Maintenance Chemotherapy or Observation Following Induction Chemotherapy and Radiation Therapy in Treating Patients With Newly Diagnosed Ependymoma
Study Details
Study Description
Brief Summary
This partially randomized phase III trial is studying maintenance chemotherapy to see how well it works compared to observation following induction chemotherapy and radiation therapy in treating young patients with newly diagnosed ependymoma. Drugs used in chemotherapy, such as vincristine sulfate, carboplatin, cyclophosphamide, etoposide, and cisplatin, 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. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Radiation therapy uses high-energy x-rays to kill tumor cells. Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Giving chemotherapy with radiation therapy may kill more tumor cells and allow doctors to save the part of the body where the cancer started.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
Phase 3 |
Detailed Description
PRIMARY OBJECTIVE:
- To determine the event free survival (EFS) and overall survival (OS) of children with completely resected ependymoma treated with post-operative conformal radiation therapy (cRT) and then randomized to receive or not receive four cycles of post radiation maintenance chemotherapy (vincristine, cisplatin, etoposide and cyclophosphamide [VCEC]).
EXPLORATORY OBJECTIVES:
-
To estimate the EFS and OS of children with incompletely resected ependymoma who are unable to achieve a complete response (CR) by post-operative induction chemotherapy or by second surgery who will then be non-randomly assigned to cRT followed by four cycles of maintenance chemotherapy (VCEC).
-
To further evaluate the EFS and OS of children with supratentorial classic ependymoma who achieve a complete resection at first or second resection OR children who achieve a CR to short course induction chemotherapy following first surgery.
-
To evaluate whether the addition of maintenance chemotherapy post-radiation therapy contributes to neurobehavioral morbidity and reduced functional outcomes over time, compared to patients treated with radiation therapy followed by observation alone.
-
To examine differences in neurobehavioral outcomes and quality of life of children treated with proton beam radiation therapy compared to children treated with conventional radiation delivery techniques.
-
To evaluate biologic prognostic factors in childhood ependymoma by studying molecular groups as defined by deoxyribonucleic acid (DNA) methylation profiling and immunohistochemistry, copy number variants to identify 1q gain in posterior fossa ependymomas, CDKN2A loss (homozygous deletion) in supratentorial ependymomas and specific genetic alterations such as RELA fusions, YAP1 fusions and the H3 K27M mutation on initial tumor samples and correlating these data with clinical outcome.
Va. To explore prognostic molecular signatures and genomic alterations in ependymomas by building upon the data derived from ACNS0121 to correlate biomarkers listed above with World Health Organization (WHO) grade, location, extent of resection, treatment, EFS and OS.
OUTLINE: Patients are assigned to Arm I or randomized to Arms II or III.
Arm I: Patients receive vincristine intravenously (IV) over 1 minute on days 1 and 8 of cycles 1 and 2, carboplatin IV over 15-60 minutes on day 1 of cycles 1 and 2, and cyclophosphamide IV over 30-60 minutes on days 1-2 of cycle 1 only. Patients also receive etoposide IV over 60-120 minutes on days 1-3 of cycle 2 only. Cycle 1 continues for 3 weeks and cycle 2 continues for 4 weeks in the absence of disease progression or unacceptable toxicity. Patients with complete response are randomized to Arm II or III. Patients achieving stable disease, partial response, or locally progressive disease and who are deemed potentially resectable undergo surgery within 15 days after completion of induction chemotherapy. Patients with sub total resection are assigned to Arm II. Patients with gross total resection undergo observation.
ARM II: Patients undergo conformal radiotherapy over 6-7 weeks. Patients then receive vincristine IV on days 1, 8, and 15 of cycles 1-3 only, etoposide IV over 60-120 minutes on days 1-3, cisplatin IV over 1-8 hours on day 1, and cyclophosphamide IV over 30-60 minutes on days 2-3. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.
ARM III: Patients undergo conformal radiotherapy over 6-7 weeks and then undergo observation.
After completion of study therapy, patients are followed up every 4 months for 5 years, and then annually thereafter.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: Arm I (radiotherapy, chemotherapy) Patients receive vincristine IV over 1 minute on days 1 and 8 of cycles 1 and 2, carboplatin IV over 15-60 minutes on day 1 of cycles 1 and 2, and cyclophosphamide IV over 30-60 minutes on days 1-2 of cycle 1 only. Patients also receive etoposide IV over 60-120 minutes on days 1-3 of cycle 2 only. Cycle 1 continues for 3 weeks and cycle 2 continues for 4 weeks in the absence of disease progression or unacceptable toxicity. |
Drug: Carboplatin
Given IV
Other Names:
Drug: Cyclophosphamide
Given IV
Other Names:
Drug: Etoposide
Given IV
Other Names:
Other: Laboratory Biomarker Analysis
Optional correlative studies
Drug: Vincristine
Given IV
Other Names:
|
Experimental: Arm II (radiotherapy, chemotherapy) Patients undergo conformal radiotherapy over 6-7 weeks. Patients then receive vincristine IV on days 1, 8, and 15 of cycles 1-3 only, etoposide IV over 60-120 minutes on days 1-3, cisplatin IV over 1-8 hours on day 1, and cyclophosphamide IV over 30-60 minutes on days 2-3. Treatment repeats every 21 days for 4 cycles in the absence of disease progression or unacceptable toxicity. |
Radiation: 3-Dimensional Conformal Radiation Therapy
Patients undergo conformal radiotherapy
Other Names:
Drug: Cisplatin
Given IV
Other Names:
Drug: Cyclophosphamide
Given IV
Other Names:
Drug: Etoposide
Given IV
Other Names:
Other: Laboratory Biomarker Analysis
Optional correlative studies
Drug: Vincristine
Given IV
Other Names:
|
Active Comparator: Arm III (radiotherapy, observation) Patients undergo conformal radiotherapy over 6-7 weeks and then undergo observation. |
Radiation: 3-Dimensional Conformal Radiation Therapy
Patients undergo conformal radiotherapy
Other Names:
Other: Clinical Observation
Patients undergo observation
Other Names:
Other: Laboratory Biomarker Analysis
Optional correlative studies
|
Outcome Measures
Primary Outcome Measures
- Event-free survival (EFS) [From first occurrence of disease progression, disease recurrence, second malignant neoplasm, or death from any cause, assessed up to 5 years]
Using Kaplan-Meier curves to estimate the observed EFS for the two randomization arms (post-radiation maintenance arm and post-radiation observation only arm). Log rank tests will be used to compare the observed EFS between the two randomization arms. Stratified log rank test will also be performed to examine the treatment difference with consideration and adjustment for the randomization groups. If outcome data on ACNS0121 or this study suggest a difference or a different pattern in outcome between the 2 randomization strata, the primary analyses will be supplemented with log-rank tests performed separately in each stratum in order not to confound the overall conclusions of the study with respect to the effect of maintenance therapy.
- Overall survival (OS) [From the time of randomization to death, assessed up to 5 years]
Using Kaplan-Meier curves to estimate the observed OS for the two randomization arms (post-radiation Maintenance arm and post-radiation Observation only arm). Log rank tests will be used to compare the observed OS between the two randomization arms. Stratified log rank test will also be performed to examine the treatment difference with consideration and adjustment for the randomization groups. If outcome data on ACNS0121 or this study suggest a difference or a different pattern in outcome between the 2 randomization strata, the primary analyses will be supplemented with log-rank tests performed separately in each stratum in order not to confound the overall conclusions of the study with respect to the effect of maintenance therapy.
Secondary Outcome Measures
- Event free survival (EFS) of children with incompletely resected ependymoma who are unable to achieve a complete response (CR) by post-operative induction chemotherapy or by second surgery [Up to 5 years]
Kaplan-Meier curves will be used to estimate the EFS for patients who were non-randomly assigned to receive maintenance chemotherapy after incomplete resection
- Overall survival (OS) of children with incompletely resected ependymoma who are unable to achieve a complete response (CR) by post-operative induction chemotherapy or by second surgery [Up to 5 years]
Kaplan-Meier curves will be used to estimate the OS for patients who were non-randomly assigned to receive maintenance chemotherapy after incomplete resection
- Event free survival (EFS) of children with supratentorial classic ependymoma who achieve complete resection at first or second surgery or children who achieve complete response (CR) after induction chemo assigned to observation [Up to 5 years]
Estimated using Kaplan-Meier curves for patients with supratentorial classic disease that achieve complete resection or CR to induction chemotherapy and are assigned to observation only.
- Overall survival (OS) of children with supratentorial classic ependymoma who achieve complete resection at first or second surgery or children who achieve complete response (CR) after induction chemo assigned to observation [Up to 5 years]
Estimated using Kaplan-Meier curves for patients with supratentorial classic disease that achieve complete resection or CR to induction chemotherapy and are assigned to observation only.
- Neurologic, neuropsychological, and endocrine long-term sequelae of surgery, conformal radiotherapy, and maintenance chemotherapy [At 9, 30, and 60 months post diagnosis]
Will be observed.
- Gene expression signatures and genomic alterations in pediatric ependymoma [At the time of first or second surgery]
Will be observed.
- Telomere maintenance [Up to 5 years]
Descriptive statistics will be used to summarize the various telomere maintenance measures. Log rank tests and multivariate Cox proportional hazards models will be used to explore the association between a telomere maintenance measurement and EFS/OS, with potential adjustments for the effects of other possible prognostic factors. Reliability of human telomerase reverse transcriptase (hTERT) immunohistochemistry results versus telomeric repeat amplification protocol (TRAP) assay results will be calculated using the kappa statistic.
Eligibility Criteria
Criteria
Inclusion Criteria:
- Patients must be newly diagnosed with histologically confirmed intracranial ependymoma; patients with classic ependymoma (WHO II) or anaplastic ependymoma (WHO
- are eligible, as are various subtypes described as clear cell, papillary, cellular or a combination of the above
-
There is no minimum performance level; children with ependymoma may suffer neurologic sequelae as a result of their tumor or surgical measures taken to establish a diagnosis and resect the tumor; in the majority of cases, there is neurologic recovery; neurologic recovery is not likely to be impeded by protocol therapy
-
REGULATORY: All patients and/or their parents or legal guardians must sign a written informed consent
-
REGULATORY: All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met
Exclusion Criteria:
-
Patients with evidence of metastatic disease will be excluded; any evidence of non-contiguous spread beyond the primary site as determined by pre or post-operative magnetic resonance (MR) imaging of brain, pre or post-operative MR imaging of the spine, and post-operative cerebrospinal fluid (CSF) cytology obtained from the lumbar CSF space (the requirement for lumbar CSF examination may be waived if deemed to be medically contraindicated); CSF cytology from a ventriculostomy or permanent ventriculoperitoneal (VP) shunt that reveals the presence of tumor cells is indicative of metastatic disease
-
Patients with a diagnosis of spinal cord ependymoma, myxopapillary ependymoma, subependymoma, ependymoblastoma, or mixed glioma are NOT eligible
-
No prior treatment other than surgical intervention and corticosteroids; patients are allowed to have had more than one attempt at resection prior to enrollment
-
Pregnant female patients are not eligible for this study
-
Post-menarchal females may not participate unless a pregnancy test with a negative result has been obtained
-
Males and females of reproductive potential may not participate unless they have agreed to use an effective contraceptive method
-
Lactating females may not participate unless they have agreed not to breastfeed a child while on this study
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Children's Hospital of Alabama | Birmingham | Alabama | United States | 35233 |
2 | University of Alabama at Birmingham Cancer Center | Birmingham | Alabama | United States | 35233 |
3 | Banner Children's at Desert | Mesa | Arizona | United States | 85202 |
4 | Phoenix Childrens Hospital | Phoenix | Arizona | United States | 85016 |
5 | Banner University Medical Center - Tucson | Tucson | Arizona | United States | 85719 |
6 | Arkansas Children's Hospital | Little Rock | Arkansas | United States | 72202-3591 |
7 | University of Arkansas for Medical Sciences | Little Rock | Arkansas | United States | 72205 |
8 | Kaiser Permanente Downey Medical Center | Downey | California | United States | 90242 |
9 | City of Hope Comprehensive Cancer Center | Duarte | California | United States | 91010 |
10 | Loma Linda University Medical Center | Loma Linda | California | United States | 92354 |
11 | Miller Children's and Women's Hospital Long Beach | Long Beach | California | United States | 90806 |
12 | Children's Hospital Los Angeles | Los Angeles | California | United States | 90027 |
13 | Cedars Sinai Medical Center | Los Angeles | California | United States | 90048 |
14 | Valley Children's Hospital | Madera | California | United States | 93636 |
15 | UCSF Benioff Children's Hospital Oakland | Oakland | California | United States | 94609 |
16 | Kaiser Permanente-Oakland | Oakland | California | United States | 94611 |
17 | Children's Hospital of Orange County | Orange | California | United States | 92868 |
18 | Lucile Packard Children's Hospital Stanford University | Palo Alto | California | United States | 94304 |
19 | Sutter Medical Center Sacramento | Sacramento | California | United States | 95816 |
20 | University of California Davis Comprehensive Cancer Center | Sacramento | California | United States | 95817 |
21 | Rady Children's Hospital - San Diego | San Diego | California | United States | 92123 |
22 | UCSF Medical Center-Parnassus | San Francisco | California | United States | 94143 |
23 | UCSF Medical Center-Mission Bay | San Francisco | California | United States | 94158 |
24 | Children's Hospital Colorado | Aurora | Colorado | United States | 80045 |
25 | Connecticut Children's Medical Center | Hartford | Connecticut | United States | 06106 |
26 | Yale University | New Haven | Connecticut | United States | 06520 |
27 | Alfred I duPont Hospital for Children | Wilmington | Delaware | United States | 19803 |
28 | MedStar Georgetown University Hospital | Washington | District of Columbia | United States | 20007 |
29 | Children's National Medical Center | Washington | District of Columbia | United States | 20010 |
30 | Broward Health Medical Center | Fort Lauderdale | Florida | United States | 33316 |
31 | Lee Memorial Health System | Fort Myers | Florida | United States | 33901 |
32 | Golisano Children's Hospital of Southwest Florida | Fort Myers | Florida | United States | 33908 |
33 | University of Florida Health Science Center - Gainesville | Gainesville | Florida | United States | 32610 |
34 | Memorial Regional Hospital/Joe DiMaggio Children's Hospital | Hollywood | Florida | United States | 33021 |
35 | Nemours Children's Clinic-Jacksonville | Jacksonville | Florida | United States | 32207 |
36 | University of Miami Miller School of Medicine-Sylvester Cancer Center | Miami | Florida | United States | 33136 |
37 | Nicklaus Children's Hospital | Miami | Florida | United States | 33155 |
38 | AdventHealth Orlando | Orlando | Florida | United States | 32803 |
39 | Arnold Palmer Hospital for Children | Orlando | Florida | United States | 32806 |
40 | Nemours Children's Clinic - Orlando | Orlando | Florida | United States | 32806 |
41 | Orlando Health Cancer Institute | Orlando | Florida | United States | 32806 |
42 | Nemours Children's Hospital | Orlando | Florida | United States | 32827 |
43 | Nemours Children's Clinic - Pensacola | Pensacola | Florida | United States | 32504 |
44 | Johns Hopkins All Children's Hospital | Saint Petersburg | Florida | United States | 33701 |
45 | Saint Joseph's Hospital/Children's Hospital-Tampa | Tampa | Florida | United States | 33607 |
46 | Saint Mary's Hospital | West Palm Beach | Florida | United States | 33407 |
47 | Children's Healthcare of Atlanta - Egleston | Atlanta | Georgia | United States | 30322 |
48 | Augusta University Medical Center | Augusta | Georgia | United States | 30912 |
49 | Memorial Health University Medical Center | Savannah | Georgia | United States | 31404 |
50 | Kapiolani Medical Center for Women and Children | Honolulu | Hawaii | United States | 96826 |
51 | Saint Luke's Cancer Institute - Boise | Boise | Idaho | United States | 83712 |
52 | Lurie Children's Hospital-Chicago | Chicago | Illinois | United States | 60611 |
53 | University of Illinois | Chicago | Illinois | United States | 60612 |
54 | University of Chicago Comprehensive Cancer Center | Chicago | Illinois | United States | 60637 |
55 | Loyola University Medical Center | Maywood | Illinois | United States | 60153 |
56 | Advocate Children's Hospital-Oak Lawn | Oak Lawn | Illinois | United States | 60453 |
57 | Saint Jude Midwest Affiliate | Peoria | Illinois | United States | 61637 |
58 | Southern Illinois University School of Medicine | Springfield | Illinois | United States | 62702 |
59 | Riley Hospital for Children | Indianapolis | Indiana | United States | 46202 |
60 | Saint Vincent Hospital and Health Care Center | Indianapolis | Indiana | United States | 46260 |
61 | Blank Children's Hospital | Des Moines | Iowa | United States | 50309 |
62 | University of Iowa/Holden Comprehensive Cancer Center | Iowa City | Iowa | United States | 52242 |
63 | University of Kentucky/Markey Cancer Center | Lexington | Kentucky | United States | 40536 |
64 | Norton Children's Hospital | Louisville | Kentucky | United States | 40202 |
65 | Tulane University Health Sciences Center | New Orleans | Louisiana | United States | 70112 |
66 | Children's Hospital New Orleans | New Orleans | Louisiana | United States | 70118 |
67 | Ochsner Medical Center Jefferson | New Orleans | Louisiana | United States | 70121 |
68 | Eastern Maine Medical Center | Bangor | Maine | United States | 04401 |
69 | Maine Children's Cancer Program | Scarborough | Maine | United States | 04074 |
70 | University of Maryland/Greenebaum Cancer Center | Baltimore | Maryland | United States | 21201 |
71 | Johns Hopkins University/Sidney Kimmel Cancer Center | Baltimore | Maryland | United States | 21287 |
72 | Walter Reed National Military Medical Center | Bethesda | Maryland | United States | 20889-5600 |
73 | Tufts Children's Hospital | Boston | Massachusetts | United States | 02111 |
74 | Massachusetts General Hospital Cancer Center | Boston | Massachusetts | United States | 02114 |
75 | Dana-Farber Cancer Institute | Boston | Massachusetts | United States | 02215 |
76 | Baystate Medical Center | Springfield | Massachusetts | United States | 01199 |
77 | C S Mott Children's Hospital | Ann Arbor | Michigan | United States | 48109 |
78 | Wayne State University/Karmanos Cancer Institute | Detroit | Michigan | United States | 48201 |
79 | Ascension Saint John Hospital | Detroit | Michigan | United States | 48236 |
80 | Michigan State University Clinical Center | East Lansing | Michigan | United States | 48824-7016 |
81 | Hurley Medical Center | Flint | Michigan | United States | 48503 |
82 | Helen DeVos Children's Hospital at Spectrum Health | Grand Rapids | Michigan | United States | 49503 |
83 | Bronson Methodist Hospital | Kalamazoo | Michigan | United States | 49007 |
84 | Children's Hospitals and Clinics of Minnesota - Minneapolis | Minneapolis | Minnesota | United States | 55404 |
85 | University of Minnesota/Masonic Cancer Center | Minneapolis | Minnesota | United States | 55455 |
86 | Mayo Clinic in Rochester | Rochester | Minnesota | United States | 55905 |
87 | University of Mississippi Medical Center | Jackson | Mississippi | United States | 39216 |
88 | Columbia Regional | Columbia | Missouri | United States | 65201 |
89 | Children's Mercy Hospitals and Clinics | Kansas City | Missouri | United States | 64108 |
90 | Cardinal Glennon Children's Medical Center | Saint Louis | Missouri | United States | 63104 |
91 | Washington University School of Medicine | Saint Louis | Missouri | United States | 63110 |
92 | Mercy Hospital Saint Louis | Saint Louis | Missouri | United States | 63141 |
93 | Children's Hospital and Medical Center of Omaha | Omaha | Nebraska | United States | 68114 |
94 | University of Nebraska Medical Center | Omaha | Nebraska | United States | 68198 |
95 | University Medical Center of Southern Nevada | Las Vegas | Nevada | United States | 89102 |
96 | Sunrise Hospital and Medical Center | Las Vegas | Nevada | United States | 89109 |
97 | Alliance for Childhood Diseases/Cure 4 the Kids Foundation | Las Vegas | Nevada | United States | 89135 |
98 | Summerlin Hospital Medical Center | Las Vegas | Nevada | United States | 89144 |
99 | Dartmouth Hitchcock Medical Center | Lebanon | New Hampshire | United States | 03756 |
100 | Hackensack University Medical Center | Hackensack | New Jersey | United States | 07601 |
101 | Saint Barnabas Medical Center | Livingston | New Jersey | United States | 07039 |
102 | Morristown Medical Center | Morristown | New Jersey | United States | 07960 |
103 | Saint Peter's University Hospital | New Brunswick | New Jersey | United States | 08901 |
104 | Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital | New Brunswick | New Jersey | United States | 08903 |
105 | Newark Beth Israel Medical Center | Newark | New Jersey | United States | 07112 |
106 | Saint Joseph's Regional Medical Center | Paterson | New Jersey | United States | 07503 |
107 | Overlook Hospital | Summit | New Jersey | United States | 07902 |
108 | University of New Mexico Cancer Center | Albuquerque | New Mexico | United States | 87102 |
109 | Albany Medical Center | Albany | New York | United States | 12208 |
110 | Montefiore Medical Center - Moses Campus | Bronx | New York | United States | 10467 |
111 | Roswell Park Cancer Institute | Buffalo | New York | United States | 14263 |
112 | NYU Winthrop Hospital | Mineola | New York | United States | 11501 |
113 | The Steven and Alexandra Cohen Children's Medical Center of New York | New Hyde Park | New York | United States | 11040 |
114 | Laura and Isaac Perlmutter Cancer Center at NYU Langone | New York | New York | United States | 10016 |
115 | Mount Sinai Hospital | New York | New York | United States | 10029 |
116 | NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center | New York | New York | United States | 10032 |
117 | Memorial Sloan Kettering Cancer Center | New York | New York | United States | 10065 |
118 | University of Rochester | Rochester | New York | United States | 14642 |
119 | State University of New York Upstate Medical University | Syracuse | New York | United States | 13210 |
120 | New York Medical College | Valhalla | New York | United States | 10595 |
121 | UNC Lineberger Comprehensive Cancer Center | Chapel Hill | North Carolina | United States | 27599 |
122 | Carolinas Medical Center/Levine Cancer Institute | Charlotte | North Carolina | United States | 28203 |
123 | Novant Health Presbyterian Medical Center | Charlotte | North Carolina | United States | 28204 |
124 | Wake Forest University Health Sciences | Winston-Salem | North Carolina | United States | 27157 |
125 | Sanford Broadway Medical Center | Fargo | North Dakota | United States | 58122 |
126 | Children's Hospital Medical Center of Akron | Akron | Ohio | United States | 44308 |
127 | Cincinnati Children's Hospital Medical Center | Cincinnati | Ohio | United States | 45229 |
128 | Rainbow Babies and Childrens Hospital | Cleveland | Ohio | United States | 44106 |
129 | Cleveland Clinic Foundation | Cleveland | Ohio | United States | 44195 |
130 | Nationwide Children's Hospital | Columbus | Ohio | United States | 43205 |
131 | Dayton Children's Hospital | Dayton | Ohio | United States | 45404 |
132 | ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital | Toledo | Ohio | United States | 43606 |
133 | Mercy Children's Hospital | Toledo | Ohio | United States | 43608 |
134 | University of Oklahoma Health Sciences Center | Oklahoma City | Oklahoma | United States | 73104 |
135 | Legacy Emanuel Children's Hospital | Portland | Oregon | United States | 97227 |
136 | Lehigh Valley Hospital-Cedar Crest | Allentown | Pennsylvania | United States | 18103 |
137 | Lehigh Valley Hospital - Muhlenberg | Bethlehem | Pennsylvania | United States | 18017 |
138 | Geisinger Medical Center | Danville | Pennsylvania | United States | 17822 |
139 | Penn State Children's Hospital | Hershey | Pennsylvania | United States | 17033 |
140 | Children's Hospital of Philadelphia | Philadelphia | Pennsylvania | United States | 19104 |
141 | Saint Christopher's Hospital for Children | Philadelphia | Pennsylvania | United States | 19134 |
142 | Children's Hospital of Pittsburgh of UPMC | Pittsburgh | Pennsylvania | United States | 15224 |
143 | Rhode Island Hospital | Providence | Rhode Island | United States | 02903 |
144 | Medical University of South Carolina | Charleston | South Carolina | United States | 29425 |
145 | Prisma Health Richland Hospital | Columbia | South Carolina | United States | 29203 |
146 | BI-LO Charities Children's Cancer Center | Greenville | South Carolina | United States | 29605 |
147 | Greenville Cancer Treatment Center | Greenville | South Carolina | United States | 29605 |
148 | Sanford USD Medical Center - Sioux Falls | Sioux Falls | South Dakota | United States | 57117-5134 |
149 | T C Thompson Children's Hospital | Chattanooga | Tennessee | United States | 37403 |
150 | East Tennessee Childrens Hospital | Knoxville | Tennessee | United States | 37916 |
151 | Saint Jude Children's Research Hospital | Memphis | Tennessee | United States | 38105 |
152 | The Children's Hospital at TriStar Centennial | Nashville | Tennessee | United States | 37203 |
153 | Vanderbilt University/Ingram Cancer Center | Nashville | Tennessee | United States | 37232 |
154 | Dell Children's Medical Center of Central Texas | Austin | Texas | United States | 78723 |
155 | Driscoll Children's Hospital | Corpus Christi | Texas | United States | 78411 |
156 | Medical City Dallas Hospital | Dallas | Texas | United States | 75230 |
157 | Cook Children's Medical Center | Fort Worth | Texas | United States | 76104 |
158 | Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center | Houston | Texas | United States | 77030 |
159 | Covenant Children's Hospital | Lubbock | Texas | United States | 79410 |
160 | UMC Cancer Center / UMC Health System | Lubbock | Texas | United States | 79415 |
161 | Children's Hospital of San Antonio | San Antonio | Texas | United States | 78207 |
162 | Methodist Children's Hospital of South Texas | San Antonio | Texas | United States | 78229 |
163 | University of Texas Health Science Center at San Antonio | San Antonio | Texas | United States | 78229 |
164 | Scott and White Memorial Hospital | Temple | Texas | United States | 76508 |
165 | Primary Children's Hospital | Salt Lake City | Utah | United States | 84113 |
166 | University of Vermont and State Agricultural College | Burlington | Vermont | United States | 05405 |
167 | Inova Fairfax Hospital | Falls Church | Virginia | United States | 22042 |
168 | Children's Hospital of The King's Daughters | Norfolk | Virginia | United States | 23507 |
169 | Naval Medical Center - Portsmouth | Portsmouth | Virginia | United States | 23708-2197 |
170 | Virginia Commonwealth University/Massey Cancer Center | Richmond | Virginia | United States | 23298 |
171 | Carilion Children's | Roanoke | Virginia | United States | 24014 |
172 | Seattle Children's Hospital | Seattle | Washington | United States | 98105 |
173 | Providence Sacred Heart Medical Center and Children's Hospital | Spokane | Washington | United States | 99204 |
174 | Mary Bridge Children's Hospital and Health Center | Tacoma | Washington | United States | 98405 |
175 | Madigan Army Medical Center | Tacoma | Washington | United States | 98431 |
176 | West Virginia University Charleston Division | Charleston | West Virginia | United States | 25304 |
177 | West Virginia University Healthcare | Morgantown | West Virginia | United States | 26506 |
178 | Saint Vincent Hospital Cancer Center Green Bay | Green Bay | Wisconsin | United States | 54301 |
179 | University of Wisconsin Hospital and Clinics | Madison | Wisconsin | United States | 53792 |
180 | Marshfield Medical Center-Marshfield | Marshfield | Wisconsin | United States | 54449 |
181 | Children's Hospital of Wisconsin | Milwaukee | Wisconsin | United States | 53226 |
182 | John Hunter Children's Hospital | Hunter Regional Mail Centre | New South Wales | Australia | 2310 |
183 | Sydney Children's Hospital | Randwick | New South Wales | Australia | 2031 |
184 | The Children's Hospital at Westmead | Westmead | New South Wales | Australia | 2145 |
185 | Royal Brisbane and Women's Hospital | Herston | Queensland | Australia | 4029 |
186 | Royal Children's Hospital-Brisbane | Herston | Queensland | Australia | 4029 |
187 | Queensland Children's Hospital | South Brisbane | Queensland | Australia | 4101 |
188 | Women's and Children's Hospital-Adelaide | North Adelaide | South Australia | Australia | 5006 |
189 | Monash Medical Center-Clayton Campus | Clayton | Victoria | Australia | 3168 |
190 | Royal Children's Hospital | Parkville | Victoria | Australia | 3052 |
191 | Princess Margaret Hospital for Children | Perth | Western Australia | Australia | 6008 |
192 | Perth Children's Hospital | Perth | Western Australia | Australia | 6009 |
193 | Alberta Children's Hospital | Calgary | Alberta | Canada | T3B 6A8 |
194 | University of Alberta Hospital | Edmonton | Alberta | Canada | T6G 2B7 |
195 | British Columbia Children's Hospital | Vancouver | British Columbia | Canada | V6H 3V4 |
196 | CancerCare Manitoba | Winnipeg | Manitoba | Canada | R3E 0V9 |
197 | Janeway Child Health Centre | Saint John's | Newfoundland and Labrador | Canada | A1B 3V6 |
198 | IWK Health Centre | Halifax | Nova Scotia | Canada | B3K 6R8 |
199 | McMaster Children's Hospital at Hamilton Health Sciences | Hamilton | Ontario | Canada | L8N 3Z5 |
200 | Kingston Health Sciences Centre | Kingston | Ontario | Canada | K7L 2V7 |
201 | Children's Hospital | London | Ontario | Canada | N6A 5W9 |
202 | Children's Hospital of Eastern Ontario | Ottawa | Ontario | Canada | K1H 8L1 |
203 | Hospital for Sick Children | Toronto | Ontario | Canada | M5G 1X8 |
204 | The Montreal Children's Hospital of the MUHC | Montreal | Quebec | Canada | H3H 1P3 |
205 | Centre Hospitalier Universitaire Sainte-Justine | Montreal | Quebec | Canada | H3T 1C5 |
206 | Saskatoon Cancer Centre | Saskatoon | Saskatchewan | Canada | S7N 4H4 |
207 | Centre Hospitalier Universitaire de Quebec | Quebec | Canada | G1V 4G2 | |
208 | Starship Children's Hospital | Grafton | Auckland | New Zealand | 1145 |
209 | Christchurch Hospital | Christchurch | New Zealand | 8011 |
Sponsors and Collaborators
- Children's Oncology Group
- National Cancer Institute (NCI)
Investigators
- Principal Investigator: Amy A Smith, Children's Oncology Group
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- ACNS0831
- NCI-2011-02029
- 10-01676
- COG-ACNS0831
- CDR0000668560
- ACNS0831
- ACNS0831
- U10CA180886
- U10CA098543