[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"trial:NCT04166409":3,"trial-entities:NCT04166409":1838,"trial-summary:NCT04166409":1841},{"id":4,"nct_id":4,"org_study_id":5,"brief_title":6,"official_title":7,"overall_status":8,"completion_date":9,"status_verified_date":10,"last_update_date":11,"start_date":12,"sponsor_name":13,"lead_sponsor_class":14,"has_dmc":15,"brief_summary":16,"detailed_description":17,"conditions":18,"keywords":25,"study_type":26,"primary_purpose":27,"phases":28,"enrollment_info":30,"interventions":33,"primary_outcomes":126,"secondary_outcomes":131,"sex":159,"minimum_age":160,"maximum_age":161,"healthy_volunteers":15,"eligibility_criteria":162,"std_ages":224,"locations":227,"central_contacts":1824,"overall_officials":1825,"references":1829,"see_also_links":1837},"NCT04166409","NCI-2019-07600","A Study of the Drugs Selumetinib vs. Carboplatin and Vincristine in Patients With Low-Grade Glioma","A Phase 3 Randomized Non-Inferiority Study of Carboplatin and Vincristine Versus Selumetinib (NSC# 748727) in Newly Diagnosed or Previously Untreated Low-Grade Glioma (LGG) Not Associated With BRAFV600E Mutations or Systemic Neurofibromatosis Type 1 (NF1)","RECRUITING","2030-12-31","2026-05","2026-09-11","2020-01-31","National Cancer Institute (NCI)","NIH",false,"This phase III trial compares the effect of selumetinib versus the standard of care treatment with carboplatin and vincristine (CV) in treating patients with newly diagnosed or previously untreated low-grade glioma (LGG) that does not have a genetic abnormality called BRAFV600E mutation and is not associated with systemic neurofibromatosis type 1. Selumetinib works by blocking some of the enzymes needed for cell growth and may kill tumor cells. Carboplatin is in a class of medications known as platinum-containing compounds. It works in a way similar to the anticancer drug cisplatin, but may be better tolerated than cisplatin. Carboplatin works by killing, stopping or slowing the growth of tumor cells. Vincristine is in a class of medications called vinca alkaloids. It works by stopping tumor cells from growing and dividing and may kill them. The overall goal of this study is to see if selumetinib works just as well as the standard treatment of CV for patients with LGG. Another goal of this study is to compare the effects of selumetinib versus CV in subjects with LGG to find out which is better. Additionally, this trial will also examine if treatment with selumetinib improves the quality of life for subjects who take it.","PRIMARY OBJECTIVE:\n\nI. To demonstrate that the efficacy of treatment with selumetinib as measured by event-free survival (EFS) is non-inferior compared to treatment with carboplatin\u002Fvincristine (CV) in previously-untreated low-grade glioma (LGG) not associated with BRAFV600E mutations or systemic neurofibromatosis type 1 (NF1).\n\nSECONDARY OBJECTIVES:\n\nI. To estimate tumor response rates to each regimen of chemotherapy. II. To evaluate visual acuity (VA) outcomes utilizing Teller Acuity Cards (TAC) and HOTV letter acuity testing in previously-untreated optic pathway gliomas (OPGs).\n\nIII. To describe the improvement in motor function as measured by the Vineland Scale in children with previously-untreated LGG that have motor deficits at enrollment.\n\nIV. To estimate the difference in EFS and tumor response rate between BRAF rearranged and non-BRAF rearranged patients treated on each chemotherapy regimen.\n\nV. To prospectively evaluate the quality of life of children with LGG not associated with BRAFV600E or systemic NF1 treated with either CV or selumetinib.\n\nVI. To prospectively evaluate the cognitive, social, emotional, and behavioral functioning of children with LGG not associated with BRAFV600E or systemic NF1 treated with either CV or selumetinib.\n\nEXPLORATORY OBJECTIVE:\n\nI. To obtain paired blood and tumor specimens for future biology studies as well as data from Molecular Characterization Initiative (MCI) testing, to correlate genomic drivers to efficacy outcomes.\n\nOUTLINE: Patients are randomized to 1 of 2 arms.\n\nARM I:\n\nINDUCTION: Patients receive vincristine sulfate intravenously (IV) on days 1, 8, 15, 22, 29, 36, 43, 50, 57, and 64, and carboplatin IV over 60 minutes on days 1, 8, 15, 22, 43, 50, 57, and 64 in the absence of disease progression or unacceptable toxicity. Patients also undergo collection of blood and magnetic resonance imaging (MRI) throughout the trial.\n\nMAINTENANCE: Patients receive vincristine sulfate IV on days 1, 8, and 15, and carboplatin IV over 60 minutes on days 1, 8, 15, and 22 of each cycle. Cycles repeat every 42 days for up to 8 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo collection of blood and MRI throughout the trial.\n\nARM II: Patients receive selumetinib sulfate orally (PO) twice daily (BID) on days 1-28 of each cycle. Cycles repeat every 28 days for up to 27 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo echocardiography (ECHO) at baseline and undergo collection of blood and MRI throughout the trial.\n\nAfter completion of study treatment, patients are followed up every 3 months for year 1, every 6 months for years 2-3, and then annually for years 4-10.",[19,20,21,22,23,24],"Low Grade Astrocytoma","Low Grade Glioma","Metastatic Low Grade Astrocytoma","Metastatic Low Grade Glioma","WHO Grade 1 Glioma","WHO Grade 2 Glioma",[],"INTERVENTIONAL","TREATMENT",[29],"PHASE3",{"count":31,"type":32},170,"ESTIMATED",[34,46,72,79,99,104,114],{"type":35,"name":36,"description":37,"armGroupLabels":38,"otherNames":41},"PROCEDURE","Biospecimen Collection","Undergo blood sample collection",[39,40],"Arm I (vincristine sulfate, carboplatin)","Arm II (selumetinib sulfate)",[42,43,44,45],"Biological Sample Collection","Biospecimen Collected","Sample Collection","Specimen Collection",{"type":47,"name":48,"description":49,"armGroupLabels":50,"otherNames":51},"DRUG","Carboplatin","Given IV",[39],[52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71],"Blastocarb","Carboplat","Carboplatin Hexal","Carboplatino","Carboplatinum","Carbosin","Carbosol","Carbotec","CBDCA","Displata","Ercar","JM-8","JM8","Nealorin","Novoplatinum","Paraplatin","Paraplatin AQ","Paraplatine","Platinwas","Ribocarbo",{"type":35,"name":73,"description":74,"armGroupLabels":75,"otherNames":76},"Echocardiography Test","Undergo ECHO",[40],[77,78],"EC","Echocardiography",{"type":35,"name":80,"description":81,"armGroupLabels":82,"otherNames":83},"Magnetic Resonance Imaging","Undergo MRI",[39,40],[84,85,86,87,88,89,90,91,92,93,94,95,96,97,98],"Magnetic Resonance","Magnetic Resonance Imaging (MRI)","Magnetic resonance imaging (procedure)","Magnetic Resonance Imaging Scan","Medical Imaging, Magnetic Resonance \u002F Nuclear Magnetic Resonance","MR","MR Imaging","MRI","MRI Scan","MRIs","NMR Imaging","NMRI","Nuclear Magnetic Resonance Imaging","sMRI","Structural MRI",{"type":100,"name":101,"description":102,"armGroupLabels":103},"OTHER","Questionnaire Administration","Ancillary studies",[39,40],{"type":47,"name":105,"description":106,"armGroupLabels":107,"otherNames":108},"Selumetinib Sulfate","Given PO",[40],[109,110,111,112,113],"AZD-6244 Hydrogen Sulfate","AZD6244 Hydrogen Sulfate","AZD6244 Hydrogen Sulphate","Koselugo","Selumetinib Sulphate",{"type":47,"name":115,"description":49,"armGroupLabels":116,"otherNames":117},"Vincristine Sulfate",[39],[118,119,120,121,122,123,124,125],"Kyocristine","Leurocristine Sulfate","Leurocristine, sulfate","Oncovin","Vincasar","Vincosid","Vincrex","Vincristine, sulfate",[127],{"measure":128,"description":129,"timeFrame":130},"Event-free survival (EFS)","The Kaplan-Meier method will be used to estimate EFS which is defined as the interval from randomization to first occurrence of clinical or radiographic disease progression, disease recurrence, second malignant neoplasm, or death from any cause, or to the date of last follow-up. Estimates with 95% confidence intervals will be reported by treatment arm. The hazard ratio with a confidence interval will also be reported to compare treatment arms based on a Cox proportional hazards model stratified by BRAF status, tumor location and size of residual tumor. Will also provide outcome estimates and their associated confidence intervals by sex, race and ethnicity, as descriptive summaries of outcome.","Up to 10 years from date of randomization",[132,136,139,143,147,151,155],{"measure":133,"description":134,"timeFrame":135},"Radiographic tumor response rate","Percentages of patients with responses (complete or partial response) will be reported by treatment arm with 95% confidence intervals. The result of an exact binomial test to test for the difference in response rates between treatment arm will also be reported. Will also provide outcome estimates and their associated confidence intervals by sex, race and ethnicity, as descriptive summaries of outcome.","Up to 10 years",{"measure":137,"description":138,"timeFrame":130},"Overall survival (OS)","The Kaplan-Meier method will be used to estimate OS by treatment arm, defined as the interval from randomization to death from any cause, or to the date of last follow-up. Estimates with confidence intervals will be reported by treatment arm. Will also provide outcome estimates and their associated confidence intervals by sex, race and ethnicity, as descriptive summaries of outcome.",{"measure":140,"description":141,"timeFrame":142},"Number of patients who experience an improvement in visual acuity (VA)","Numbers of patients that show improvement in VA after 12 months of treatment will be reported by treatment arm. Patients with at least 1 impaired eye are evaluable. In a patient with a unilateral optic nerve glioma, only the affected eye is considered. In patients with bilateral visual impairment, if VA improves in 1 eye but worsens in the other, the patient will be coded as a treatment failure, whereas if 1 eye improves and the other is at least stable, the patient will be coded as a success.","After the first 12 months of treatment",{"measure":144,"description":145,"timeFrame":146},"Change in motor function","Motor function is measured using the Vineland-3 Motor Scale. Only patients with motor function deficits at baseline are included. Magnitudes of change from baseline between the 2 treatment arms and provide a 90% 2-sided confidence interval for this difference.","After 48 weeks of therapy",{"measure":148,"description":149,"timeFrame":150},"Change in quality of life (QOL)","QOL will be measured using the PedsQL Total Scale Score as measured from the validated PedsQL Generic Module (for children 2-21 years old). Mean differences in the total scale score between 9 months and baseline will be reported by treatment arm. The results of 2-sample t-test comparing differences in the QOL scores between the 2 arms will also be reported. If change scores do not follow normal distributions, non-parametric alternatives may be employed for analysis.","Baseline and 9 months after treatment initiation",{"measure":152,"description":153,"timeFrame":154},"Processing speed function","Measured by Wechsler Processing Speed Index (standard score). Scores at 9 months will be summarized by treatment arm and reported as means (with standard deviations) or medians (with ranges) depending on the data distribution.","Up to 9 months post-treatment initiation",{"measure":156,"description":157,"timeFrame":158},"Change in executive function","Executive function will be measured by the Behavior Rating Inventory of Executive Function, Second Edition BRIEF Cognitive Regulation Index (CRI). Summary statistics for the differences in scores from baseline to 9 months will be reported by treatment arm.","Baseline and 9-months","ALL","2 Years","21 Years",{"inclusion":163,"exclusion":199,"raw_text":223},[164,165,166,167,168,169,170,171,172,173,174,175,176,177,178,179,180,181,182,183,184,185,186,187,188,189,190,191,192,193,194,195,196,197,198],"Patients must be \\>= 2 years and =\\\u003C 21 years at the time of enrollment","Patients must have a body surface area (BSA) of \\>= 0.5 m\\^2 at enrollment","Patients must have non-neurofibromatosis type 1 (non-NF1) low-grade glioma (LGG) without a BRAFV600E mutation as confirmed by Rapid Central Pathology and Molecular Screening Reviews performed on APEC14B1 (NCT02402244) Childhood Cancer Data Initiative (CCDI)-MCI, or accepted Clinical Laboratory Improvement Act (CLIA)-certified test and that has not been treated with any modality besides surgery. Note: Patients may be newly-diagnosed OR previously diagnosed, and there is no required time frame between biopsy\u002Fsurgery and treatment initiation.","Patients with residual tumor after resection or progressive tumor after initial diagnosis (with or without surgery) who have not received treatment (chemotherapy and\u002For radiation) are eligible","Patients must have two-dimensional measurable tumor \\>= 1 cm\\^2 to be eligible","Patients with ependymoma are not eligible","Eligible histologies will include all tumors considered low-grade glioma or low-grade astrocytoma (World Health Organization \\[WHO\\] grade I and II) by 5th edition WHO classification of central nervous system (CNS) tumors with the exception of subependymal giant cell astrocytoma","Patients with metastatic disease or multiple independent primary LGG are eligible","Creatinine clearance or radioisotope glomerular filtration rate (GFR) \\>= 70 mL\u002Fmin\u002F1.73 m\\^2 OR a serum creatinine based on age\u002Fsex as follows (performed within 7 days prior to enrollment):","Age: Maximum Serum Creatinine (mg\u002FdL)","2 to \\\u003C 6 years: 0.8 mg\u002FdL (male); 0.8 mg\u002FdL (female)","6 to \\\u003C 10 years: 1 mg\u002FdL (male); 1 mg\u002FdL (female)","10 to \\\u003C 13 years: 1.2 mg\u002FdL (male); 1.2 mg\u002FdL (female)","13 to \\\u003C 16 years: 1.5 mg\u002FdL (male); 1.4 mg\u002FdL (female)","\\>= 16 years: 1.7 mg\u002FdL (male); 1.4 mg\u002FdL (female)","Total bilirubin =\\\u003C 1.5 x upper limit of normal (ULN) for age (performed within 7 days prior to enrollment) (children with a diagnosis of Gilbert's syndrome will be allowed on study regardless of their total and indirect \\[unconjugated\\] bilirubin levels as long as their direct \\[conjugated\\] bilirubin is \\\u003C 3.1 mg\u002FdL)","Serum glutamic pyruvic transaminase (SGPT) (alanine aminotransferase \\[ALT\\]) =\\\u003C 135 U\u002FL (performed within 7 days prior to enrollment). For the purpose of this study, the ULN for SGPT is 45 U\u002FL","Albumin \\>= 2 g\u002FdL (performed within 7 days prior to enrollment)","Left ventricular ejection fraction (LVEF) \\>= 53% (or institutional normal; if the LVEF result is given as a range of values, then the upper value of the range will be used) by echocardiogram (performed within 4 weeks prior to enrollment)","Corrected QT (QTc) interval =\\\u003C 450 msec by electrocardiography (EKG) (performed within 4 weeks prior to enrollment)","Absolute neutrophil count \\>= 1,000\u002FuL (unsupported) (performed within 7 days prior to enrollment)","Platelets \\>= 100,000\u002FuL (unsupported) (performed within 7 days prior to enrollment)","Hemoglobin \\>= 8 g\u002FdL (may be supported) (performed within 7 days prior to enrollment)","Patients with a known seizure disorder must be stable and must not have experienced a significant increase in seizure frequency within 2 weeks prior to enrollment","Patients 2-17 years of age must have a blood pressure that is =\\\u003C 95th percentile for age, height, and sex at the time of enrollment (with or without the use of anti-hypertensive medications)","Patients \\>= 18 years of age must have a blood pressure =\\\u003C 130\u002F80 mmHg at the time of enrollment (with or without the use of anti-hypertensive medications)","Note for patients of all ages: Adequate blood pressure can be achieved using medication for the treatment of hypertension","All patients must have ophthalmology toxicity assessments performed within 8 weeks prior to enrollment","For all patients, an MRI of the brain (with orbital cuts for optic pathway tumors) and\u002For spine (depending on the site(s) of primary disease) with and without contrast must be performed within 8 weeks prior to 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 =\\\u003C 16 years of age","Patients must have the ability to swallow whole capsules","All patients and\u002For their parents or legal guardians must sign a written informed consent","All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met","All patients have signed an appropriate consent form and Health Insurance Portability and Accountability Act (HIPAA) authorization form (if applicable)","All patients have been consented and enrolled on APEC14B1 (NCT02402244) Part A for Pre-Enrollment Eligibility Screening for ACNS1833",[200,201,202,203,204,205,206,207,208,209,210,211,212,213,214,215,216,217,218,219,220,221,222],"Patients must not have received any prior tumor-directed therapy including chemotherapy, radiation therapy, immunotherapy, or bone marrow transplant. Prior surgical intervention (with the exclusion of laser interstitial thermal therapy \\[LITT\\]) is permitted","Patients with a concurrent malignancy or history of treatment (other than surgery) for another tumor within the last year are ineligible","Patients with diffuse intrinsic pontine tumors as seen on MRI (\\> 2\u002F3 of pons involvement on imaging) are not eligible even if biopsy reveals grade I\u002FII histology","Patients may not be receiving any other investigational agents","Patients with any serious medical or psychiatric illness\u002Fcondition, including substance use disorders or ophthalmological conditions, likely in the judgment of the investigator to interfere or limit compliance with study requirements\u002Ftreatment","Patients who, in the opinion of the investigator, are not able to comply with the study procedures are not eligible","Female patients who are pregnant are not eligible 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 are not eligible","Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation and for 1 week after stopping study therapy are not eligible.","Note: Women study participants of child-bearing potential must use acceptable contraception during the study and for 1 week (7 days) after the last dose of selumetinib. Men study participants with sexual partners who are pregnant or who are of child-bearing potential must use acceptable contraception during the study and for 1 week (7 days) after the last dose of study agent. Acceptable contraception includes implants, injectables, or oral contraceptives (all combined with barrier methods), some intrauterine devices (IUDs), vasectomy or abstinence","Known genetic disorder that increases risk for coronary artery disease. Note: The presence of dyslipidemia in a family with a history of myocardial infarction is not in itself an exclusion unless there is a known genetic disorder documented","Symptomatic heart failure","New York Health Association (NYHA) class II-IV prior or current cardiomyopathy","Severe valvular heart disease","History of atrial fibrillation","Current or past history of central serous retinopathy","Current or past history of retinal vein occlusion or retinal detachment","Patients with uncontrolled glaucoma","If checking pressure is clinically indicated, patients with intraocular pressure (IOP) \\> 22 mmHg or ULN adjusted by age are not eligible","Supplementation with vitamin E greater than 100% of the daily recommended dose. Any multivitamin containing vitamin E must be stopped prior to study enrollment even if less than 100% of the daily recommended dosing for vitamin E","Surgery within 2 weeks prior to enrollment, with the exception of surgical biopsy, placement of a vascular access device or cerebral spinal fluid (CSF) diverting procedure such as endoscopic third ventriculostomy (ETV) and ventriculoperitoneal (VP) shunt.","Note: Patients must have healed from any prior surgery","Patients who have an uncontrolled infection are not eligible","Inclusion Criteria:\n\n* Patients must be \\>= 2 years and =\\\u003C 21 years at the time of enrollment\n* Patients must have a body surface area (BSA) of \\>= 0.5 m\\^2 at enrollment\n* Patients must have non-neurofibromatosis type 1 (non-NF1) low-grade glioma (LGG) without a BRAFV600E mutation as confirmed by Rapid Central Pathology and Molecular Screening Reviews performed on APEC14B1 (NCT02402244) Childhood Cancer Data Initiative (CCDI)-MCI, or accepted Clinical Laboratory Improvement Act (CLIA)-certified test and that has not been treated with any modality besides surgery. Note: Patients may be newly-diagnosed OR previously diagnosed, and there is no required time frame between biopsy\u002Fsurgery and treatment initiation.\n\n  * Patients with residual tumor after resection or progressive tumor after initial diagnosis (with or without surgery) who have not received treatment (chemotherapy and\u002For radiation) are eligible\n  * Patients must have two-dimensional measurable tumor \\>= 1 cm\\^2 to be eligible\n  * Patients with ependymoma are not eligible\n* Eligible histologies will include all tumors considered low-grade glioma or low-grade astrocytoma (World Health Organization \\[WHO\\] grade I and II) by 5th edition WHO classification of central nervous system (CNS) tumors with the exception of subependymal giant cell astrocytoma\n* Patients with metastatic disease or multiple independent primary LGG are eligible\n* Creatinine clearance or radioisotope glomerular filtration rate (GFR) \\>= 70 mL\u002Fmin\u002F1.73 m\\^2 OR a serum creatinine based on age\u002Fsex as follows (performed within 7 days prior to enrollment):\n\n  * Age: Maximum Serum Creatinine (mg\u002FdL)\n  * 2 to \\\u003C 6 years: 0.8 mg\u002FdL (male); 0.8 mg\u002FdL (female)\n  * 6 to \\\u003C 10 years: 1 mg\u002FdL (male); 1 mg\u002FdL (female)\n  * 10 to \\\u003C 13 years: 1.2 mg\u002FdL (male); 1.2 mg\u002FdL (female)\n  * 13 to \\\u003C 16 years: 1.5 mg\u002FdL (male); 1.4 mg\u002FdL (female)\n  * \\>= 16 years: 1.7 mg\u002FdL (male); 1.4 mg\u002FdL (female)\n* Total bilirubin =\\\u003C 1.5 x upper limit of normal (ULN) for age (performed within 7 days prior to enrollment) (children with a diagnosis of Gilbert's syndrome will be allowed on study regardless of their total and indirect \\[unconjugated\\] bilirubin levels as long as their direct \\[conjugated\\] bilirubin is \\\u003C 3.1 mg\u002FdL)\n* Serum glutamic pyruvic transaminase (SGPT) (alanine aminotransferase \\[ALT\\]) =\\\u003C 135 U\u002FL (performed within 7 days prior to enrollment). For the purpose of this study, the ULN for SGPT is 45 U\u002FL\n* Albumin \\>= 2 g\u002FdL (performed within 7 days prior to enrollment)\n* Left ventricular ejection fraction (LVEF) \\>= 53% (or institutional normal; if the LVEF result is given as a range of values, then the upper value of the range will be used) by echocardiogram (performed within 4 weeks prior to enrollment)\n* Corrected QT (QTc) interval =\\\u003C 450 msec by electrocardiography (EKG) (performed within 4 weeks prior to enrollment)\n* Absolute neutrophil count \\>= 1,000\u002FuL (unsupported) (performed within 7 days prior to enrollment)\n* Platelets \\>= 100,000\u002FuL (unsupported) (performed within 7 days prior to enrollment)\n* Hemoglobin \\>= 8 g\u002FdL (may be supported) (performed within 7 days prior to enrollment)\n* Patients with a known seizure disorder must be stable and must not have experienced a significant increase in seizure frequency within 2 weeks prior to enrollment\n* Patients 2-17 years of age must have a blood pressure that is =\\\u003C 95th percentile for age, height, and sex at the time of enrollment (with or without the use of anti-hypertensive medications)\n* Patients \\>= 18 years of age must have a blood pressure =\\\u003C 130\u002F80 mmHg at the time of enrollment (with or without the use of anti-hypertensive medications)\n* Note for patients of all ages: Adequate blood pressure can be achieved using medication for the treatment of hypertension\n* All patients must have ophthalmology toxicity assessments performed within 8 weeks prior to enrollment\n* For all patients, an MRI of the brain (with orbital cuts for optic pathway tumors) and\u002For spine (depending on the site(s) of primary disease) with and without contrast must be performed within 8 weeks prior to enrollment\n* 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 =\\\u003C 16 years of age\n* Patients must have the ability to swallow whole capsules\n* All patients and\u002For their parents or legal guardians must sign a written informed consent\n* All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met\n* All patients have signed an appropriate consent form and Health Insurance Portability and Accountability Act (HIPAA) authorization form (if applicable)\n* All patients have been consented and enrolled on APEC14B1 (NCT02402244) Part A for Pre-Enrollment Eligibility Screening for ACNS1833\n\nExclusion Criteria:\n\n* Patients must not have received any prior tumor-directed therapy including chemotherapy, radiation therapy, immunotherapy, or bone marrow transplant. Prior surgical intervention (with the exclusion of laser interstitial thermal therapy \\[LITT\\]) is permitted\n* Patients with a concurrent malignancy or history of treatment (other than surgery) for another tumor within the last year are ineligible\n* Patients with diffuse intrinsic pontine tumors as seen on MRI (\\> 2\u002F3 of pons involvement on imaging) are not eligible even if biopsy reveals grade I\u002FII histology\n* Patients may not be receiving any other investigational agents\n* Patients with any serious medical or psychiatric illness\u002Fcondition, including substance use disorders or ophthalmological conditions, likely in the judgment of the investigator to interfere or limit compliance with study requirements\u002Ftreatment\n* Patients who, in the opinion of the investigator, are not able to comply with the study procedures are not eligible\n* Female patients who are pregnant are not eligible 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\n* Lactating females who plan to breastfeed their infants are not eligible\n* Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation and for 1 week after stopping study therapy are not eligible.\n\n  * Note: Women study participants of child-bearing potential must use acceptable contraception during the study and for 1 week (7 days) after the last dose of selumetinib. Men study participants with sexual partners who are pregnant or who are of child-bearing potential must use acceptable contraception during the study and for 1 week (7 days) after the last dose of study agent. Acceptable contraception includes implants, injectables, or oral contraceptives (all combined with barrier methods), some intrauterine devices (IUDs), vasectomy or abstinence\n* Known genetic disorder that increases risk for coronary artery disease. Note: The presence of dyslipidemia in a family with a history of myocardial infarction is not in itself an exclusion unless there is a known genetic disorder documented\n* Symptomatic heart failure\n* New York Health Association (NYHA) class II-IV prior or current cardiomyopathy\n* Severe valvular heart disease\n* History of atrial fibrillation\n* Current or past history of central serous retinopathy\n* Current or past history of retinal vein occlusion or retinal detachment\n* Patients with uncontrolled glaucoma\n\n  * If checking pressure is clinically indicated, patients with intraocular pressure (IOP) \\> 22 mmHg or ULN adjusted by age are not eligible\n* Supplementation with vitamin E greater than 100% of the daily recommended dose. Any multivitamin containing vitamin E must be stopped prior to study enrollment even if less than 100% of the daily recommended dosing for vitamin E\n* Surgery within 2 weeks prior to enrollment, with the exception of surgical biopsy, placement of a vascular access device or cerebral spinal fluid (CSF) diverting procedure such as endoscopic third ventriculostomy (ETV) and ventriculoperitoneal (VP) shunt.\n\n  * Note: Patients must have healed from any prior surgery\n* Patients who have an uncontrolled infection are not eligible",[225,226],"CHILD","ADULT",[228,246,259,271,284,297,309,321,331,340,353,366,379,391,404,418,431,444,458,472,486,494,507,517,525,534,547,557,564,576,580,593,606,620,633,647,660,669,679,692,704,717,727,741,753,766,779,792,805,818,832,844,852,856,869,880,893,900,914,923,935,948,962,974,984,997,1006,1019,1032,1045,1058,1070,1081,1090,1096,1108,1120,1134,1146,1158,1171,1183,1197,1210,1223,1235,1248,1260,1274,1288,1302,1314,1327,1336,1349,1362,1376,1389,1399,1412,1425,1437,1451,1464,1477,1490,1503,1512,1525,1534,1547,1557,1566,1579,1593,1607,1620,1633,1646,1659,1672,1682,1696,1710,1723,1738,1752,1766,1780,1790,1803,1816],{"facility":229,"status":8,"city":230,"state":231,"zip":232,"country":233,"contacts":234,"geoPoint":243},"Children's Hospital of Alabama","Birmingham","Alabama","35233","United States",[235,240],{"name":236,"role":237,"phone":238,"email":239},"Site Public Contact","CONTACT","205-638-9285","oncologyresearch@peds.uab.edu",{"name":241,"role":242},"Laura K. Metrock","PRINCIPAL_INVESTIGATOR",{"lat":244,"lon":245},33.52066,-86.80249,{"facility":247,"status":8,"city":248,"state":249,"zip":250,"country":233,"contacts":251,"geoPoint":256},"Banner Children's at Desert","Mesa","Arizona","85202",[252,254],{"name":236,"role":237,"phone":253},"480-412-3100",{"name":255,"role":242},"Joseph C. Torkildson",{"lat":257,"lon":258},33.42227,-111.82264,{"facility":260,"status":8,"city":261,"state":249,"zip":262,"country":233,"contacts":263,"geoPoint":268},"Phoenix Childrens Hospital","Phoenix","85016",[264,266],{"name":236,"role":237,"phone":265},"602-546-0920",{"name":267,"role":242},"Kazuhiro Sabet",{"lat":269,"lon":270},33.44838,-112.07404,{"facility":272,"status":8,"city":273,"state":274,"zip":275,"country":233,"contacts":276,"geoPoint":281},"Arkansas Children's Hospital","Little Rock","Arkansas","72202-3591",[277,279],{"name":236,"role":237,"phone":278},"501-364-7373",{"name":280,"role":242},"Michael W. 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Forouhar",{"lat":1670,"lon":1671},{"facility":1683,"status":8,"city":1684,"state":1685,"zip":1686,"country":233,"contacts":1687,"geoPoint":1693},"West Virginia University Healthcare","Morgantown","West Virginia","26506",[1688,1691],{"name":236,"role":237,"phone":1689,"email":1690},"304-293-7374","cancertrialsinfo@hsc.wvu.edu",{"name":1692,"role":242},"Ashley E. Meyer",{"lat":1694,"lon":1695},39.62953,-79.9559,{"facility":1697,"status":8,"city":1698,"state":1699,"zip":1700,"country":233,"contacts":1701,"geoPoint":1707},"University of Wisconsin Carbone Cancer Center - University Hospital","Madison","Wisconsin","53792",[1702,1705],{"name":236,"role":237,"phone":1703,"email":1704},"800-622-8922","clinicaltrials@cancer.wisc.edu",{"name":1706,"role":242},"Nicholas J. Pytel",{"lat":1708,"lon":1709},43.07305,-89.40123,{"facility":1711,"status":8,"city":1712,"state":1699,"zip":1713,"country":233,"contacts":1714,"geoPoint":1720},"Children's Hospital of Wisconsin","Milwaukee","53226",[1715,1718],{"name":236,"role":237,"phone":1716,"email":1717},"414-955-4727","MACCCTO@mcw.edu",{"name":1719,"role":242},"Sarah Rumler",{"lat":1721,"lon":1722},43.0389,-87.90647,{"facility":1724,"status":8,"city":1725,"state":1726,"zip":1727,"country":1728,"contacts":1729,"geoPoint":1735},"British Columbia Children's Hospital","Vancouver","British Columbia","V6H 3V4","Canada",[1730,1733],{"name":236,"role":237,"phone":1731,"phoneExt":1732},"604-875-2345","6477",{"name":1734,"role":242},"Rebecca J. Deyell",{"lat":1736,"lon":1737},49.24966,-123.11934,{"facility":1739,"status":8,"city":1740,"state":1741,"zip":1742,"country":1728,"contacts":1743,"geoPoint":1749},"Janeway Child Health Centre","St. John's","Newfoundland and Labrador","A1B 3V6",[1744,1747],{"name":236,"role":237,"phone":1745,"email":1746},"709-777-8727","beverlyj.mitchell@easternhealth.ca",{"name":1748,"role":242},"Lisa A. Goodyear",{"lat":1750,"lon":1751},47.56494,-52.70931,{"facility":1753,"status":8,"city":1754,"state":1755,"zip":1756,"country":1728,"contacts":1757,"geoPoint":1763},"IWK Health Centre","Halifax","Nova Scotia","B3K 6R8",[1758,1761],{"name":236,"role":237,"phone":1759,"email":1760},"902-470-8520","Research@iwk.nshealth.ca",{"name":1762,"role":242},"Chelsea Ash",{"lat":1764,"lon":1765},44.64269,-63.57688,{"facility":1767,"status":8,"city":1768,"state":1769,"zip":1770,"country":1728,"contacts":1771,"geoPoint":1777},"The Montreal Children's Hospital of the MUHC","Montreal","Quebec","H3H 1P3",[1772,1775],{"name":236,"role":237,"phone":1773,"email":1774},"514-412-4445","info@thechildren.com",{"name":1776,"role":242},"Stephanie Mourad",{"lat":1778,"lon":1779},45.50884,-73.58781,{"facility":1781,"status":8,"city":1768,"state":1769,"zip":1782,"country":1728,"contacts":1783,"geoPoint":1789},"Centre Hospitalier Universitaire Sainte-Justine","H3T 1C5",[1784,1787],{"name":236,"role":237,"phone":1785,"email":1786},"514-345-4931","yvan.samson@umontreal.ca",{"name":1788,"role":242},"Monia Marzouki",{"lat":1778,"lon":1779},{"facility":1791,"status":8,"city":1792,"state":1769,"zip":1793,"country":1728,"contacts":1794,"geoPoint":1800},"Centre Hospitalier Universitaire de Sherbrooke-Fleurimont","Sherbrooke","J1H 5N4",[1795,1798],{"name":236,"role":237,"phone":1796,"email":1797},"819-820-6480","crcinformation.chus@ssss.gouv.qc.ca",{"name":1799,"role":242},"Stephanie Vairy",{"lat":1801,"lon":1802},45.40008,-71.89908,{"facility":1804,"status":8,"city":1805,"zip":1806,"country":1728,"contacts":1807,"geoPoint":1813},"CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)","Québec","G1V 4G2",[1808,1811],{"name":236,"role":237,"phone":1809,"email":1810},"418-525-4444","rechclinique@crchudequebec.ulaval.ca",{"name":1812,"role":242},"Bruno Michon",{"lat":1814,"lon":1815},46.81228,-71.21454,{"facility":1817,"status":488,"city":1818,"zip":1819,"country":1820,"geoPoint":1821},"HIMA San Pablo Oncologic Hospital","Caguas","00726","Puerto Rico",{"lat":1822,"lon":1823},18.23412,-66.0485,[],[1826],{"name":1827,"affiliation":1828,"role":242},"Peter M de Blank","Children's Oncology Group",[1830,1834],{"pmid":1831,"type":1832,"citation":1833},"33395032","DERIVED","Bergqvist C, Wolkenstein P. MEK inhibitors in RASopathies. Curr Opin Oncol. 2021 Mar 1;33(2):110-119. doi: 10.1097\u002FCCO.0000000000000711.",{"pmid":1835,"type":1832,"citation":1836},"32597469","Arnold A, Rodriguez F, Eberhart CG, Raabe EH. Response to letter to the editor: \"All models are wrong; some models are useful\". Neuro Oncol. 2020 Sep 29;22(9):1406-1407. doi: 10.1093\u002Fneuonc\u002Fnoaa137. No abstract available.",[],{"nct_id":4,"conditions":1839,"biomarkers":1840},[19,20,23,24],[],{"nct_id":4,"found":1842,"summary":1843,"prompt_version":1853},true,{"design":1844,"status":1845,"heading":1846,"summary":1847,"follow_up":1848,"word_count":1849,"commitments":1850,"compensation":1851,"drugs_mentioned":1852},"This is a phase III interventional study comparing selumetinib to carboplatin and vincristine in 170 participants.","completed","Selumetinib vs. Carboplatin and Vincristine for Low-Grade Glioma","This study is comparing two treatments for children and young adults (ages 2-21) with a type of brain tumor called low-grade glioma (LGG). You might be eligible if your LGG does not have a specific genetic change (BRAFV600E mutation) and is not linked to neurofibromatosis type 1. The study is testing selumetinib, a drug that blocks enzymes needed for cell growth, against the standard treatment, which is a combination of carboplatin and vincristine. Carboplatin works by killing or slowing tumor cells, and vincristine is another type of chemotherapy. The main goal is to see if selumetinib is at least as effective as carboplatin and vincristine in preventing the tumor from growing or coming back. The study aims to enroll 170 participants, but its current status is unclear.","Your event-free survival (how long you live without the tumor growing or coming back) will be measured for up to 10 years from the date you start the study.",127,"You would undergo blood sample collection, echocardiography (ECHO) tests, and Magnetic Resonance Imaging (MRI) scans. You would also complete questionnaires.","Not stated in the trial record.",[48],"v2"]