Combination Chemotherapy Followed by Surgery in Treating Infants With Newly Diagnosed Neuroblastoma
European Infant Neuroblastoma Study - Stage 4 With Bone, Lung, Pleura or CNS Involvement; MYCN Not Amplified
  • Phase

    Phase 2
  • Study Type

  • Status

    Completed No Results Posted
  • Study Participants

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug, and giving them before surgery, may shrink the tumor so that it can be removed during surgery.

PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy followed by surgery in treating infants who have newly diagnosed neuroblastoma.

Confirm that the management of infants with newly diagnosed stage IV neuroblastoma without MYCN amplification treated with etoposide and carboplatin and cyclophosphamide, doxorubicin, and vincristine followed by surgery does not require intensive high-dose chemotherapy consolidation.
Determine whether deletion of chromosome 1p or diploidy/tetraploidy are prognostic factors in these patients.
Determine whether there are other prognostic criteria that could be used in future therapeutic stratification of these patients.

OUTLINE: This is a multicenter study.

Patients receive VP-CARBO chemotherapy comprising etoposide IV over 2 hours and carboplatin IV over 1 hour on days 1-3. Treatment repeats every 21 days for 2 courses.

Patients without disease progression receive 2 additional courses of VP-CARBO chemotherapy. Patients with metastatic complete response (CR) undergo surgical resection of primary disease.

Patients with disease progression after 2 or 4 courses of VP-CARBO chemotherapy receive CADO chemotherapy comprising cyclophosphamide IV over 1 hour on days 1-5, doxorubicin IV over 6 hours on days 4 and 5, and vincristine IV on days 1 and 5. Treatment repeats every 21 days for 2 courses.

After 2 courses of CADO chemotherapy, patients with metastatic CR undergo surgical resection of primary disease. Patients with residual disease receive 2 additional courses of CADO chemotherapy. Patients with residual disease after 4 courses of CADO chemotherapy are removed from the study. Patients with metastatic CR after additional CADO chemotherapy undergo surgical resection of primary disease.

Patients are followed within 6 months and then annually for 5 years.

PROJECTED ACCRUAL: A total of 60 patients will be accrued for this study within 4 years.
Study Started
Jul 31
Study Completion
Mar 31
Last Update
Sep 17

Drug carboplatin

Drug cyclophosphamide

Drug doxorubicin hydrochloride

Drug etoposide

Drug vincristine sulfate

Procedure conventional surgery



Histologically confirmed newly diagnosed stage IV neuroblastoma or ganglioneuroblastoma

Metastases to bone, CNS, or pleura/lung by x-ray or CT scan
No MYCN amplification (i.e., fewer than 10 copies)



Under 12 months at diagnosis

Performance status:

Not specified

Life expectancy:

Not specified


Not specified


Not specified


Not specified


Biologic therapy

Not specified


Not specified

Endocrine therapy

Not specified


Not specified


Not specified
No Results Posted