 1 Year)

Population: Evaluable local population

ArmMeasureValue (MEDIAN)
Temozolomide + Irinotecan for MedulloblastomaTime to Tumor Progression (TTP)5.6 months
Temozolomide + Irinotecan for High-Grade GliomaTime to Tumor Progression (TTP)1.6 months

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026