| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
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| MedDRA Classification |
| E.1.3 | Condition being studied is a rare disease | Yes |
| E.2 Objective of the trial |
| E.2.1 | Main objective of the trial |
To determine the effectiveness and short-term toxicity of an intensified new chemotherapy regime in children with high risk hepatoblastoma. To increase the rate of complete surgical resection by full implementation of liver transplantation in the treatment strategy as a valid option for tumour removal when partial liver resection or other surgical options remain unfeasible even after extensive pre-operative chemotherapy. To evaluate prospectively the role of pre-operative chemotherapy in rendering unresectable tumours, resectable. To assess the accuracy of initial imaging in predicting the surgical options after pre-operative chemotherapy in children presenting with unresectable disease.
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| E.2.2 | Secondary objectives of the trial |
Improve overall and EFS with acceptable toxicity Assess toxicity of Cisplatin intensive regimen Assess response rate to pre-operative chemotherapy Assess whether response to chemotherapy defined by the modified RECIST criteria can be used for better response monitoring Assess whether the fall of AFP during pre-operative chemotherapy can be used as a prognostic factor Further evaluate feasibility of rapid central review of pre-treatment tumour extent of disease and resectability for 'difficult' patients Prospectively collect radiological, surgical and tumour pathological characteristics data to identify novel factors that may influence treatment choice and disease outcome Continue collecting biological materials derived from HB patients to improve knowledge of the pathology and biology of HB and facilitate research on this tumour Improve clinical care by giving guidelines for the diagnostic, therapeutic and follow-up management of these patients
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| E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
| E.3 | Principal inclusion criteria |
Histologically confirmed hepatoblastoma Risk category: high-risk (as defined above) Written informed consent and national/local ethical committee approval Ability to comply with requirements for submission of materials for central review Age less than 18 years
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| E.4 | Principal exclusion criteria |
All patients who do not fulfil the eligibility criteria of the protocol are excluded from the trial Additional exclusion criteria are: Diagnosis not confirmed by histology Age greater thsn or equal to 18 years Any previous chemotherapy or any previous treatment for hepatoblastoma Interval between date of diagnostic biopsy and start of chemotherapy > 15 days Abnormal renal function at diagnosis defined as GFR < 75-50% of the lower limit of normal for age which over 2 years of age is < 60 ml/min/1.73 mP2 P Patient unable to follow the protocol for any reason. Patients referred for recurrent disease No written informed consent or no ethical committee approval
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| E.5 End points |
| E.5.1 | Primary end point(s) |
Primary end-point: The primary endpoint of the trial is the rate of complete remission (CR) after the end of trial treatment (chemotherapy and partial resection or liver transplant), defined as a normal serum AFP level and absence of disease on imaging (abdominal ultrasound/CT and lung CT). Complete remission, as defined above, coincides with disease-free status. Total hepatectomy followed by liver transplantation will be considered as complete tumour resection and will be counted – if accompanied by no remaining tumour lesion on imaging and normal AFP - as complete resection and not failure of chemotherapy
Secondary end-points: UComplete resection rateU is considered as a surrogate marker of overall and progression free survival and, for the purpose of early monitoring of outcome, will also be evaluated in this trial. UResponse rateU (RR) to pre-operative chemotherapy URate of grade 2 cardiac and renal, grade 3 oto and grade 4 non haematological toxicityU during and at the end of trial treatment UOverallU and Uevent free survivalU (OS, EFS)
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| E.6 and E.7 Scope of the trial |
| E.6 | Scope of the trial |
| E.6.1 | Diagnosis | No |
| E.6.2 | Prophylaxis | No |
| E.6.3 | Therapy | Yes |
| E.6.4 | Safety | Yes |
| E.6.5 | Efficacy | Yes |
| E.6.6 | Pharmacokinetic | No |
| E.6.7 | Pharmacodynamic | No |
| E.6.8 | Bioequivalence | No |
| E.6.9 | Dose response | Yes |
| E.6.10 | Pharmacogenetic | Information not present in EudraCT |
| E.6.11 | Pharmacogenomic | No |
| E.6.12 | Pharmacoeconomic | No |
| E.6.13 | Others | No |
| E.7 | Trial type and phase |
| E.7.1 | Human pharmacology (Phase I) | No |
| E.7.1.1 | First administration to humans | No |
| E.7.1.2 | Bioequivalence study | No |
| E.7.1.3 | Other | No |
| E.7.1.3.1 | Other trial type description | |
| E.7.2 | Therapeutic exploratory (Phase II) | Yes |
| E.7.3 | Therapeutic confirmatory (Phase III) | No |
| E.7.4 | Therapeutic use (Phase IV) | No |
| E.8 Design of the trial |
| E.8.1 | Controlled | No |
| E.8.1.1 | Randomised | No |
| E.8.1.2 | Open | Information not present in EudraCT |
| E.8.1.3 | Single blind | Information not present in EudraCT |
| E.8.1.4 | Double blind | Information not present in EudraCT |
| E.8.1.5 | Parallel group | Information not present in EudraCT |
| E.8.1.6 | Cross over | Information not present in EudraCT |
| E.8.1.7 | Other | Information not present in EudraCT |
| E.8.2 | Comparator of controlled trial |
| E.8.2.1 | Other medicinal product(s) | No |
| E.8.2.2 | Placebo | No |
| E.8.2.3 | Other | No |
| E.8.3 |
The trial involves single site in the Member State concerned
| No |
| E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
| E.8.5 | The trial involves multiple Member States | Yes |
| E.8.6 Trial involving sites outside the EEA |
| E.8.6.1 | Trial being conducted both within and outside the EEA | No |
| E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
| E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
| E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Accrual of target number of patients and completion of treatment.
Projected accrual: 25-30 patients /year. Projected total accrual: 57 evaluable patients. Expected duration of the trial: ca. 2 years.
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| E.8.9 Initial estimate of the duration of the trial |
| E.8.9.1 | In the Member State concerned years | 2 |
| E.8.9.1 | In the Member State concerned months | 0 |
| E.8.9.1 | In the Member State concerned days | |
| E.8.9.2 | In all countries concerned by the trial years | 2 |
| E.8.9.2 | In all countries concerned by the trial months | 0 |