Targeted therapies for childhood and adolescent cancer

Optimal Precision TherapIes to CustoMISE Care in Childhood and Adolescent Cancer

This study is testing if new targeted treatments based on the genetic makeup of tumors can help kids and teens with cancer feel better and improve their chances of recovery.

Quick facts

• Phase: Phase1; Phase2
• Study type: Interventional
• Enrollment: 90 (estimated)
• Ages: 0 Years to 21 Years
• Sex: All
• Sponsor: Australian & New Zealand Children's Haematology/Oncology Group (Academic / other)
• Locations: 14 sites (Newcastle, New South Wales and 13 other locations)
• Trial ID: NCT06208657 on ClinicalTrials.gov

What this trial studies

This trial aims to link pediatric patients with childhood and adolescent cancers to novel targeted therapies based on their tumor genetic profiles. It utilizes precision oncology programs from Australia and Canada, which perform in-depth genetic profiling of cancer samples. The trial features multiple basket arms that focus on common genetically altered pathways in these cancers, allowing for histopathology-agnostic testing of innovative combination therapies to enhance clinical outcomes.

Who should consider this trial

Good fit: Ideal candidates are patients under 21 years old with solid tumors, CNS tumors, or lymphomas that have progressed despite standard therapies.

Not a fit: Patients with tumors that are not genetically profiled or those with effective standard therapies available may not benefit from this trial.

Why it matters

Potential benefit: If successful, this trial could provide personalized treatment options for children and adolescents with difficult-to-treat cancers.

How similar studies have performed: Other precision oncology studies have shown promise in improving outcomes for pediatric cancers, indicating a potential for success with this approach.

Eligibility criteria

Inclusion Criteria:

1. Patients must be diagnosed with a solid tumor, CNS tumor or lymphoma that has progressed despite standard therapy, or for which no effective standard therapy exists.
2. Age \<21 years at inclusion; patients 21 years and older may be included after approval by the Study Chair if they have a pediatric type recurrent/refractory malignancy.
3. Patients must be enrolled on a precision medicine study (i.e. PROFYLE, ZERO or equivalent as agreed with Study Chair).
4. Patients enrolled in a Phase I cohort must have either evaluable or measurable disease.
5. Patients enrolled in a Phase II cohort must have measurable disease. Evaluable and measurable disease are defined by standard imaging criteria for the patient's tumor type.
6. Disease evaluations, laboratory tests, and other clinical assessments that are considered standard of care may be undertaken at the patient's local oncology treatment centre with results transferred to study site for evaluation.
7. Performance status: Karnofsky performance status (for patients \> 16 years of age) or Lansky play score (for patients ≤ 16 years of age) ≥ 50%.
8. Life expectancy ≥ 6 weeks.
9. Patients must have fully recovered from the acute toxic effects of all prior anticancer therapy and must meet the following minimum duration from prior anticancer-directed therapy prior to enrolment.
10. Adequate organ function.
11. Able to comply with scheduled follow-up and with management of toxicity.
12. Females of childbearing potential must have a negative serum or urine pregnancy test.
13. Fertile males must agree to use adequate contraception during the study and following completion of treatment.
14. Provide a signed and dated informed consent form.

Exclusion Criteria:

1. Patients with symptomatic central nervous system (CNS) primary or metastatic tumours who are neurologically unstable or require increasing doses of corticosteroids or local CNS-directed therapy to control their CNS disease. Patients on stable doses of corticosteroids for at least 7 days prior to receiving study drug may be included.
2. Impairment of gastrointestinal (GI) function or GI disease that may significantly alter drug absorption of oral drugs (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhoea, or malabsorption syndrome) - only for arms that include orally administered therapeutic agents.
3. Clinically significant, uncontrolled heart disease (including history of any cardiac arrhythmias, e.g., ventricular, supraventricular, nodal arrhythmias, or conduction abnormality), unstable ischemia, congestive heart failure within 12 months of screening.
4. Known active viral hepatitis or human immunodeficiency virus (HIV) infection or any other uncontrolled infection.
5. Major surgery within 21 days of the first dose of investigational drug. Gastrostomy, ventriculo-peritoneal shunt, endoscopic ventriculostomy, tumour biopsy and insertion of central venous access devices are not considered major surgery, but for these procedures, a 48-hour interval must be maintained before the first dose of the investigational drug is administered.
6. Known hypersensitivity to any study drug or component of the formulation.
7. Pregnant or nursing (lactating) females.
8. Any other concomitant serious medical condition or organ dysfunction that in the opinion of the investigator would either compromise patient safety or interfere with the evaluation of the safety of the investigational drug(s).

Where this trial is running

Newcastle, New South Wales and 13 other locations

• John Hunter Children's Hospital — Newcastle, New South Wales, Australia (Recruiting)
• Sydney Children's Hospital, Randwick — Sydney, New South Wales, Australia (Recruiting)
• The Children's Hospital at Westmead — Sydney, New South Wales, Australia (Recruiting)
• Queensland Children's Hospital — Brisbane, Queensland, Australia (Recruiting)
• Women's and Children's Hospital — Adelaide, South Australia, Australia (Recruiting)
• Royal Hobart Hospital — Hobart, Tasmania, Australia (Recruiting)
• Monash Children's Hospital — Melbourne, Victoria, Australia (Recruiting)
• The Royal Children's Hospital — Melbourne, Victoria, Australia (Recruiting)
• Perth Children's Hospital — Perth, Western Australia, Australia (Recruiting)
• Stollery Children's Hospital — Edmonton, Canada (Not_yet_recruiting)
• CHU Sainte Justine — Montreal, Canada (Recruiting)
• Children's Hospital of Eastern Ontario — Ottawa, Canada (Not_yet_recruiting)
• The Hospital for Sick Children — Toronto, Canada (Recruiting)
• BC Children's Hospital — Vancouver, Canada (Recruiting)

Study contacts

• Study coordinator: International Study Coordinator

Conditions Childhood Cancer; Childhood Solid Tumor; Childhood Brain Tumor; Recurrent Cancer; Refractory Cancer; children; basket trial; platform study