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    Summary
    EudraCT Number:2013-002766-39
    Sponsor's Protocol Code Number:ET13-002
    National Competent Authority:Finland - Fimea
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2016-03-21
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedFinland - Fimea
    A.2EudraCT number2013-002766-39
    A.3Full title of the trial
    SIOP Ependymoma II - An International Clinical Program for the diagnosis and treatment of children, adolescents and young adults with Ependymoma
    Programme SIOP EPENDYMOME II : Programme clinique international pour le diagnostic et le traitement d’enfants, adolescents et jeunes adultes présentant un épendymome
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    SIOP Ependymoma II - An International Clinical Program for the diagnosis and treatment of children, adolescents and young adults with Ependymoma
    Programme SIOP EPENDYMOME II : Programme clinique international pour le diagnostic et le traitement d’enfants, adolescents et jeunes adultes présentant un épendymome
    A.3.2Name or abbreviated title of the trial where available
    SIOP Ependymoma II
    A.4.1Sponsor's protocol code numberET13-002
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorCENTRE LEON BERARD
    B.1.3.4CountryFrance
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportPHRC 2012
    B.4.2CountryFrance
    B.4.1Name of organisation providing supportSFCE
    B.4.2CountryFrance
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCENTRE LEON BERARD
    B.5.2Functional name of contact pointDRCI- Pôle opérations cliniques
    B.5.3 Address:
    B.5.3.1Street Address28 rue Laennec
    B.5.3.2Town/ cityLyon
    B.5.3.3Post code69008
    B.5.3.4CountryFrance
    B.5.4Telephone number334787828287740
    B.5.5Fax number33478782715
    B.5.6E-mailhanane.gheit@lyon.unicancer.fr
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameVincristine
    D.3.2Product code VCR
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNVINCRISTINE
    D.3.9.1CAS number 57-22-7
    D.3.9.2Current sponsor codeVCR
    D.3.9.4EV Substance CodeSUB00059MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameEtoposide
    D.3.2Product code VP16
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNETOPOSIDE
    D.3.9.1CAS number 33419-42-0
    D.3.9.3Other descriptive nameETOPOSIDE
    D.3.9.4EV Substance CodeSUB07337MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameCYCLOPHOSPHAMIDE
    D.3.2Product code CPM
    D.3.4Pharmaceutical form Powder for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCYCLOPHOSPHAMIDE
    D.3.9.1CAS number 50-18-0
    D.3.9.2Current sponsor codeCPM
    D.3.9.4EV Substance CodeSUB06859MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number500 to 1000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameCISPLATIN
    D.3.2Product code CDDP
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCISPLATIN
    D.3.9.1CAS number 15663-27-1
    D.3.9.2Current sponsor codeCDDP
    D.3.9.3Other descriptive nameCISPLATIN
    D.3.9.4EV Substance CodeSUB07483MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 5
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameCARBOPLATIN
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCARBOPLATIN
    D.3.9.1CAS number 41575-94-4
    D.3.9.3Other descriptive nameCARBOPLATIN
    D.3.9.4EV Substance CodeSUB06614MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 6
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameSODIUM VALPROATE
    D.3.2Product code VPA
    D.3.4Pharmaceutical form
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNSODIUM VALPROATE
    D.3.9.1CAS number 1069-66-5
    D.3.9.2Current sponsor codeVPA
    D.3.9.4EV Substance CodeSUB12318MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeup to
    D.3.10.3Concentration number40
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 7
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameMETHOTREXATE
    D.3.2Product code MTX
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNMETHOTREXATE
    D.3.9.1CAS number 59052
    D.3.9.2Current sponsor codeMTX
    D.3.9.3Other descriptive nameMETHOTREXATE
    D.3.9.4EV Substance CodeSUB08856MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Newly diagnosed with an intracranial or spinal ependymoma (all WHO grades) including ependymoma variants: cellular, papillary, myxopapillary, clear-cell and tanicytic) or anaplastic ependymoma.
    Nouvellement diagnostiqué avec un épendymome intracrânien ou spinal (quel que soit le grade mesuré selon la classification définie par l’OMS) incluant les variants : cellulaire, papillaire, myxopapillaire, à cellules claires, les épendymomes tanicityque ou anaplasique
    E.1.1.1Medical condition in easily understood language
    ependymoma brain tumour
    Tumeur intracranienne, Ependymome
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 18.1
    E.1.2Level PT
    E.1.2Classification code 10014967
    E.1.2Term Ependymoma
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    •Overall program
    To determine whether the assessment of residual disease can be improved by a centralized review of post-operative MRI and whether such review increases the rate of complete resection compared to historical controls. Does central neurosurgical and radiological review increase resection rates?

    •Stratum 1
    To compare PFS in patients who receive 16 weeks chemotherapy with VEC+CDDP following complete surgical resection, with no residual disease, and radiotherapy when compared to those that undergo complete surgical resection, with no residual disease, and radiotherapy alone.

    •Stratum 2
    To compare the activity of 2 post-operative chemotherapy schedules with VEC or VEC+HD-MTX in patients who have incompletely resected tumour.

    •Stratum3
    To evaluate the PFS in children unable to receive radiation therapy and who receive valproate, as a HDCAI in addition to the primary chemotherapy strategy when compared to those that undergo chemotherapy without valproate.
    Programme Global
    Déterminer dans quelle mesure l’évaluation de la maladie résiduelle et le taux de résection complète peuvent être améliorés par des revues centralisées systématiques post chirurgicales des images IRM et des données d’anapathologie

    Strate 1 Tester l’hypothèse d’une amélioration de la survie sans évènement des patients recevant 16 semaines de chimiothérapie (VEC-CDDP) après résection chirurgicale et radiothérapie conformationnelle comparée aux patients recevant une radiothérapie conformationnelle seule après chirurgie

    Strate 2 Comparer l'activité de deux chimiothérapies post chirurgicales VEC ou VEC+HD-MTX chez les patients présentant des résidus tumoraux après opération

    Strate 3: Evaluer la survie sans progression des patients non éligibles à la radiothérapie et recevant du valproate comme inbiteur d’histone d’acetylase en plus de leur chimiothérapie standard en comparaison des patients ne recevant que la chimiothérapie standard
    E.2.2Secondary objectives of the trial
    Overall program
    To evaluate second look surgery rates as compared to historical controls

    Stratum 1
    To evaluate whether OS is improved
    To compare the neuroendocrine morbidity
    To evaluate the QoS
    To evaluate the neuropsychological morbidity
    To determine the safety and the tolerance

    Stratum 2
    To determine the safety and tolerability
    To evaluate whether OS is improved
    To evaluate whether PFS is improved
    To compare neuroendocrine morbidity
    To evaluate the QOS
    To evaluate the neuropsychological morbidity
    To determine Safety of 8 Gy Boost radiotherapy

    Stratum 3
    To evaluate whether OS is improved
    To evaluate whether radiotherapy free survival is improved
    To compare the neuroendocrine morbidity
    To evaluate the Quality of Survival
    To evaluate the neuropsychological morbidity
    To determine the safety and tolerability of valproate

    Global:
    Etudier les taux d’une chirurgie de seconde intention

    Strate 1
    Etudier la survie globale
    Evaluer la morbidité neuropsychologique et qualité de survie
    Comparer la morbidité neuroendocrinienne
    Déterminer le profil de sécurité et de tolérance

    Strate 2
    Déterminer le profil de sécurité et de tolérance
    Déterminer la survie globale
    Evaluer la survie sans progression
    Evaluer la morbidité neuropsychologique et la qualité de survie
    Comparer la morbidité neuroendocrinienne
    Evaluer Déterminer la sécurité et la tolérance d’une augmentation de la dose de radiation

    Strate 3
    Evaluer la survie globale
    Evaluer la survie sans radiothérapie
    Evaluer la qualité de survie et la morbidité neuropsychologique
    Comparer la morbidité neuroendocrinienne
    Etudier le profil de sécurité et de tolérance du valproate
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Linked Biological Study:
    This part of the program will be organised by the European Ependymoma biology consortium called “Biomarkers of Ependymomas in Children and Adolescents (BIOMECA)” throughout a cooperation agreement with the aim to identify informative prognostic biomarkers for assessment of disease status and predictive response to therapy. The SIOP Ependymoma Program II supports the identification of informative prognostic biomarkers within the collaborative BIOMECA study. This high priority initiative is an essential element of the overall program to improve future treatment of ependymoma.

    Exploratory objectives:
    •To test the hypothesis that key molecular events are predictive of clinical behaviour of ependymoma.
    •To identify new biomarkers for Ependymoma clinical and biological behaviour (location, recurrence, chemo resistance, invasion, metastasis).
    •To validate known biomarkers in the context of the new international prospective study for newly diagnosed Ependymoma
    •To provide a new comprehensive grading scheme based on the histological, and immunohistochemical and/or biological criteria that could be used for newly diagnosed Ependymoma.
    •To validate and compare the techniques to assess biomarkers for further use in the stratification of patients
    •To select the best biomarker(s) and establish a prognostic signature for ependymoma.
    •To prospectively evaluate 1q copy-number status, Tenascin C, NELL2, LAMA 2, RELA-fusion and molecular subgroup as prognostic and predictive biomarkers in ependymoma within clinical trial setting.
    Cette partie du programme sera organisée par le consortium BIOMECA “Biomarkers of Ependymomas in Children and Adolescents (BIOMECA)” à travers une collaboration dont le but est d’identifier les bio marqueurs informatifs et pronostics pour l’evaluation de la maladie et la prédiction de la réponse au traitement. Cette initiative hautement prioritaire est un élément essentiel du programme global SIOP Ependymoma II pour l’amélioration des traitements de l’épendymome.
    Objectif exploratoire:
    • Tester l’hypothèse que certains évènements moléculaires clés sont prédictifs de l’expression clinique des épendymomes
    • Validation des biomarqueurs connus de l’Ependymome
    • Identification et évaluation de nouveaux marqueurs du comportement clinique et biologique de l’épendymome (localisation, chimiorésistance, invasion, métastases)
    • Fournir un nouveau schéma de gradation des épendymomes basé sur des critères immunohistochimique et/ou des critères biologiques potentiellement utilisables lors du diagnostic initial des épendymomes
    • Validation et comparaison des techniques d’identification et d’évaluation des biomarqueurs en vue de futures stratifications de patients
    • Sélectionner les biomarqueurs les plus pertinents comme facteurs pronostiques signatures des épendymomes.
    •Evaluer prospectivement les gènes 1q, Tenascin C, NELL2, LAMA 2, RELA-fusion et les sous-groupes moléculaires (par méthylation) comme bio marqueurs pronostiques et prédictifs de l’épendymome.
    E.3Principal inclusion criteria
    Overall program
    • Main residence in one of the participating countries
    • Age < 22 years old at the diagnosis
    • Newly diagnosed intracranial or spinal ependymoma (all WHO grades) including ependymoma variants: cellular, papillary myxopapillary, clear-cell and tanicytic) or anaplastic ependymoma
    • Delivery to national referral pathology center of FFPE tumour tissue blocks (or charged slides with sufficient interpretable material and curls in an Eppendorf tube)
    • Written informed consent for data and study biological samples collection
    • All patients and/or their parents or legal guardians willing and able to comply with protocol schedule and agree to sign a written informed consent
    • Patients must be affiliated to a Social Security System in countries where this is mandatory

    After Initial surgery and staging phase, patients will be enrolled in one of 3 different interventional strata where they will be offered a set of therapeutic interventions based on the outcome of the intervention (no measurable residue vs residual inoperable disease), their age and/or their eligibility /suitability to receive radiotherapy.

    Patients with centrally and histologically confirmed intracranial ependymoma (histology confirmed by National Reference centre for Biology and Pathology review) meeting the following criteria will be enrolled into one of interventional strata:

    •Main residence in one of the participating countries,
    •Age below 22 years old at the diagnosis,
    •Newly diagnosed with an ependymoma WHO grade II and III, including ependymoma variants: cellular, papillary, clear-cell and tanycytic or anaplastic ependymoma.
    •Post-menarchal female not pregnant or nursing (breast feeding) and with a negative beta-HCG pregnancy test prior to commencing the trial,
    •Males and females of reproductive age and childbearing potential with effective contraception (see section 4.1.2.4 Definition of highly effective methods of contraception) for the duration of their treatment and 6 months after the completion of their treatment,
    •Patients and/or their parents or legal guardians willing and able to comply with scheduled visits, treatment plan, laboratory tests and other study procedure

    Specific inclusion criteria have been defined for each stratum of the program.

    Stratum 1:
    •Age > 12 months and < 22 years at time of study entry
    •No residual measurable ependymoma based on the central neuroradiological review (detailed in protocol)
    •Histologically confirmed WHO Grade II-III ependymoma by central pathological review
    •No metastasis on spinal MRI and on CSF cytology assessments
    •No previous radiotherapy
    •No previous chemotherapy (except steroids)
    •No co-existent unrelated disease (e.g. renal, hematological) at the time of study entry
    •No medical contraindication to radiotherapy and chemotherapy,
    •No signs of infection
    •Adequate bone marrow function(detailed in protocol)
    •Adequate liver function (detailed in protocol)
    •Adequate renal function (In case of suspected compromised renal function, glomerular filtration should be measured by an isotope GFR method such as EDTA clearance or by creatinine clearance:detailed in protocol)

    Stratum 2:
    •Age > 1 year and <22 years at time of entry to study
    •Residual non reoperable measurable ependymoma based on central neuro-radiological review (detailed in protocol)
    •Histologically confirmed WHO Grade II-III ependymoma by central pathological review
    •No metastasis on spinal MRI and on CSF cytology assessments
    •No previous radiotherapy
    •No previous chemotherapy (except steroids)
    •No co-existent unrelated disease (e.g. renal, hematological) at the time of study entry
    •No medical contraindication to radiotherapy and chemotherapy,
    •No signs of infection
    •Adequate bone marrow function (detailed in protocol)
    •Adequate liver function (In case of suspected compromised renal function, glomerular filtration should be measured by an isotope GFR method such as EDTA clearance or by creatinine clearance:detailed in protocol)

    Stratum 3
    •Children younger than 12 months at time of entry to study or any children ineligible to receive radiotherapy due to age at diagnosis, tumour location or clinician/parent decision and according to national criteria and according to national criteria
    •Histologically confirmed WHO Grade II-III ependymoma by central pathological review
    •Adequate bone marrow function(detailed in protocol)
    •Adequate liver function (detailed in protocol)
    •Adequate renal function (In case of suspected compromised renal function, glomerular filtration should be measured by an isotope GFR method such as EDTA clearance or by creatinine clearance:detailed in protocol)
    •No previous chemotherapy
    •No previous radiotherapy
    •No contraindication to chemotherapy

    Patients that do not fulfill the inclusion criteria of one of the interventional strata will be enrolled and followed up into an observational study and descriptive analysis will be performed
    Programme global:
    •Résidant au sein de l’un des pays participant à l’étude
    • Agé de moins de 22 ans au moment du diagnostic
    • Nouvellement diagnostiqué avec un épendymome intracrânien ou spinal (quel que soit le grade mesuré selon la classification définie par l’OMS) incluant les variants : cellulaire, papillaire, myxopapillaire, à cellules claires, les épendymomes tanicityque ou anaplasique
    • Patient acceptant de faire don au centre national de référence d’anapathologie d’un bloc de tissus tumoraux fixés au formol et inclus dans la paraffine (au minimum 20 sections de 5µm sur lames chargées avec suffisamment de matériel interprétable et au moins dix curls de 10 µm en tube Eppendorf)
    • Consentement écrit du patient et/ou de ses parents ou tuteurs légaux pour la participation à l’étude proposée et acceptant de se conformer aux procédures du protocole ainsi qu’à la collection et aux transferts des données cliniques les concernant.
    • Consentement écrit du patient et/ou de ses parents ou tuteurs légaux pour la collection et le transfert des échantillons biologiques nécessaires à la confirmation de son diagnostic et à son suivi clinique
    • Affilié à un régime de sécurité social lorsque cela est requis dans le pays concerné

    Après chirurgie et staging, leses patients seront inclus dans l’une des trois strates interventionnelles de l’étude. Ces trois strates correspondent à trois stratégies thérapeutiques différentes proposées
    en fonction des résultats obtenus à l’issue de la chirurgie initiale (présence ou non de résidus tumoraux), de l’âge du patient ainsi que de son éligibilité à la radiothérapie.
    Les patients dont le diagnostic d'un ependymome intracranial est confirmé par le pathologiste referent et correspondant aux critère d'elligibilité ci-dessous pourront être inclus dans l'une des strates interventionnelles.

    Etudes interventionnelles :
    • Agé de moins de 22 ans au moment du diagnostic
    • Nouvellement diagnostiqué avec un épendymome de grade II et III selon la classification de l’OMS incluant les variants : cellulaire, papillaire, à cellules claires, les épendymomes tanicityque ou anaplasique
    • Femme en âge de procréer non enceinte ou allaitante (test de grossesse négatif à l’entrée dans l’étude).
    •Hommes ou femmes en âge de procréer et acceptant l’utilisation d’un moyen de contraception efficace tel que défini dans la section 4.1.2.4 du protocole (Définition of highly effective methods of contraception) pendant toute la durée du traitement et 6 mois après la fin de celui-ci.
    •Patient et/ou leurs parents ou tuteurs légaux acceptant de respecter le calendrier des visites, le plan de traitement, les analyses de laboratoires et les procédures de l’étude.
    • Pas de radiothérapie antérieure
    • Pas de chimiothérapie antérieure (sauf stéroïdes pour strates II et 3)
    • Pas de maladie coexistente non liée au moment de l’entrée dans l’étude
    • Pas de signe d’infection
    • Fonction médullaire satisfaisante (cf. protocole)
    • Fonction hépatique satisfaisante (cf. protocole)
    • Fonction rénale satisfaisante (cf. protocole)
    • Pas de contre-indication à la radiothérapie et la chimiothérapie

    Strate 1 :
    •Agé de 12 mois et plus au moment du diagnostic
    •Pas de résidus tumoraux mesurable d’après la revue centralisée neuroradiologique de l’étude (cf. protocole)
    • Absence de métastases d’après l’IRM spinal et l’analyse du LCR lors du staging.

    Strate 2 :
    • Agé de 12 mois et plus au moment de l’entrée dans l’étude
    • Présence de résidus mesurables et non opérables d’emblée d’après la revue centralisée neuroradiologique de l’étude. (cf. protocole)
    • Absence de métastases d’après l’IRM spinal et l’analyse du LCR lors du staging

    Strate 3:
    •Enfant de moins de 12 mois au moment de l’entrée dans l’étude ou non éligible à la radiothérapie de part l'âge de l'enfant au diagnostic, la localiation de la tumeur, l'opinion des parents et/ou du clinicien et selon les critères nationaux
    E.4Principal exclusion criteria
    All interventional stata
    •Tumour entity other than primary intracranial ependymoma
    •Primary diagnosis predating the opening of SIOP Ependymoma II
    •Patients with WHO grade I ependymoma including ependymoma variants: myxopapillary ependymomas and subependymomas
    •Patients with spinal cord location of the primary tumour
    •Participation within a different trial for treatment of ependymoma
    •Age ≥ 22 years
    •Contraindication to one of the IMP used in this stratum according to the SmPCs in appendix 4 of the protocol (SmPCs in appendixes are those from UK which were chosen for the assessment of the safety aspects of the study)
    •Concurrent treatment with any anti-tumour agents
    •Inability to tolerate chemotherapy
    •Unable to tolerate intravenous hydration
    •Pre-existing mucositis, peptic ulcer, inflammatory bowel disease, ascites, or pleural effusion
    •Pregnancy and breast feeding


    Stratum 1 and 2:
    •Ineligible to receive radiotherapy
    •Patient for whom imaging remains RX despite all effort to clarify the MRI conclusion
    •Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration, or may interfere with the interpretation of study results in the judgment of the Investigator


    Stratum 3:
    •Pre-existing severe hepatic (liver) and/or renal (kidney) damage
    Family history of severe epilepsy
    •Presence of previously undiagnosed mitochondrial disorder detected by screening as part of trial
    •Elevated blood ammonium level ≥ 1.5 x upper limit of the normal
    •Elevated Blood lactate level ≥ 1.5 x upper limit of the normal
    •Other severe acute or chronic medical or laboratory abnormality that may increase the risk associated with study participation or investigational product administration, or may interfere with the interpretation of study results in the judgment of the Investigator
    Programme global:
    •Tumeur autre qu’un épendymome
    •Diagnostic initial antérieur à la date d’ouverture de l’étude SIOP Ependymome II
    •Age ≥ 22 ans
    •Patients présentant une épendymome de type Subépendymome ou épendymoblastoma

    Etudes interventionnelles:
    •Tumeur d’une tout autre nature qu’un épendymome intracrânien
    •Date du diagnostic initial antérieure à la date d’ouverture de l’étude SIOP Ependymome II
    •Ependymome de grade I incluant les variants de types myxopapillaires et subépendymomes
    •Tumeur primaire située au niveau de la moelle épinière
    •Participant à un autre essai médicamenteux pour le traitement de l’épendymome
    • Agé ≥ 22 ans au moment de l’inclusion
    • Contre-indication à l’administration de l’un des IMP proposés (voir RCP en annexe 4 du protocole – ces RCPs sont celles sélectionnées pour l’évaluation de sécurité, soit celles du Royaume-Uni)
    • Sous quelque autre traitement pouvant concurrencer l’activité anti-tumorale des traitements à l’étude
    • Intolérance à la chimiothérapie
    • Intolérance à l’hydratation par voie intraveineuse
    •Mucosites, ulcère gastro-duodénal, maladie inflammatoire de l'intestin, ascite, ou épanchement pleural

    Strates 1 et 2 :
    •Enceinte ou allaitante
    •Non éligibles à la radiothérapie
    •Imagerie reste RX malgré tout effort pour clarifier la conclusion IRM (voir protocole section 8.2.4 Définitions de tumeur résiduelle)
    • Présentant tout autre condition médicale ou psychiatrique aiguës ou chronique sévère ou anomalie biologique pouvant augmenter le risque associé à sa participation à l'étude, à l'administration des traitements à l’étude, ou pouvant interférer avec l'interprétation des résultats de l'étude selon l’opinion de l'investigateur

    Strate 3:
    •Atteinte rénale et /ou hépatique sévère et pré-existante,
    • Antécédents familiaux d'épilepsie sévère
    • Présence de maladie mitochondriale non diagnostiquée auparavant et détectée lors du dépistage réalisé dans le cadre de l’essai
    •Taux d’ammonium sanguin ≥ 1,5 fois la limite supérieure du taux normal
    •Taux de lactate sanguin ≥ 1,5 fois la limite supérieure du taux normal
    • Présentant tout autre condition médicale ou chronique sévère ou anomalie biologique pouvant augmenter le risque associé à sa participation à l'étude, à l'administration des traitements à l’étude, ou pouvant interférer avec l'interprétation des résultats de l'étude selon l’opinion de l'investigateur
    E.5 End points
    E.5.1Primary end point(s)
    Overall program: Gross Total Resection (GTR) rate (Only descriptive statistics will be produced)

    Stratum 1 : Progression free survival from the date of randomisation to the date of event defined as progression or death due to any cause.

    Stratum 2: Number of chemotherapy responders. Objective response to chemotherapy is measured based on SIOP-E Neuro Imaging guidelines.

    Stratum 3: Progression free survival from the date of randomisation to the date of event defined as progression or death due to any cause.
    Programme Global: Taux de résection complète (analyse descriptive)
    Strate 1: Survie sans progression
    Strate 2: Taux de réponse objective
    Strate 3: Survie sans progression (SSP)

    E.5.1.1Timepoint(s) of evaluation of this end point
    Stratum 1:The final analysis of trial data will be performed after 3 years follow-up of the last included patient.

    Stratum 2: The first main analysis of trial data will take place 6 months after the final patient has been entered into the study, when response data from all patients will be available.

    Stratum 3: The first main analysis of trial data for primary outcome will take place 2.5 years after the final patient has been entered into the study.
    Strate 1: L'analyse final des données de ce cette strate sera réalisée après 3 ans de suivi du dernier patient inclus dans celle-ci

    Strate 2: La première analyse principale des données de cette strate sera réalisée 6 mois après l'inclusion du dernier patient dans cette strate (lorsque les données de réponse de tous les patients seront disponibles)

    Stratum 3: La première analyses principale des données de cette strate sera réalisée 2,5 ans après l'inclusion du dernier patient dans cette strate
    E.5.2Secondary end point(s)
    Overall program:
    Second look surgery rate (Only descriptive statistics will be produced)

    •Stratum 1:
    Overall survival measured from the date of randomisation to the date of death due to any cause.
    Quality of survival (QoS)
    Neuropsychological outcomes
    Neuroendocrine outcomes (Neuroendocrine late effects)
    Short and long term Safety: Adverse Events (CTCAE v4.03)

    •Stratum 2:
    Overall survival measured from the date of randomisation to the date of death due to any cause.
    Progression Free Survival from the date of randomisation to the date of event defined as progression or death due to any cause.
    Quality of survival (QoS)
    Neuropsychological outcomes
    Neuroendocrine outcomes (Neuroendocrine late effects)
    Short and long term safety of frontline chemotherapy: Adverse Events (CTCAE v4.03)

    Exploratory endpoint measure:
    Toxicity will be monitored in the subgroup receiving radiotherapy boost.
    Event Free survival for patients with boost of radiotherapy.


    •Stratum 3:
    Overall survival measured from the date of randomisation to the date of death due to any cause.
    Radiotherapy free survival rate
    Quality of survival (QoS)
    Neuropsychological outcomes
    Neuroendocrine outcomes (Neuroendocrine late effects)
    Short and long term Safety and Toxicity of frontline chemotherapy based on proportion of patients experiencing Toxicity grade 3 to 4 (Adverse Events (CTCAE v4.03)).

    Exploratory Endpoint measures (optional):
    Pharmacokinetic modelling will be carried out using Valproate pharmacokinetic parameters in conjunction with patient characteristics and clinical parameters in order to investigate the key factors involved in determining individual valproate drug exposures within the patient population.
    •Valproate pharmacodynamics will be followed throughout changes in histone H3 and H4 acetylation. Changes between baseline and time of steady state valproate will be correlated with valproate trough levels and clinical response.
    Programme Global:
    Taux de chirurgie de seconde intention (analyse descriptive)

    Etudes interventionnelles:
    Survie globale
    Qualité de survie
    Résultats neuropsychologiques
    Résultats neuroendocriniens (effets à long terme)
    Sécurité à court et long termes : évènements indésirables (CTCA v4.03) SSP (strate 2 uniquement)
    Survie sans radiothérapie (strate 3 uniquement)

    Mesures exploratoires :
    State 2: La toxicité sera suivie dans le sous-groupe de patients recevant une augmentation de dose de radiation après la radiothérapie conformationnelle. La survie sans événement des patients recevant une augmentation de radiation après la radiothérapie conformationnelle.

    Strate 3 (optionel):
    L’analyse des échantillons de sang collectés permettront de déterminer les paramètres pharmacocinétiques du valproate : Aire sous la courbe (AUC), Clairance, et demi-vie t ½), Concentration minimale de Valproate à l’état d’équilibre.
    La modélisation pharmacocinétique sera réalisée à l'aide de ces données et sera mise en relation avec les caractéristiques des patients et leurs données cliniques. Cette modélisation permettra d'étudier les facteurs clés impliqués par l’administration de Valproate au sein de la population cible.
    Cette étude permettra en outre de définir les concentrations optimales de Valproate et d’identifier les bio marqueurs prédictifs l'activité ou de la réponse au valproate.
    La pharmacodynamique du valproate sera suivie tout au long des variations du taux acétylation des histones H3 et H4. Les variations du taux d’acétylation entre l’administration du valproate et l’état d’équilibre du valproate seront corrélées avec concentrations de valproate et aux réponses cliniques observées.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Stratum 1:
    5 years after the last patient recruited has completed his treatment

    Stratum 2:
    5 years after the last patient recruited has completed his treatment

    Stratum 3:
    5 years after the last patient recruited has completed his treatment
    Strate 1: 5 ans après que le dernier patient inclus ait terminé son traitement

    Strate2: 5 ans après que le dernier patient inclus ait terminé son traitement

    Strate 3: 5 ans après que le dernier patient inclus ait terminé son traitement
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis Yes
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Quality of life, quality of survival neuropshychological and neuroendocrine morbidity.
    Qualité de vie, Qualité de survie, morbidité neurophsychologique et neuroendocrienne
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Stratum1:Observation/Stratum2:VEC alone/Stratum3:Standard alterned ±myelosuppressive chemotherapy
    E.8.2.4Number of treatment arms in the trial6
    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.8.4.1Number of sites anticipated in Member State concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA90
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.7Trial has a data monitoring committee Yes
    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
    LVLS
    Dernière visite du dernier patient inclus
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years12
    E.8.9.1In the Member State concerned months2
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years12
    E.8.9.2In all countries concerned by the trial months2
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    F.1.1Number of subjects for this age range: 480
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) Yes
    F.1.1.4.1Number of subjects for this age range: 92
    F.1.1.5Children (2-11years) Yes
    F.1.1.5.1Number of subjects for this age range: 271
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 92
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 25
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    Children under age of giving consent
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state20
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 480
    F.4.2.2In the whole clinical trial 480
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    After the end of the trial, best treatment plan will be decided by each investigator according to the state of health of the patient concerned.
    Après la fin de l'étude, la meilleure stratégie thérapeutqiue sera retenue selon l'opinion de chaque investigateur en fonction du statut clinique du patient concerné
    G. Investigator Networks to be involved in the Trial
    G.4 Investigator Network to be involved in the Trial: 1
    G.4.1Name of Organisation SFCE: Société française de lutte contre les cancers et les leucemies de l'Enfant et de l'adolescent
    G.4.3.4Network Country France
    G.4 Investigator Network to be involved in the Trial: 2
    G.4.1Name of Organisation AIEOP: Associazione Italiana Ematologia Oncologia
    G.4.3.4Network Country Italy
    G.4 Investigator Network to be involved in the Trial: 3
    G.4.1Name of Organisation CRCTU: Cancer Research Campaign Trials Unit
    G.4.3.4Network Country United Kingdom
    G.4 Investigator Network to be involved in the Trial: 4
    G.4.1Name of Organisation GPOH
    G.4.3.4Network Country Germany
    G.4 Investigator Network to be involved in the Trial: 5
    G.4.1Name of Organisation NOHPHO: Nordic society of paeditaric Haematology
    G.4.3.4Network Country Norway
    G.4 Investigator Network to be involved in the Trial: 6
    G.4.1Name of Organisation SKION
    G.4.3.4Network Country Netherlands
    G.4 Investigator Network to be involved in the Trial: 7
    G.4.1Name of Organisation DCOG
    G.4.3.4Network Country Germany
    G.4 Investigator Network to be involved in the Trial: 8
    G.4.1Name of Organisation SIOP: Société Internationale d'Oncologie Pediatrique
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2016-04-20
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-03-24
    P. End of Trial
    P.End of Trial StatusOngoing
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