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NCT02567435

PHASE3

Combination Chemotherapy With or Without Temsirolimus in Treating Patients With Intermediate Risk Rhabdomyosarcoma

Sponsor: National Cancer Institute (NCI)

View on ClinicalTrials.gov

Summary

This randomized phase III trial studies how well combination chemotherapy (vincristine sulfate, dactinomycin, cyclophosphamide alternated with vincristine sulfate and irinotecan hydrochloride or vinorelbine) works compared to combination chemotherapy plus temsirolimus in treating patients with rhabdomyosarcoma (cancer that forms in the soft tissues, such as muscle), and has an intermediate chance of coming back after treatment (intermediate risk). Drugs used 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. Combination chemotherapy and temsirolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether chemotherapy plus temsirolimus is more effective than chemotherapy alone in treating patients with intermediate-risk rhabdomyosarcoma.

Official title: A Randomized Phase 3 Study of Vincristine, Dactinomycin, Cyclophosphamide (VAC) Alternating With Vincristine and Irinotecan (VI) Versus VAC/VI Plus Temsirolimus (TORI, Torisel, NSC# 683864) in Patients With Intermediate Risk (IR) Rhabdomyosarcoma (RMS)

Key Details

Gender

All

Age Range

Any - 40 Years

Study Type

INTERVENTIONAL

Enrollment

325

Start Date

2016-06-01

Completion Date

2026-10-27

Last Updated

2026-10-01

Healthy Volunteers

Conditions

Alveolar Rhabdomyosarcoma Botryoid-Type Embryonal Rhabdomyosarcoma Embryonal Rhabdomyosarcoma Rhabdomyosarcoma Sclerosing Rhabdomyosarcoma Spindle Cell Rhabdomyosarcoma

Interventions

DRUG

Cyclophosphamide

Given IV and PO

BIOLOGICAL

Dactinomycin

Given IV

DRUG

Irinotecan Hydrochloride

Given IV

OTHER

Laboratory Biomarker Analysis

Correlative studies

OTHER

Questionnaire Administration

Ancillary studies

RADIATION

Radiation Therapy

Undergo RT

DRUG

Temsirolimus

Given IV

DRUG

Vincristine Sulfate

Given IV

DRUG

Vinorelbine

Given IV

Inclusion Criteria: * Feasibility Phase: Patients must be \< 21 years of age at the time of enrollment; please note: the feasibility phase is complete, effective with amendment #1 * Efficacy Phase: Patients must be =\< 40 years of age at the time of enrollment * Patients with newly diagnosed RMS of any subtype, except adult-type pleomorphic, based upon institutional histopathologic classification, are eligible to enroll on the study based upon stage, group, and age, as below * RMS types included under embryonal rhabdomyosarcoma (ERMS) include those classified in the 1995 International Classification of Rhabdomyosarcoma (ICR) as ERMS (classic, spindle cell, and botryoid variants), which are reclassified in the 2013 World Health Organization (WHO) classification as ERMS (classic, dense and botryoid variants) and spindle cell/sclerosing RMS (encompassing the historical spindle cell ERMS variant and the newly recognized sclerosing RMS variant); classification of alveolar rhabdomyosarcoma (ARMS) in the 2013 WHO classification is the same as in the ICR and includes classic and solid variants * ERMS * Stage 1, group III (non-orbit) * Stage 3, group I/II * Stage 2/3, group III * Stage 4, group IV, \< 10 years old * ARMS: * Stages 1-3, groups I-III * Specimen Submission: Patients must have sufficient tissue available for the required biology study * Lansky performance status score \>= 50 for patients =\< 16 years of age; Karnofsky performance status score \>= 50 for patients \> 16 years of age * Peripheral absolute neutrophil count (ANC) \>= 750/uL * Platelet count \>= 75,000/uL * Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 mL/min/1.73 m\^2 or a serum creatinine based on age/gender as follows: * 1 month to \< 6 months old: 0.4 mg/dl (male), 0.4 mg/dl (female) * 6 months to \< 1 year old: 0.5 mg/dl (male), 0.5 mg/dl (female) * 1 to \< 2 years old: 0.6 mg/dl (male), 0.6 mg/dl (female) * 2 to \< 6 years old: 0.8 mg/dl (male), 0.8 mg/dl (female) * 6 to \< 10 years old: 1 mg/dl (male), 1 mg/dl (female) * 10 to \< 13 years old: 1.2 mg/dl (male), 1.2 mg/dl (female) * 13 to \< 16 years old: 1.5 mg/dl (male), 1.4 mg/dl (female) * \>= 16 years old: 1.7 mg/dl (male), 1.4 mg/dl (female) * Patients with an elevated serum creatinine due to obstructive hydronephrosis secondary to tumor are still eligible; however, patients with urinary tract obstruction by tumor must have unimpeded urinary flow established via diversion (i.e. percutaneous nephrostomies or ureteric stents) of the urinary tract * Total bilirubin =\< 1.5 x upper limit of normal (ULN) for age * All patients and/or their parents or legal guardians must sign a written informed consent. * All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met. Exclusion Criteria: * Patients who have previously received temsirolimus, another mTOR inhibitor, or any other investigational agent * Patients who have received any chemotherapy (excluding steroids) and/or RT prior to this enrollment * Patients with uncontrolled hyperglycemia * Patients with uncontrolled hyperlipidemia * Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation and for at least 3 months after treatment is completed * Female patients who are pregnant are not eligible since fetal toxicities or teratogenic effects have been noted for several of the study drugs; Note: A pregnancy test is required for female patients of childbearing potential prior to study entry * Lactating females who plan to breastfeed their infants are not eligible

Locations (382)

Children's Hospital of Alabama

Birmingham, Alabama, United States

USA Health Strada Patient Care Center

Mobile, Alabama, United States

Anchorage Associates in Radiation Medicine