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Brief Title: Nivolumab in Combination With Metronomic Chemotherapy in Paediatrics Refractory / Relapsing Solid Tumors
Official Title: Metro-PD1: a Phase I/II Trial Evaluating Anti-PD1 (Nivolumab) in Combination With Metronomic Chemotherapy in Children and Teenagers With Refractory / Relapsing Solid Tumors
Study ID: NCT03585465
Brief Summary: The study is a two-stage trial: 1. First stage (closed - 16 patients recruited in France): Phase I feasibility trial to evaluate the safety of the combination of Nivolumab + metronomic chemotherapy considering three possible metronomic chemotherapy regimens 2. Second stage (opened - 86 patients expected in France and Belgium): Phase II randomized controlled balanced 1:1 open-label trial comparing the efficacy of the metronomic chemotherapy regimen selected at the end of the previous stage (arm C: cyclophosphamide, capecitabine, vinblastine), with or without nivolumab. 3. "Trans-MetroPD1" ancillary sub-study is partially implemented since April 2022, and proposed to patients participating to second stage
Detailed Description: 1. First stage (closed): * Arm A: Nivolumab + Cyclophosphamide-Vinblastine * Arm B: Nivolumab + Capecitabin * Arm C: Nivolumab + Cyclophosphamide-Vinblastine + Capecitabin Arm A and Arm B have been allocated sequentially (A/B/A/B/A/B). Arm C has been opened, since arm A and Arm B were deemed safe. In each arm, the second patient was not recruited before the first patient has been observed for a 28-day duration. 2. Second stage (opened): Following the analysis of safety data from first stage, and according to IDMC's recommendations on December 2020, the metronomic chemotherapy selected for second stage was arm C: cyclophosphamide, capecitabine, vinblastine Randomization will be balanced 1:1, controlling for: * histological type: embryonal brain tumor, ependymoma, low-grade glioma, rhabdomyosarcoma, neuroblastoma, Ewing sarcoma, and other solid tumors after approval from coordinators, * and treating center, using a dynamic allocation of treatment (minimization program) with a random factor set at 0.8. 3. Trans-MetroPD1 is divided into 3 axes: * to evaluate the health-related quality of life * to measure the kinectis of progastrin/hPG80, a biomarker over-expressed in a wide range of cancers * to determine the distribution of immune cells within blood tissue
Minimum Age: 0 Years
Eligible Ages: CHILD, ADULT
Sex: ALL
Healthy Volunteers: No
Cliniques Universitaires Saint-Luc (CUSL), Brussel, , Belgium
University Hospital Ghent, Gent, , Belgium
University Hospital Leuven, Leuven, , Belgium
Centre Oscar Lambret, Lille, , France
Centre Léon Bérard (IHOPe), Lyon, , France
Hôpital La Timone, AP-HM, Marseille, , France
Hôpital d'Enfants - CHRU Nancy, Nancy, , France
Hôpital Mère-Enfant, CHU Nantes, Nantes, , France
Institut Curie, Paris, , France
Hôpital de Hautepierre, CHRU Strasbourg, Strasbourg, , France
Hôpital des Enfants - CHU Toulouse, Toulouse, , France
Name: Pierre LEBLOND, MD
Affiliation: Centre Oscar Lambret
Role: STUDY_DIRECTOR
Name: Nicolas ANDRE, MD
Affiliation: CHU La Timone
Role: STUDY_DIRECTOR
Name: Leen WILLEMS, MD
Affiliation: University Hospital, Ghent
Role: STUDY_DIRECTOR