Phase II Study of Combined Chemotherapy With Arsenic Trioxide in Stage 4/M Neuroblastoma

Phase 2

Active, not recruiting

Brief Summary: This clinical trial aims to explore and evaluate the efficacy and safety of combined chemotherapy with arsenic trioxide for stage 4/M neuroblastoma.

Detailed Description: This study is a prospective, single-arm, open-lable, multi-center clinical trial. Children≤ 14 years old are eligible for this study if they were newly diagnosed with neuroblastoma and assessed as stage 4 according to the International Neuroblastoma Staging System (INSS) or stage M according to the International Neuroblastoma Risk Group (INRG) respectively. Patients enrolled in this study will receive combined induction chemotherapy with arsenic trioxide following an modifed protocol based on N7 and NB2004 protocols. Objective response rate (ORR) at 4 weeks after completing induction chemotherapy was defined as the main outcome and adverse events were monitored and graded in the meantime.

Recruitment & Eligibility

Inclusion Criteria

Untreated Stage 4/M neuroblastoma patients according to the International Neuroblastoma Staging System（INSS) or the International Neuroblastoma Risk Group (INRG) staging system;
Patients not more than 14 years old;
There are measurable lesions;
Guardians agreed and signed informed consent.

Exclusion Criteria

Patients who had suffered from other tumors and received chemotherapy or abdominal radiotherapy.
Patients with one or more critical organs failure such as heart, brain, kidney failure.

Arm && Interventions

Group	Intervention	Description
ATO-combined chemotherapy	Arsenic Trioxide	Patients receive combined induction chemotherapy with arsenic trioxide.

Primary Outcome Measures

Name	Time	Method
Objective Response Rate	Four weeks after ATO-combined induction chemotherapy	The percentage of patients who had complete remission（CR）or partial remission（PR）after induction chemotherapy combined ATO. Per Response Evaluation Criteria In Solid Tumors Criteria (WHO criteria) for target lesions and assessed by MRI or CT: CR: All lesions completely disappear, maintained for at least 4 weeks. PR: Estimated tumor size reduction by more than 50%, maintained for at least 4 weeks.

Secondary Outcome Measures

Name	Time	Method
Overall Survival Rate	3 years.	The proportion of patients who are alive from the date of randomization to 3 years, regardless of the cause of death.
Progression Free Survival Rate	3 years.	The proportion of patients who have not experienced progression or death from any cause, whichever occurs first, within a maximum of 3 years from the date of enrollment. Treatment response was evaluated according to the WHO criteria for the efficacy of solid tumours, which was classified as complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). PD was characterized as more than 25% increase in one or more lesions or appearance of new lesions.
Number of Participants With Adverse Events	From date of ATO-combined chemotherapy until the date of first documented adverse event, and follow up for 3 years.	Adverse events are monitored and graded by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE)