BMC Pediatrics (May 2020)

A phase II JN-I-10 efficacy study of IDRF-based surgical decisions and stepwise treatment intensification for patients with intermediate-risk neuroblastoma: a study protocol

  • Tomoko Iehara,
  • Akihiro Yoneda,
  • Atsushi Kikuta,
  • Toshihiro Muraji,
  • Kazuaki Tokiwa,
  • Hideto Takahashi,
  • Satoshi Teramukai,
  • Tetsuya Takimoto,
  • Shigeki Yagyu,
  • Hajime Hosoi,
  • Tatsuro Tajiri,
  • the Japan Children’s Cancer Group Neuroblastoma Committee

DOI
https://doi.org/10.1186/s12887-020-02061-5
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 9

Abstract

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Abstract Background Few clinical trials have been reported for patients with intermediate-risk neuroblastoma because of the scarcity of the disease and the variety of clinical and biological characteristics. A multidisciplinary treatment that consists of multidrug chemotherapy and surgery is expected to lead to a good prognosis with few complications. Therefore, a clinical trial for patients with intermediate-risk tumors was designed to establish a standard treatment that reduces complications and achieves good outcomes. Methods We planned a prospective phase 2, single-arm study of the efficacy of image-defined risk factors (IDRF)-based surgical decision and stepwise treatment intensification for patients with intermediate-risk neuroblastomas. For the localized tumor group, IDRF evaluations will be performed after each three-course chemotherapy, and surgery will be performed when appropriate. For patients with metastatic tumors, a total of five chemotherapy courses will be performed, and primary lesions will be removed when the IDRF becomes negative. The primary endpoint is 3-year progression-free survival rate, and the secondary endpoints include 3-year progression-free survival rates and overall survival rates of the localized group and the metastasis group and the incidence of adverse events. From international results, 75% is considered an appropriate 3-year progression-free survival rate. If this trial’s expected 3-year progression-free survival rate of 85% is statistically greater than 75% in the lower limit of the 95.3% confidence interval, with an accuracy 10% (85 ± 10%), both groups require more than 65 patients. Discussion This study is the first clinical trial on the efficacy of IDRF-based surgical decision and stepwise treatment intensification for patients with intermediate-risk neuroblastomas. We expect that this study will contribute to the establishment of a standard treatment for patients with intermediate-risk neuroblastoma. Trial registration UMIN000004700 , jRCTs051180203 ; Registered on December 9, 2010.

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