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A Randomized Phase III Study of Sodium Thiosulfate for the Prevention of Cisplatin-Induced Ototoxicity in Children

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City:   San Francisco
State:   California
Zip Code:   94115
Conditions:   Brain and Central Nervous System Tumors - Childhood Germ Cell Tumor - Extragonadal Germ Cell Tumor - Liver Cancer - Neuroblastoma - Ototoxicity - Ovarian Cancer - Sarcoma
Purpose:   RATIONALE: Sodium thiosulfate may reduce or prevent hearing loss in young patients receiving cisplatin for cancer. It is not yet known whether sodium thiosulfate is more effective than no additional treatment in preventing hearing loss. PURPOSE: This randomized phase III trial is studying sodium thiosulfate to see how well it works compared with no additional treatment in preventing hearing loss in young patients receiving cisplatin for newly diagnosed germ cell tumor, hepatoblastoma, medulloblastoma, neuroblastoma, osteosarcoma, or other malignancy.
Study Summary:   OBJECTIVES: Primary - To compare the efficacy of sodium thiosulfate vs observation in preventing hearing loss in young patients receiving cisplatin for the treatment of newly diagnosed germ cell tumor, hepatoblastoma, medulloblastoma, neuroblastoma, osteosarcoma, or other malignancy. Secondary - To compare the mean change in hearing thresholds for key frequencies in these patients. - To compare the incidences of cisplatin-related grade 3 and 4 nephrotoxicity and grade 3 and 4 cytopenia in these patients. - To compare the event-free survival and overall survival of these patients. - To evaluate the association of two key gene mutations (TPMT and COMT) with the development of cisplatin-induced hearing loss in these patients. OUTLINE: This is a multicenter study. Patients are stratified according to prior cranial radiation (yes vs no), age (< 5 years vs ≥ 5 years) and duration of cisplatin infusion (< 2 hours vs ≥ 2 hours). Patients are randomized to 1 of 2 arms. - Arm I (sodium thiosulfate): Patients receive sodium thiosulfate IV over 15 minutes beginning 6 hours after the completion of each cisplatin infusion. Treatment with sodium thiosulfate continues until the completion of cisplatin therapy. - Arm II (observation): Patients do not receive sodium thiosulfate. Patients undergo audiological assessment at baseline, prior to each course of cisplatin, and then at 4 weeks and 1 year after the last course of cisplatin or other cancer treatment. Some patients may undergo saliva collection for DNA studies. After completion of study, patients are followed periodically for 10 years.
Criteria:   DISEASE CHARACTERISTICS: - Newly diagnosed (previously untreated or currently receiving cancer treatment for the diagnosis that made the patient eligible for this study) with germ cell tumor, hepatoblastoma, medulloblastoma, neuroblastoma, osteosarcoma, or other malignancy - Planning to receive a chemotherapy treatment regimen that includes a cumulative cisplatin dose ≥ 200 mg/m² with individual cisplatin doses to be infused over ≤ 6 hours - Enrolled on hearing assessment clinical trial COG-ACCL05C1 - Normal auditory results PATIENT CHARACTERISTICS: - Karnofsky performance status (PS) 50-100% (for patients > 16 years of age) - Lansky PS 50-100% (for patients ≤ 16 years of age) - Serum sodium normal - Absolute granulocyte count > 1,000/mm³ - Platelet count > 100,000/mm³ - Creatinine clearance or radioisotope glomerular filtration rate ≥ 70mL/min OR serum creatinine between 0.4 and 1.7 mg/dL, based on age and gender - Total bilirubin ≤ 1.5 times upper limit of normal (ULN) for age - AST or ALT < 2.5 times ULN for age - Not pregnant or nursing - Negative pregnancy test (if patient has child-bearing capacity) - Fertile patients must use effective contraception - No known hypersensitivity to sodium thiosulfate or other thiol agents (e.g., amifostine trihydrate, N-acetylcysteine, MESNA, or captopril) PRIOR CONCURRENT THERAPY: - See Disease Characteristics - No prior platinum-based chemotherapy (cisplatin or carboplatin) - Other prior chemotherapy allowed - Prior cranial radiotherapy (e.g., for treatment of medulloblastoma) allowed provided normal hearing is documented after completion of radiotherapy and before enrollment and administration of cisplatin chemotherapy - At least 6 months since prior hematopoietic stem cell transplantation - No evidence of graft-versus-host disease - No concurrent enrollment on another COG clinical trial for treatment of the cancer - Concurrent enrollment on a non-COG clinical trial (e.g., Headstart) allowed - No concurrent cranial irradiation during the chemotherapy regimen (i.e., prior to the administration of the final dose of cisplatin) - Cranial irradiation after the completion of all systemic chemotherapy allowed provided post end-of-treatment audiometry is completed prior to beginning irradiation - Concurrent radiotherapy to extracranial sites allowed
NCT ID:   NCT00716976
Primary Contact:   Study Chair
David R. Freyer, DO, MS
Children's Hospital Los Angeles

Backup Contact:   N/A
Location Contact:   San Francisco, California 94115
United States

Clinical Trials Office - UCSF Helen Diller Family Comprehensi
Phone: 877-827-3222

Site Status: Recruiting

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Data Source:   ClinicalTrials.gov
Date Processed:   June 18, 2013
Modifications to this listing:   Only selected fields are shown, please use the link below to view all information about this clinical trial.
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