"I was delighted to take part in a clinical trial as it has the potential to really help others in the future.”
A trial looking at etoposide for children and young people with ependymoma (CNS 2001 04)
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Please note - this trial is no longer recruiting patients. We hope to add results when they are available.
This trial is looking at a chemotherapy drug called etoposide to treat children and young people with ependymoma that has not been completely removed or has come back after treatment.
This trial is for children and young people up to and including the age of 20. We use the term ‘you’ in this summary, but if you are a parent, we are referring to your child.
Ependymoma is a type of brain tumour. Children with ependymoma brain tumours are usually treated with surgery and radiotherapy. But it is not always possible to completely remove the tumour, or it may come back after it has been treated. If it comes back (recurs), it is more difficult to treat.
Some studies have suggested that etoposide may help some children with ependymoma. But there has not been enough research for doctors to be sure about this.
This trial aims to find out how well etoposide works for children and young people with ependymomas.
Who can enter
You can enter this trial if you
- Have been diagnosed with an ependymoma brain tumour that either cannot be removed or has come back after treatment
- Have cancer that can be measured by MRI scan
- Are less than 21 years old
- Are well enough to take part in the trial
- Have satisfactory blood tests
You cannot enter this trial if you
This trial is recruiting at least 14 patients. Your doctor may recommend that you have a central or long line put in. This is sometimes called a ‘wiggly line’. It makes it easier to give chemotherapy and take blood samples.
After this, you will have no treatment for a week. Then, if the blood tests are OK, you will have another 3 weeks of etoposide (cycle 2). Then you will have an MRI scan to see if the treatment is working.
If the tumour has grown, the chemotherapy may be stopped. Your doctor will talk to you about the possibility of other treatment.
If the tumour has not grown, you will have a 3rd cycle of etoposide and then another MRI scan. A specialist brain surgeon (neurosurgeon) will then decide whether it is possible to remove the tumour. If the neurosurgeon thinks that surgery is possible, you will have an operation rather than continue the chemotherapy.
If it is not possible to remove your tumour but the tumour has not grown, you will have a further 3 cycles of etoposide. After another MRI scan, the neurosurgeon will assess you again to see if it is possible to operate.
After the chemotherapy, your doctor may also decide whether radiotherapy treatment will help.
Before you start chemotherapy, a doctor will examine you. You will have an MRI scan and some blood tests. You may have to stay in hospital overnight if you are having a long line put in, but this may be done as a day case.
When you are having treatment, you will have to travel to the hospital 3 times a week. During the weeks when you are not having treatment, you will need to visit the hospital weekly to see the doctor and have some blood tests.
After the chemotherapy treatment has finished, the doctor will see you every 8 weeks for 1 year and then every 4 months for the next 2 years. The doctor will examine you and ask if there have been any problems.
After the chemotherapy has finished, you will have an MRI scan
- 6 weeks after the treatment
- Every 6 months for 2 years
- Every year for 5 years
You may be asked to take part in another study as part of this trial. It is called a "pharmacokinetic" study. This will look at how etoposide behaves in the body. It will involve having extra blood tests during the first chemotherapy treatment. On the first day of treatment, you will need to stay in the day unit for about 6 hours. This is because you will have 6 blood samples taken from your long line before, during and after your treatment.
On days 2 and 3, blood samples will be taken from your long line before and after treatment. The amount of blood taken should not cause you any problems.
These blood tests are taken for the purposes of the study. Although the results will not directly help you, they may help doctors to improve the way etoposide is given in the future.
All chemotherapy drugs have possible side effects. The most common side effects of etoposide are
- Hair loss
- A drop in blood cells causing an increased risk of infection, bleeding problems, tiredness and breathlessness
- Feeling or being sick
You may find it difficult to have an MRI scan because it is very noisy and can make people feel claustrophobic (closed in). If this is the case, you could speak to the doctor about this. They may be able to give you a sedative tablet or injection beforehand, to help you relax. Very young children will routinely be given a sedative or a general anaesthetic so that they are asleep throughout the scan.
How to join a clinical trial
Dr S. Picton
Dr L. Lashford
Cancer Research UK Children's Cancer Trials Team
University of Birmingham
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer