NCT06470464

Thalidomide Combined With Chemotherapy in the Treatment of Relapsed or Refractory Yolk Sac Tumor

Clinical Study of Thalidomide Combined With Chemotherapy in the Treatment of Relapsed or Refractory Yolk Sac Tumor in Children

• Status: Completed
• Phase: Phase 2
• Study type: Interventional
• Enrollment: 20 (actual)
• Sponsor: Shandong First Medical University · Academic / Other
• Sex: All
• Age: 1 Year – 18 Years
• Healthy volunteers: Not accepted

Summary

Remarkable progress has been made in treating germ-cell tumor (GCT) through the use of platinum-based regimens. However, part of yolk sac tumor (YST) with cisplatin resistance or recurrence is nevertheless prone to relapse after second-line treatment. This leaves a gap in effective treatment, which needs to be filled by novel therapeutic approaches. This paper is the first one to report the treatment combining thalidomide with nab-paclitaxel, gemcitabine, and epirubicin (T-TGA) for children with repeated relapsed or refractory yolk sac tumor (rrrYST).

Detailed description

Thalidomide (THD) is currently widely used in the treatment of immune rheumatic diseases, blood tumors and solid tumors. Solid tumors are mostly used in the treatment of lung cancer, liver cancer, stomach cancer, colorectal cancer, pancreatic cancer, etc., and are limited to patients with advanced or advanced tumors. The main mechanisms of its action are inhibition of angiogenesis, immune regulation, induction of apoptosis, target teratogenesis and so on. However, whether from animal experiments or clinical studies, thalidomide alone or in combination with chemotherapy has not been seen to have a very effective therapeutic effect or exact clinical application in the treatment of these solid tumors. According to the latest relevant case analysis reports and clinical trial results abroad, TIP regimen is still the priority recommended treatment regimen in the previous data for children with recurrent and refractory malignant germ cell tumors. However, the combination of Sirolimus and TIC regimen (nab-paclitaxel + isocyclophosphamide + carboplatin) previously explored by our research group can greatly improve the remission rate of recurrent and refractory germinal cell tumors, especially for recurrent and refractory yolk sac tumors, a certain proportion can be cured or the opportunity for surgery and radiotherapy can be obtained to achieve cure. However, there are still some children who are insensitive or progress again after 2 cycles of remission. For these children with multiple relapsed or particularly difficult yolk sac tumors, there is no effective treatment plan in the world at present, and there is no relevant clinical trial. However, through our clinical experience and understanding in the treatment process of these children, The results of thalidomide combined with TGA chemotherapy regimen (nab-paclitaxel + gemcitabine + epirubicin) were satisfactory. Therefore, we hope to evaluate the therapeutic effectiveness and adverse reactions of this regimen through clinical trials, so as to provide an effective treatment option for children with recurrent and refractory yolk sac tumor. This paper is the first one to report the treatment combining thalidomide with nab-paclitaxel, gemcitabine, and epirubicin (T-TGA) for children with repeated relapsed or refractory yolk sac tumor (rrrYST).

Conditions

• Germ Cell Tumor
• Yolk Sac Tumor

Interventions

Type	Name	Description
DRUG	Thalidomide combined with TGA chemotherapy (nab-paclitaxel + gemcitabine+ epirubicin)	The oral dose of thalidomide is 1.5-2.5mg/kg/d daily (maximum 28g). Each cycle lasts for 21 days (every three weeks), and if treatment parameters are met as described in the study, cycle two and subsequent cycles begin on day 22. Treatment will be discontinued if there is drug-related dose-limiting toxicity or disease progression. Tumor response assessment will be repeated using AFP and LDH every one cycle and imaging examination every two cycles. Children who complete the trial may continue this regimen or undergo surgery or radiation therapy if their disease goes into remission.

Timeline

• Start date: 2021-11-11
• Primary completion: 2024-06-16
• Completion: 2024-06-16
• First posted: 2024-06-24
• Last updated: 2025-09-18

Locations

1 site across 1 country: China