COG APPROVED & ACTIVE PROTOCOLS

 

 

LEUKEMIA

 

AALL02P2                              Treatment of Late Isolated Extramedullary Relapse from Acute

                                                Lymphoblastic Leukemia (ALL) (Initial CR1 > 18 months)

                                                            Eligibility: Ages > 18 months and < 30 years of age at

                                                                                     relapse

                                                                              Diagnosis of ALL (either B-precursor or T-

                                                                                                                Lineage) in first BM remission with first

                                                                                                                isolated CNS and/or testicular relapse

                                                                                                      Length of initial complete remission must be

                                                                                                           >18 months from the time of initial diagnosis

                                                                                                      Total anthracycline dosage must be <360mg/m2

                                                                                                      Must be enrolled on AALL03B1 banking study

 

AALL0232                              High Risk B-Precursor Acute Lymphoblastic Leukemia

                                                            Eligibility:  Ages 1 – 30 years of age, inclusive

                                                                               Newly diagnosed B-precursor ALL

                                                                                                       WBC Criteria:

                                                                                                                                Age 1.00-9.999: WBC >50,000

                                                                                                                                Age 10.00-30.999: any WBC

                                                                                                                                Prior Steroid therapy: any WBC

                                                                                                                                Testicular disease:  any WBC

                                                                                                       No prior systemic chemotherapy except steroids and IT cytarabine

                                                                                                        Must be enrolled on AALL03B1 banking study

 

AALL03B1                              Classification of Acute Lymphoblastic Leukemia

                                                            Eligibility:  Age < 31 years of age

                                                                        Newly diagnosed acute leukemia suspected to be

                                                                                                ALL: > 25% blasts on a bone marrow aspirate or

                                                                                                pathologic diagnosis on a bone marrow biopsy or

                                                                                                complete blood count documenting the presence of

                                                                                                at least 10,000 WBC and at least 25% circulating

                                                                                                blasts.

                                                                                                Samples must be provided to the reference and/or

                                                                                                                COG-approved cytogenetics lab (Genzyme

               Genetics is an approved lab)

                                                                                                If blast morphology is obviously myeloid, or whose

                                                                                                blasts are myeloperoxidase positive should not be

                                                                                                enrolled.      

AALL0331                              Standard Risk B-Precursor Acute Lymphoblastic Leukemia
                                                            Eligibility: Age between 1 year and < 10 years
                                                            Initial WBC count < 50,000; newly diagnosed B-precursor ALL;
                                                                                No overt testicular disease

AALL0433                              Intensive Treatment for Intermediate-Risk Relapse of Childhood
                                                B-precursor Acute Lymphoblastic Leukemia (ALL):  A Randomized Trial of Vincristine Strategies
                                                            Eligibility: Age < 30 years of age
                                                            Initial intermediate – risk relapse of B-precursor ALL
                                                            Intermediate-risk relapse is defined as:

  • Bone marrow relapse > 36 months from initial diagnosis or
  • Combined bone marrow & extramedullary (CNS and/or testicular) relapse > 36 months from initial diagnosis or
  • Isolated extramedullary (CNS and/or testicular) relapse < 18 months from initial diagnosis

 

 

AALL0434                              Intensified Methotrexate, Nelarabine (Compound 506U78; IND #52611) and Augmented BFM Therapy for Children and Young Adults with Newly Diagnosed T-cell Acute Lymphoblastic Leukemia

                                                            Eligibility: Age < 30 years of age

                                                            Must be enrolled on AALL03B1

                                                            Newly diagnosed T-cell ALL

ADVL04P2                             A Feasibility Pilot and Phase 2 Study of Chemoimmunotherapy with Epratuzumab for ;                                               Children with Relapsed CD22-Positive Acute Lymphoblastic Leukemia
                                                            Eligibility: Age > 2 and < 31 years of age
                                                            Must have immunophenotypic confirmation of CD22 expression
                                                                                (> 25% expression) 

AAML0531                             A Phase III Randomized Trial of Gemtuzumab Ozogamicin (Mylotarg) Combine with Conventional Chemotherapy for De Novo Acute Myeloid Leukemia (AML) in Children, Adolescents and Young Adults.   

                                                                        Eligibility:  Age < 30 years of age

                                                                        Untreated primary AML, who meet the criteria for

                                                                                                AML with > 20% bone marrow blasts;

                                                                                                If bone marrow aspirate or biopsy is clinically

                                                                                                                prohibitive, peripheral blood with an excess

                                                                                                                of 20% blasts and in which adequate flow

                                                                                                                cytometric and cytogenetics/FISH testing is

                                                                                                                feasible, can be substituted for the marrow

                                                                                                                exam

                                                                                                Patients with cytopenias and bone marrow blasts

                                                                                                who do not meet the customary criteria for the

                                                                                                diagnosis of AML are eligible if they have a

                                                                                                karyotypic abnormality characteristic of de novo

                                                                                                AML (t(8;21)(q22;q22), inv(16)(p13;q22) or 11q23

                                                                                                abnormalities or they have the unequivocal presence

                                                                                                of megakaryoblasts, as set out in the WHO Myeloid

                                                                                                Neoplasm classification

                                                                                                Patients with isolated myeloid sarcoma

                                                                                                (myeloblastoma; chloroma) are eligible.  

AAML0431                             The Treatment of Down Syndrome Children with Acute Myeloid
                                                Leukemia (AML) and Myelodysplastic Syndrome (MDS) Under the Age of 4 years
                                                            Eligibility: Age < 4 years
                                                            Confirmed diagnosis of Down Syndrome (DS) or DS mosaicism;
                                                             Newly diagnosed AML or MDS with <30% blasts; no prior treatment 

AALL05B1                              A Children’s Oncology Group Protocol for Collecting and Banking Relapsed Acute Lymphoblastic Leukemia Research Specimens

                                                                        Eligibility: Age- Must have been < 31 years of

                                                                                    age at the time of initial diagnosis

                                                                        Patient has ALL at first or subsequent marrow

                                                                                                relapse with > 25% blasts in the bone marrow

                                                                                                and/or peripheral blood.

                                                                                                No treatment for the relapse with exception of IT

                                                                                                therapy.  

                                                                                                Adequate bone marrow or peripheral blood

                                                                                                specimens must be sent.

 

LYMPHOMA

 

AHOD0031                             A Phase III Study of Dose-Intensive, Response Based

Chemotherapy and Radiation Therapy for Children and Adolescents with Newly Diagnosed Intermediate Risk Hodgkin

Disease

                        Eligibility:  Ages 0-21 years inclusive

                        Newly Diagnosed, pathologic confirmed Hodgkin

                                Disease who meet the follow clinical stages:

                                                All Stage IB

                                                All Stage IIB

                                                Stage IA only with bulk disease

                                                Stage II A only with bulk disease

                                                All Stage IAE, IIAE

                                                All Stage IIIA, IIIAE, IIIAS, IIIAE+S

                                                All Stge IVA, IVAE

 

 

 

AHOD03P1                             Treatment of Children with Newly – Diagnosed Low Stage

                                                Lymphocyte Predominant Hodgkin Disease (LPHD)

                                                            Eligibility:  Age 0-21 years inclusive

                                                                                Newly-diagnosed, untreated, biopsy proven lymphocyte

                                                                                                predominant Hodgkin disease          

                                                                                Clinical Stages:

                                                                                                IA without bulk disease

                                                                                                II A without bulk disease

                                                                                No previous chemo or radiation, No systemic

                                                                                 Corticosteroids  within 30 days

 

AHOD0431                             A Phase III Study for the Treatment of Children and Adolescents with Newly Diagnosed Low-Risk Hodgkin Disease

                                                            Eligibility:  Ages 0-21 years inclusive

                                                            Newly diagnosed, histologically confirmed Hodgkin

                                                                                Disease who meet the following criteria:

·         Stage IA, without bulk disease

·         Stage II A, without bulk disease

·         No lymphocyte predominance histology

No prior chemotherapy or radiation therapy

 

AHOD0521                             A Phase II Study of Bortezomib (Velcade, PS-341, IND #58443)
                                                In Combination with Ifosfamide/Vinorelbine in Pediatric Patients
                                                And Young Adults with Refractory/Recurrent Hodgkin Disease
                                                            Eligibility: Age < 30 years
                                                            All patients with HD with either primary refractory or disease in first                                                                                        relapse
                                                                                Histologic verification of Hodgkin disease at the time of relapse or
                                                                                progression of disease.
                                                                                Must have measurable disease

AHOD04B1                            Hodgkin Disease Banking Study
                                                            Eligibility:  Ages 0-21 years inclusive
                                                                                Newly diagnosed or recurrent hodgkin disease
                                                                                Samples needed are: tumor tissue, serum and peripheral blood

 

ANHL0131                             A Phase III Study of Treatment of Advanced Stage Anaplastic Large Cell Lymphoma (ALCL) with Standard APO (Doxorubicin, Prednisone, Vincristine) versus Consolidation with a Regimen Including Vinblastine

                                                            Eligibility: Age < 21 years

                                                            Newly diagnosed with CD30 positive anaplastic large

                                                                                                cell lymphoma, Murphy stage III and IV

                                                                                Slides must be sent for central review

   

ANHL0221                             A Phase II Study of the Combination of Cyclophosphamide, Prednisone and Rituximab (CPR) in Children, Adolescents, and Young Adults with CD20 Positive Post-Transplant Lymphoproliferative Disease (PTLD) following Solid Organ Transplantation (SQT)

                                                            Eligibility:  Age < 31 years

                                                            Must have had solid organ transplantation

                                                                                Criteria in Non-Fulminant (NF) PTLD (NF_PTLD)

                                                                                                PTLD histologic diagnosis

                                                                                                CD20 positivity

                                                                                                EBV positivitity-EBERs in-situ hybridization

                                                                                                (preferred) &/or LMP immunoperoxidase

                                                                                                staining

                                                                                Criteria in Fulminant (F)-PTLD (F_PTLD) patients

                                                                                                PTLD histologic diagnosis

                                                                                                CD20 positivity

                                                                                                EBV positivitity-EBERs in-situ hybridization

                                                                                                (preferred) &/or LMP immunoperoxidase

                                                                                                staining

 

NEUROBLASTOMA

 

ANBLOOB1                           Neuroblastoma Biology Studies

                                                            Eligibility:  No age restriction

                                                                                Newly diagnosed neuroblastoma, ganglioneuroblastoma

                                                                                                Or ganglioneuroma (maturing subtype)

                                                                                Must be enrolled within 2 weeks of diagnosis and the INSS

                                                                                                stage must be know before enrollment.

ANBL0032                              Phase III Randomized Study of Chimeric Antibody 14.18 in High
                                                Risk Neuroblastoma Following Myeloablative Therapy and Autologous Stem Cell Rescue
                                                           Eligibility: Age < 31
                                                               Diagnosed with Neuroblastoma and categorized as high risk; Must have
                                                               achieved CR, VGPR or PR following frontline therapy prior to ASCT
                                                               evaluation.

ANBL00P2                             Perinatal Neuroblastoma, Expectant Observation
                                                            Eligibility:  Age < 6 months
                                                            Disease must be limited to the adrenal gland; no prior treatment

 

RHABDOMYOSARCOMA

                                               

ARST0321                              A Phase II Study of Sulindec and Tamoxifen in Patients with

                                                Desmoid Tumors That are Recurrent or Not Amenable to

                                                Standard Therapy

                                                            Eligibility:  Must have been < 18 years of age when

                                                                        originally diagnosed

                                                                                Must have biopsy proven desmoid tumor, patients with

                                                                                Lipofibromatosis or desmoplastic fibroma of bone (both

                                                                                    thought to be synonymous with DT)

                                                                                Patients with newly diagnosed DT are eligible if (a) they

                                                                                have had no prior therapy and (b) they have disease for

                                                                                which complete surgical resection and/or radiation

                                                                                therapy is not thought to be feasible.

                                                                                Patients with recurrent DT are eligible if (a) they have

                                                                                radiographically documented recurrent or progressive

                                                                                disease, (b) prior anti-tumor therapy has not included

                                                                                treatment with non-steroidal anti-inflammatory or

                                                                                estrogen antagonists and (c) they have had no chemotherapy or RT for the present recurrence

                                                                                Must have measurable disease.

 

ARST0331                              Vincristine, Dactinomycin and Lower Doses of Cyclophosphamide

                                                With or Without Radiation Therapy for Patients with Newly

Diagnosed Low-Risk Embryonal/Botryoid/Spindle Cell

Rhabdomyosarcoma

            Eligibility: Age must be < 50 years                             

                Newly diagnosed with embryonal rhabdomyosarcoma (RMS), botryoid or spindle cell
variants of embryonal

                RMS or embryonal ectomesenchymoma.

                Must be enrolled on D9902

ARST0332                              Risk Based Treatment for Pediatric Non-Rhabdomyosarcoma Soft
                                                Tissue Sarcoma (NRSTS)
                                                            Eligibility: Age < 30 years
                                                            Newly diagnosed non-rhabdomyosarcoma soft tissue sarcoma
                                                            Must be enrolled on D9902 for central review and confirmation of                                                             diagnosis  

ARST0531                              Randomized Study of Vincristine, Dactinomycin and

                                                Cyclophosphamide (VAC) versus VAC alternating with

                                                Vincristine and Irinotecan (VI) for Patients with Intermediate-

                                                Risk Rhabdomyosarcoma

                                                            Eligibility:  Age < 50 years

                                                            Must be enrolled on D9902

                                                            Must have Intermediate – risk RMS defined as:

·         Embryonal, botryoid, or spindle cell RMS, or ectomesenchymoma: Stage 2 or 2 and Group III or

·         Alveolar RMS: Stage 1-3 and Group I-III

No prior chemotheraoy or radiation unless tranferring from ARST0331 (low risk study)

 

ARST0431                              Intensive Multi-Agent Therapy, Including Dose-Compressed

                                                Cycles of Ifosfamide/Etoposide (IE) and Vincristine/Doxorubicin/

                                                Cyclophosphamide (VDC) for Patients with High-Risk

                                                 Rhabdomyosarcoma

                                                            Eligibility: Age < 50 years

                                                                                Newly diagnosed, biopsy proven metastatic

                                                                                                rhabdomyosarcoma or ectomesenchymoma

                                                                                                (Stage IV, Clinical Group IV)

                                                                                Prior enrollment on D9902 to confirm local histologic

                                                                                                Diagnosis

                                                                                No prior chemotherapy or radiotherapy.

 

D9902                                     A COG Protocol for Collecting and Banking Soft Tissue

Specimens

            Eligibility: Age < 50 years

                Must have diagnosis of Rhabdomyosarcoma (RMS) or

                Non-rhabdomyosarcoma soft tissue sarcoma (NRSTS,

                                Including chordoma, desmoid fibromatosis,

                                desmoplastic round cell tumors, malignant

                                rhabdoid tumors and undifferentiated embryonal

                                sarcoma of the liver.

                Tissue must be sent for central pathologic review

 

GERM CELL TUMORS

 

AGCT0132                              A Phase III Study of Reduced Therapy in the Treatment of

Children with Low and Intermediate Risk Extracranial Germ

Cell Tumors

            Eligibility: Age < 21 except patients with testicular

                        primary tumors must be < 15 years of age.

            Primary extracranial germ cell tumors which are

                histologically verified to by yolk sac (EST) tumor,

                embryonal carcinoma, choriocarcinoma or a mixed

                germ cell tumor which may be immature, mature

                teratoma, dysgerminoma, or seminoma mixed with one

                of the previously mentioned tumors.

 

 

EWINGS/OSTEOSARCOMA

 

AEWS0331                             European Ewing Tumor Working Initiative of National Groups

                                                Ewing Tumor Studies

                                                            Eligibility: Age <50 years of age

                                                                                Isolated pulmonary or pleural metastases at the initial

                                                                                                diagnosis of Ewing Sarcoma

                                                                                No previous chemotherapy

 

AEWS02P1                             A Pilot Study of Low-Dose Antiangiogenic Chemotherapy in

Combination with standard Multiagent Chemotherapy for

Patients with Newly-Diagnosed Metastatic Ewing Sarcoma Family of Tumors

            Eligibility: Age < 50 years of age.

                Newly diagnosed metastatic Ewing Sarcoma family of

                                tumors of the bone or soft tissues, excluding

                                the central nervous system. Paraspinal tumors

                                of extra-dural origin and Askin’s tumor of the

                                chest wall are eligible.

                No prior treatment.

 

AEWSO2B1                            A Groupwide Biology and Banking Study for Ewing Sarcoma

                                                            Eligibility:  No age restriction

                                                                                Specimen submission required.

 

AEWS0621                             Phase II Trial of Intermediate-Dose Cytarabine to Modulate
                                                EWS/FLI for Children and Young Adults with Recurrent or
                                                Refractory Ewing Sarcoma
                                                Eligibility: Age < 30
                                                Diagnosis of Ewing sarcoma or PNET
Must have at least one site of measurable disease involving lung or soft tissue

 

 

AOST0221                              A Phase II Study of Aerosolized GM-CSF (NSC#613795,

IND#11042) in Osteosarcoma Patients with First Pulmonary

Recurrence of Osteosarcoma   

            Eligibility:  Age < 39 years of age

                Histologic verification of osteosarcoma at original dx.

                Must have resectable pulmonary nodule(s), First

                                recurrence of osteosarcoma.

                No other metastatic sites.

                Must have only received one prior treatment regimen.

           

AOST0331                              A Randomized Trial of the European and American Osteosarcoma

                                                Study Group to Optimize Treatment Strategies for Resectable

                                                Osteosarcoma Based on Histological Response to Pre-operative

                                                Chemotherapy – A Phase III Intergroup Study

                                                            Eligibility: Age > 5 and < 40 years of age

                                                            Must have high grade osteosarcoma.  This includes second

                                                                                Malignancies.  Rapid central review of diagnostic biopsy materials is

                                                                                Required.  Site of the primary tumor must be in:

·         Long bone of upper limb, scapula

·         Short bone of upper limb

·         Long bone of lower limb

·         Short bone of lower limb

·         Vertebral column

·         Ribs, sternum, clavicle

·         Pelvic bones, sacrum, coccyx

Craniofacial osteosarcom is NOT included

All tumor (primary, metastatic, or both) is resectable or is expected to

Become resectable after the intital chemotherapy

No previous treatment for osteosarcoma or previous chemotherapy for any disease. 
Previous radiotherapy for a prior cancer (other than osteosarcoma) is permitted

 

P9851                                      Osteosarcoma Biology Protocol:  Companion to Group-Wide

                                                Therapeutic Studies

                                                            Eligibility: No age restriction

                                                                                Specimen submission required.

 

CENTRAL NERVOUS SYSTEM

 

ACNS0121                             A Phase II Trial of Conformal RT for Pediatric Patients with

                                                Localized Ependymoma, Chemotherapy Prior to Second Surgery

                                                For Incompletely Resected Ependymoma and Observation for

                                                Completely Resected, Differentiated, Supratentorial Ependymoma

                                                            Eligibility:  Age > 12 months and < 21 years og age

                                                                                Must be enrolled within 56 days of initial surgical resection

                                                                                Histologically confirmed intracranial ependymoma.

Patients with differentiated ependymoma or anaplastic

ependymoma are eligible.

Ineligible tumors:  primary spinal cord ependymoma,

myxopapillary ependymoma, subependymoma,

ependymoblastoma or mixed gliomas.

 

ACNS0122                             A Phase II Study to Assess the Ability of Neoadjuvant

Chemotherapy +/- Second Look Surgery to Eliminate All

Measurable Disease Prior to Radiotherapy for NGGCT

            Eligibility:  Age < 25 years of age.

            Eligible Histological Diagnosis:

Endodermal sinus tumor

Embryonal carcinoma

Choriocarcinoma

Immature teratoma and teratoma with

malignant transformation

Mixed germ cell tumor

                                                                                Any Histologically confirmed germinoma tumor with

                                                                                                elevation of serum and/or CSF beta HCG>50 IU/dl

                                                                                                or any elevation of serum and/or CSF alpha

fetoprotein >10 IU/L

                                                                                Histologically unconfirmed pineal and/or suprasellar

                                                                                                tumors with serum and/or CSF tumor markers

                                                                                                of beta HCG > 50IU/dl or any elevation of

                                                                                                alpha fetoprotein > 10 IU/l

 

ACNS0331                             A Study Evaluating Limited Target Volume Boost Irradiation and

                                                Reduced Craniospinal Radiotherapy 18.00 Gy and Chemotherapy

                                                In Children with Newly Diagnosed Standard Risk

Medulloblastoma: A Phase III Double Randomized Trial

            Eligibility: Age < 22 years of age.

                Posterior fossa medulloblastoma with presence of minimal

                                volume, non-disseminated disease.  Patients with

                                brain stem involvement are eligible.

                No prior treatment.

 

 

ACNS0221                             A Phase II Study of Conformal Radiotherapy in Patients with
                                                Low-Grade Gliomas
                                                            Eligibility: Age > 3 and < 21 years of age
                                                            Histological Diagnosis of : juvenile pilocytic astrocytoma (JPA); pleomorphic JPA;                                                            diffuse astrocytoma (fibrillary,
                                                           Gemistocytic, giant cell or pleomorphic astrocytoma); low-
                                                           grade oligoastrocytoma; low-grade oligodendroglioma; or
                                                           low-grade glioma NOS 

 

ACNS02B3                             A Children Oncology Group Protocol for Collecting and Banking

                                                Pediatric Brain Tumor specimens

                                                            Eligibility: No age restriction

                                                                                Specimen submission required.

 

RENAL TUMORS

 

AREN03B2                             Renal Tumor Classification, Biology and Banking Study

                                                            Eligibility:  Age < 30 years old at time of dx

                                                                                Tumors of the following histologic types:

                                                                                                Nephroblastic Tumors including

                                                                                                                Nephroblastoma (Wilms Tumor)

                                                                                                                    Favorable histology

                                                                                                                     Anaplasia (Diffuse, Focal)

                                                                                                                Nephrogenic rests and nephroblastomatosis

                                                                                                                Cystic Nephroma and Cystic Partially

                                                                                                                Differentiated Nephroblastoma

                                                                                                                Metanephric Tumors

                                                                                                                     Metanephric Adenoma

                                                                                                                     Metanephric Adenofibroma

                                                                                                                     Metanephric Stromal Tumor

                                                                                                Mesoblastic Nephroma

                                                                                                                Cellular, Classic, Mixed

                                                                                                Clear Cell Sarcoma

                                                                                                Rhabdoid Tumor – any malignant rhabdoid tumor

                                                                                                                occurring outside the CNS

                                                                                                Renal epitheloid tumors of childhood:

                                                                                                                Papillary renal cell carcinoma

                                                                                                                Renal medullary carcinoma

                                                                                                                Renal tumors with Xp11.2 translocations

                                                                                                                Oncocytic renal neoplasms following

 Neuroblastoma

                                                                                                Angiolipoma

                                                                                                Ossifying renal tumor of infancy

                                                                                Specimens and copies of imaging studies must be

 Submitted within 10 days of diagnostic procedure

 

AREN0321                              Treatment of High Risk Renal Tumors

                                                            Eligibility:  Age must be < 30 years old at diagnosis

                                                                                Newly diagnosed with one of the following histological

Types:                                                   

·         Focal Anaplastic Wilms Tumor

·         Diffuse Anaplastic Wilms Tumor

·         Clear Cell Sarcoma of Kidney

·         Malignant Rhabdoid Tumor (renal or extra renal)

·         Renal Cell carcinoma

(clear cell, papillary, renal medullary, oncocytoid,

sarcomatoid, chromophobe, collecting duct, carcinoma associated with
neuroblastoma, renal cell carcinoma unclassified)

                                                                                Must be enrolled on AREN03B2

 

 

AREN0532                              Treatment for Very Low, Low and Standard Risk Favorable

                                                Histology Wilms Tumor

                                                            Eligibility: Age must be < 30 years

                                                                                Newly diagnosed Stage I-III favorable histology Wilms

                                                                                                Tumor, confirmed by central pathology and

                                                                                                radiology review.

                                                                                Must be enrolled on AREN03B2

AREN0533                              Treatment of Newly Diagnosed Higher Risk Favorable
                                                Histology Wilms Tumor
                                                            Eligibility: Age must be < 30 years
                                                            Newly diagnosed Stage IV favorable histology Wilms Tumor
                                                                                                with or without LOH 1p and 16q or
                                                                                Newly diagn