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    Clinical Trial Results:
    Etude de phase I associant la rapamycine et l’irinotecan dans toutes tumeurs solides réfractaires de l’enfant – RAPIRI

    Summary
    EudraCT number
    2010-022329-13
    Trial protocol
    FR  
    Global end of trial date
    31 Mar 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    24 Jul 2026
    First version publication date
    24 Jul 2026
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    4791
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01282697
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Hôpitaux Universitaires de Strasbourg- direction de la Recherche Clinique et des Innovations
    Sponsor organisation address
    1, place de l’Hôpital, , STRASBOURG, France, 67000
    Public contact
    Mme Sarah HUSTACHE, Hôpitaux Universitaires de Strasbourg- direction de la Recherche Clinique et des Innovations, dpidrci@chru-strasbourg.fr
    Scientific contact
    Pr Natacha ENTZ-WERLE, Hôpital de Hautepierre– Unité d’Onco-Hématologie Pédiatrique, dpidrci@chru-strasbourg.fr
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    23 Mar 2014
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    23 Mar 2014
    Global end of trial reached?
    Yes
    Global end of trial date
    31 Mar 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    a. Déterminer la dose maximale tolérée (DMT) de l’association thérapeutique d’irinotecan et de rapamycine dans toutes tumeurs solides réfractaires pédiatriques b. Evaluer la pharmacocinétique de la rapamycine et de l’irinotecan au cours du 1er cycle de chimiothérapie.
    Protection of trial subjects
    Les enfants seront suivis pendant 12 mois à l’issue de leur traitement (si minimum deux mois de traitement effectués). La phase de suivi comprendra 4 visites (tous les 3 mois) et sera réalisée conformément aux recommandations habituelles de suivi dans les pathologies cancéreuses correspondantes.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    22 Apr 2011
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Regulatory reason
    Long term follow-up duration
    12 Months
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 42
    Worldwide total number of subjects
    42
    EEA total number of subjects
    42
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    18
    Adolescents (12-17 years)
    18
    Adults (18-64 years)
    6
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Potential subjects aged 1 to 21 years with recurrent or refractory solid tumors (including central nervous system tumors and sarcomas) who had exhausted standard therapeutic options were screened for eligibility. Screening criteria required adequate hematological, hepatic, and renal functions, a life expectancy of at least 8 weeks, and a ps >70%

    Period 1
    Period 1 title
    Inclusion (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    Rapamycin + Irinotecan
    Arm description
    Single-arm, 3+3 dose escalation study evaluating 10 dose levels of combined Rapamycin and Irinotecan in pediatric patients with refractory solid tumors
    Arm type
    Experimental

    Investigational medicinal product name
    IRINOTECAN
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Administered as a 90-minute intravenous infusion on Day 1 and Day 15 of each 28-day cycle. The dosage depends on the dose-escalation level assigned to the patient (ranging from 125 mg/m² to 240 mg/m²)

    Investigational medicinal product name
    RAPAMUNE
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet, Oral solution
    Routes of administration
    Oral use
    Dosage and administration details
    Administered once daily, every day (from Day 1 to Day 28 of each cycle). The first daily dose is administered at the end of the Irinotecan infusion. Subsequent daily doses must be taken at a fixed time every day. The dosage depends on the dose-escalation level (ranging from 0.5 mg/m²/day to 2.5 mg/m²/day)

    Number of subjects in period 1
    Rapamycin + Irinotecan
    Started
    42
    Completed
    42

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Inclusion
    Reporting group description
    -

    Reporting group values
    Inclusion Total
    Number of subjects
    42 42
    Age categorical
    Age >=1 an et <= 21 ans
    Units: Subjects
        Children (2-11 years)
    23 23
        Adolescents (12-17 years)
    17 17
        Adults (18-64 years)
    2 2
    Gender categorical
    Units: Subjects
        Female
    16 16
        Male
    26 26

    End points

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    End points reporting groups
    Reporting group title
    Rapamycin + Irinotecan
    Reporting group description
    Single-arm, 3+3 dose escalation study evaluating 10 dose levels of combined Rapamycin and Irinotecan in pediatric patients with refractory solid tumors

    Primary: Dose-Limiting Toxicities

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    End point title
    Dose-Limiting Toxicities [1]
    End point description
    End point type
    Primary
    End point timeframe
    First 28 days (Cycle 1) of treatment combination exposure
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Single arm study descriptive analysis
    End point values
    Rapamycin + Irinotecan
    Number of subjects analysed
    42
    Units: number of patient
    3
    No statistical analyses for this end point

    Primary: Maximum Tolerated Dose

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    End point title
    Maximum Tolerated Dose [2]
    End point description
    Determine the maximum tolerated dose (MTD) of irinotecan and rapamycin combination in children with refractory solid tumors. The Dose-Limiting Toxicity (DLT) of the drug combination is determined during the first cycle (J1 to J28) of treatment. MTD will be defined as the dose level immediately below the dose level at which 2 patients in a cohort of 3 to 6 patients will have experienced a DLT. No MTD was reached. ( Dose Max IRINOTECAN 240mg/m² / RAPAMYCIN 2,5mg/m²/day)
    End point type
    Primary
    End point timeframe
    J1-J28
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No MTD reached
    End point values
    Rapamycin + Irinotecan
    Number of subjects analysed
    42
    Units: mg/m2
        number (not applicable)
    240
    No statistical analyses for this end point

    Primary: AUC

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    End point title
    AUC [3]
    End point description
    AUC RAPAMYCIN D8
    End point type
    Primary
    End point timeframe
    J8
    Notes
    [3] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Single arm study descriptive analysis
    End point values
    Rapamycin + Irinotecan
    Number of subjects analysed
    42
    Units: min.mg/L
        number (not applicable)
    8
    No statistical analyses for this end point

    Adverse events

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    Adverse events information [1]
    Timeframe for reporting adverse events
    During overall study participation
    Adverse event reporting additional description
    old study, no possibility of MedDRA coding for non-serious AE
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23.1
    Reporting groups
    Reporting group title
    experimental
    Reporting group description
    -

    Notes
    [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported.
    Justification: Old study, no possibility of MedDRA coding for AE
    Serious adverse events
    experimental
    Total subjects affected by serious adverse events
         subjects affected / exposed
    17 / 42 (40.48%)
         number of deaths (all causes)
    3
         number of deaths resulting from adverse events
    3
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasm progression
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    General disorders and administration site conditions
    Disease progression
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pain
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    pyrexia
         subjects affected / exposed
    4 / 42 (9.52%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Oropharyngeal pain
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pleural effusion
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Pneumothorax
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tachypnoea
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Congenital, familial and genetic disorders
    Aplasia pure red cell
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Ventricular fibrillation
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Coma
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intracranial pressure increased
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Stomatitis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Hepatocellular injury
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal failure
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pain in jaw
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Osteomyelitis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Acidosis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Decreased appetite
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    experimental
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    0 / 42 (0.00%)

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    24 Nov 2010
    Modification de la date de démarrage de l'étude: janvier 2011 ajout au cours du 1er cycle: l’étude de pharmacodynamie (quantification des progéniteurs endothéliaux circulants et dosage de marqueurs angiogéniques protéiques (cytokines et chimiokines))
    27 Oct 2011
    Modification des modalités de pré-inclusion et d'inclusion modification paragraphe V.3.2: contre-indications thérapeutiques

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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