NCT07466316ClinicalTrials.gov
A Study Comparing Higher Dose Chemotherapy Over a Shorter Amount of Time to Lower Dose Chemotherapy Plus Maintenance Over a Longer Amount of Time in Patients With Newly Diagnosed Intermediate-Risk Rhabdomyosarcoma (IR RMS)
A Randomized Phase 3 Study to Compare VAC (Higher Cyclophosphamide Dose and Intensity) Versus VAC/VI (Lower Cyclophosphamide Dose and Intensity) Plus Maintenance Therapy in Patients With Newly Diagnosed Intermediate-Risk Rhabdomyosarcoma
In brief
This phase III trial compares higher dose chemotherapy, with vincristine, dactinomycin and cyclophosphamide, over a shorter amount of time to lower dose chemotherapy plus maintenance, with vincristine, dactinomycin, cyclophosphamide, irinotecan and vinorelbine, over a longer amount of time, along with…
Phase 3342 participants sought87 sites2 countries
Categories
Registered in 1 registry
- ClinicalTrials.govNCT07466316Open this record at ClinicalTrials.govSynced 4 weeks ago
One study can be registered in several registries. We show it once and link every record we hold.
Trial information is shown as published by the registry, in its original language.
Interested in this study?
Sign in or create an account to register your interest and follow this study.
How this study is set up
The points below are drawn from the public registry record for this study. Each one cites the field or sentence it came from. A dash (—) means the record does not state something — not that it is missing or wrong. Many well-run studies, especially small ones, leave some of these blank.
- Present: Registered before enrolment beganFirst posted 2026-03-12; recorded start 2026-07-14
- Present: Has a defined primary outcomeA primary outcome measure is listed in the record
- Present: The primary outcome states a time frameThe primary outcome measure records a time frame
- Present: Participants are randomly assignedAllocation is recorded as randomised
- Present: Has a comparison groupThe record lists a placebo or comparator arm, or more than one study arm
- Not stated: Open label (no blinding)Masking is recorded as none (open label)
- Not stated: An ethics committee is not stated in the registry recordThis registry's ingested record has no ethics-committee field
- Not stated: Regulatory oversight (such as an IND or IDE) is not stated in the registry recordThis registry's ingested record has no regulatory-authorisation field
- Not stated: A data monitoring committee is not stated in the registry recordThis registry's ingested record has no data-monitoring-committee fieldA data monitoring committee is not required for many smaller studies, and its absence here is not unusual.
- Present: No cost to participants is mentioned in the recordChecked the summary, description and eligibility text; no cost-to-participant phrase found
- Present: Sponsor has 183 other studies in this databaseCounted from the lead sponsor named in the record (Children's Oncology Group)
- Present: Sponsor has posted results for at least one studyBased on the sponsor’s studies in this database
- The record lists 1 condition.
- Lead sponsor type recorded as: research network.
- Intervention regulatory context: investigational, within a phased regulatory pathway.
Trial stature
Three independent measures of this study, described from its registry record — not a recommendation about it. A rigorous study by investigators nobody has heard of is better evidence than a weak study led by a famous one. How these are scored.
A moderately rigorous design for a phase 3 study, judged from its ClinicalTrials.gov record.
How this score is built
- Randomised allocation20/20
Participants are randomly allocated between arms
- Blinding0/20
Open-label
- Control arm0/15
No comparator arm stated in the record
- Primary-outcome specificity10/10
Named primary outcome with a defined time frame
- Endpoint type10/10
Mortality / MACE endpoint (hard clinical outcome)
- Multi-centre8/8
Multi-centre: 65 sites
- Data monitoring committee0/7
No data monitoring committee stated
- Prospective registration5/5
Registered before the study start date
- Protocol / SAP posted0/5
No protocol or SAP posted to the registry
A medium-sized study, international in scope: 342 participants (target), run at 87 sites, across 2 countries.
How this score is built
- Enrolment25/40
342 participants (target)
- Site count21/25
65 sites
- Country count0/15
Single country
- Planned duration10/10
Planned over about 57 months
- Sponsor scale9/10
Children's Oncology Group has led 182 trials in our corpus
We have no verifiable track record for the investigator named on this trial. That is common for early-career investigators and for records held outside ClinicalTrials.gov — it is not a negative signal.
How this score is built
- Investigator standing0/100
No investigator recorded in the registry for this trial
These describe the registry record only, and today we hold ClinicalTrials.gov data. Absent fields lower a score, and absence often reflects registration practice rather than study quality. A high-stature trial is not necessarily safer or a better choice for you — enrolling in a large definitive trial can mean a higher chance of receiving placebo, while a small early-phase study may be the only route to a new therapy.
Summary
This phase III trial compares higher dose chemotherapy, with vincristine, dactinomycin and cyclophosphamide, over a shorter amount of time to lower dose chemotherapy plus maintenance, with vincristine, dactinomycin, cyclophosphamide, irinotecan and vinorelbine, over a longer amount of time, along with standard of care surgery and radiation, in patients with newly diagnosed intermediate risk rhabdomyosarcoma. Vincristine and vinorelbine are in a class of medications called vinca alkaloids. They work by stopping tumor cells from growing and dividing and may kill them. Dactinomycin is a type of antibiotic that is only used in cancer chemotherapy (antineoplastic antibiotic). It works by damaging the cell's DNA and may kill tumor cells. Cyclophosphamide is in a class of medications called alkylating agents. It works by damaging the cell's DNA and may kill tumor cells. It may also lower the body's immune response. Irinotecan is in a class of antineoplastic medications called topoisomerase I inhibitors. It blocks a certain enzyme needed for cell division and DNA repair and may kill tumor cells. It is not yet known if the higher dose chemotherapy over a shorter amount of time or the lower dose chemotherapy with maintenance over a longer amount of time is more effective in the treatment of patient with newly diagnosed, intermediate risk rhabdomyosarcoma.
Conditions
- Rhabdomyosarcoma
Eligibility
| Sex | All |
|---|---|
| Ages | No minimum – 50 Years |
| Healthy volunteers | No |
Eligibility as written in the registry
Eligibility in plain statements
This record's criteria have not been broken into separate statements yet. The registry text above is complete and is the authoritative version.
Study design
| Study type | Interventional |
|---|---|
| Phase | Phase 3 |
| Allocation | Randomised |
| Intervention model | PARALLEL |
| Primary purpose | TREATMENT |
| Masking | NONE (0) |
| Enrolment | 342 participants sought |
Sponsor and collaborators
- Children's Oncology Group Sponsor
Arms and interventions
- Regimen A (Higher cyclophosphamide dose regimenEXPERIMENTAL
See Detailed Description for Regimen A.
- Regimen B (Lower cyclophosphamide dose, maintenance)EXPERIMENTAL
See Detailed Description for Regimen B.
Interventions
- Procedure Biospecimen Collection
Undergo blood and cerebrospinal fluid sample collection
- Procedure Bone Marrow Aspiration
Undergo bone marrow aspiration
- Procedure Bone Marrow Biopsy
Undergo bone marrow biopsy
- Procedure Bone Scan
Undergo bone scan
- Procedure Computed Tomography
Undergo CT scan
- Drug Cyclophosphamide
Given IV and PO
- Biological Dactinomycin
Given IV
- Drug Irinotecan Hydrochloride
Given IV
- Procedure Lumbar Puncture
Undergo lumbar puncture
- Procedure Lymph Node Biopsy
Undergo lymph node biopsy
- Procedure Magnetic Resonance Imaging
Undergo MRI
- Procedure Positron Emission Tomography
Undergo FDG PET scan
- Radiation Radiation Therapy
Undergo radiation therapy
- Procedure Resection
Undergo resection surgery
- Other Survey Administration
Ancillary studies
- Drug Vincristine Sulfate
Given IV
- Drug Vinorelbine Tartrate
Given IV
Outcome measures
Primary outcome
Event free survival (EFS)
Will be estimated using the Kaplan-Meier method and will be compared between the randomized treatment groups using the stratified log-rank test.
Time frame From randomization until the first occurrence of progression or relapse, second malignancy, or death, assessed up to 5 years
Secondary outcome
Overall survival (OS)
Will be estimated using the Kaplan-Meier method and will be compared between the randomized treatment groups using the stratified log-rank test.
Time frame From randomization to death from any cause, assessed up to 4 years
Secondary outcome
Clinician-reported adverse events (AEs)
Clinician-reported treatment-related grade 3 or higher AEs will be reported using Common Terminology Criteria for Adverse Events version 5.0. Comparison of toxicities will be conducted using Fisher's exact test. The maximum grade for each toxicity will be recorded for each patient. Averages and confidence intervals for these toxicity frequencies will be provided.
Time frame Up to 5 years
Secondary outcome
Proportion of patients undergoing delayed primary excision (DPE) among patients deemed to be DPE eligible on retrospective central review
Eligibility for DPE will be established through a retrospective central review of diagnostic and pre-local control imaging. Among the patients deemed eligible for DPE, the proportion of those who undergo DPE will be determined along with 95% confidence interval. Cohen's kappa will be used to assess the concordance between site reviews and central reviews. 95% confidence of kappa statistics will be provided.
Time frame Up to week 12 of treatment
Secondary outcome
Local failure rate for patients deemed eligible for DPE
Cumulative incidence curves will be used to present the local failure rates over time.
Time frame Up to 5 years
Secondary outcome
Percentage of molecular biomarker testing that is resulted within the 6-week timeframe
Assessing the feasibility of reporting diagnostic tumor molecular features in patients with clinical group III intermediate risk rhabdomyosarcoma via the molecular characterization initiative (MCI) among the first 50 Clinical Group III patients who initiated treatment and consent to MCI. If 14 or more patients cannot have diagnostic tumor molecular features identified via MCI within 6 weeks of treatment, this aim will be considered not feasible.
Time frame Up to cycle 3 (each cycle is 21 days)
Other outcome
Somatic molecular features TP53 mutation
Binary (1 = Mutation present, 0 = Mutation absent) no unit. Assessed via MCI to determine association with EFS and OS. EFS and OS will be estimated using KM method. The distribution will be compared by molecular features using log-rank test
Time frame Up to 5 years
Other outcome
Somatic molecular features MYCN amplification
Binary (1 = Amplified, 0 = Not amplified) no unit. Assessed via MCI to determine association with EFS and OS. EFS and OS will be estimated using KM method. The distribution will be compared by molecular features using log-rank test.
Time frame Up to 5 years
Other outcome
Somatic molecular features MYOD1 mutation
Binary (1 = Mutation present, 0 = Mutation absent) no unit. Assessed via MCI to determine association with EFS and OS. EFS and OS will be estimated using KM method. The distribution will be compared by molecular features using log-rank test.
Time frame Up to 5 years
Other outcome
Somatic molecular features CDK4 amplification
Binary (1 = Not amplified, 0 = Amplified) no unit. Assessed via MCI to determine association with EFS and OS. EFS and OS will be estimated using KM method. The distribution will be compared by molecular features using log-rank test.
Time frame Up to 5 years
Other outcome
Methylation patterns: EFS
Deoxyribonucleic acid (DNA) methylation data from rhabdomyosarcoma tumors collected during the conduct of ARST2531 will be analyzed. This data will be collected by array-based methods as part of MCI. The clinical significance of the rhabdomyosarcoma subsets determined in our DNA methylation studies will be analyzed. The association of DNA methylation subsets to EFS will be analyzed using the log-rank test and Cox model.
Time frame Up to 5 years
Other outcome
Methylation patterns: OS
DNA methylation data from rhabdomyosarcoma tumors collected during the conduct of ARST2531 will be analyzed. This data will be collected by array-based methods as part of MCI. The clinical significance of the rhabdomyosarcoma subsets determined in our DNA methylation studies will be analyzed. The association of DNA methylation subsets to OS will be analyzed using the log-rank test and Cox model.
Time frame Up to 5 years
Other outcome
Use of digital pathology/artificial intelligence: Risk predictions compared to EFS
Risk predictions will be recorded and ultimately compared to clinical outcomes, specifically 4-year EFS.
Time frame 4 years from study enrollment
Other outcome
Use of digital pathology/artificial intelligence: Risk predictions compared to OS
Risk predictions will be recorded and ultimately compared to clinical outcomes, specifically 4-year OS.
Time frame 4 years from study enrollment
Other outcome
Clinical practices of fertility discussions/procedures
Fertility consultation information (risk assessment, available fertility preservation options) will be collected and summarized using frequency and percentage. Frequency and percentage of eligible patients undergoing fertility preservation procedures will be summarized.
Time frame Up to 5 years
Other outcome
Patient derived xenograft rhabdomyosarcoma model generation
Will viably collect tumor samples for generation of patient-derived xenograft models that can be used in future research studies to advance the understanding of rhabdomyosarcoma biology.
Time frame Pre-treatment and cycle 3 (each cycle is 21 days)
Other outcome
Household material hardship (HMH)
HMH will be analyzed first as a binary variable (present/absent) and then as an ordinal (0-4) variable. Cox proportional hazard model will be used to assess the association between the binary HMH variable with EFS and OS. Then association between the ordinal measure and EFS and OS will be assessed using COX model.
Time frame At time of survey completion, from enrollment until start of cycle 3 (each cycle is 21 days)
Other outcome
EFS by treatment arm within racial subgroups
Will be estimated using the Kaplan-Meier method. The corresponding 95% confidence interval (CI) will be estimated using Peto-peto method.
Time frame Up to 5 years
Other outcome
EFS by treatment arm within ethnicity subgroups
Will be estimated using the Kaplan-Meier method. The corresponding 95% CI will be estimated using Peto-peto method.
Time frame Up to 5 years
Other outcome
EFS by treatment arm within sex subgroups
Will be estimated using the Kaplan-Meier method. The corresponding 95% CI will be estimated using Peto-peto method.
Time frame Up to 5 years
Dates
| Start date | July 14, 2026 (actual) |
|---|---|
| Primary completion | March 31, 2031 (estimated) |
| Completion | March 31, 2031 (estimated) |
| First posted | March 12, 2026 (actual) |
| Last updated | August 25, 2026 |
| Results posted | Not stated in the registry record |
| Status last verified | August 2026 |
Actual means the event happened. Estimated means the sponsor expects it. The two mean different things.
Locations
85 sites are recruiting
Canada
| Facility | City | State or region | Status |
|---|---|---|---|
| Centre Hospitalier Universitaire Sainte-Justine | Montreal | Quebec | Recruiting |
United States
| Facility | City | State or region | Status |
|---|---|---|---|
| Children's Hospital Medical Center of Akron | Akron | Ohio | Recruiting |
| Albany Medical Center | Albany | New York | Recruiting |
| Lehigh Valley Hospital-Cedar Crest | Allentown | Pennsylvania | Recruiting |
| Mission Hospital | Asheville | North Carolina | Recruiting |
| Children's Healthcare of Atlanta - Arthur M Blank Hospital | Atlanta | Georgia | Recruiting |
| Children's Hospital Colorado | Aurora | Colorado | Recruiting |
| Dell Children's Medical Center of Central Texas | Austin | Texas | Recruiting |
| Sinai Hospital of Baltimore | Baltimore | Maryland | Recruiting |
| MaineHealth Coastal Cancer Treatment Center | Bath | Maine | Recruiting |
| Bronson Battle Creek | Battle Creek | Michigan | Recruiting |
| Children's Hospital of Alabama | Birmingham | Alabama | Recruiting |
| Dana-Farber Cancer Institute | Boston | Massachusetts | Recruiting |
| University of Virginia Cancer Center | Charlottesville | Virginia | Recruiting |
| University of Illinois | Chicago | Illinois | Recruiting |
| Lurie Children's Hospital-Chicago | Chicago | Illinois | Recruiting |
| Driscoll Children's Hospital | Corpus Christi | Texas | Recruiting |
| UT Southwestern/Simmons Cancer Center-Dallas | Dallas | Texas | Recruiting |
| Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center | Denver | Colorado | Recruiting |
| Blank Children's Hospital | Des Moines | Iowa | Recruiting |
| City of Hope Comprehensive Cancer Center | Duarte | California | Recruiting |
| Inova Fairfax Hospital | Falls Church | Virginia | Recruiting |
| Golisano Children's Hospital of Southwest Florida | Fort Myers | Florida | Recruiting |
| Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital | Grand Rapids | Michigan | Recruiting |
| Trinity Health Grand Rapids Hospital | Grand Rapids | Michigan | Recruiting |
| Corewell Health Grand Rapids Hospitals - Butterworth Hospital | Grand Rapids | Michigan | Recruiting |
| Connecticut Children's Medical Center | Hartford | Connecticut | Recruiting |
| Memorial Regional Hospital/Joe DiMaggio Children's Hospital | Hollywood | Florida | Recruiting |
| Riley Hospital for Children | Indianapolis | Indiana | Recruiting |
| University of Mississippi Medical Center | Jackson | Mississippi | Recruiting |
| Nemours Children's Clinic-Jacksonville | Jacksonville | Florida | Recruiting |
| Bronson Methodist Hospital | Kalamazoo | Michigan | Recruiting |
| West Michigan Cancer Center | Kalamazoo | Michigan | Recruiting |
| Beacon Kalamazoo | Kalamazoo | Michigan | Recruiting |
| Children's Mercy Hospitals and Clinics | Kansas City | Missouri | Recruiting |
| East Tennessee Childrens Hospital | Knoxville | Tennessee | Recruiting |
| University of Kentucky/Markey Cancer Center | Lexington | Kentucky | Not yet recruiting |
| Arkansas Children's Hospital | Little Rock | Arkansas | Recruiting |
| Loma Linda University Medical Center | Loma Linda | California | Recruiting |
| Cedars-Sinai Medical Center | Los Angeles | California | Recruiting |
| Mattel Children's Hospital UCLA | Los Angeles | California | Recruiting |
| Norton Children's Hospital | Louisville | Kentucky | Recruiting |
| Valley Children's Hospital | Madera | California | Recruiting |
| University of Wisconsin Carbone Cancer Center - University Hospital | Madison | Wisconsin | Recruiting |
| University of Wisconsin Carbone Cancer Center - Eastpark Medical Center | Madison | Wisconsin | Recruiting |
| Children's Hospital of Wisconsin | Milwaukee | Wisconsin | Recruiting |
| USA Health Strada Patient Care Center | Mobile | Alabama | Recruiting |
| Trinity Health Muskegon Hospital | Muskegon | Michigan | Recruiting |
| The Children's Hospital at TriStar Centennial | Nashville | Tennessee | Recruiting |
| Corewell Health Lakeland Hospitals - Niles Hospital | Niles | Michigan | Recruiting |
37 further sites are listed in the registry record.
Study documents
No documents are linked in this registry record.
Changes over time
- August 25, 2026
Site added
2 sites added (87 total)
8587
- August 21, 2026
Site added
20 sites added (85 total)
6585
- July 30, 2026
Status changed
Status changed from Not yet recruiting to Recruiting
NOT_YET_RECRUITINGRECRUITING
- July 30, 2026
Recruitment opened
Recruitment opened
NOT_YET_RECRUITINGRECRUITING
- July 30, 2026
Site added
65 sites added (65 total)
065