RecruitingPhase 2Phase 3ACTRN12618001825246

rEECur: Chemotherapy for the treatment of recurrent and primary refractory Ewing sarcoma

International Randomised Controlled Trial of Chemotherapy for the Treatment of Recurrent and Primary Refractory Ewing Sarcoma


Sponsor

University of Birmingham

Enrollment

600 participants

Start Date

Nov 25, 2018

Study Type

Interventional

Conditions

Summary

The purpose of this study is to determine which of the most commonly used chemotherapy used in recurrent and primary refractory Ewing sarcoma is most beneficial. Who is it for? You may be eligible for this study if you are aged 2 years or above and have been diagnosed with relapsed or refractory Ewing sarcoma. Study details: Participants in this trial will be randomly allocated to one of the available treatment groups. Before treatment starts the following routine tests will be performed: Physical check-up including measuring height and weight Blood tests +/- urine tests Assessment of kidney function called a GFR. Scans (which may include CT, PET-CT, MRI, bone scan, x-ray). The doctor will decide which type of scans needed depending on where the tumour is located. A quality of life questionnaire will also be completed before treatment commences. During trial treatment While you are having chemotherapy treatment you will be carefully monitored using the same routine tests that would be used if you were having chemotherapy but were not in the trial. These routine tests will include blood +/- urine tests, scans and GFR. These tests are to ensure that you are fit to continue chemotherapy. In addition if you have had a PET-CT scan before treatment, you will have another PET-CT scan after 4 cycles of chemotherapy. You will be asked to complete two more quality of life questionnaires, one on completion of cycle 2 and one on completion of cycle 4. All treatments in this study are those which are currently used routinely for treatment of Ewing sarcoma. It is hoped that this research will help to determine which of the treatments is most effective in improving overall survival, side effects, tumour shrinkage, quality of life and days spent in hospital.


Eligibility

Sex: Both males and femalesMin Age: 2 Yearss

Plain Language Summary

Simplified for easier understanding

Ewing sarcoma is a rare but aggressive bone and soft tissue cancer that most often affects children, teenagers, and young adults. When it comes back after initial treatment (relapsed) or does not respond to first-line therapy (refractory), the prognosis is very difficult and there is no clear agreement on which chemotherapy works best. This international trial — called rEECur — aims to answer that question by directly comparing the chemotherapy regimens most commonly used in this situation. Participants are randomly assigned to one of several active treatment arms, allowing the trial to identify which drug combination produces the best survival, tumour shrinkage, and quality of life outcomes with the fewest side effects. All treatments used are already in routine clinical use for Ewing sarcoma. You (or your child) may be eligible if the person has a confirmed diagnosis of Ewing sarcoma, is 2 years or older, and has disease that has progressed or come back during or after previous treatment. They must be medically well enough to receive chemotherapy. Pregnant or breastfeeding women, and those who have already participated in this trial previously, are not eligible.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

A comparison of widely used chemotherapy regimens for the treatment of Ewing sarcoma, a type of bone cancer, to see which is most effective and/or has the fewest side effects. High dose Ifosfamide

A comparison of widely used chemotherapy regimens for the treatment of Ewing sarcoma, a type of bone cancer, to see which is most effective and/or has the fewest side effects. High dose Ifosfamide (IFOS): 4 cycles of 21 days, additional cycles at clinician's discretion. IV infusion of Ifosfamide 3g/m2 on days 1, 2, 3, 4, 5 High dose Ifosfamide and Lenvatinib (IFOS-L), 4 cycles, of 21 days, additional IFOS cycles at clinician’s discretion. Lenvatinib capsules taken once daily continuously throughout and for up to 2 years in total. IV infusion of Ifosfamide 3g/m2 on days 1, 2, 3, 4, 5 & 14mg/m2 (oral) starting d1 then daily, continuous Please note – Gemcitabine and Docetaxel (GD) arm closed in November 2018 and Irinotecan and Temozolomide (IT) arm closed in March 2020. Please note- Topotecan and Cyclophosphamide (TC) arm was closed in November 2021. The closed arms: Gemcitabine and Docetaxel (GD): 6 cycles of 21 days, additional cycles at clinician's discretion. IV infusion of Gemcitabine 900mg/m2 on days 1, 8. IV infusion of Docetxal 800mg/m2 on day 8. Irinotecan and Temozolomide (IT): 6 cycles of 21 days, additional cycles at clinician's discretion. IV infusion of Irinotecan 50mg/m2 on days 1, 2, 3, 4, 5 Temozolomide 100mg/m2 orally on days 1, 2, 3, 4, 5 Topotecan and Cyclophosphamide (TC): 6 cycles of 21 days, additional cycles at clinician's discretion. IV Infusion of Topotecan 0.75mg/m2 and Cyclophosphamide 250mg/m2 on day 1, 2, 3, 4, 5 Carboplatin and Etoposide (CE): 6 cycles of 21 days, additional cycles at clinician’s discretion. IV infusion of Carboplatin 400mg/m2 on day 1, and IV infusion of Etoposide on Days 1, 2, 3


Locations(28)

The Chris O’Brien Lifehouse - Camperdown

NSW,QLD,SA,WA,VIC, Australia

Princess Alexandra Hospital - Woolloongabba

NSW,QLD,SA,WA,VIC, Australia

Peter MacCallum Cancer Centre - Melbourne

NSW,QLD,SA,WA,VIC, Australia

The Royal Adelaide Hospital - Adelaide

NSW,QLD,SA,WA,VIC, Australia

The Children's Hospital at Westmead - Westmead

NSW,QLD,SA,WA,VIC, Australia

John Hunter Children's Hospital - New Lambton

NSW,QLD,SA,WA,VIC, Australia

Monash Children’s Hospital - Clayton

NSW,QLD,SA,WA,VIC, Australia

Perth Children's Hospital - Nedlands

NSW,QLD,SA,WA,VIC, Australia

Sydney Children's Hospital - Randwick

NSW,QLD,SA,WA,VIC, Australia

Womens and Childrens Hospital - North Adelaide

NSW,QLD,SA,WA,VIC, Australia

Queensland Children's Hospital - South Brisbane

NSW,QLD,SA,WA,VIC, Australia

Sir Charles Gairdner Hospital - Nedlands

NSW,QLD,SA,WA,VIC, Australia

United Kingdom

Spain

Italy

Norway

Finland

Denmark

Sweden

France

Hungary

Belgium

Netherlands

Czech Republic

Poland

Germany

Switzerland

New Zealand

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