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RECRUITING Phase 2 ClinicalTrials.gov

A Study of Combination Chemotherapy for Patients With Newly Diagnosed DAWT and Relapsed FHWT

Sponsor: Children's Oncology Group • ClinicalTrials.gov ID: NCT04322318

Registry updated: 2026-08-25
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Description

This phase II trial studies how well combination chemotherapy works in treating patients with newly diagnosed stage II-IV diffuse anaplastic Wilms tumors (DAWT) or favorable histology Wilms tumors (FHWT) that have come back (relapsed). Drugs used in chemotherapy regimens such as UH-3 (vincristine, doxorubicin, cyclophosphamide, carboplatin, etoposide, and irinotecan) and ICE/Cyclo/Topo (ifosfamide, carboplatin, etoposide, cyclophosphamide, and topotecan) work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. This trial may help doctors find out what effects, good and/or bad, regimen UH-3 has on patients with newly diagnosed DAWT and standard risk relapsed FHWT (those treated with only 2 drugs for the initial WT) and regimen ICE/Cyclo/Topo has on patients with high and very high risk relapsed FHWT (those treated with 3 or more drugs for the initial WT).

Interventions

  • Biopsy Procedure (Procedure)
    Undergo a biopsy
  • Biospecimen Collection (Procedure)
    Undergo blood sample collection
  • Bone Scan (Procedure)
    Undergo a bone scan
  • Carboplatin (Drug)
    Given IV
  • Computed Tomography (Procedure)
    Undergo a CT scan
  • Cyclophosphamide (Drug)
    Given IV
  • Doxorubicin (Drug)
    Given IV
  • Etoposide (Drug)
    Given IV
  • Ifosfamide (Drug)
    Given IV
  • Irinotecan (Drug)
    Given IV
  • Magnetic Resonance Imaging (Procedure)
    Undergo MRI
  • Positron Emission Tomography (Procedure)
    Undergo a PET scan
  • Radiation Therapy (Radiation)
    Undergo RT
  • Surgical Procedure (Procedure)
    Undergo surgery
  • Topotecan (Drug)
    Given IV
  • Transabdominal Ultrasound (Procedure)
    Undergo abdominal ultrasound
  • Vincristine (Drug)
    Given IV
  • X-Ray Imaging (Procedure)
    Undergo a chest x-ray

Eligibility criteria

Inclusion Criteria: * Patients with newly diagnosed stages 2 - 4 diffuse anaplastic Wilms tumor must be enrolled on APEC14B1, consented to Part A - Eligibility Screening, and have received an initial stratum assignment showing DAWT (if anaplasia first identified at diagnostic, pre-treatment nephrectomy or biopsy) or a final stratum assignment showing DAWT (if anaplasia first noted at delayed nephrectomy) prior to enrollment on AREN1921. Prior enrollment on APEC14B1 is not an eligibility requirement for patients with relapsed favorable histology Wilms tumor. * Patients must be =\< 30 years old at study enrollment * Patients with the following diagnoses are eligible for this study: * Newly diagnosed stages 2 - 4 diffuse anaplastic Wilms tumor as confirmed by central review * Favorable histology Wilms tumor at first relapse. Relapsed FHWT patients must have previously achieved remission for their initial FHWT diagnosis to be eligible for this study. The relapse risk groups are defined as follows, regardless of radiation therapy: * Standard-Risk relapse: Patients who received two chemotherapy agents for frontline therapy; primarily actinomycin D and vincristine * High-Risk relapse: Patients who received three chemotherapy agents for frontline therapy; primarily vincristine, actinomycin D and doxorubicin or vincristine, actinomycin D and irinotecan * Very High-Risk relapse: Patients who received four or more chemotherapy agents as part of initial therapy; primarily regimen M or its variations * Patients with newly diagnosed DAWT must have had histologic verification of the malignancy. For relapsed FHWT patients, biopsy to prove recurrence is encouraged, but not required * Note: For relapsed FHWT patients, an institutional pathology report confirming favorable histology Wilms tumor (from relapse, if available, or from original diagnosis) must be available for upload prior to initiation of protocol therapy * Patients with newly diagnosed Stages 2 - 4 diffuse anaplastic Wilms tumor must be enrolled on AREN1921 within 2 weeks of the tumor-directed surgery or biopsy procedure that first confirms a diagnosis of DAWT, whether at initial diagnostic procedure or delayed nephrectomy (such surgery/biopsy is day 0). For patients who received prior therapy for presumed favorable histology Wilms tumor, later confirmed to have diffuse anaplastic Wilms tumor at subsequent review of the initial biopsy * Patients with newly diagnosed DAWT who undergo upfront nephrectomy must have at least 1 lymph node sampled prior to study enrollment * Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1 or 2. Use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age * Patients must have a life expectancy of \>= 8 weeks * Diffuse Anaplastic Wilms Tumor: Patients with diffuse anaplastic histology must have had no prior systemic therapy, except in the following situations: * Patients with diffuse anaplastic Wilms tumor who received no more than 12 weeks of pre nephrectomy chemotherapy for what was originally presumed to be favorable histology Wilms tumor, subsequently confirmed to be diffuse anaplastic Wilms tumor at delayed nephrectomy * Patients with diffuse anaplastic Wilms tumor who received no more than 6 weeks of chemotherapy following upfront biopsy, initiated within 14 days of biopsy, for presumed favorable histology Wilms tumor based on institutional review, but subsequently corrected to diffuse anaplastic Wilms tumor based on the initial stratum assignment on APEC14B1-REN * Treatment consisting of vincristine/doxorubicin/cyclophosphamide initiated on an emergent basis and within allowed timing as described * Note: Patients who received prior therapy for presumed favorable histology Wilms tumor, later identified to have diffuse anaplastic Wilms tumor as per above, must begin study treatment starting at cycle 3 (week 7) of regimen UH 3. Patients who received emergency radiation to preserve organ function are eligible as noted. Patients who received radiation as part of standard of care for presumed newly diagnosed favorable histology Wilms tumor, along with chemotherapy as noted above, prior to identification of diffuse anaplasia, are also eligible * Relapsed Favorable Histology Wilms Tumor: Patients must not have received prior chemotherapy for their relapsed favorable histology Wilms tumor diagnosis. In addition, patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study * Myelosuppressive chemotherapy: Must not have received within 2 weeks of entry onto this study * Radiation therapy (RT): \>= 2 weeks (wks) must have elapsed for local palliative RT (small port); \>= 6 months must have elapsed if prior craniospinal RT or if \>= 50% radiation of pelvis; \>= 6 wks must have elapsed if other substantial bone marrow (BM) radiation. Patients with relapsed favorable histology Wilms tumor who received emergency radiation to preserve organ function are eligible and do not need to washout with the above criteria * Patients may not be receiving any other investigational agents (within 4 weeks prior to study enrollment) * Peripheral absolute neutrophil count (ANC) \>= 750/uL (performed within 7 days prior to enrollment) * Platelet count \>= 75,000/uL (transfusion independent) (performed within 7 days prior to enrollment) * Hemoglobin \>= 8.0 g/dL (may receive red blood cell \[RBC\] transfusions) (performed within 7 days prior to enrollment) * Patients with high-risk or very high-risk relapsed FHWT who will be treated with regimen ICE/Cyclo/Topo, must have renal function assessed by creatinine clearance or radioisotope glomerular filtration rate (GFR) and meet the following requirement: * Creatinine clearance or radioisotope GFR \>= 60 mL/min/1.73 m\^2 (performed within 7 days prior to enrollment) * Patients diagnosed with stage 2-4 DAWT or standard risk relapsed FHWT, who will be treated with regimen UH 3, may either obtain a creatinine clearance, radioisotope GFR (meeting the above criteria of GFR \>= 60 mL/min/1.73 m\^2), or an adequate serum creatinine as per the following table: * Age: Maximum Serum Creatinine (mg/dL) * 1 month to \< 6 months: 0.4 (male and female) * 6 months to \< 1 year: 0.5 (male and female) * 1 to \< 2 years: 0.6 (male and female) * 2 to \< 6 years: 0.8 (male and female) * 6 to \< 10 years: 1 (male and female) * 10 to \< 13 years: 1.2 (male and female) * 13 to \< 16 years: 1.5 (male), 1.4 (female) * \>= 16 years: 1.7 (male), 1.4 (female) * Total bilirubin =\< 1.5 x upper limit of normal (ULN) for age or direct bilirubin =\< ULN for patients whose total bilirubin \> 1.5 x ULN (performed within 7 days prior to enrollment) * Serum glutamic-oxaloacetic transaminase (SGOT) (aspartate aminotransferase \[AST\]) or serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\]) \< 2.5 x upper limit of normal (ULN) for age or =\< 5 x ULN for patients with liver metastases (performed within 7 days prior to enrollment) * Shortening fraction of \>= 27% by echocardiogram, or ejection fraction of \>= 50% by radionuclide angiogram (obtained within 21 days prior to enrollment and start of protocol therapy) Exclusion Criteria: * Patients with a history of bilateral Wilms tumor (synchronous or metachronous) * Patients with any uncontrolled, intercurrent illness including, but not limited to, ongoing or active infection, or symptomatic congestive heart failure (defined as grade 2 or higher heart failure per Common Terminology Criteria for Adverse Events \[CTCAE\] version 5.0) * Relapsed FHWT patients who did not receive frontline chemotherapy (e.g., very low risk FHWT initially observed without chemotherapy) or received only one chemotherapy agent for frontline therapy * For patients with high-risk or very high-risk relapsed FHWT: * Patients with renal tubular acidosis (RTA) as evidenced by serum bicarbonate \< 16 mmol/L and serum phosphate =\< 2 mg/dL (or \< 0.8 mmol/L) without supplementation * For stages 2-4 DAWT and standard-risk relapsed FHWT patients: * Chronic inflammatory bowel disease and/or bowel obstruction * Concomitant use of St. John's wort, which cannot be stopped prior to the start of trial treatment * Female patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs. A pregnancy test is required for female patients of childbearing potential * Lactating females who plan to breastfeed their infants * Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation

Conditions

Anaplastic Kidney Wilms Tumor Recurrent Kidney Wilms Tumor Stage II Kidney Wilms Tumor Stage III Kidney Wilms Tumor Stage IV Kidney Wilms Tumor

Locations

  • Children's Hospital of Alabama — Birmingham, Alabama, United States
  • USA Health Strada Patient Care Center — Mobile, Alabama, United States
  • Providence Alaska Medical Center — Anchorage, Alaska, United States
  • Banner Children's at Desert — Mesa, Arizona, United States
  • Phoenix Childrens Hospital — Phoenix, Arizona, United States
  • Banner University Medical Center - Tucson — Tucson, Arizona, United States
  • Arkansas Children's Hospital — Little Rock, Arkansas, United States
  • Kaiser Permanente Downey Medical Center — Downey, California, United States
  • Loma Linda University Medical Center — Loma Linda, California, United States
  • Miller Children's and Women's Hospital Long Beach — Long Beach, California, United States
  • Children's Hospital Los Angeles — Los Angeles, California, United States
  • Cedars-Sinai Medical Center — Los Angeles, California, United States
  • Mattel Children's Hospital UCLA — Los Angeles, California, United States
  • Valley Children's Hospital — Madera, California, United States
  • UCSF Benioff Children's Hospital Oakland — Oakland, California, United States
  • Kaiser Permanente-Oakland — Oakland, California, United States
  • Children's Hospital of Orange County — Orange, California, United States
  • Lucile Packard Children's Hospital Stanford University — Palo Alto, California, United States
  • University of California Davis Comprehensive Cancer Center — Sacramento, California, United States
  • Rady Children's Hospital - San Diego — San Diego, California, United States
  • UCSF Medical Center-Mission Bay — San Francisco, California, United States
  • Children's Hospital Colorado — Aurora, Colorado, United States
  • Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center — Denver, Colorado, United States
  • Connecticut Children's Medical Center — Hartford, Connecticut, United States
  • Yale University — New Haven, Connecticut, United States
  • Alfred I duPont Hospital for Children — Wilmington, Delaware, United States
  • MedStar Georgetown University Hospital — Washington D.C., District of Columbia, United States
  • Children's National Medical Center — Washington D.C., District of Columbia, United States
  • Broward Health Medical Center — Fort Lauderdale, Florida, United States
  • Golisano Children's Hospital of Southwest Florida — Fort Myers, Florida, United States
  • UF Health Cancer Institute - Gainesville — Gainesville, Florida, United States
  • Memorial Regional Hospital/Joe DiMaggio Children's Hospital — Hollywood, Florida, United States
  • Nemours Children's Clinic-Jacksonville — Jacksonville, Florida, United States
  • University of Miami Miller School of Medicine-Sylvester Cancer Center — Miami, Florida, United States
  • Nicklaus Children's Hospital — Miami, Florida, United States
  • Arnold Palmer Hospital for Children — Orlando, Florida, United States
  • Nemours Children's Hospital — Orlando, Florida, United States
  • Nemours Children's Clinic - Pensacola — Pensacola, Florida, United States
  • Sacred Heart Hospital — Pensacola, Florida, United States
  • Johns Hopkins All Children's Hospital — St. Petersburg, Florida, United States
  • Tampa General Hospital — Tampa, Florida, United States
  • Saint Joseph's Hospital/Children's Hospital-Tampa — Tampa, Florida, United States
  • Saint Mary's Medical Center — West Palm Beach, Florida, United States
  • Children's Healthcare of Atlanta - Arthur M Blank Hospital — Atlanta, Georgia, United States
  • Augusta University Medical Center — Augusta, Georgia, United States
  • Atrium Health Navicent — Macon, Georgia, United States
  • Memorial Health University Medical Center — Savannah, Georgia, United States
  • Kapiolani Medical Center for Women and Children — Honolulu, Hawaii, United States
  • Saint Luke's Cancer Institute - Boise — Boise, Idaho, United States
  • Lurie Children's Hospital-Chicago — Chicago, Illinois, United States
  • University of Illinois — Chicago, Illinois, United States
  • University of Chicago Comprehensive Cancer Center — Chicago, Illinois, United States
  • Loyola University Medical Center — Maywood, Illinois, United States
  • Advocate Children's Hospital-Oak Lawn — Oak Lawn, Illinois, United States
  • Advocate Children's Hospital-Park Ridge — Park Ridge, Illinois, United States
  • OSF Children's Hospital of Illinois — Peoria, Illinois, United States
  • Southern Illinois University School of Medicine — Springfield, Illinois, United States
  • Riley Hospital for Children — Indianapolis, Indiana, United States
  • Ascension Saint Vincent Indianapolis Hospital — Indianapolis, Indiana, United States
  • Blank Children's Hospital — Des Moines, Iowa, United States
  • University of Iowa/Holden Comprehensive Cancer Center — Iowa City, Iowa, United States
  • University of Kentucky/Markey Cancer Center — Lexington, Kentucky, United States
  • Norton Children's Hospital — Louisville, Kentucky, United States
  • Children's Hospital New Orleans — New Orleans, Louisiana, United States
  • Ochsner Medical Center Jefferson — New Orleans, Louisiana, United States
  • Eastern Maine Medical Center — Bangor, Maine, United States
  • Maine Children's Cancer Program — Scarborough, Maine, United States
  • Sinai Hospital of Baltimore — Baltimore, Maryland, United States
  • Johns Hopkins University/Sidney Kimmel Cancer Center — Baltimore, Maryland, United States
  • Tufts Children's Hospital — Boston, Massachusetts, United States
  • Dana-Farber Cancer Institute — Boston, Massachusetts, United States
  • UMass Memorial Medical Center - University Campus — Worcester, Massachusetts, United States
  • C S Mott Children's Hospital — Ann Arbor, Michigan, United States
  • Children's Hospital of Michigan — Detroit, Michigan, United States
  • Michigan State University — East Lansing, Michigan, United States
  • Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital — Grand Rapids, Michigan, United States
  • Bronson Methodist Hospital — Kalamazoo, Michigan, United States
  • Corewell Health Children's — Royal Oak, Michigan, United States
  • Children's Hospitals and Clinics of Minnesota - Minneapolis — Minneapolis, Minnesota, United States
  • University of Minnesota/Masonic Cancer Center — Minneapolis, Minnesota, United States
  • Mayo Clinic in Rochester — Rochester, Minnesota, United States
  • University of Mississippi Medical Center — Jackson, Mississippi, United States
  • University of Missouri Children's Hospital — Columbia, Missouri, United States
  • Children's Mercy Hospitals and Clinics — Kansas City, Missouri, United States
  • Cardinal Glennon Children's Medical Center — St Louis, Missouri, United States
  • Washington University School of Medicine — St Louis, Missouri, United States
  • Mercy Hospital Saint Louis — St Louis, Missouri, United States
  • Children's Hospital and Medical Center of Omaha — Omaha, Nebraska, United States
  • University of Nebraska Medical Center — Omaha, Nebraska, United States
  • University Medical Center of Southern Nevada — Las Vegas, Nevada, United States
  • Sunrise Hospital and Medical Center — Las Vegas, Nevada, United States
  • Alliance for Childhood Diseases/Cure 4 the Kids Foundation — Las Vegas, Nevada, United States
  • Summerlin Hospital Medical Center — Las Vegas, Nevada, United States
  • Renown Regional Medical Center — Reno, Nevada, United States
  • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center — Lebanon, New Hampshire, United States
  • Hackensack University Medical Center — Hackensack, New Jersey, United States
  • Morristown Medical Center — Morristown, New Jersey, United States
  • Saint Peter's University Hospital — New Brunswick, New Jersey, United States
  • Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital — New Brunswick, New Jersey, United States
  • Newark Beth Israel Medical Center — Newark, New Jersey, United States
  • Saint Joseph's Regional Medical Center — Paterson, New Jersey, United States
  • Presbyterian Hospital — Albuquerque, New Mexico, United States
  • University of New Mexico Cancer Center — Albuquerque, New Mexico, United States
  • Albany Medical Center — Albany, New York, United States
  • Roswell Park Cancer Institute — Buffalo, New York, United States
  • The Steven and Alexandra Cohen Children's Medical Center of New York — New Hyde Park, New York, United States
  • Mount Sinai Hospital — New York, New York, United States
  • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center — New York, New York, United States
  • Memorial Sloan Kettering Cancer Center — New York, New York, United States
  • NYP/Weill Cornell Medical Center — New York, New York, United States
  • University of Rochester — Rochester, New York, United States
  • Stony Brook University Medical Center — Stony Brook, New York, United States
  • State University of New York Upstate Medical University — Syracuse, New York, United States
  • Montefiore Medical Center - Moses Campus — The Bronx, New York, United States
  • New York Medical College — Valhalla, New York, United States
  • Mission Hospital — Asheville, North Carolina, United States
  • Carolinas Medical Center/Levine Cancer Institute — Charlotte, North Carolina, United States
  • Novant Health Presbyterian Medical Center — Charlotte, North Carolina, United States
  • Duke University Medical Center — Durham, North Carolina, United States
  • East Carolina University — Greenville, North Carolina, United States
  • Wake Forest University Health Sciences — Winston-Salem, North Carolina, United States
  • Sanford Broadway Medical Center — Fargo, North Dakota, United States
  • Children's Hospital Medical Center of Akron — Akron, Ohio, United States
  • Cincinnati Children's Hospital Medical Center — Cincinnati, Ohio, United States
  • Rainbow Babies and Childrens Hospital — Cleveland, Ohio, United States
  • Cleveland Clinic Foundation — Cleveland, Ohio, United States
  • Nationwide Children's Hospital — Columbus, Ohio, United States
  • Dayton Children's Hospital — Dayton, Ohio, United States
  • ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital — Toledo, Ohio, United States
  • University of Oklahoma Health Sciences Center — Oklahoma City, Oklahoma, United States
  • Legacy Emanuel Children's Hospital — Portland, Oregon, United States
  • Oregon Health and Science University — Portland, Oregon, United States
  • Lehigh Valley Hospital-Cedar Crest — Allentown, Pennsylvania, United States
  • Geisinger Medical Center — Danville, Pennsylvania, United States
  • Penn State Children's Hospital — Hershey, Pennsylvania, United States
  • Children's Hospital of Philadelphia — Philadelphia, Pennsylvania, United States
  • Saint Christopher's Hospital for Children — Philadelphia, Pennsylvania, United States
  • Children's Hospital of Pittsburgh of UPMC — Pittsburgh, Pennsylvania, United States
  • Rhode Island Hospital — Providence, Rhode Island, United States
  • Medical University of South Carolina — Charleston, South Carolina, United States
  • Prisma Health Richland Hospital — Columbia, South Carolina, United States
  • BI-LO Charities Children's Cancer Center — Greenville, South Carolina, United States
  • Sanford USD Medical Center - Sioux Falls — Sioux Falls, South Dakota, United States
  • T C Thompson Children's Hospital — Chattanooga, Tennessee, United States
  • East Tennessee Childrens Hospital — Knoxville, Tennessee, United States
  • Saint Jude Children's Research Hospital — Memphis, Tennessee, United States
  • The Children's Hospital at TriStar Centennial — Nashville, Tennessee, United States
  • Vanderbilt University/Ingram Cancer Center — Nashville, Tennessee, United States
  • Texas Tech University Health Sciences Center-Amarillo — Amarillo, Texas, United States
  • Dell Children's Medical Center of Central Texas — Austin, Texas, United States
  • Driscoll Children's Hospital — Corpus Christi, Texas, United States
  • Medical City Dallas Hospital — Dallas, Texas, United States
  • UT Southwestern/Simmons Cancer Center-Dallas — Dallas, Texas, United States
  • El Paso Children's Hospital — El Paso, Texas, United States
  • Cook Children's Medical Center — Fort Worth, Texas, United States
  • Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center — Houston, Texas, United States
  • UT MD Anderson Cancer Center — Houston, Texas, United States
  • Covenant Children's Hospital — Lubbock, Texas, United States
  • UMC Cancer Center / UMC Health System — Lubbock, Texas, United States
  • Children's Hospital of San Antonio — San Antonio, Texas, United States
  • Methodist Children's Hospital of South Texas — San Antonio, Texas, United States
  • University of Texas Health Science Center at San Antonio — San Antonio, Texas, United States
  • Primary Children's Hospital — Salt Lake City, Utah, United States
  • University of Virginia Cancer Center — Charlottesville, Virginia, United States
  • Inova Fairfax Hospital — Falls Church, Virginia, United States
  • Children's Hospital of The King's Daughters — Norfolk, Virginia, United States
  • VCU Massey Comprehensive Cancer Center — Richmond, Virginia, United States
  • Carilion Children's — Roanoke, Virginia, United States
  • Seattle Children's Hospital — Seattle, Washington, United States
  • Providence Sacred Heart Medical Center and Children's Hospital — Spokane, Washington, United States
  • Mary Bridge Children's Hospital and Health Center — Tacoma, Washington, United States
  • Madigan Army Medical Center — Tacoma, Washington, United States
  • West Virginia University Charleston Division — Charleston, West Virginia, United States
  • Edwards Comprehensive Cancer Center — Huntington, West Virginia, United States
  • Saint Vincent Hospital Cancer Center Green Bay — Green Bay, Wisconsin, United States
  • University of Wisconsin Carbone Cancer Center - University Hospital — Madison, Wisconsin, United States
  • Marshfield Medical Center-Marshfield — Marshfield, Wisconsin, United States
  • Children's Hospital of Wisconsin — Milwaukee, Wisconsin, United States
  • John Hunter Children's Hospital — Hunter Regional Mail Centre, New South Wales, Australia
  • Sydney Children's Hospital — Randwick, New South Wales, Australia
  • The Children's Hospital at Westmead — Westmead, New South Wales, Australia
  • Queensland Children's Hospital — South Brisbane, Queensland, Australia
  • Women's and Children's Hospital-Adelaide — North Adelaide, South Australia, Australia
  • Monash Medical Center-Clayton Campus — Clayton, Victoria, Australia
  • Royal Children's Hospital — Parkville, Victoria, Australia
  • Perth Children's Hospital — Perth, Western Australia, Australia
  • Alberta Children's Hospital — Calgary, Alberta, Canada
  • University of Alberta Hospital — Edmonton, Alberta, Canada
  • British Columbia Children's Hospital — Vancouver, British Columbia, Canada
  • CancerCare Manitoba — Winnipeg, Manitoba, Canada
  • Janeway Child Health Centre — St. John's, Newfoundland and Labrador, Canada
  • IWK Health Centre — Halifax, Nova Scotia, Canada
  • McMaster Children's Hospital at Hamilton Health Sciences — Hamilton, Ontario, Canada
  • Children's Hospital — London, Ontario, Canada
  • Children's Hospital of Eastern Ontario — Ottawa, Ontario, Canada
  • Hospital for Sick Children — Toronto, Ontario, Canada
  • The Montreal Children's Hospital of the MUHC — Montreal, Quebec, Canada
  • Centre Hospitalier Universitaire Sainte-Justine — Montreal, Quebec, Canada
  • Centre Hospitalier Universitaire de Sherbrooke-Fleurimont — Sherbrooke, Quebec, Canada
  • CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL) — Québec, Canada
  • Starship Children's Hospital — Grafton, Auckland, New Zealand
  • Christchurch Hospital — Christchurch, New Zealand
  • HIMA San Pablo Oncologic Hospital — Caguas, Puerto Rico
  • University Pediatric Hospital — San Juan, Puerto Rico
  • King Faisal Specialist Hospital and Research Centre — Riyadh, Saudi Arabia
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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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