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ACNS0122 set the modern American standard for children with the more aggressive kind of germ cell tumour of the brain: chemotherapy first, surgery for anything left, then radiotherapy to the whole brain and spine, which cured about nine in ten and became the benchmark that later trials tried to match with less radiation.
ACNS0122 was a Children's Oncology Group phase 2 study of 104 patients with newly diagnosed non-germinomatous germ cell tumours of the central nervous system. Induction was six cycles of carboplatin and etoposide alternating with ifosfamide and etoposide; patients with residual disease had second-look surgery, and those still not in complete response received high-dose thiotepa and etoposide with autologous stem cell rescue before craniospinal irradiation of 36 Gy with a boost to 54 Gy. The primary endpoint was the response rate to induction.
In the registry results 74 of 85 evaluable patients responded to induction chemotherapy. Three-year progression-free and overall survival were 92 and 94.1 percent, figures quoted as the benchmark in the successor trial ACNS1123, which tested reduced whole-ventricular radiotherapy against this standard. The corpus's germ cell tumour pages cite ACNS0122 for the chemotherapy-then-craniospinal-irradiation approach.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
104 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Response to induction chemotherapy (registry results)primary | Responders | - | 74 participants | - | - | link |
| Non-responders | - | 11 participants | ||||
| Progression-free survival at 3 years (as reported in the ACNS1123 comparison) | Chemotherapy, second-look surgery, 36 Gy craniospinal irradiation with boost | - | 92% | - | - | link |
| Overall survival at 3 years (as reported in the ACNS1123 comparison) | Chemotherapy, second-look surgery, 36 Gy craniospinal irradiation with boost | - | 94.1% | - | - | link |
Shares ACNS1123: response-based reduced radiotherapy for localised CNS non-germinomatous germ cell tumours, Central nervous system germ cell tumours (germinoma and non-germinomatous), Ifosfamide, Brain and spinal cord tumours (all types) and the tag soc-trials.
Shares Thiotepa, Autologous stem cell transplant (high-dose therapy), Brain and spinal cord tumours (all types), Childhood cancers (all types) and the tag soc-trials.
Shares Brain and spinal cord tumours (all types), Childhood cancers (all types), Children's Oncology Group (COG), Etoposide and the tag soc-trials.
Shares Thiotepa, Ifosfamide, Autologous stem cell transplant (high-dose therapy), Brain and spinal cord tumours (all types) and the tag soc-trials.
Shares Ifosfamide, Childhood cancers (all types), Children's Oncology Group (COG), Etoposide and the tag soc-trials.
Shares Childhood cancers (all types), Children's Oncology Group (COG), Etoposide, Carboplatin and the tag soc-trials.
Shares Autologous stem cell transplant (high-dose therapy), Childhood cancers (all types), Children's Oncology Group (COG), Etoposide and the tag soc-trials.
Shares Childhood cancers (all types), Children's Oncology Group (COG), Etoposide, Carboplatin and the tag soc-trials.