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CTRI Number  CTRI/2025/08/092696 [Registered on: 08/08/2025] Trial Registered Prospectively
Last Modified On: 08/08/2025
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Drug 
Study Design  Single Arm Study 
Public Title of Study   Intravenous chemotherapy for early stage retinoblastoma localised to one or both eyes  
Scientific Title of Study   Systemic Vincrstine and Topotecan chemotherapy for Intra-ocular group A, B and C Retinoblastoma – A prospective, single arm study 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Maharshi Trivedi 
Designation  Associate Professor 
Affiliation  The Gujarat Cancer and Research Institute 
Address  OPD no 102, Pediatric OPD, A Block, GCRI, Asarwa, Ahmedabad

Ahmadabad
GUJARAT
380004
India 
Phone  9408716111  
Fax    
Email  dr.maharshi@yahoo.com  
 
Details of Contact Person
Scientific Query
 
Name  Maharshi Trivedi 
Designation  Associate Professor 
Affiliation  The Gujarat Cancer and Research Institute 
Address  OPD no 102, Pediatric OPD, A Block, GCRI, Asarwa, Ahmedabad


GUJARAT
380004
India 
Phone  9408716111  
Fax    
Email  dr.maharshi@yahoo.com  
 
Details of Contact Person
Public Query
 
Name  Maharshi Trivedi 
Designation  Associate Professor 
Affiliation  The Gujarat Cancer and Research Institute 
Address  OPD no 102, Pediatric OPD, A Block, GCRI, Awarwa, Ahmedabad


GUJARAT
380004
India 
Phone  9408716111  
Fax    
Email  dr.maharshi@yahoo.com  
 
Source of Monetary or Material Support  
The Gujarat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad 
 
Primary Sponsor  
Name  The Gujarat Cancer and Research Institution 
Address  Civil hospital campus, Asarwa, Ahmedabad, 380016 
Type of Sponsor  Research institution and hospital 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Maharshi Trivedi  The Gujarat Cancer Research Institute   Pediatric OPD no 102, A Block, GCRI, Civil Hospital campus, Asarwa, Ahmedabad 380016
Ahmadabad
GUJARAT 
9408716111

dr.maharshi@yahoo.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
GCRI/GCS Ethics Committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: C692||Malignant neoplasm of retina,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Nil  Nil 
Intervention  Vincristin topotecan chemotherapy  Children less than 18 years age diagnosed with unilateral or bilateral group A, B or C retinoblastoma will be treated with systemic vincristine topotecan chemotherapy along with focal therapy as per protocol Treatment details – systemic chemotherapy RBM25 protocol includes intravenous vincristine and topotecan chemotherapy as in below mentioned dose and schedule as per RET5 protocol 11 Vincristine – more than 10 kg - 1.5 mg per m2 day 1 less than 10 kg – 0.05 mg per kg day 1 Topotecan – age based dose per day for 5 days Sr no Age Dose 1 0 – 3 months 2.25 mg per m2 2 3 – 6 months 2.5 mg per m2 3 6 – 9 months 2.75 mg per m2 4 more than 9 months 3 mg per m2 This will be followed by inj Peg – G CSF on day 6 – (24 hours after last dose of chemotherapy). Complete blood counts will be monitored weekly till recovery. Cycle will be repeated every 21 days from day 1 of the previous chemotherapy. Pre-requisite for starting chemotherapy 1. Absolute neutrophil counts more than 1000 per microliter, Platelets more than 75000 per microlitre and signs of count recovery 2. Direct bilirubin less than 2 mg per dL 3. SGOT and SGPT less than 3 times ULN 4. S Creatinine within normal range for age If the next cycle is delayed more than 28 days from day 1 of the previous chemotherapy cycle due to treatment related toxicity or side effects, topotecan dose will be reduced by 25 percentage for next cycle. Same process would be followed for each cycle. Maximum four cycles will be delivered.  
 
Inclusion Criteria  
Age From  0.00 Day(s)
Age To  18.00 Year(s)
Gender  Both 
Details  Children less than 18 years of age newly diagnosed with unilateral or bilateral Intra-ocular (stage-0) group A, B and/or C disease with
In case of bilateral retinoblastoma the other eye being either group A, B or C disease requiring no chemotherapy or vincristine topotecan chemotherapy or group D or E enucleated disease not requiring post enucleation chemotherapy
Not previously treated with any form of chemotherapy including intravitreal, intra-arterial or systemic chemotherapy
Adequate liver and renal function at diagnosis (total bilirubin, AST, ALT and serum creatinine less than 3 times upper limit of normal for age and sex)
 
 
ExclusionCriteria 
Details  1. Any of the eye having group D, E disease requiring upfront or post-enucleation chemotherapy other than vincristine-topotecan RBM25 protocol
2. The other eye with extraocular disease
3. Presence of metastatic disease
 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment    
Blinding/Masking    
Primary Outcome  
Outcome  TimePoints 
Event free survival (EFS) at 2 years is the primary outcome. Events for EFS will be change of chemotherapy anytime for any reasons, enucleation or use of radiotherapy  2 years EFS will be calculated 
 
Secondary Outcome  
Outcome  TimePoints 
Event for overall survival (OS) will be death due to any cause.
2. Ocular survival (ocular salvage) 
two year 
 
Target Sample Size   Total Sample Size="26"
Sample Size from India="26" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 2/ Phase 3 
Date of First Enrollment (India)   26/08/2025 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="3"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Yet Recruiting 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - All of the individual participant data collected during the trial, after de-identification.

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan

  3. Who will be able to view these files?
    Response - Researchers whose proposed use of the data has been approved by an independent review committee identified for this purpose.

  4. For what types of analyses will this data be available?
    Response - To achieve aims in the approved proposal.

  5. By what mechanism will data be made available?
    Response - Proposals should be directed to [dr.maharshi@yahoo.com].

  6. For how long will this data be available start date provided 20-08-2025 and end date provided 13-08-2031?
    Response - Beginning 9 months and ending 36 months following article publication.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - NIL
Brief Summary  

Data collection

Demographic details (age, sex, diagnosis etc), details of baseline diagnostic investigations, staging investigations, and laboratory diagnostics will be recorded. Treatment details and information on response evaluation will be collected at defined timepoints.

Baseline assessment

Clinical history and physical examination will be conducted at presentation. Complete blood counts, renal function test, liver function test will be done at baseline. Examination under anaesthesia will be done by ocular oncologist. Magnetic resonance imaging (MRI) both orbit and brain will be done.

Laboratory investigations

Complete blood counts, renal function test and liver function test will be done before each chemotherapy cycles. Other investigations if needed will be done as per unit protocol.

Treatment details – systemic chemotherapy

RBM25 protocol includes intravenous vincristine and topotecan chemotherapy as in below mentioned dose and schedule

Vincristine –

more than 10 kg - 1.5 mg per m2 day 1

less than 10 kg – 0.05 mg per kg day 1

Topotecan – age based dose per day for 5 days

Sr no

Age

Dose

1

0 – 3 months

2.25 mg per m2

2

3 – 6 months

2.5 mg per m2

3

6 – 9 months

2.75 mg per m2

4

more than 9 months

3 mg per m2

 

This will be followed by inj Peg – G CSF on day 6 – (24 hours after last dose of chemotherapy).

Complete blood counts will be monitored weekly till recovery. Cycle will be repeated every 21 days from day 1 of the previous chemotherapy.

Pre-requisite for starting chemotherapy

1.     Absolute neutrophil counts more than 1000 per microliter, Platelets more than 75000 per microlitre and signs of count recovery

2.     Direct bilirubin less than 2 mg per dL

3.     SGOT and SGPT less than 3 times ULN

4.     S Creatinine within normal range for age

If the next cycle is delayed more than 28 days from day 1 of the previous chemotherapy cycle due to treatment related toxicity or side effects, topotecan dose will be reduced by 25 percentage for next cycle. Same process would be followed for each cycle.

Maximum four cycles will be delivered. If the child does not

Treatment details – local-focal therapy

Intravitreal topotecan injections will be considered as per ocular oncologist’s assessment and discretion. Cryotherapy would be applied to the peripheral active retinoblastoma lesions anterior to the equator. If needed laser treatment would be applied to the lesions posterior to the equator.

Response assessment

Examination under anaesthesia will be done after first cycle and after that as per ocular oncologist’s discretion and eye will be evaluated for need and feasibility of focal therapy. Response will be recorded as per RB-RECIST criteria. Patient will be taken off protocol in the event of progressive disease. Response will be recorded after 4 cycles of chemotherapy or before that if treatment stopped or discontinued before that in view of complete resolution of disease. Response will be assessed by MRI both orbit and brain and examination under anaesthesia. Response will be recorded per eye, not per individual.

Toxicity monitoring

Patients will be monitored for any treatment related toxicities and adverse events. Toxicities will be recorded as per CTCAE v5 criteria. 
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