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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04402073
Additional trial details provided through ANZCTR are available at the end of this record.
Registration number
NCT04402073
Ethics application status
Date submitted
1/04/2020
Date registered
26/05/2020
Date last updated
26/08/2024
Titles & IDs
Public title
Personalized Risk-Adapted Therapy in Post-Pubertal Patients With Newly-Diagnosed Medulloblastoma
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Scientific title
Personalized Risk-Adapted Therapy in Post-Pubertal Patients With Newly-Diagnosed Medulloblastoma (PersoMed-I)
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Secondary ID [1]
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1634
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Universal Trial Number (UTN)
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Trial acronym
PersoMed-I
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Medulloblastoma
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Condition category
Condition code
Cancer
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Children's - Brain
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Cancer
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Brain
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Sonidegib
Treatment: Drugs - Cisplatin
Treatment: Drugs - Lomustine
Treatment: Drugs - Vincristine
Treatment: Other - radiotherapy
Other: standard arms - Criteria: Adult SHH (p53wt) M0-1, adult WNT M0-1, adult Group 4 M0-1.
Radiotherapy to the cranio-spinal axis of 35.2 Gy in 22 daily fractions of 1.6 Gy, followed by an additional boost to the tumour site of 19.8 Gy in 11 daily fractions of 1.8 Gy, summing up to a total dose of 55.0 Gy in 33 daily fractions of 1.6/1.8 Gy.
Criteria: Post pubertal \< 18 y SHH (p53wt) M0.
Radiotherapy to the cranio-spinal axis of 23.4 Gy in 13 daily fractions of 1.8 Gy, followed by an additional boost to the tumour site of 30.6 Gy in 17 daily fractions of 1.8 Gy, summing up to a total dose of 54.0 Gy in 30 daily fractions of 1.8 Gy.
Experimental: experimental arms - Radiotherapy Criteria: Adult and post-pubertal SHH (p53wt) M0; adult WNT M0, adult Group 4 M0.
Radiotherapy to the cranio-spinal axis of 23.4 Gy in 13 daily fractions of 1.8 Gy, followed by an additional boost to the tumour site of 30.6 Gy in 17 daily fractions of 1.8 Gy, summing up to a total dose of 54.0 Gy in 30 daily fractions of 1.8 Gy.
SMO-inhibitor Criteria: Adult and post-pubertal SHH (p53wt) M0.
Sonidegib 200 mg/day (daily) from first day of radio-chemotherapy until end of maintenance chemotherapy, including 6w chemotherapy break.
Treatment: Drugs: Sonidegib
Sonidegib is a selective smoothened inhibitor that inhibits the sonic hedgehog-signaling pathway. It is used in patients with locally advanced basal cell carcinoma (BCC) that has recurred following surgery or radiation therapy, or those who are not candidates for surgery or radiation therapy.
Treatment: Drugs: Cisplatin
Cisplatin (CIS) is a platinum derivate used in the treatment in several epithelial tumours. The application route is through the veins.
Treatment: Drugs: Lomustine
Lomustine is a nitrosourea used in the treatment of brain tumours and Hodgkin's disease. The application route is oral.
Treatment: Drugs: Vincristine
Vincristine sulfate (VCR) is an inhibitor of microtubule formation in the mitotic spindle, resulting in an arrest of dividing cells at the metaphase stage. Vincristine sulfate is indicated in acute leukemia, Hodgkin's disease, non-Hodgkin's lymphomas, rhabdomyosarcoma, neuroblastoma, and Wilms' tumor. The application route is through the vein.
Treatment: Other: radiotherapy
Radiotherapy to the cranio-spinal axis of 35.2 Gy in 22 daily fractions of 1.6 Gy, followed by an additional boost to the tumour site of 19.8 Gy in 11 daily fractions of 1.8 Gy, summing up to a total dose of 55.0 Gy in 33 daily fractions of 1.6/1.8 Gy.
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Progression Free Survival
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Assessment method [1]
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compare progression-free survival (PFS) by central review of a personalized intensity-modulated therapy (experimental arm; sonidegib) vs. standard therapy in the SHH-activated subgroup in post-pubertal patients with newly diagnosed standard risk medulloblastoma.
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Timepoint [1]
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91 months after the date of recruitment of the first patient
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Secondary outcome [1]
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Progression Free Survival (PFS)
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Assessment method [1]
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Timepoint [1]
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when 43 PFS events are observed which is estimated to occur 91 months after the date of recruitment of the first patient.
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Secondary outcome [2]
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overall survival (OV)
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Assessment method [2]
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Timepoint [2]
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when 43 PFS events are observed which is estimated to occur 91 months after the date of recruitment of the first patient.
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Secondary outcome [3]
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safety and tolerability profile: CTCAE
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Assessment method [3]
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This study will use the International Common Terminology Criteria for Adverse Events (CTCAE), version 5.0, for adverse event reporting (with neurological, kidney, auditory, endocrine and radiotherapy associated as AE of special interest). The highest CTCAE v. 5 grading per cycle and per patient will be computed at the EORTC HQ for analysis . Safety and tolerability analyses will be performed in the safety population. Severe grades (3/4) which did not resolve after treatment discontinuation or emerged during follow-up will be identified and listed.
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Timepoint [3]
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when 43 PFS events are observed which is estimated to occur 91 months after the date of recruitment of the first patient.
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Secondary outcome [4]
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health-related quality of life (HRQoL)
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Assessment method [4]
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The primary HRQoL endpoint that is considered relevant for this study is social functioning. The other scales from the QLQ-C30 and BN20 will be considered as exploratory in nature.
A difference of 10 points on the 100-point QLQ-C30 social functioning scale between the two arms will be considered as clinically relevant.
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Timepoint [4]
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when 43 PFS events are observed which is estimated to occur 91 months after the date of recruitment of the first patient.
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Secondary outcome [5]
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overall survival
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Assessment method [5]
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Timepoint [5]
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when 43 PFS events are observed which is estimated to occur 91 months after the date of recruitment of the first patient.
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Eligibility
Key inclusion criteria
* Newly diagnosed, histologically proven, genetically classified, centrally confirmed medulloblastoma (WNT M0-1, SHH M0-1 (p53wt), Group 4 M0-1)
* Molecular subtype: medulloblastoma, SHH-activated and TP53-wildtype, M0-1; medulloblastoma, WNT-activated, M0-1; medulloblastoma, Group 4, M0-1
* Histologic subtype: medulloblastoma, classic (CMB); medulloblastoma, desmoplastic/nodular (DNMB); medulloblastoma, with extensive nodularity (MBEN); medulloblastoma, large cell/anaplastic (LCA)
* Adult (18 years and above): in WNT-activated and Group 4 medulloblastoma
* Post-pubertal, defined as females with a bone age of at least 15 years and males with a bone age of at least 17 years, or adult (greater than 18 y of age) (see appendix N) in SHH-activated and TP53-wildtype medulloblastoma
* Availability of prognostic markers (MYC/MYCN amplification, MYC/MYCN mutation)
* Availability of paraffin embedded tumour tissue (FFPE) (1 block or 30 unstained slides) and whole blood sample (10 ml) for central review
* For patients with SHH activated tumours: exclusion of germline alteration of TP53, PTCH, SUFU, BRCA2 and PALB2 if known before randomization
* Clinical status within 2 weeks of randomization: Karnofsky 50-100. NANO-score 0 to 9 (allowing full-blown cerebellar symptoms)
* Clinically standard-risk (centrally assessed MRI review) defined as: total or near total surgical resection with less than or equal to 1.5 cm2 (measured in axial plane) of residual tumour on early post-operative MRI, without and with contrast; no CNS metastasis on MRI (cranial and spinal); Chang stage M0-1 with no clinical evidence of extra-CNS metastasis
* Full recovery from surgery or any post-surgical complication (e.g. Bleeding, infections etc)
* Pre-surgery and/or post-surgery MRI available.
* Baseline brain MRI and spinal MRI available within 2 weeks of randomization.
* Normal liver, renal and haematological function within 2 weeks of randomization.
* WBC greater than or equal to 3×10^9/L
* ANC greater than or equal to 1.5×10^9/L
* Platelet count of greater than or equal to 100×10^9/L independent of transfusion
* Hemoglobin greater than or equal to 10 g/dl
* Total Bilirubin less than or equal to 1.5 ULN
* ALT (SGPT), AST (SGOT), alkaline phosphatase (ALP) less than or equal to 2.5 × ULN
* Serum creatinine less than 1.5 x ULN or creatinine clearance (CrCl) greater than 30 mL/min (using the Cockcroft-Gault formula)
* Negative serum or urine pregnancy test within 7 days of randomization for WOCBP.
* Patients of childbearing / reproductive potential (WOCBP) must use two methods of adequate birth control, including a highly effective method and a barrier method during the study treatment period and for at least 20 months after the last study treatment is mandatory for the patients that received sonidegib, for all other patients this period is at least 6 months after the last study treatment. A highly effective method of birth control is defined as those which result in low failure rate (i.e. less than 1% per year) when used consistently and correctly. Male patients even those who have had a vasectomy must always use a condom during treatment and for 6 months after last treatment. Men should not donate semen during treatment and for at least 6 months after ending treatment (donation of semen for the semen analyses of the fertility project 1 b is allowed). Appendix H.
* Female subjects who are breast feeding must discontinue nursing prior to the first dose of study treatment and until 20 months after the last study treatment.
* Before patient registration/randomization, written informed consent must be given according to ICH/GCP, and national/local regulations. For patients less than 18 years of age, consent has to be obtained from the parent(s) or legal representative.
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Minimum age
15
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Prior treatment for medulloblastoma
* Unavailability of central review pathology results.
* Inability to start radiotherapy within 43 days of surgery
* Significant sensorineural hearing deficit as defined by pure tone audiometry with bone conduction or air conduction and normal tympanogram showing impairment greater than or equal to 20 dB at 1-3 kHz
* Any medical contraindication to radiotherapy or chemotherapy.
* Hypersensitivity to contrast medium for MRI.
* Hypersensitivity towards the active substance of any of study drugs or their excipients
* Prior or current use of mitoxantrone, methotrexate, topotecan, imatinib, irinotecan or statins
* Concurrent severe or uncontrolled medical disease (e.g., active systemic infection, diabetes, psychiatric disorder) that, in the opinion of the investigator, would compromise the safety of the patient or compromise the ability of the patient to complete the study
* Prior or second invasive malignancy, except non-melanoma skin cancer, completely resected cervical carcinoma in situ, low risk prostate cancer (cT1-2a N0 and Gleason score less than or equal to 6 and PSA less than 10 ng/mL), either totally resected or irradiated with curative intent (with PSA of less than or equal to 0.1 ng/mL) or under active surveillance as per ESMO guidelines. Other cancers for which the subject has completed potentially curative treatment more than 5 years prior to diagnosis of medulloblastoma study entry are allowed
* Known history or current evidence of active Hepatitis B (e.g., positive HBV surface antigen) or C (e.g., HCV RNA [qualitative] is detected)
* Known or current evidence of Human Immunodeficiency Virus (HIV) infection (positive HIV-1/2 antibodies)
* Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial.
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Study design
Purpose of the study
Other
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
11/11/2022
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/04/2025
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Actual
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Sample size
Target
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Accrual to date
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Final
20
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Royal Adelaide Hospital - Adelaide
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Princess Alexandra Hospital - University Of Queensland - Brisbane
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Austin Health - Austin hospital - Melbourne
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Peter Maccallum Cancer Institute - Melbourne
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Sir Charles Gairdner Hospital - Nedlands
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John Hunter Children's Hospital - New Lambton Heights
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Prince Of Wales Hospital - Sydney
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Royal North Shore Hospital - Sydney
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Sydney Children's Hospital - Sydney
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Westmead Hospital - Crown Princess Mary Cancer Center - Westmead
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- Adelaide
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- Brisbane
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- Melbourne
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- Nedlands
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- New Lambton Heights
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- Sydney
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Recruitment postcode(s) [7]
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- Westmead
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Recruitment outside Australia
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Austria
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Innsbruck
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Austria
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Wien
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France
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Lille
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France
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Lyon
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France
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Marseille
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France
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Nice
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France
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Paris
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France
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Saint-Herblain
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France
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Toulouse
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Germany
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Bochum
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Germany
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Bonn
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Germany
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Dresden
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Germany
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Erfurt
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Germany
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Essen
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Germany
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Frankfurt
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Germany
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Freiburg
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Germany
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Goettigen
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Leipzig
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Germany
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Mainz
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Mannheim
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Bologna
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Italy
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Florence
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Italy
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Milano
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Italy
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Torino
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Italy
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Treviso
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Groningen
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Rotterdam
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Spain
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Badalona
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Spain
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Barcelona
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Madrid
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Lausanne
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Switzerland
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Zürich
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Funding & Sponsors
Primary sponsor type
Other
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Name
European Organisation for Research and Treatment of Cancer - EORTC
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
Medulloblastoma is a rare brain malignancy, mainly affecting children. Treatment of this rapidly growing tumor begins with maximal surgical removal plus radiation and chemotherapy. Treatment toxicity is high. Post-pubertal and pediatric medulloblastomas are biologically and prognostically different, which mandates age-adapted treatment strategies. Patients after puberty bear an intermediate to high prognostic risk. This means that a large number of these patients, are faced with death and/or disability (mainly neurocognitive). Therefore, the scientific and medical need is high. One of the genetic subgroups of medulloblastoma, the SHH-subgroup (Sonic HedgeHog- subgroup), is highly overrepresented in medulloblastoma patients after puberty. This subgroup can be treated with a targeted therapy. The investigators will therefore randomize patients and treat SHH-subgroup patients with sonidegib and a reduction of radiotherapy dose in the experimental arm of the trial. The hypothesis that this personalized risk-adapted therapy will improve outcomes in view of increased efficacy and decreased toxicity.
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Trial website
https://clinicaltrials.gov/study/NCT04402073
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Peter Hau
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Address
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EORTC study coordinator
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Country
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0
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Phone
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0
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Email
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Contact person for public queries
Name
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EORTC HQ
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Address
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Phone
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003227741611
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Fax
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0
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Email
0
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[email protected]
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04402073
Additional trial details provided through ANZCTR
Accrual to date
Recruiting in Australia
Recruitment state(s)
NSW,QLD,SA,WA,VIC
Recruitment hospital [1]
145
John Hunter Children's Hospital
Recruitment hospital [2]
146
Prince of Wales Hospital
Recruitment hospital [3]
147
Royal North Shore Hospital
Recruitment hospital [4]
148
Westmead Hospital
Recruitment hospital [5]
149
Sydney Children's Hospital
Recruitment hospital [6]
150
Princess Alexandra Hospital
Recruitment hospital [7]
151
Royal Brisbane & Womens Hospital
Recruitment hospital [8]
152
The Royal Adelaide Hospital
Recruitment hospital [9]
153
Austin Health - Austin Hospital
Recruitment hospital [10]
154
Peter MacCallum Cancer Centre
Recruitment hospital [11]
155
Sir Charles Gairdner Hospital
Recruitment postcode(s) [1]
146
2305
Recruitment postcode(s) [2]
147
2031
Recruitment postcode(s) [3]
148
2065
Recruitment postcode(s) [4]
149
2145
Recruitment postcode(s) [5]
150
4102
Recruitment postcode(s) [6]
151
4029
Recruitment postcode(s) [7]
152
5000
Recruitment postcode(s) [8]
153
3084
Recruitment postcode(s) [9]
154
3000
Recruitment postcode(s) [10]
155
6009
Funding & Sponsors
Funding source category [1]
57
Charities/Societies/Foundations
Name [1]
57
CanTeen
Address [1]
57
75 King Street Newtown NSW 2043
Country [1]
57
Australia
Funding source category [2]
58
Government body
Name [2]
58
Cancer Australia
Address [2]
58
14/300 Elizabeth Street Surry Hills NSW 2010
Country [2]
58
Australia
Funding source category [3]
65
Charities/Societies/Foundations
Name [3]
65
The Kids’ Cancer Project
Address [3]
65
Suite 1, Level 1/789 Botany Rd, Rosebery NSW 2018
Country [3]
65
Australia
Primary sponsor
Other Collaborative groups
Primary sponsor name
European Organisation for Research and Treatment of Cancer (EORTC)
Primary sponsor address
Avenue E. Mounierlaan 83/11
Brussel 1200 Bruxelles
België - Belgique
Primary sponsor country
Belgium
Secondary sponsor category [1]
60
University
Name [1]
60
The University of Sydney
Address [1]
60
Camperdown NSW 2006
Country [1]
60
Australia
Other collaborator category [1]
61
Other Collaborative groups
Name [1]
61
Cooperative Trials Group for Neuro-Oncology (COGNO)
Address [1]
61
NHMRC Clinical Trials Centre Level 4 92-94 Parramatta Road Camperdown NSW Australia 2050
Country [1]
61
Australia
Ethics approval
Ethics application status
Approved
Ethics committee name [1]
41
Sydney Local Health District HREC (RPAH Zone)
Address [1]
41
Research Ethics and Governance Office Royal Prince Alfred Hospital Camperdown NSW 2050
Country [1]
41
Australia
Date submitted for ethics approval [1]
41
27/04/2021
Approval date [1]
41
09/06/2021
Ethics approval number [1]
41
Public notes
Contacts
Principal investigator
Title
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Prof
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Name
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David Ziegler
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Address
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NHMRC Clinical Trials Centre, University of Sydney Lifehouse Level 6 119–143 Missenden Road, Camperdown NSW 2050
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Australia
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Phone
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+61 02 9382 1730
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Fax
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Email
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[email protected]
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Contact person for public queries
Title
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Ms
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Name
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PersoMed-I Trial Coordinator
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Address
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NHMRC Clinical Trials Centre, University of Sydney Lifehouse Level 6 119–143 Missenden Road, Camperdown NSW 2050
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Australia
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Phone
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+61 02 9562 5000
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Email
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[email protected]
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Contact person for scientific queries
Title
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Ms
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Name
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PersoMed-I Trial Coordinator
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Address
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NHMRC Clinical Trials Centre, University of Sydney Lifehouse Level 6 119–143 Missenden Road, Camperdown NSW 2050
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Australia
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+61 02 9562 5000
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[email protected]
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