Cyclophosphamide, Doxorubicin, Vincristine w/ Irinotecan and Temozolomide in Ewings Sarcoma

This study has been terminated.
Information provided by (Responsible Party):
Kristen Ganjoo, Stanford University Identifier:
First received: March 10, 2011
Last updated: June 18, 2014
Last verified: June 2014
The outcome of patients with metastatic Ewings Sarcoma is poor with current standard of care chemotherapy, with less than 30% survival. Based on recent encouraging pediatric literature we have designed this trial to improve the outcome of patients with metastatic Ewings sarcoma using Irinotecan and Temozolomide in addition to standard chemotherapy.

Condition Intervention Phase
Bone Cancer
Ewing's Sarcoma
Drug: Irinotecan
Drug: Vincristine
Drug: Temozolomide
Drug: Doxorubicin
Drug: Cytoxan
Drug: Pegfilgrastim
Drug: Mesna
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Pilot Study of Cyclophosphamide, Doxorubicin, Vincristine Alternating With Irinotecan and Temozolomide in Patients With Newly Diagnosed Metastatic Ewing's Sarcoma

Resource links provided by NLM:

Further study details as provided by Stanford University:

Primary Outcome Measures:
  • Overall Response Rate (Partial and Complete Response) [ Time Frame: 24 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • progression free survival [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]

Enrollment: 3
Study Start Date: May 2011
Study Completion Date: January 2014
Primary Completion Date: November 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Combination Therapy

Regimen A alternate with Regimen B every 21 days

Regimen A:

Cytoxan=1200mg/m2 Doxorubicin=75mg/m2 (Maxiumum allowed dose 450mg/m2) Vincristine=2mg/m2 (capped at 2mg total dose)

Regimen B:

Irinotecan=50 mg/m2/day x 5 days Temozolomide=100 mg/m2/day x 5 days followed by two weeks of treatment-free period.

Drug: Irinotecan
50 mg/m2/day x 5 days
Other Names:
  • Camptosar
  • Campto
Drug: Vincristine
2 mg/m2 (capped at 2mg total do)
Other Names:
  • Oncovin
  • leurocristine
Drug: Temozolomide
100 mg/m2/day x 5 days
Other Names:
  • Temodar
  • Temodal
Drug: Doxorubicin
75 mg/m2
Other Names:
  • Adriamycin
  • hydroxydaunorubicin
Drug: Cytoxan
1200 mg/m2
Other Names:
  • Cyclophosphamide
  • Endoxan
  • Neosar
  • Procytox
  • Revimmune
  • cytophosphane
Drug: Pegfilgrastim
6 mg
Other Name: Neulasta
Drug: Mesna
240 mg/m2 in 50 ml NS
Other Names:
  • Uromitexan
  • Mesnex


Ages Eligible for Study:   13 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Histologically or cytologically confirmed diagnosis of metastatic Ewing's sarcoma.
  • Patients must have measurable disease defined as lesions that can be measured by medical imaging techniques such as CT or MRI. Ascites, pleural fluid, bone marrow disease, lesions seen on scan will not be considered measurable.
  • Patients must have metastatic disease.
  • Age 13 years or older
  • Life expectancy of at least 3 months.
  • ECOG performance status of <= 3.
  • Normal hepatic function (Direct bilirubin <1.5mg/dl, SGOT or SGPT <3x upper limit of normal).
  • Left Ventricular Ejection fraction of at least 50%.
  • Adequate renal function: Creatinine clearance >= 50 ml/min or Serum creatinine < 1.5 x ULN for age.
  • Adequate bone marrow reserve (defined as an absolute peripheral granulocyte count of >=1500/mm3, platelet count of >=75,000/mm3); unless bone marrow infiltrated with metastatic Ewing's sarcoma; ANC >= 500 and Platelet >= 50,000 mm3.
  • Ability to understand and willing to sign a written informed consent document.
  • Patients of childbearing potential must agree to use an effective method of contraception.

Exclusion Criteria:

  • No prior chemotherapy for Ewing's sarcoma; No prior doxorubicin, temozolomide or irinotecan.
  • Known hypersensitivity to any of the components of the protocol drugs.
  • Clinically significant unrelated systemic illness (such as serious infections requiring active systemic intravenous antibiotic therapy; cardiovascular disease [congestive heart failure, recent myocardial infarction, unstable angina, inadequately controlled hypertension].
  • No prior history of chronic diarrhea, bowel obstruction, Crohn's disease or ulcerative colitis.
  • Pregnant or nursing woman are not included in the study.
  • HIV-positive patients will be excluded from the study due to risk of infection or other serious side effects.
  • Other medical, psychiatric or social condition incompatible with study treatment.
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Please refer to this study by its identifier: NCT01313884

United States, California
Stanford University School of Medicine
Stanford, California, United States, 94305
Sponsors and Collaborators
Stanford University
Principal Investigator: Kristen N. Ganjoo Stanford University
  More Information

Responsible Party: Kristen Ganjoo, Assistant Professor of Medicine, Stanford University Identifier: NCT01313884     History of Changes
Other Study ID Numbers: SARCOMA0007  SU-03082011-7559  20323 
Study First Received: March 10, 2011
Last Updated: June 18, 2014
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Sarcoma, Ewing
Neoplasms by Histologic Type
Neoplasms, Bone Tissue
Neoplasms, Connective Tissue
Neoplasms, Connective and Soft Tissue
Liposomal doxorubicin
Alkylating Agents
Antibiotics, Antineoplastic
Antimitotic Agents
Antineoplastic Agents
Antineoplastic Agents, Alkylating
Antineoplastic Agents, Phytogenic
Antirheumatic Agents
Enzyme Inhibitors
Immunologic Factors
Immunosuppressive Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Myeloablative Agonists
Physiological Effects of Drugs
Topoisomerase I Inhibitors
Topoisomerase II Inhibitors processed this record on May 26, 2016