| 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
|
|
|
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
|
|
|
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
- What data in particular will be shared?
Response - All of the individual participant data collected during the trial, after de-identification.
- What additional supporting information will be shared?
Response - Study Protocol Response - Statistical Analysis Plan
- 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.
- For what types of analyses will this data be available?
Response - To achieve aims in the approved proposal.
- By what mechanism will data be made available?
Response - Proposals should be directed to [dr.maharshi@yahoo.com].
- 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.
- 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. |