Observation, Combination Chemotherapy, Radiation Therapy, and/or Autologous Stem Cell Transplant in Treating Young Patients With Neuroblastoma

The recruitment status of this study is unknown because the information has not been verified recently.
Verified January 2008 by National Cancer Institute (NCI).
Recruitment status was  Recruiting
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
First received: December 11, 2006
Last updated: August 6, 2013
Last verified: January 2008

RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving combination chemotherapy may kill more tumor cells. Radiation therapy uses high-energy x-rays to kill tumor cells. An autologous stem cell transplant may be able to replace blood-forming cells that were destroyed by chemotherapy and radiation therapy. This may allow more chemotherapy to be given so that more tumor cells are killed. Sometimes, after surgery, the tumor may not need more treatment until it progresses. In this case, observation may be sufficient. It is not yet known whether observation is more effective than combination chemotherapy, radiation therapy, and/or autologous stem cell transplant in treating neuroblastoma.

PURPOSE: This randomized phase III and phase IV trial is studying observation, combination chemotherapy, radiation therapy, and/or autologous stem cell transplant to compare how well they work in treating young patients with neuroblastoma.

Condition Intervention Phase
Biological: filgrastim
Drug: carboplatin
Drug: cisplatin
Drug: cyclophosphamide
Drug: dacarbazine
Drug: doxorubicin hydrochloride
Drug: etoposide phosphate
Drug: ifosfamide
Drug: isotretinoin
Drug: melphalan
Drug: topotecan hydrochloride
Drug: vincristine sulfate
Drug: vindesine
Procedure: autologous hematopoietic stem cell transplantation
Procedure: conventional surgery
Procedure: peripheral blood stem cell transplantation
Radiation: iobenguane I 131
Radiation: radiation therapy
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Masking: Open Label
Primary Purpose: Treatment
Official Title: NB2004 Trial Protocol for Risk Adapted Treatment of Children With Neuroblastoma

Resource links provided by NLM:

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Event-free survival (EFS) [ Designated as safety issue: No ]
  • Locoregional EFS [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Time from diagnosis to transition to stage 4 disease, to death from disease, or to the last follow-up (if no transition to stage 4 disease is observed) [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]
  • Time to the beginning of primary tumor regression (in patients in the low-risk group [LRG]) [ Designated as safety issue: No ]
  • Time to the normalization of tumor markers HVA and VMA in urine [ Designated as safety issue: No ]
  • Time to no evidence of disease (in patients in the LRG with stage 4S disease) [ Designated as safety issue: No ]
  • Status of the primary tumor 12 months after diagnosis (LRG) [ Designated as safety issue: No ]
  • Best status of the primary tumor within the first 12 months (LRG) [ Designated as safety issue: No ]
  • Status of chromosome 1p (unblinded) and status of chromosome 11q (blinded) [ Designated as safety issue: No ]
  • Comparison of the extent of initial surgery (incomplete resection vs macroscopic complete resection) (LRG) [ Designated as safety issue: No ]
  • Comparison of the extent of best surgery during protocol treatment (incomplete resection vs macroscopic complete resection) [ Designated as safety issue: No ]
  • Surgery-related complications (i.e., bleeding, infection, intestinal obstruction, or other) [ Designated as safety issue: No ]
  • Disease progression and symptoms controlled after the first, second, third, and fourth N4 course (LRG) [ Designated as safety issue: No ]
  • Disease progression and symptoms not controlled after four N4 courses (LRG) [ Designated as safety issue: No ]
  • Transition to stage 4 disease at any time (LRG) [ Designated as safety issue: No ]
  • Acute and late side effects of external-beam radiotherapy (medium-risk group [MRG] and high-risk group [HRG]) [ Designated as safety issue: Yes ]
  • Early response after 2 courses of induction therapy (N5 and N6 or two courses of N8) (HRG) [ Designated as safety issue: No ]
  • Response to induction therapy prior to conditioning therapy or after 280 days (HRG) [ Designated as safety issue: No ]
  • Grade of toxicity observed during induction therapy course 1 (N5 or N8) (HRG) [ Designated as safety issue: Yes ]
  • Grade of toxicity observed during induction therapy course 2 (N6 or N8) (HRG) [ Designated as safety issue: Yes ]
  • Frequency of grade 3 or 4 toxicity observed during the last 6 courses of induction therapy (3 courses of N5 and N6) (HRG) [ Designated as safety issue: Yes ]
  • Activity and whole body dose of radiotherapy [ Designated as safety issue: No ]

Estimated Enrollment: 642
Study Start Date: October 2004
Estimated Primary Completion Date: December 2010 (Final data collection date for primary outcome measure)
  Show Detailed Description


Ages Eligible for Study:   up to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No


  • Diagnosis of neuroblastoma by histology using tumor tissue or as evidenced by the presence of distinct neuroblastoma cells in the bone marrow AND elevated catecholamine metabolites (i.e., homovanillic acid [HVA] and vanillylmandelic acid [VMA]) in blood or urine

    • Newly diagnosed disease (for patients in the low-risk group)
    • Diagnosis from tumor tissue (for patients in the medium-risk group)
  • Meets criteria for 1 of the following risk groups:

    • Low-risk group

      • No MYCN amplification AND meets 1 of the following criteria:

        • Stage 1 disease
        • Stage 2 disease with no chromosome 1p deletion or imbalance
        • Stage 3 disease with no chromosome 1p deletion or imbalance (for patients < 2 years of age)
        • Stage 4S disease (for patients < 1 year of age)
    • Medium-risk group

      • No MYCN amplification AND meets 1 of the following criteria:

        • Stage 2 disease with chromosome 1p deletion or imbalance
        • Stage 3 disease with chromosome 1p deletion or imbalance

          • Any chromosome 1p status (for patients ≥ 2 years of age)
        • Stage 4 disease (for patients < 1 year of age)
    • High-risk group, meeting 1 of the following criteria:

      • Any stage disease with MYCN amplification

        • Any MYCN status (for patients ≥ 1 year of age)


  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception


  • No prior nephrectomy or other mutilating surgery as initial surgery (for patients in the low-risk group)
  • No other concurrent anticancer therapy
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00410631

  Show 80 Study Locations
Sponsors and Collaborators
Gesellschaft fur Padiatrische Onkologie und Hamatologie - Germany
Study Chair: Frank Berthold, MD Children's Hospital Medical Center, Cincinnati
  More Information

ClinicalTrials.gov Identifier: NCT00410631     History of Changes
Other Study ID Numbers: GPOH-NB2004  CDR0000517312  EU-20661 
Study First Received: December 11, 2006
Last Updated: August 6, 2013
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
localized resectable neuroblastoma
localized unresectable neuroblastoma
regional neuroblastoma
stage 4S neuroblastoma
disseminated neuroblastoma
recurrent neuroblastoma

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Neoplasms, Germ Cell and Embryonal
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neuroectodermal Tumors, Primitive
Neuroectodermal Tumors, Primitive, Peripheral
Etoposide phosphate
Liposomal doxorubicin
Antibiotics, Antineoplastic
Antimitotic Agents
Antineoplastic Agents
Antineoplastic Agents, Phytogenic
Dermatologic Agents
Enzyme Inhibitors
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Topoisomerase I Inhibitors
Topoisomerase II Inhibitors
Topoisomerase Inhibitors

ClinicalTrials.gov processed this record on May 26, 2016