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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04023669
Additional trial details provided through ANZCTR are available at the end of this record.
Registration number
NCT04023669
Ethics application status
Date submitted
11/07/2019
Date registered
17/07/2019
Date last updated
7/02/2025
Titles & IDs
Public title
Evaluation of LY2606368 Therapy in Combination With Cyclophosphamide or Gemcitabine for Children and Adolescents With Refractory or Recurrent Group 3/Group 4 or SHH Medulloblastoma Brain Tumors
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Scientific title
St. Jude ELIOT: Phase 1 Evaluation of LY2606368, a Molecularly-Targeted CHK1/2 Inhibitor Therapy, in Combination With Cyclophosphamide or Gemcitabine for Children and Adolescents With Refractory or Recurrent Group 3/Group 4 or SHH Medulloblastoma Brain Tumors
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Secondary ID [1]
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NCI-2019-04787
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Secondary ID [2]
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SJELIOT
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Brain Tumor
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Brain Tumor, Recurrent
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Brain Tumor, Refractory
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Brain Tumor, Pediatric
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Medulloblastoma
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Medulloblastoma Recurrent
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Medulloblastoma, Non-WNT/Non-SHH
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Medulloblastoma, Non-WNT/Non-SHH, Group 3
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Medulloblastoma, Non-WNT/Non-SHH, Group 4
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Brain Cancer
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CNS Cancer
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CNS Tumor
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CNS Neoplasm
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Condition category
Condition code
Cancer
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Brain
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Cancer
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Children's - Brain
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Other
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Research that is not of generic health relevance and not applicable to specific health categories listed above
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Prexasertib
Treatment: Drugs - Cyclophosphamide
Treatment: Drugs - Gemcitabine
Treatment: Other - filgrastim
Treatment: Other - peg-filgrastim
Experimental: A: prexasertib + cyclophosphamide - Stratum A: Participants receive combination treatment with cyclophosphamide given intravenously (IV) on days 1 and 15 and prexasertib given intravenously (IV) on days 2 and 16. Cycles repeat every 28 days for up to 24 months (26 cycles) in the absence of disease progression or unacceptable toxicity. They may also receive growth therapy support with filgrastim or peg-filgrastim.
Note: Only if absolutely necessary, cyclophosphamide may be given on day 16 and prexasertib may be given on day 17.
Experimental: B: prexasertib + gemcitabine - Stratum B: Participants receive combination treatment with gemcitabine given intravenously (IV) on days 1 and 15 and prexasertib given intravenously (IV) on days 2 and 16. Cycles repeat every 28 days for up to 24 months (26 cycles) in the absence of disease progression or unacceptable toxicity. They may also receive growth therapy support with filgrastim or peg-filgrastim.
Note: Only if absolutely necessary, gemcitabine may be given on day 16 and prexasertib may be given on day 17.
Treatment: Drugs: Prexasertib
IV
Treatment: Drugs: Cyclophosphamide
IV
Treatment: Drugs: Gemcitabine
IV
Treatment: Other: filgrastim
Given subcutaneously (SQ). Alternatively, pegfilgrastim may be given.
Treatment: Other: peg-filgrastim
Given subcutaneously (SQ). Alternatively, filgrastim may be given.
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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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Estimate the Maximum tolerated dose (MTD)/Recommended Phase 2 Dose (RP2D) of each doublet by stratum
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Assessment method [1]
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The maximum tolerated dose (MTD) is empirically defined as the highest dose level at which six patients have been treated with at most one patient experiencing a dose-limiting toxicity (DLT) and the next higher dose level has been determined to be too toxic. The MTD estimate will not be available if the lowest dose level studied is too toxic or the highest dose level studied is considered safe. In the latter case, the highest studied safe dose may be considered as the recommended phase 2 dose (RP2D). The MTD estimation will be limited to evaluable patients and toxicity assessments from course 1 (28 days).
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Timepoint [1]
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1 month after start of prexasertib and cyclophosphamide or gemcitabine treatment
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Primary outcome [2]
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To determine the safety and tolerability of combination treatment with prexasertib and cyclophosphamide or gemcitabine.
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Assessment method [2]
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Incidence of adverse event data at least possibly related to treatment will be summarized in tables by treatment combination and by dose level.
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Timepoint [2]
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Up to 2 years after start of prexasertib and cyclophosphamide or gemcitabine treatment
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Primary outcome [3]
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To characterize the area under the concentration-time curve (AUC0-8) of prexasertib in combination with cyclophosphamide or gemcitabine.
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Assessment method [3]
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Prexasertib area under the curve (AUC0-8) is estimated based on course 1, days 2 through 7 PK samples.
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Timepoint [3]
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prexasertib and cyclophosphamide or gemcitabine treatment course 1 days 2 through 7
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Primary outcome [4]
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To characterize the systemic clearance (CL) of prexasertib in combination with cyclophosphamide or gemcitabine.
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Assessment method [4]
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Prexasertib systemic clearance (CL) is estimated based on course 1, days 2 through 7 pharmacokinetic samples.
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Timepoint [4]
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prexasertib and cyclophosphamide or gemcitabine treatment course 1 days 2 through 7
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Secondary outcome [1]
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Rate of objective response (complete or partial response) by stratum
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Assessment method [1]
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The incidence of objective responses (complete or partial response) observed during prexasertib and cyclophosphamide or gemcitabine treatment or during follow-up prior to progression or initiation of alternative cancer therapy.
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Timepoint [1]
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Up to 1 year after completion of prexasertib and cyclophosphamide or gemcitabine treatment
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Secondary outcome [2]
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Duration of objective response by stratum
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Assessment method [2]
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The duration of objective response is measured from the time the measurement criteria are met for complete response (CR) or partial response (PR), whichever is recorded first, until the first day on which recurrent or progressive disease is objectively documented.
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Timepoint [2]
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Up to 1 year after completion of prexasertib and cyclophosphamide or gemcitabine treatment
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Secondary outcome [3]
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Progression-free survival for patients treated with prexasertib and cyclophosphamide or gemcitabine
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Assessment method [3]
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Progression-free survival (PFS) is defined from the time of treatment initiation until disease progression or until death from any cause (whichever is earlier) for patients who experience an event and until the date of last follow-up for those who are alive and progression free at the time of analysis. PFS is estimated by Kaplan-Meier approach and median PFS is reported.
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Timepoint [3]
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Up to 3 years from diagnosis
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Secondary outcome [4]
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To characterize the area under the concentration-time curve (AUC0-24h) of cyclophosphamide.
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Assessment method [4]
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Cyclophosphamide area under the curve (AUC0-24h) is estimated based on course 1, days 1 and 2 PK samples.
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Timepoint [4]
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prexasertib and cyclophosphamide treatment course 1, days 1 and 2
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Secondary outcome [5]
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To characterize the systemic clearance (CL) of cyclophosphamide.
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Assessment method [5]
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Cyclophosphamide systemic clearance (CL) is estimated based on course 1, days 1 and 2 PK samples.
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Timepoint [5]
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prexasertib and cyclophosphamide treatment course 1, days 1 and 2
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Secondary outcome [6]
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To characterize the area under the concentration-time curve (AUC0-24h) of 4-hydroxy-cyclophosphamide.
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Assessment method [6]
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4-hydroxy-cyclophosphamide are under the curve AUC0-24h is estimated based on course 1, days 1 and 2 PK samples.
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Timepoint [6]
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prexasertib and cyclophosphamide treatment course 1, days 1 and 2
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Secondary outcome [7]
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To characterize the area under the concentration-time curve (AUC0-24h) of carboxyethylphosphoramide mustard.
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Assessment method [7]
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Carboxyethylphosphoramide mustard area under the curve (AUC0-24h) is estimated based on course 1, days 1 and 2. PK samples.
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Timepoint [7]
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prexasertib and cyclophosphamide treatment course 1, days 1 and 2
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Secondary outcome [8]
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To characterize the area under the concentration-time curve (AUC0-4h) of gemcitabine.
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Assessment method [8]
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Gemcitabine area under the curve (AUC0-4h) is estimated based on course 1, day 1 PK samples.
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Timepoint [8]
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prexasertib and gemcitabine treatment course 1, day 1.
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Secondary outcome [9]
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To characterize the systemic clearance (CL) of gemcitabine.
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Assessment method [9]
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Gemcitabine systemic clearance (CL) is estimated based on course 1, day 1 PK samples.
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Timepoint [9]
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prexasertib and cyclophosphamide treatment course 1, day 1
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Secondary outcome [10]
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To characterize the area under the concentration-time curve (AUC0-4h) of gemcitabine triphosphate (only at St. Jude Children's Research Hospital).
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Assessment method [10]
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Gemcitabine triphosphate are under the curve AUC0-4h is estimated based on course 1, day 1 PK samples.
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Timepoint [10]
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prexasertib and cyclophosphamide treatment course 1, day 1
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Eligibility
Key inclusion criteria
Screening Phase
* Participants with recurrent, refractory, or progressive medulloblastoma.
* Age = 1 year and < 25 years at the time of screening.
* Participants and/or guardian can understand and is willing to sign a written informed consent document according to institutional guidelines.
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Minimum age
1
Year
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Maximum age
24
Years
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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
Screening Phase
* Previous exposure to any CHK1 inhibitor.
* Participants with a history of clinically significant, uncontrolled heart disease and/or repolarization abnormalities.
* Participants with any history of QTc prolongation (i.e. QTc interval of > 480 msec).
Inclusion Criteria: Strata A and B
* Participant must be =1 year and <25 years of age at time of screening.
* Participant must have recurrent, progressive or refractory Group 3/Group 4 or SHH medulloblastoma (per central pathology confirmation of primary tissue and/or relapsed tissue). Central pathology review previously completed at St. Jude Children's Research Hospital using equivalent methods can be used for enrollment. Note: Group 3/Group 4 may be referred to as Non-WNT Non-SHH (NWNS) in pathology reports. Medulloblastoma patients with indeterminate molecular subgroup after central pathology review are eligible for enrollment on stratum A.
* Participant must have measurable or evaluable disease as defined in the protocol.
* Participant must have received their last dose of myelosuppressive anticancer chemotherapy at least 3 weeks prior to study enrollment.
* Participants must have had their last fraction of radiation (including CSI) at least 4 weeks prior to study enrollment. Participants who received radiation therapy for palliation must have had their last fraction of radiation at least 2 weeks prior to study enrollment.
-- Note: Participants must have relapsed with recurrent, progressive or refractory disease after any prior radiation therapy that is not considered palliative. Palliative radiation therapy is defined as local small port RT to alleviate and/or palliate symptoms. (CSI, whole brain RT, large field/port RT, or large field/port multilevel spinal RT will not be considered palliative at any dose.)
* Participant who are receiving corticosteroids must be on a stable or decreasing dose for at least 1 week prior to enrollment with no plans for escalation.
* Participant must have a Lansky (= 16 years) or Karnofsky (> 16 years) performance score of =50 and, in the opinion of the investigator, a minimum life expectancy of at least 6 weeks.
-- Note: Participants who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score.
* Participant must have adequate bone marrow and organ function as defined as:
* ANC = 1.0 x 10^9/L without growth factor support within 7 days
* Platelet count = 75x 10^9/L without support of a platelet transfusion within 7 days
* Hemoglobin =8.0 g/dL without support of a blood transfusion within 7 days
* Potassium, total calcium (corrected for serum albumin), magnesium, sodium and phosphorus within institutional normal limits or corrected to within normal limits with supplements before first dose of study medication
* Serum creatinine = the maximum serum creatinine based on age/gender: Age: 1 to < 2 years; maximum serum creatinine (mg/dL): 0.6 (male, female); Age: 2 to < 6 years; maximum serum creatinine (mg/dL): 0.8 (male, female); Age: 6 to < 10 years; maximum serum creatinine (mg/dL): 1 (male, female); Age: 10 to < 13 years; maximum serum creatinine (mg/dL): 1.2 (male, female); Age: 13 to < 16 years; maximum serum creatinine (mg/dL): 1.5 (male), 1.4 (female); Age := 16 years; maximum serum creatinine (mg/dL): 1.7 (male), 1.4 (female).
* Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) = 2.5 x ULN. For the purposes of this study the ULN of ALT and AST is 45 U/L.
* Total bilirubin = ULN; or if > ULN then direct bilirubin = 1.5 x ULN
* Female participants of childbearing age must have a negative pregnancy test at the time of enrollment.
* Participants of childbearing or child fathering potential must be willing to use medically acceptable form of birth control during treatment and for 16 weeks after stopping treatment.
* Participants and/or guardian have the ability to understand and the willingness to sign a written informed consent document according to institutional guidelines.
Strata A and B
* Participant who is receiving any other investigational agents.
* Participants with other clinically significant medical disorders (i.e. serious infections or significant cardiac, pulmonary, hepatic, psychiatric, or other organ dysfunction) that could compromise their ability to tolerate protocol therapy or would interfere with the study procedures or results.
* Participant with a history of clinically significant, uncontrolled heart disease and/or repolarization abnormalities as documented by a standard 12-lead ECG.
* Shortening fraction of <27% by ECHO or ejection fraction of <50% by gated radionuclide study.
* Prior history of QTc prolongation or QTc interval of > 480 msec.
* Female participants who are breastfeeding a child.
* Participants are excluded if unable to comply with guidelines listed in appendix I.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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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
8/08/2019
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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
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Actual
13/01/2025
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Sample size
Target
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Accrual to date
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Final
21
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
Country [1]
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0
United States of America
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State/province [1]
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Tennessee
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Funding & Sponsors
Primary sponsor type
Other
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Name
St. Jude Children's Research Hospital
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Address
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Eli Lilly and Company
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
SJELIOT is a phase 1 trial that aims to explore the combination of prexasertib with established DNA-damaging agents used in medulloblastoma to evaluate tolerance and pharmacokinetics in recurrent or refractory disease. Additionally, a small expansion cohort will be incorporated into the trial at the combination MTD/RP2D (maximum tolerated dose/recommended phase two dose) to detect a preliminary efficacy signal. Stratum A: Prexasertib and Cyclophosphamide Primary Objectives * To determine the safety and tolerability and estimate the maximum tolerated dose (MTD)/recommended phase 2 dose (RP2D) of combination treatment with prexasertib and cyclophosphamide in participants with recurrent/refractory Group 3 and Group 4 medulloblastoma and recurrent/refractory sonic hedgehog (SHH) medulloblastoma. * To characterize the pharmacokinetics of prexasertib in combination with cyclophosphamide. Secondary Objectives * To estimate the rate and duration of objective response and progression free survival (PFS) associated with prexasertib and cyclophosphamide treatment in this patient population. * To characterize the pharmacokinetics of cyclophosphamide and metabolites. Stratum B: Prexasertib and Gemcitabine Primary Objectives * To determine the safety and tolerability and estimate the MTD/RP2D of combination treatment with prexasertib and gemcitabine in participants with recurrent/refractory Group 3 and Group 4 medulloblastoma. * To characterize the pharmacokinetics of prexasertib in combination with gemcitabine. Secondary Objectives * To estimate the rate and duration of objective response and PFS associated with prexasertib and gemcitabine treatment in this patient population. * To characterize the pharmacokinetics of gemcitabine and gemcitabine triphosphate (only at St. Jude Children's Research Hospital).
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Trial website
https://clinicaltrials.gov/study/NCT04023669
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Trial related presentations / publications
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Public notes
This record is viewable in the ANZCTR as it had previously listed Australia and/or New Zealand as a recruitment site, however these sites have since been removed
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Contacts
Principal investigator
Name
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Giles W. Robinson, MD
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Address
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St. Jude Children's Research Hospital
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Country
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0
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Individual participant de-identified datasets containing the variables analyzed in the published article will be made available (related to the study primary or secondary objectives contained in the publication). Supporting documents such as the protocol, statistical analyses plan, and informed consent are available through the CTG website for the specific study. Data used to generate the published article will be made available at the time of article publication. Investigators who seek access to individual level de-identified data will contact the computing team in the Department of Biostatistics (
[email protected]
) who will respond to the data request.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP), Informed consent form (ICF)
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When will data be available (start and end dates)?
Data will be made available at the time of article publication.
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Available to whom?
Data will be provided to researchers following a formal request with the following information: full name of requestor, affiliation, data set requested, and timing of when data is needed. As an informational point, the lead statistician and study principal investigator will be informed that primary results datasets have been requested.
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Informed consent form
https://cdn.clinicaltrials.gov/large-docs/69/NCT04023669/ICF_000.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04023669
Additional trial details provided through ANZCTR
Accrual to date
1
Recruiting in Australia
Recruitment state(s)
WA
Funding & Sponsors
Primary sponsor
Primary sponsor name
Primary sponsor address
Primary sponsor country
Secondary sponsor category [1]
28
Other Collaborative groups
Name [1]
28
ANZCHOG
Address [1]
28
27-31 Wright Street, Clayton VIC 3168
Country [1]
28
Australia
Ethics approval
Ethics application status
Public notes
Perth Children's Hospital
Contacts
Principal investigator
Title
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Dr
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Name
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Nick Gottardo
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Address
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15 Hospital Ave, Nedlands WA 6009
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Country
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Australia
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Phone
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+618 6456 0241
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Fax
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+618 6456 0241
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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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Mrs
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Robyn Strong
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Address
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27-31 Wright Street, Clayton VIC 3168
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Australia
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Phone
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+613 8572 2684
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Fax
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+613 9902 4810
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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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Dr
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Name
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Nick Gottardo
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Address
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15 Hospital Ave, Nedlands WA 6009
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Country
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Australia
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Phone
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+618 6456 0241
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Fax
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+618 6456 0241
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Email
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[email protected]
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