CYP3A5 Gene as a Risk Factor for Kidney Damage in Young Patients With Cancer Treated With Ifosfamide

Children's Cancer and Leukaemia Group

Status: Unknown

Conditions: Chemotherapeutic Agent Toxicity; Sarcoma; Unspecified Childhood Solid Tumor, Protocol Specific

Treatments: Genetic: polymorphism analysis; Genetic: gene expression analysis; Procedure: management of therapy complications

Study type: Observational

Funder types: Other

Identifiers

NCT00514345

EU-20743

CDR0000560128 (Registry Identifier)

CCLG-PK-2007-02

Details and patient eligibility

About

RATIONALE: Studying the genes expressed in samples of blood from young patients with cancer treated with ifosfamide may help doctors identify risk factors for kidney damage.

PURPOSE: This clinical trial is looking at the CYP3A5 gene to see if having the gene may be a risk factor for kidney damage in young patients with cancer treated with ifosfamide.

Full description

OBJECTIVES:

Primary

• To determine the CYP3A5 genotype in young patients with cancer who have received ifosfamide.
• To document renal function and nephrotoxicity on one occasion between 1 month and 5 years after completion of ifosfamide treatment.
• To determine the relationship between CYP3A5 genotype and ifosfamide nephrotoxicity.

Secondary

• To compare the measured glomerular filtration rate (GFR) (using a radioisotope clearance method) with that calculated using the Cole (weight and creatinine) model.

OUTLINE: This is a multicenter study.

Nephrotoxicity assessment is performed in patients who have not undergone prior assessment*.

NOTE: *Nephrotoxicity assessment is performed once between 1 month and 5 years after completion of ifosfamide chemotherapy.

All patients will undergo a single blood sample collection. DNA will be extracted from this sample and genotyped for the known functional polymorphisms in CYP3A5. The technique of restriction fragment length polymorphism (RFLP) will be used to detect any single nucleotide polymorphisms in CYP3A5.

DNA may be obtained from stored tumor samples from patients for whom the results of renal investigations are available, but for whom blood is not available for CYP3A5 genotyping.

Enrollment: 300 estimated patients

Sex: All

Ages: Under 20 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

DISEASE CHARACTERISTICS:

• Received ifosfamide before the age of 21 as part of treatment for cancer including, but not limited to, any of the following:

  • Ewing sarcoma
  • Rhabdomyosarcoma
  • Non-rhabdomyosarcoma soft tissue sarcoma

• No renal infiltration by tumor at any stage of illness

• May have been treated on one of the following clinical trials:

  • Euro-Ewing-Intergroup-EE99

  • SIOP-MMT-95

    • Patients who received CEV chemotherapy (carboplatin, epirubicin, and vincristine) on strategy 952 or 953 are not eligible

  • CCLG-EPSSG-NRSTS-2005

  • CCLG-EPSSG-RMS-2005

PATIENT CHARACTERISTICS:

• Clinically stable to undergo renal investigations
• No pre-existing renal impairment (glomerular or tubular) prior to treatment with ifosfamide
• No known nephrotoxicity for which nephrotoxic supportive treatment (aminoglycosides, amphotericin, acyclovir, cyclosporine, or tacrolimus) was a major contributory cause of renal damage

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• Recovered from the acute non-renal toxicity of the last course of chemotherapy
• No other prior nephrotoxic chemotherapy (e.g., cisplatin, carboplatin, melphalan, or high-dose methotrexate)
• No prior radiotherapy to a field including the kidneys
• No prior removal of renal tissue
• No concurrent ifosfamide