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Modafinil in Treating Children With Memory and Attention Problems Caused by Cancer Treatment for a Brain Tumor

Phase 2
Completed
Conditions
Brain and Central Nervous System Tumors
Cognitive/Functional Effects
Fatigue
Neurotoxicity
Psychosocial Effects of Cancer and Its Treatment
Interventions
Other: placebo
Drug: modafinil
Registration Number
NCT01381718
Lead Sponsor
University of South Florida
Brief Summary

RATIONALE: Modafinil may help improve memory, attention, and fatigue caused by cancer treatment.

PURPOSE: This phase II randomized trial studies how well modafinil works in treating children with memory and attention problems caused by cancer treatment for a brain tumor.

Detailed Description

OBJECTIVES:

Primary

* Determine whether a 6-week drug trial of modafinil, compared to placebo, is associated with improvement in neurocognitive function as defined by direct assessment of attention in children with cognitive impairment after treatment for a primary brain tumor.

Secondary

* Determine whether modafinil, compared to placebo, is associated with improved executive function, as assessed using the BRIEF executive function and hippocampal learning and executive function tasks from the CogState battery. Determine whether modafinil, compared to placebo, is associated with improved attention, as assessed by the Conners' (3rd Edition) 3 Parent Rating Scale (CPRS-3) - Short Form.

* Determine whether modafinil, compared to placebo, is associated with reduced fatigue as assessed using the PedsQL Multidimensional Fatigue Scale.

* Evaluate the safety of modafinil in this population.

OUTLINE: This is a multicenter study. Participants are randomized to 1 of 2 treatment arms.

* Arm I: Participants receive modafinil orally (PO) once daily (QD) on days 1-42.

* Arm II: Participants receive placebo PO QD on days 1-42. Participants complete a semi-automated, computerized cognitive-testing system (CogState) designed to assess psychomotor, attention/vigilance, memory, and other components of executive function by presenting different tasks, each with its own set of rules, at baseline and after completion of study therapy. Participants also complete the PedsQL Multidimensional Fatigue Scale (Peds QL-MFS).

Parents or legal guardians complete the PedsQL-MFS, the Conners Parent Reported Scale (CPR-3), and the Behavior Rating Inventory of Executive Function (BRIEF) at baseline and after completion of study therapy.

Clinical and/or research staff administer the Systematic Assessment for Treatment Emergency Events (SAFTEE), a semi-structured interview designed to elicit adverse events, at baseline and periodically during study.

After completion of study therapy, participants are followed up for 30 days.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
112
Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm IIplaceboParticipants receive placebo PO QD on days 1-42.
Arm ImodafinilParticipants receive modafinil orally (PO) once daily (QD) on days 1-42.
Primary Outcome Measures
NameTimeMethod
Change in Age-Adjusted Scores at Week Six From Baseline in the Attention Task of the CogState BatteryBaseline and 6 weeks

CogState Battery. CogState is a semi-automated, computerized cognitive testing system that was developed as a rapid and accurate test of cognitive function specifically for repeated assessment that is sensitive to the effects of medication in children over the age of 5 years and in adults from different language, cultural and socio-economic backgrounds. The CogState tasks to assess processing speed, visual attention, working memory and executive function were used. The CogState battery was administered in the following order: Detection Task, Identification Task, One Card Learning Task, One Back Task, and lastly, the Modified Groton Maze Learning Task. It was administered at baseline and 6 weeks. A positive change from baseline is an improvement. There is not a minimum or maximum since the value is reported as a z-score, but with the mean = 0 and the SD = 1, the range should be between -3 and 3.

Secondary Outcome Measures
NameTimeMethod
Number of Reported Adverse Events (AEs)30 days post intervention

AEs gathered using SAFTEE (Systematic Assessment for Treatment Emergent Effects) and participant report on daily log.

Change in Working Memory Score at 6 Weeks From Baseline as Assessed on BRIEFBaseline and 6 weeks

Behavior Rating Inventory of Executive Function (BRIEF). The BRIEF is a behavior rating scale designed to assess executive functions in the home and school environments. The measure was selected to provide parent-reported outcomes of problems related to attention, memory and executive function that occur in everyday life. The instrument was utilized to measure the change in working memory, according to the parent's perspective only, from baseline to 6 weeks. Scores are linear transformations of raw scores into T scores (mean = 50, SD = 10); higher scores indicate greater difficulties. The baseline score was subtracted from the 6 week score. Positive change from baseline is an improvement. The total scale ranges from 0 to 172. A T score \>60 on the BRIEF working memory subscale indicates cognitive impairment.

Change in PedsQL Score at 6 Weeks From BaselineBaseline and 6 weeks

PedsQL is Pediatric Quality of Life Inventory Multi-dimensional Fatigue Scale. This scale is designed as a generic symptom-specific instrument to measure fatigue. Higher scores indicate fewer symptoms of fatigue. It was administered at baseline and 6 weeks. The score is the sum of the answers. The baseline score was subtracted from the 6 week score. A positive change indicates worsening. The scale total score range is from 0-72 for both the parent and patient reported instruments.

Trial Locations

Locations (60)

A. I. duPont Hospital for Children

🇺🇸

Wilmington, Delaware, United States

Connecticut Children's Medical Center

🇺🇸

Hartford, Connecticut, United States

Lucile Packard Children's Hospital Stanford University

🇺🇸

Palo Alto, California, United States

Joe DiMaggio Children's Hospital

🇺🇸

Hollywood, Florida, United States

Nemours Children's Clinic- Pensacola

🇺🇸

Pensacola, Florida, United States

Children's Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Lee Memorial Health System

🇺🇸

Fort Myers, Florida, United States

Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas

🇺🇸

Dallas, Texas, United States

Miller Children's Hospital

🇺🇸

Long Beach, California, United States

All Children's Hospital

🇺🇸

Saint Petersburg, Florida, United States

East Tennessee Children's Hospital

🇺🇸

Knoxville, Tennessee, United States

St. Jude Children's Research Hospital

🇺🇸

Memphis, Tennessee, United States

Hackensack University Medical Center

🇺🇸

Hackensack, New Jersey, United States

Children's Hospital Medical Center of Akron

🇺🇸

Akron, Ohio, United States

Driscoll Children's Hospital

🇺🇸

Corpus Christi, Texas, United States

St. Vincent Hospital

🇺🇸

Green Bay, Wisconsin, United States

SUNY Upstate Medical University

🇺🇸

Syracuse, New York, United States

Saint Louis University Cancer Center

🇺🇸

Saint Louis, Missouri, United States

Children's Hospital of The King's Daughters

🇺🇸

Norfolk, Virginia, United States

Riley Hospital for Children- Indiana University

🇺🇸

Indianapolis, Indiana, United States

Children's Hospital Boston

🇺🇸

Boston, Massachusetts, United States

Johns Hopkins University

🇺🇸

Baltimore, Maryland, United States

Rady Children's Hospital - San Diego

🇺🇸

San Diego, California, United States

Nevada Cancer Research Foundation

🇺🇸

Las Vegas, Nevada, United States

University of Texas Health Science Center at San Antonio

🇺🇸

San Antonio, Texas, United States

University of Mississippi

🇺🇸

Jackson, Mississippi, United States

University of Virginia

🇺🇸

Charlottesville, Virginia, United States

Dayton Children's Hospital

🇺🇸

Dayton, Ohio, United States

Children's Healthcare of Atlanta

🇺🇸

Atlanta, Georgia, United States

Children's Hospital Los Angeles

🇺🇸

Los Angeles, California, United States

Nemours Children's Clinic

🇺🇸

Jacksonville, Florida, United States

Children's National Medical Center

🇺🇸

Washington, District of Columbia, United States

Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center

🇺🇸

New York, New York, United States

Children's Hospital of Colorado; Saint Joseph Hospital

🇺🇸

Denver, Colorado, United States

CS Mott/University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Wayne State University

🇺🇸

Detroit, Michigan, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Wake Forest University Health Sciences

🇺🇸

Winston-Salem, North Carolina, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

Doernbecher Children's Hospital/ Oregoon Health Science University

🇺🇸

Portland, Oregon, United States

Vanderbilt Children's Hospital

🇺🇸

Nashville, Tennessee, United States

Midwest Children's Cancer Center

🇺🇸

Milwaukee, Wisconsin, United States

Tampa General Hospital

🇺🇸

Tampa, Florida, United States

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

SunCoast CCOP Research Base at the University of South Florida

🇺🇸

Tampa, Florida, United States

Saint Peter's University Hospital

🇺🇸

New Brunswick, New Jersey, United States

St. Luke's Mountain States Tumor Institute

🇺🇸

Boise, Idaho, United States

University of Illinois at Chicago

🇺🇸

Chicago, Illinois, United States

Children's Hospitals and Clinics of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

New York University Langone Medical Center

🇺🇸

New York, New York, United States

St. Christopher's Hospital for Children

🇺🇸

Philadelphia, Pennsylvania, United States

Saint Louis University / Cardinal Glennon Children's Medical Center

🇺🇸

Saint Louis, Missouri, United States

Children's Hospital of Pittsburgh of UPMC

🇺🇸

Pittsburgh, Pennsylvania, United States

Nemours Children's Hospital

🇺🇸

Orlando, Florida, United States

Kosair Children's Hospital

🇺🇸

Louisville, Kentucky, United States

Children's Mercy Hospital and Clinics

🇺🇸

Kansas City, Missouri, United States

University of Florida

🇺🇸

Gainesville, Florida, United States

Kapiolani Medical Center for Women and Children

🇺🇸

Honolulu, Hawaii, United States

University of New Mexico

🇺🇸

Albuquerque, New Mexico, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

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