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Studies of Temozolomide in Combination With Topotecan in Refractory and Relapsed Paediatric Solid Tumours (TOTEM2)

This study has been completed.
St. Anna Kinderkrebsforschung
Catholic University of the Sacred Heart
Erasmus Medical Center
Information provided by (Responsible Party):
Gustave Roussy, Cancer Campus, Grand Paris Identifier:
First received: June 8, 2009
Last updated: January 25, 2016
Last verified: January 2016
The purpose of the study is to determine whether the combination of Hycamtin (Topotecan) and Temozolomide is effective in the treatment of relapsed and refractory neuroblastoma and other paediatric solid tumors.

Condition Intervention Phase
Neuroblastoma Brain Tumors Solid Tumors Drug: Temozolomide/Hycamtin (Topotecan) Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase 2 Single- Arm Studies of Temozolomide in Combination With Topotecan in Refractory and Relapsed Neuroblastoma and Other Paediatric Solid Tumours

Resource links provided by NLM:

Further study details as provided by Gustave Roussy, Cancer Campus, Grand Paris:

Primary Outcome Measures:
  • Response rate [ Time Frame: after 2 cycles=8 weeks of therapy ]

Secondary Outcome Measures:
  • safety and adverse event profile of the combination safety and adverse event [ Time Frame: 28 days ]
  • time-to-event endpoints: duration of response, time to progressive disease, time to treatment failure and overall survival [ Time Frame: every 8 weeks ]

Enrollment: 129
Study Start Date: June 2009
Study Completion Date: August 2015
Primary Completion Date: October 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Toptecan + temozolomide Drug: Temozolomide/Hycamtin (Topotecan)

Temozolomide: bottles containing 5 capsules of 5, 20, 100 and 250 mg

Hycamtin (Topotecan): a lyophilisate for infusion in vials containing 4 mg

Patients receive during 5 days (Day 1 to Day 5):

Temozolomide 150 mg/m2/day per os, dose will be adjusted to the closest 5 mg, followed one hour later by Hycamtin(Topotecan) 0.75 mg/m2/day as an intravenous infusion over 30 minutes

Other Name: Hycamtin:Topotecan

  Show Detailed Description


Ages Eligible for Study:   6 Months to 20 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion criteria:

  • Histologically or cytologically confirmed neuroblastoma, brain tumor or other solid tumor (at diagnosis)
  • Relapsed or refractory tumors in which correct standard treatment approaches have failed
  • No more than 2 lines of prior chemotherapy
  • Measurable primary and/or metastatic disease on CT/MRI at least one bi-dimensionally measurable lesion.

For patients with neuroblastoma, measurable disease will be defined by the modified International Neuroblastoma Staging System (Brodeur et al.1993) completed with MIBG scoring.

  • Age at inclusion: 6 months to ≤ 20 years
  • Lansky play score ≥ 70% or ECOG performance status ≤ 1
  • Life expectancy ≥ 3 months
  • Adequate organ function:

Adequate haematological function: haemoglobin ≥ 80 g/l, neutrophil count ≥ 1.0 x 109/L, platelet count ≥ 100 x 109/L; in case of bone marrow disease: neutrophils ≥ 0.5 x 109/l and platelets ≥ 75 x 109/l;

Adequate renal function: normal creatinine related to patient's age:

  • 0 - 1 year: ≤ 40 µmol/L
  • 1 - 15 years: ≤ 65 µmol/L
  • 15 - 20 years: ≤ 110 µmol/L Adequate hepatic function: bilirubin ≤ 1.5 x ULN; AST and ALT ≤ 2.5 x ULN (AST, ALT ≤5xULN in case of liver metastases)

    • Wash-out of 4 weeks in case of prior chemotherapy, 6 weeks if treatment included nitrosoureas, 2 weeks in case of vincristine alone; 6 weeks in case of prior radiotherapy (except palliative radiotherapy on non measurable lesions). Patients must have recovered from the acute toxic effects of all prior therapy before enrolment into the study.
    • Patients previously treated with only one of the 2 drugs are eligible.
    • Able to comply with scheduled follow-up and with management of toxicity.
    • All patients with reproductive potential must practice an effective method of birth control while on study. Female patients aged > 12 years must have a negative pregnancy test within 7 days before study treatment.
    • Written informed consent from patient, parents or legal guardian.

Exclusion Criteria:

  • Concurrent administration of any other anti-tumour therapy.
  • Serious concomitant systemic disorder (for example, active infection including HIV or cardiac disease) that in the opinion of the investigator, would compromise the patient's ability to complete the study.
  • History of allergic reaction to the compounds or their solvents.
  • History of allergic reaction to Dacarbazine (DITC).
  • Galactosemia, Glucose-galactose malabsorption or lactase deficiency.
  • Pregnant or breast feeding young women.
  • Presence of symptomatic brain metastases in patients with solid non-CNS tumors.
  Contacts and Locations
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Please refer to this study by its identifier: NCT00918320

Institut Gustave Roussy
Villejuif, France, 94805
Sponsors and Collaborators
Gustave Roussy, Cancer Campus, Grand Paris
St. Anna Kinderkrebsforschung
Catholic University of the Sacred Heart
Erasmus Medical Center
Principal Investigator: Birgit Geoerger, MD, PHD Gustave Roussy, Cancer Campus, Grand Paris
  More Information

Responsible Party: Gustave Roussy, Cancer Campus, Grand Paris Identifier: NCT00918320     History of Changes
Other Study ID Numbers: CSET 2008/1378
Study First Received: June 8, 2009
Last Updated: January 25, 2016

Keywords provided by Gustave Roussy, Cancer Campus, Grand Paris:
paediatric solid tumours
Miscellaneous other solid tumours

Additional relevant MeSH terms:
Neuroectodermal Tumors, Primitive, Peripheral
Neuroectodermal Tumors, Primitive
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Topoisomerase I Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors processed this record on September 21, 2017