Lobradimil and Carboplatin in Treating Children With Brain Tumors

Sponsor

National Cancer Institute (NCI) (NIH)

Overall Status

Completed

CT.gov ID

NCT00019422

Collaborator

Children's Oncology Group (Other)

236

Locations

Duration (Months)

Study Details

Study Description

Brief Summary

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Lobradimil may increase the effectiveness of a chemotherapy drug by making tumor cells more sensitive to the drug.

PURPOSE: Phase II trial to study the effectiveness of carboplatin and lobradimil in treating children with brain tumors that have not responded to previous treatment.

Condition or Disease	Intervention/Treatment	Phase
Brain and Central Nervous System Tumors	Drug: carboplatin Drug: lobradimil	Phase 2

Detailed Description

OBJECTIVES:

Determine the objective response rate in patients with recurrent or refractory childhood brain tumors treated with lobradimil and carboplatin.
Determine the time to progression in patients treated with this regimen.
Assess the toxicity of this regimen in this patient population.
Determine the quality of life of patients treated with this regimen.

OUTLINE: This is a multicenter study.

Patients are stratified according to histology (high-grade glioma vs low-grade glioma vs brainstem or visual pathway glioma vs medulloblastoma/primitive neuroectodermal tumor vs ependymoma). (Brainstem glioma stratum closed to accrual as of 12/21/2000.) (High-grade glioma stratum closed to accrual as of 01/08/2002.)

Patients receive carboplatin IV over 15 minutes and lobradimil IV over 10 minutes on days 1 and 2. Treatment repeats every 4 weeks for up to 12 courses in the absence of disease progression or unacceptable toxicity. After completion of course 12, patients may receive additional courses at the discretion of the institutional investigator.

Quality of life is assessed at baseline and then every 3 courses.

Patients are followed every 3 months for 1 year or until evidence of disease progression or initiation of a new therapy.

PROJECTED ACCRUAL: A maximum of 146 patients will be accrued for this study within 2-4 years.

Study Design

Study Type:

Interventional

Primary Purpose:

Treatment

Official Title:

A Phase II Trial of Intravenous Cereport (RMP-7) and Carboplatin in Childhood Brain Tumors

Study Start Date :

Mar 1, 1998

Actual Study Completion Date :

Apr 1, 2003

Outcome Measures

Primary Outcome Measures

Eligibility Criteria

Criteria

Ages Eligible for Study:

N/A to 21 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

DISEASE CHARACTERISTICS:

Histologically confirmed childhood brain tumor that is recurrent or refractory or for which no standard chemotherapy exists
High-grade glioma (anaplastic astrocytoma or glioblastoma multiforme) (High-grade glioma stratum closed to accrual as of 01/08/2002)
Low-grade glioma
Medulloblastoma/primitive neuroectodermal tumor (PNET)
Ependymoma
Brainstem tumor or visual pathway glioma (with radiographic evidence only) (Brainstem glioma stratum closed to accrual as of 12/21/2000)
Evidence of recurrent or progressive disease after front-line therapy documented as an increase in tumor size or appearance of new lesion(s) on MRI
Patients who did not previously receive radiotherapy as front-line therapy are eligible at time of second recurrence if the first recurrence was treated with radiotherapy only
Measurable disease in at least 2 dimensions by MRI
Diffuse meningeal involvement not considered measurable if it is the only site of disease
Disease must not be limited to the meninges
No metastases outside of the CNS

PATIENT CHARACTERISTICS:

Age:

21 and under at diagnosis

Performance status:

ECOG 0-2

Life expectancy:

At least 8 weeks

Hematopoietic:

Absolute granulocyte count at least 1,000/mm^3
Hemoglobin at least 8.0 g/dL (transfusion allowed)
Platelet count at least 100,000/mm^3

Hepatic:

Bilirubin less than 1.5 times upper limit of normal (ULN)
SGPT no greater than 2.5 times ULN
No significant hepatic illness

Renal:

Creatinine within limits as defined below by age:
Age 5 and under: less than 1.2 mg/dL
Age 6 to 10: less than 1.5 mg/dL
Age 11 to 15: less than 1.8 mg/dL
Age 16 and over: less than 2.4 mg/dL

Cardiovascular:

No significant cardiac illness

Pulmonary:

No significant pulmonary illness

Other:

No significant systemic illness or organ dysfunction that would preclude study
No allergic reaction to platinum-containing compounds
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

At least 72 hours since filgrastim (G-CSF)
No concurrent biologic therapy for brain tumor

Chemotherapy:

See Disease Characteristics
No prior carboplatin or lobradimil
No more than 1 prior chemotherapy regimen for high-grade glioma, low-grade glioma, or ependymoma
No more than 2 prior chemotherapy regimens for medulloblastoma/PNET
At least 4 weeks since prior nitrosoureas (2 weeks if also received stem cell/bone marrow rescue)
At least 2 weeks since any other prior myelosuppressive chemotherapy and recovered
No other concurrent chemotherapy for brain tumor

Endocrine therapy:

Concurrent corticosteroids for management of tumor-related edema allowed

Radiotherapy:

See Disease Characteristics
At least 6 weeks since prior radiotherapy to measurable disease and recovered
No concurrent radiotherapy for brain tumor

Surgery:

No concurrent surgery except for ventriculo-peritoneal shunt placement or revision

Other:

At least 24 hours since prior vasodilating agents, angiotensin-converting enzyme inhibitors, calcium channel blockers, or beta-blockers

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	University of Alabama at Birmingham Comprehensive Cancer Center	Birmingham	Alabama	United States	35233
2	University of South Alabama Medical Center	Mobile	Alabama	United States	36604
3	Phoenix Children's Hospital	Phoenix	Arizona	United States	85016-7710
4	Arizona Cancer Center	Tucson	Arizona	United States	85724
5	University of Arkansas for Medical Sciences	Little Rock	Arkansas	United States	72205
6	Southern California Permanente Medical Group	Downey	California	United States	90242
7	City of Hope Comprehensive Cancer Center	Duarte	California	United States	91010-3000
8	Rebecca and John Moores UCSD Cancer Center	La Jolla	California	United States	92093-0658
9	Loma Linda University Medical Center	Loma Linda	California	United States	92354
10	Jonathan Jaques Children's Cancer Center	Long Beach	California	United States	90801-1428
11	Children's Hospital Los Angeles	Los Angeles	California	United States	90027-0700
12	Cedars-Sinai Medical Center	Los Angeles	California	United States	90048
13	Jonsson Comprehensive Cancer Center, UCLA	Los Angeles	California	United States	90095-1781
14	Children's Hospital Central California	Madera	California	United States	93638-8762
15	Children's Hospital of Oakland	Oakland	California	United States	94609-1809
16	Chao Family Comprehensive Cancer Center	Orange	California	United States	92868
17	Children's Hospital of Orange County	Orange	California	United States	92868
18	Lucile Packard Children's Hospital at Stanford	Palo Alto	California	United States	94304
19	Sutter Cancer Center	Sacramento	California	United States	95816
20	University of California Davis Medical Center	Sacramento	California	United States	95817
21	Kaiser Permanente Medical Center/Kaiser Foundation Hospital - San Diego	San Diego	California	United States	92120
22	Children's Hospital San Diego	San Diego	California	United States	92123-4282
23	Kaiser Permanente Medical Center - San Francisco Geary Campus	San Francisco	California	United States	94115
24	UCSF Comprehensive Cancer Center	San Francisco	California	United States	94143-0128
25	Santa Barbara Cottage Hospital	Santa Barbara	California	United States	93102
26	Kaiser Permanente Medical Center - Santa Clara	Santa Clara	California	United States	95051-5386
27	David Grant Medical Center	Travis Air Force Base	California	United States	94535
28	Children's Hospital of Denver	Denver	Colorado	United States	80218-1088
29	Childhood Hematology/Oncology Associates	Denver	Colorado	United States	80218
30	Presbyterian-St Luke's Medical Center	Denver	Colorado	United States	80218
31	University of Connecticut Health Center	Farmington	Connecticut	United States	06360-7106
32	Yale Comprehensive Cancer Center	New Haven	Connecticut	United States	06520-8028
33	Alfred I. Dupont Institute	Wilmington	Delaware	United States	19899
34	Lombardi Cancer Center	Washington	District of Columbia	United States	20007
35	Children's National Medical Center	Washington	District of Columbia	United States	20010-2970
36	Walter Reed Army Medical Center	Washington	District of Columbia	United States	20307-5000
37	Broward General Medical Center	Fort Lauderdale	Florida	United States	33316
38	Children's Hospital of Southwest Florida	Fort Myers	Florida	United States	33908
39	Shands Hospital and Clinics, University of Florida	Gainesville	Florida	United States	32610-100277
40	Joe DiMaggio Children's Hospital at Memorial	Hollywood	Florida	United States	33021
41	Nemours Children's Clinic	Jacksonville	Florida	United States	32207
42	University of Miami-Jackson Memorial Hospital	Miami	Florida	United States	33136
43	Miami Children's Hospital	Miami	Florida	United States	33155-4069
44	Baptist Hospital of Miami	Miami	Florida	United States	33176-2197
45	Florida Hospital Cancer Institute	Orlando	Florida	United States	32803
46	Nemours Children's Clinic-Orlando	Orlando	Florida	United States	32806
47	Sacred Heart Children's Hospital	Pensacola	Florida	United States	32504
48	All Children's Hospital	St. Petersburg	Florida	United States	33701
49	Tampa Children's Hospital	Tampa	Florida	United States	33677-4227
50	St. Mary's Hospital	West Palm Beach	Florida	United States	33407
51	Emory University Hospital - Atlanta	Atlanta	Georgia	United States	30322
52	Children's Healthcare of Atlanta - Scottish Rite	Atlanta	Georgia	United States	30342
53	Medical College of Georgia Comprehensive Cancer Center	Augusta	Georgia	United States	30912-4000
54	Medical Center of Central Georgia	Macon	Georgia	United States	31201
55	Memorial Health University Medical Center, Inc.	Savannah	Georgia	United States	31403-3089
56	Cancer Research Center of Hawaii	Honolulu	Hawaii	United States	96813
57	MBCCOP - Hawaii	Honolulu	Hawaii	United States	96813
58	Tripler Army Medical Center	Honolulu	Hawaii	United States	96859-5000
59	Mountain States Tumor Institute	Boise	Idaho	United States	83712
60	University of Chicago Cancer Research Center	Chicago	Illinois	United States	60601
61	Rush-Presbyterian-St. Luke's Medical Center	Chicago	Illinois	United States	60612
62	University of Illinois at Chicago	Chicago	Illinois	United States	60612
63	Children's Memorial Hospital - Chicago	Chicago	Illinois	United States	60614
64	Hope Children's Hospital	Oak Lawn	Illinois	United States	60453
65	Lutheran General Hospital	Park Ridge	Illinois	United States	60068-1174
66	Saint Jude Midwest Affiliate	Peoria	Illinois	United States	61637
67	Southern Illinois University School of Medicine	Springfield	Illinois	United States	62794-9658
68	Indiana University Cancer Center	Indianapolis	Indiana	United States	46202-5289
69	St. Vincent Hospital and Health Care Center	Indianapolis	Indiana	United States	46260
70	Raymond Blank Memorial Hospital for Children	Des Moines	Iowa	United States	50308
71	John Stoddard Cancer Center	Des Moines	Iowa	United States	50309
72	Holden Comprehensive Cancer Center	Iowa City	Iowa	United States	52242-1009
73	Wesley Medical Center	Wichita	Kansas	United States	67214
74	Albert B. Chandler Medical Center, University of Kentucky	Lexington	Kentucky	United States	40536-0284
75	Kosair Children's Hospital	Louisville	Kentucky	United States	40202-3830
76	Tulane University School of Medicine	New Orleans	Louisiana	United States	70112
77	Children's Hospital of New Orleans	New Orleans	Louisiana	United States	70118
78	Ochsner Clinic	New Orleans	Louisiana	United States	70121
79	Eastern Maine Medical Center	Bangor	Maine	United States	04401
80	Maine Children's Cancer Program	Scarborough	Maine	United States	04074
81	Marlene and Stewart Greenebaum Cancer Center, University of Maryland	Baltimore	Maryland	United States	21201-1595
82	Sinai Hospital of Baltimore	Baltimore	Maryland	United States	21225
83	Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins	Baltimore	Maryland	United States	21231-2410
84	Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support	Bethesda	Maryland	United States	20892-1182
85	Floating Hospital for Children	Boston	Massachusetts	United States	02111
86	Dana-Farber Cancer Institute	Boston	Massachusetts	United States	02115
87	Baystate Medical Center	Springfield	Massachusetts	United States	01107
88	University of Massachusetts Memorial Medical Center - University Campus	Worcester	Massachusetts	United States	01655
89	Mott Children's Hospital	Ann Arbor	Michigan	United States	48109-0914
90	Children's Hospital of Michigan	Detroit	Michigan	United States	48201
91	Henry Ford Hospital	Detroit	Michigan	United States	48202
92	St. John Hospital and Medical Center	Detroit	Michigan	United States	48236
93	Michigan State University	East Lansing	Michigan	United States	48824
94	Hurley Medical Center	Flint	Michigan	United States	48503
95	Spectrum Health and DeVos Children's Hospital	Grand Rapids	Michigan	United States	49503
96	Bronson Methodist Hospital	Kalamazoo	Michigan	United States	49007
97	CCOP - Beaumont	Royal Oak	Michigan	United States	48073-6769
98	William Beaumont Hospital	Royal Oak	Michigan	United States	48073-6769
99	St. Mary's/Duluth Clinic Cancer Center	Duluth	Minnesota	United States	55805-1983
100	Children's Hospitals and Clinics - Minneapolis	Minneapolis	Minnesota	United States	55404
101	Mayo Clinic Cancer Center	Rochester	Minnesota	United States	55905
102	Children's Hospitals and Clinics of Minnesota	Saint Paul	Minnesota	United States	55102
103	University of Mississippi Medical Center	Jackson	Mississippi	United States	39216-4505
104	Children's Mercy Hospital	Kansas City	Missouri	United States	64108
105	Cardinal Glennon Children's Hospital	Saint Louis	Missouri	United States	63104
106	St. Louis Children's Hospital	Saint Louis	Missouri	United States	63110
107	Children's Hospital of Omaha	Omaha	Nebraska	United States	68114
108	University of Nebraska Medical Center	Omaha	Nebraska	United States	68198-2168
109	Sunrise Hospital and Medical Center	Las Vegas	Nevada	United States	89109-2306
110	Norris Cotton Cancer Center	Lebanon	New Hampshire	United States	03756-0002
111	Hackensack University Medical Center	Hackensack	New Jersey	United States	07601
112	Cancer Institute of New Jersey	New Brunswick	New Jersey	United States	08903
113	Newark Beth Israel Medical Center	Newark	New Jersey	United States	07112-2094
114	St. Joseph's Hospital and Medical Center	Paterson	New Jersey	United States	07503
115	Atlantic Health System	Summit	New Jersey	United States	07901
116	University of New Mexico Cancer Research and Treatment Center	Albuquerque	New Mexico	United States	87131
117	Cancer Center of Albany Medical Center	Albany	New York	United States	12208
118	Albert Einstein Clinical Cancer Center	Bronx	New York	United States	10461
119	Brooklyn Hospital Center	Brooklyn	New York	United States	11201
120	State University of New York Health Science Center at Brooklyn College of Medicine	Brooklyn	New York	United States	11203
121	Brookdale University Hospital and Medical Center	Brooklyn	New York	United States	11212
122	Maimonides Medical Center	Brooklyn	New York	United States	11219
123	Roswell Park Cancer Institute	Buffalo	New York	United States	14263-0001
124	North Shore University Hospital	Manhasset	New York	United States	11030
125	Schneider Children's Hospital	New Hyde Park	New York	United States	11042
126	New York Presbyterian Hospital - Cornell Campus	New York	New York	United States	10021-4885
127	Memorial Sloan-Kettering Cancer Center	New York	New York	United States	10021
128	Mount Sinai School of Medicine	New York	New York	United States	10029
129	Columbia Presbyterian Hospital	New York	New York	United States	10032
130	James P. Wilmot Cancer Center	Rochester	New York	United States	14642
131	State University of New York Health Sciences Center - Stony Brook	Stony Brook	New York	United States	11790-7775
132	State University of New York - Upstate Medical University	Syracuse	New York	United States	13210
133	New York Medical College	Valhalla	New York	United States	10595
134	Mission Saint Joseph's Health System	Asheville	North Carolina	United States	28801
135	Lineberger Comprehensive Cancer Center, UNC	Chapel Hill	North Carolina	United States	27599-7295
136	Carolinas Medical Center	Charlotte	North Carolina	United States	28232-2861
137	Presbyterian Healthcare	Charlotte	North Carolina	United States	28233-3549
138	Duke Comprehensive Cancer Center	Durham	North Carolina	United States	27710
139	East Carolina University School of Medicine	Greenville	North Carolina	United States	27858-4354
140	Comprehensive Cancer Center at Wake Forest University	Winston-Salem	North Carolina	United States	27157-1081
141	Dakota Cancer Institute	Fargo	North Dakota	United States	58103-4940
142	Children's Hospital Medical Center of Akron	Akron	Ohio	United States	44308
143	Children's Hospital Medical Center - Cincinnati	Cincinnati	Ohio	United States	45229-3039
144	Ireland Cancer Center	Cleveland	Ohio	United States	44106-5065
145	Cleveland Clinic Taussig Cancer Center	Cleveland	Ohio	United States	44195
146	Children's Hospital of Columbus	Columbus	Ohio	United States	43205-2696
147	Children's Medical Center - Dayton	Dayton	Ohio	United States	45404
148	Toledo Children's Hospital	Toledo	Ohio	United States	43601
149	St. Vincent Mercy Medical Center	Toledo	Ohio	United States	43608
150	Forum Health-Tod Childrens Hospital	Youngstown	Ohio	United States	44501
151	Children's Hospital of Oklahoma	Oklahoma City	Oklahoma	United States	73104
152	CCOP - Oklahoma	Tulsa	Oklahoma	United States	74136
153	Natalie Warren Bryant Cancer Center	Tulsa	Oklahoma	United States	74136
154	Doernbecher Children's Hospital	Portland	Oregon	United States	97201-3098
155	Legacy Emanuel Hospital and Health Center	Portland	Oregon	United States	97227
156	Geisinger Medical Center	Danville	Pennsylvania	United States	17822-1320
157	Milton S. Hershey Medical Center	Hershey	Pennsylvania	United States	17033-0850
158	Children's Hospital of Philadelphia	Philadelphia	Pennsylvania	United States	19104
159	St. Christopher's Hospital for Children	Philadelphia	Pennsylvania	United States	19134-1095
160	Children's Hospital of Pittsburgh	Pittsburgh	Pennsylvania	United States	15213
161	Rhode Island Hospital	Providence	Rhode Island	United States	02818
162	Medical University of South Carolina	Charleston	South Carolina	United States	29425-0721
163	Palmetto Health South Carolina Cancer Center	Columbia	South Carolina	United States	29203
164	Children's Hospital of Greenville Hospital System	Greenville	South Carolina	United States	29605
165	Avera Cancer Institute	Sioux Falls	South Dakota	United States	57105-1080
166	Sioux Valley Hospital	Sioux Falls	South Dakota	United States	57117
167	East Tennessee State University Cancer Center at JCMC	Johnson City	Tennessee	United States	37604
168	East Tennessee Children's Hospital	Knoxville	Tennessee	United States	37901
169	Saint Jude Children's Research Hospital	Memphis	Tennessee	United States	38105-2794
170	Vanderbilt-Ingram Cancer Center	Nashville	Tennessee	United States	37232-6838
171	Texas Tech University Health Sciences Center School of Medicine	Amarillo	Texas	United States	79106
172	Children's Hospital of Austin	Austin	Texas	United States	78701
173	Medical City Dallas Hospital	Dallas	Texas	United States	75230
174	Simmons Cancer Center - Dallas	Dallas	Texas	United States	75235-9154
175	Cook Children's Medical Center - Fort Worth	Fort Worth	Texas	United States	76104
176	University of Texas Medical Branch	Galveston	Texas	United States	77555-0361
177	University of Texas - MD Anderson Cancer Center	Houston	Texas	United States	77030-4009
178	Baylor College of Medicine	Houston	Texas	United States	77030
179	San Antonio Military Pediatric Cancer and Blood Disorders Center	Lackland Air Force Base	Texas	United States	78236-5300
180	Covenant Children's Hospital	Lubbock	Texas	United States	79410
181	University of Texas Health Science Center at San Antonio	San Antonio	Texas	United States	78207
182	Methodist Health Care System	San Antonio	Texas	United States	78229-3902
183	Scott and White Memorial Hospital	Temple	Texas	United States	76508
184	Huntsman Cancer Institute	Salt Lake City	Utah	United States	84112
185	Vermont Cancer Center	Burlington	Vermont	United States	05401-3498
186	Cancer Center at the University of Virginia	Charlottesville	Virginia	United States	22908
187	Inova Fairfax Hospital	Falls Church	Virginia	United States	22042-3300
188	Children's Hospital of the King's Daughters	Norfolk	Virginia	United States	23507
189	Naval Medical Center, Portsmouth	Portsmouth	Virginia	United States	23708-5100
190	Massey Cancer Center	Richmond	Virginia	United States	23298-0037
191	Carilion Medical Center for Children	Roanoke	Virginia	United States	24013
192	Children's Hospital and Regional Medical Center - Seattle	Seattle	Washington	United States	98105
193	Fred Hutchinson Cancer Research Center	Seattle	Washington	United States	98109-1024
194	Group Health Cooperative	Seattle	Washington	United States	98112
195	Deaconess Medical Center	Spokane	Washington	United States	99210-0248
196	Mary Bridge Children's Health Center	Tacoma	Washington	United States	98415-0299
197	Madigan Army Medical Center	Tacoma	Washington	United States	98431-5000
198	West Virginia University - Charleston	Charleston	West Virginia	United States	25302
199	Cabell-Huntington Hospital, Inc	Huntington	West Virginia	United States	25701
200	West Virginia University Hospitals	Morgantown	West Virginia	United States	26506-9300
201	Bellin Memorial Hospital	Green Bay	Wisconsin	United States	54301
202	CCOP - St. Vincent Hospital Cancer Center, Green Bay	Green Bay	Wisconsin	United States	54301
203	St. Vincent Hospital	Green Bay	Wisconsin	United States	54307-9070
204	Gundersen Lutheran Medical Center	La Crosse	Wisconsin	United States	54601
205	University of Wisconsin Hospital and Clinics	Madison	Wisconsin	United States	53792-0001
206	Marshfield Clinic	Marshfield	Wisconsin	United States	54449-5772
207	Midwest Children's Cancer Center	Milwaukee	Wisconsin	United States	53226
208	Sydney Children's Hospital	Randwick	New South Wales	Australia	2031
209	Children's Hospital at Westmead	Westmead	New South Wales	Australia	2145
210	Royal Children's Hospital	Brisbane	Queensland	Australia	4029
211	Women's and Children's Hospital	North Adelaide	South Australia	Australia	5006
212	Royal Children's Hospital	Parkville	Victoria	Australia	3052
213	Princess Margaret Hospital for Children	Perth	Western Australia	Australia	6001
214	Alberta Children's Hospital	Calgary	Alberta	Canada	T2T 5C7
215	Cross Cancer Institute	Edmonton	Alberta	Canada	T6G 1Z2
216	British Columbia Children's Hospital	Vancouver	British Columbia	Canada	V6H 3V4
217	CancerCare Manitoba	Winnipeg	Manitoba	Canada	R3E 0V9
218	Janeway Children's Health and Rehabilitation Centre	St. John's	Newfoundland and Labrador	Canada	A1B 3V6
219	IWK Health Centre	Halifax	Nova Scotia	Canada	B3J 3G9
220	Children's Hospital	Hamilton	Ontario	Canada	L8N 3Z5
221	Children's Hospital of Western Ontario	London	Ontario	Canada	N6C 2V5
222	Children's Hospital of Eastern Ontario	Ottawa	Ontario	Canada	K1H 8L1
223	Hospital for Sick Children	Toronto	Ontario	Canada	M5G 1X8
224	McGill University Health Center - Montreal Children's Hospital	Montreal	Quebec	Canada	H3H 1P3
225	Hopital Sainte Justine	Montreal	Quebec	Canada	H3T 1C5
226	Centre Hospitalier de L'Universite Laval	Sainte Foy	Quebec	Canada	GIV 4G2
227	Laval University Medical Center	Sainte-Foy	Quebec	Canada	G1V 4G2
228	Allan Blair Cancer Centre	Regina	Saskatchewan	Canada	S4T 7T1
229	Saskatoon Cancer Centre	Saskatoon	Saskatchewan	Canada	S7N 4H4
230	Academisch Ziekenhuis Groningen	Groningen		Netherlands	9700 RB
231	Starship Children's Hospital	Auckland		New Zealand
232	University of Puerto Rico School of Medicine Medical Sciences Campus	San Juan		Puerto Rico	00936-5067
233	San Jorge Childrens Hospital	Santurce		Puerto Rico	00912
234	Swiss Pediatric Oncology Group Bern	Bern		Switzerland	CH 3010
235	Swiss Pediatric Oncology Group Geneva	Geneva		Switzerland	CH 1211
236	Swiss Pediatric Oncology Group Lausanne	Lausanne		Switzerland	CH 1011