{ "FullStudy":{ "Rank":217667, "Study":{ "ProtocolSection":{ "IdentificationModule":{ "NCTId":"NCT01518413", "OrgStudyIdInfo":{ "OrgStudyId":"SorIrin1576" }, "Organization":{ "OrgFullName":"Children's National Research Institute", "OrgClass":"OTHER" }, "BriefTitle":"Dose Escalation Study of Sorafenib and Irinotecan Combination Therapy in Pediatric Patients With Solid Tumors", "OfficialTitle":"Phase 1 Dose Escalation Study of Sorafenib and Irinotecan Combination Therapy in Pediatric Patients With Relapsed or Refractory Solid Tumors" }, "StatusModule":{ "StatusVerifiedDate":"February 2015", "OverallStatus":"Completed", "ExpandedAccessInfo":{ "HasExpandedAccess":"No" }, "StartDateStruct":{ "StartDate":"December 2011" }, "PrimaryCompletionDateStruct":{ "PrimaryCompletionDate":"January 2015", "PrimaryCompletionDateType":"Actual" }, "CompletionDateStruct":{ "CompletionDate":"January 2015", "CompletionDateType":"Actual" }, "StudyFirstSubmitDate":"January 4, 2012", "StudyFirstSubmitQCDate":"January 25, 2012", "StudyFirstPostDateStruct":{ "StudyFirstPostDate":"January 26, 2012", "StudyFirstPostDateType":"Estimate" }, "LastUpdateSubmitDate":"February 26, 2015", "LastUpdatePostDateStruct":{ "LastUpdatePostDate":"February 27, 2015", "LastUpdatePostDateType":"Estimate" } }, "SponsorCollaboratorsModule":{ "ResponsibleParty":{ "ResponsiblePartyType":"Sponsor-Investigator", "ResponsiblePartyInvestigatorFullName":"HMeany", "ResponsiblePartyInvestigatorTitle":"Holly Meany, MD", "ResponsiblePartyInvestigatorAffiliation":"Children's National Research Institute" }, "LeadSponsor":{ "LeadSponsorName":"HMeany", "LeadSponsorClass":"OTHER" } }, "OversightModule":{ "OversightHasDMC":"Yes" }, "DescriptionModule":{ "BriefSummary":"The purpose of this study is to determine the safest and most effective oral dose combinations of sorafenib and irinotecan in pediatric patients with solid tumors, i.e. relapsed or refractory.", "DetailedDescription":"Sorafenib, a multi-kinase inhibitor of several targets felt to be important in tumor growth and angiogenesis, has been well studied and shown promising clinical results in adult cancer patients and the Maximum Tolerated Dose or MTD has been determined in pediatric patients. Irinotecan is known to be effective and is widely used in pediatric malignancies. The combination of sorafenib with irinotecan is of interest as these agents have different mechanisms of action. In addition, the combination has been evaluated in adult patients and deemed tolerable without alterations in the pharmacokinetic (PK) profile at the MTD. The trial we are proposing also offers the advantage of being a completely oral regimen, adding convenience and cost effectiveness. Given these considerations, if the sorafenib/irinotecan combination proves tolerable in phase I studies and shows efficacy in phase II studies, it would be an attractive combination to incorporate into existing chemotherapy regimens for pediatric cancer." }, "ConditionsModule":{ "ConditionList":{ "Condition":[ "Rhabdomyosarcoma and Other Soft Tissue Sarcomas", "Ewing's Sarcoma Family of Tumors", "Osteosarcoma", "Neuroblastoma", "Brain Tumors" ] }, "KeywordList":{ "Keyword":[ "Sora./Irino. combination therapy" ] } }, "DesignModule":{ "StudyType":"Interventional", "PhaseList":{ "Phase":[ "Phase 1" ] }, "DesignInfo":{ "DesignInterventionModel":"Single Group Assignment", "DesignPrimaryPurpose":"Treatment", "DesignMaskingInfo":{ "DesignMasking":"None (Open Label)" } }, "EnrollmentInfo":{ "EnrollmentCount":"17", "EnrollmentType":"Actual" } }, "ArmsInterventionsModule":{ "ArmGroupList":{ "ArmGroup":[ { "ArmGroupLabel":"Combination Therapy", "ArmGroupType":"Experimental", "ArmGroupDescription":"Three to 6 patient will be enrolled at each dose level and dose escalations will proceed in the absence of dose-limiting toxicity attributed to therapy, first with dose escalation of sorafenib and then, if tolerated, escalation of irinotecan.", "ArmGroupInterventionList":{ "ArmGroupInterventionName":[ "Drug: sorafenib", "Drug: irinotecan" ] } } ] }, "InterventionList":{ "Intervention":[ { "InterventionType":"Drug", "InterventionName":"sorafenib", "InterventionDescription":"sorafenib (50 and 200 mg tablets) orally twice daily, on a continuous schedule at a starting dose of 150mg/m2/dose.", "InterventionArmGroupLabelList":{ "InterventionArmGroupLabel":[ "Combination Therapy" ] } },{ "InterventionType":"Drug", "InterventionName":"irinotecan", "InterventionDescription":"irinotecan (70 mg/m2/dose) orally, concurrently, once daily,starting at the beginning of the 21 day cycle,repeated every 21 days", "InterventionArmGroupLabelList":{ "InterventionArmGroupLabel":[ "Combination Therapy" ] } } ] } }, "OutcomesModule":{ "PrimaryOutcomeList":{ "PrimaryOutcome":[ { "PrimaryOutcomeMeasure":"Toxicity Profile", "PrimaryOutcomeDescription":"Determine the toxicity profile, dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of sorafenib, when administered in combination with oral irinotecan in children with relapsed or refractory solid tumors.", "PrimaryOutcomeTimeFrame":"24 months" },{ "PrimaryOutcomeMeasure":"Patient Related Outcomes", "PrimaryOutcomeDescription":"Demonstrate the feasibility of incorporating measurement of patient-related outcome into a four site phase 1 trial of sorafenib and irinotecan for children and adolescents.\n\nDemonstrate feasibility: defined as 70% of participants will complete the 5 patient-reported outcomes (PROs) (pain, fatigue, worry, sadness and physical functioning) at both baseline (pre-treatment) and at the end of the first course and missing data will not be greater than 15% across the 5 PROs at either data point.", "PrimaryOutcomeTimeFrame":"24 months" } ] }, "SecondaryOutcomeList":{ "SecondaryOutcome":[ { "SecondaryOutcomeMeasure":"Pharmacokinetic Profile", "SecondaryOutcomeDescription":"Describe the plasma pharmacokinetic profile of sorafenib and irinotecan when administered as combination therapy in children and adolescents.", "SecondaryOutcomeTimeFrame":"24 months" },{ "SecondaryOutcomeMeasure":"Disease Evaluation", "SecondaryOutcomeDescription":"Evaluate disease response, based on criteria for measurable lesions (RECIST) and evaluable lesions, to guide further development in phase 2 studies.", "SecondaryOutcomeTimeFrame":"24 months" },{ "SecondaryOutcomeMeasure":"Integration of Patient Related Outcomes with other outcome measures", "SecondaryOutcomeDescription":"Correlate and integrate the PRO scores with traditional endpoints of toxicity, pharmacokinetic profile, and tumor response associated with the sorafenib and irinotecan combination.", "SecondaryOutcomeTimeFrame":"24 months" } ] } }, "EligibilityModule":{ "EligibilityCriteria":"Inclusion Criteria:\n\nAGE: >=2 year and <22 years of age.\n\nDIAGNOSIS: solid tumors, which may include but are not limited to rhabdomyosarcoma and other soft tissue sarcomas, Ewing's sarcoma family of tumors, osteosarcoma, neuroblastoma, Wilms' tumor, hepatic tumors, germ cell tumors and brain tumors.\nMEASURABLE/EVALUABLE DISEASE: Patients must have measurable or evaluable disease.\nTHERAPEUTIC OPTIONS:\n\nThe patient's cancer must have relapsed after or failed to respond to frontline curative therapy and there must not be other potentially curative treatment options available. Curative therapy may include surgery, radiation therapy, chemotherapy, or any combination of these modalities.\n\n• PRIOR THERAPY:\n\nPatients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to enrolling on this study.\nNo limitation on the number of prior chemotherapy regimens that the patient may have received prior to study enrollment.\nMyelosuppressive chemotherapy: The last dose of all myelosuppressive anticancer drugs must be at least 3 weeks prior to study entry.\nImmunotherapy: The last dose of immunotherapy (monoclonal antibody or vaccine) must be at least 4 weeks prior to study entry.\nBiologic (anti-cancer agent): The last dose of all biologic agents for the treatment of the patient's cancer (such as retinoids or tyrosine kinase inhibitors) must be at least 7 days prior to study entry. For agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur. The duration of this interval must be discussed with the study chair.\nInvestigational anti-cancer agent: The last dose of all investigational agents must be at least 30 days prior to study entry.\nRadiation therapy: The last dose of radiation to more than 25% of marrow containing bones (pelvis, spine, skull) must be at least 4 weeks prior to study entry. The last dose of all other local palliative (limited port) radiation must be at least 2 weeks prior to study entry.\nStem Cell Transplantation. At least 2 months post-autologous stem cell transplant or at least 3 months post-allogeneic transplant and recovered from toxicities without evidence of graft versus host disease.\nPrior camptothecins: Patients who previously received irinotecan as front line treatment or in an adjuvant setting are eligible if they did not experience severe toxicities (defined as grade 4 non-hematologic toxicity or failure to recover from any non-hematologic or hematologic toxicity within 6 weeks of receiving the drug) possibly, probably or definitely related to the agent, and they did not experience tumor progression during the time they received the agent. Patients who previously received topotecan are eligible.\n\nGrowth Factors. The last dose of colony stimulating factors, such as filgrastim, sargramostim, and erythropoietin, must be at least 1 week prior to study entry, the last dose of long-acting colony stimulating factors, such as pegfilgrastim, must be at least 2 weeks prior to study entry.\n\n• CONCURRENT THERAPIES:\n\nNo other anti-cancer therapy (chemotherapy, biological therapy, radiation therapy) is permitted.\n\n• PERFORMANCE STATUS:\n\nPatients > 10 years old must have a Karnofsky performance level >= 50%, and children <= 10 years old must have a Lansky performance level >= 50%.\n\nPatients who are unable to walk because of paralysis or motor weakness, but who are up in a wheelchair will be considered ambulatory for the purpose of calculating the performance score.\n\n• HEMATOLOGIC FUNCTION:\n\nPeripheral absolute neutrophil count (ANC) of >=750/mcL\n\nPlatelet count >=75,000/mcL without administration of platelets\n\n• HEPATIC FUNCTION:\n\nTotal bilirubin must be gender\n\nSGPT (ALT) must be - Serum albumin >/= 2 g/dL\n\nRENAL FUNCTION: Age-adjusted normal serum creatinine (see table below) OR a creatinine clearance >=60 mL/min/1.73 m2. Age Maximum Serum Creatinine (Years) (mg/dl) Male Female 2 to less than 6 years 0.8 0.8 6 to less than 10 years 1 1 10 to less than 13 years 1.2 1.2 13 years to less than 16 years 1.5 1.4 Greater than or equal to 16 years 1.7 1.4 The threshold creatinine values in this table were derived from the Schwartz formula for estimating GFR (Schwartz et.al. J Peds 106:522, 1985) utilizing child length and stature data published by the CDC.\nADEQUATE PULMONARY FUNCTION: Defined as no dyspnea at rest, no exercise intolerance, and a pulse oximetry >94% on room air if there is clinical indication for determination (cough, etc).\nNormal serum amylase and lipase\nPT and PTT <= 1.5 times the upper limit of normal for age (including patients on prophylactic anticoagulation). Prophylactic anticoagulation as described below is permitted:\nLow dose warfarin with PT-INR <= 1.5 x ULN. For subjects receiving warfarin, the PT-INR should be measured prior to initiation of trial drugs and should be monitored at least weekly, or as defined by the local standard of care, until it is stable.\nLow-dose aspirin (<= 100 mg daily).\nProphylactic doses of heparin.\nBlood pressure (BP) <= the 95th percentile for age, height and gender and not receiving anti-hypertensive medications or well controlled on antihypertensive medications for one week. Blood pressure will be recorded as the average of 2 measurements separated by at least 2 minutes. If the second value is more than 5 mmHg different from the first, continued measurements should be made every 2 minutes until a stable value is attained. The recorded value should be the average of the last two measurements obtained. Blood pressure is to be measured preferably in the right arm with an appropriate sized cuff, taken in a seated position after 3 minutes of rest. Oscillometric blood pressure measurements that exceed the 95th percentile should be confirmed by auscultation.\nBIRTH CONTROL: Patients of childbearing or child-fathering potential will be required and must be willing to use a medically acceptable form of birth control, which includes abstinence, while they are being treated on this study.\n\nExclusion Criteria:\n\nClinically significant unrelated systemic illness, such as serious infections, hepatic,renal or other organ dysfunction, which in the judgment of the Principal or Associate Investigator would compromise the patient's ability to tolerate the agents used in this trial or are likely to interfere with the study procedures or results.\n\nPatients with known intra-axial metastatic central nervous system lesions.\nPregnant or breast-feeding females are excluded because of the potential harmful effects of sorafenib and irinotecan on a developing fetus or nursing child.\nPatients currently receiving other anticancer agents or radiation therapy.\nPatients currently receiving other investigational agents.\nPrior treatment with a sorafenib containing regimen.\nInability to swallow pills.\nEvidence of bleeding diathesis and/or on therapeutic anti-coagulation medications.\nPatients with known Gilbert syndrome.\nPatients who take cytochrome P450 enzyme-inducing antiepileptic agents (phenytoin, carbamazepine, phenobarbitol), rifampin, erythromycin, azithromycin, azole antifungals, grape fruit juice or St. Johns Wort. Patients must have discontinued these medications at least 7 days prior to enrollment of trial.\nPatients with baseline hypertension (>=95th BP percentile for age, height and gender) and not controlled on anti-hypertensive medications.\nPatients with a malabsorption syndrome.\nPatients with known human immunodeficiency virus (HIV) infection or current chronic or active hepatitis B or C infection.\nPatients with serious non-healing wound, ulcer, or bone fracture.\nPatients with thrombotic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months.\nPatients with cardiac ventricular arrhythmias requiring anti-arrhythmic therapy,unstable angina (anginal symptoms at rest) or new onset angina (began within the last 3 months) or myocardial infarction within the past 6 months\nPatients who have undergone major surgery, open biopsy or significant traumatic injury within 4 weeks of study enrollment.\nPatients with known or suspected allergy to any agent given in the course of this trial.", "HealthyVolunteers":"No", "Gender":"All", "MinimumAge":"2 Years", "MaximumAge":"22 Years", "StdAgeList":{ "StdAge":[ "Child", "Adult" ] } }, "ContactsLocationsModule":{ "OverallOfficialList":{ "OverallOfficial":[ { "OverallOfficialName":"Holly Meany, MD", "OverallOfficialAffiliation":"Children's National Research Institute", "OverallOfficialRole":"Principal Investigator" } ] }, "LocationList":{ "Location":[ { "LocationFacility":"Children's National Medical Center", "LocationCity":"Washington", "LocationState":"District of Columbia", "LocationZip":"20010", "LocationCountry":"United States" },{ "LocationFacility":"National Cancer Institute", "LocationCity":"Bethesda", "LocationState":"Maryland", "LocationZip":"20892", "LocationCountry":"United States" },{ "LocationFacility":"Children's Hospital Boston/Dana-Farber Cancer Institute", "LocationCity":"Boston", "LocationState":"Massachusetts", "LocationZip":"02215", "LocationCountry":"United States" },{ "LocationFacility":"The Children's Hospital of Philadelphia", "LocationCity":"Philadelphia", "LocationState":"Pennsylvania", "LocationZip":"19104", "LocationCountry":"United States" } ] } } }, "DerivedSection":{ "MiscInfoModule":{ "VersionHolder":"April 22, 2020" }, "InterventionBrowseModule":{ "InterventionMeshList":{ "InterventionMesh":[ { "InterventionMeshId":"D000077146", "InterventionMeshTerm":"Irinotecan" },{ "InterventionMeshId":"D000077157", "InterventionMeshTerm":"Sorafenib" } ] }, "InterventionAncestorList":{ "InterventionAncestor":[ { "InterventionAncestorId":"D000059004", "InterventionAncestorTerm":"Topoisomerase I Inhibitors" },{ "InterventionAncestorId":"D000059003", "InterventionAncestorTerm":"Topoisomerase Inhibitors" },{ "InterventionAncestorId":"D000004791", "InterventionAncestorTerm":"Enzyme Inhibitors" },{ "InterventionAncestorId":"D000045504", "InterventionAncestorTerm":"Molecular Mechanisms of Pharmacological Action" },{ "InterventionAncestorId":"D000000970", "InterventionAncestorTerm":"Antineoplastic Agents" },{ "InterventionAncestorId":"D000047428", "InterventionAncestorTerm":"Protein Kinase Inhibitors" } ] }, "InterventionBrowseLeafList":{ "InterventionBrowseLeaf":[ { "InterventionBrowseLeafId":"M1680", "InterventionBrowseLeafName":"Sorafenib", "InterventionBrowseLeafAsFound":"Sorafenib", "InterventionBrowseLeafRelevance":"high" },{ "InterventionBrowseLeafId":"M1671", "InterventionBrowseLeafName":"Irinotecan", "InterventionBrowseLeafAsFound":"Irinotecan", "InterventionBrowseLeafRelevance":"high" },{ "InterventionBrowseLeafId":"M27936", "InterventionBrowseLeafName":"Topoisomerase I Inhibitors", "InterventionBrowseLeafRelevance":"low" },{ "InterventionBrowseLeafId":"M24407", "InterventionBrowseLeafName":"Protein Kinase Inhibitors", "InterventionBrowseLeafRelevance":"low" } ] }, "InterventionBrowseBranchList":{ "InterventionBrowseBranch":[ { "InterventionBrowseBranchAbbrev":"ANeo", "InterventionBrowseBranchName":"Antineoplastic Agents" },{ "InterventionBrowseBranchAbbrev":"All", "InterventionBrowseBranchName":"All Drugs and Chemicals" } ] } }, "ConditionBrowseModule":{ "ConditionMeshList":{ "ConditionMesh":[ { "ConditionMeshId":"D000012509", "ConditionMeshTerm":"Sarcoma" },{ "ConditionMeshId":"D000009447", "ConditionMeshTerm":"Neuroblastoma" },{ "ConditionMeshId":"D000012516", "ConditionMeshTerm":"Osteosarcoma" },{ "ConditionMeshId":"D000012208", "ConditionMeshTerm":"Rhabdomyosarcoma" },{ "ConditionMeshId":"D000012512", "ConditionMeshTerm":"Sarcoma, Ewing" },{ "ConditionMeshId":"D000009369", "ConditionMeshTerm":"Neoplasms" } ] }, "ConditionAncestorList":{ "ConditionAncestor":[ { "ConditionAncestorId":"D000018204", "ConditionAncestorTerm":"Neoplasms, Connective and Soft Tissue" },{ "ConditionAncestorId":"D000009370", "ConditionAncestorTerm":"Neoplasms by Histologic Type" },{ "ConditionAncestorId":"D000018241", "ConditionAncestorTerm":"Neuroectodermal Tumors, Primitive, Peripheral" },{ "ConditionAncestorId":"D000018242", "ConditionAncestorTerm":"Neuroectodermal Tumors, Primitive" },{ "ConditionAncestorId":"D000018302", "ConditionAncestorTerm":"Neoplasms, Neuroepithelial" },{ "ConditionAncestorId":"D000017599", "ConditionAncestorTerm":"Neuroectodermal Tumors" },{ "ConditionAncestorId":"D000009373", "ConditionAncestorTerm":"Neoplasms, Germ Cell and Embryonal" },{ "ConditionAncestorId":"D000009375", "ConditionAncestorTerm":"Neoplasms, Glandular and Epithelial" },{ "ConditionAncestorId":"D000009380", "ConditionAncestorTerm":"Neoplasms, Nerve Tissue" },{ "ConditionAncestorId":"D000018213", "ConditionAncestorTerm":"Neoplasms, Bone Tissue" },{ "ConditionAncestorId":"D000009372", "ConditionAncestorTerm":"Neoplasms, Connective Tissue" },{ "ConditionAncestorId":"D000009217", "ConditionAncestorTerm":"Myosarcoma" },{ "ConditionAncestorId":"D000009379", "ConditionAncestorTerm":"Neoplasms, Muscle Tissue" } ] }, "ConditionBrowseLeafList":{ "ConditionBrowseLeaf":[ { "ConditionBrowseLeafId":"M13910", "ConditionBrowseLeafName":"Sarcoma", "ConditionBrowseLeafAsFound":"Sarcoma", "ConditionBrowseLeafRelevance":"high" },{ "ConditionBrowseLeafId":"M13917", "ConditionBrowseLeafName":"Osteosarcoma", "ConditionBrowseLeafAsFound":"Osteosarcoma", "ConditionBrowseLeafRelevance":"high" },{ "ConditionBrowseLeafId":"M3791", "ConditionBrowseLeafName":"Brain Neoplasms", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M10974", "ConditionBrowseLeafName":"Neuroblastoma", "ConditionBrowseLeafAsFound":"Neuroblastoma", "ConditionBrowseLeafRelevance":"high" },{ "ConditionBrowseLeafId":"M13620", "ConditionBrowseLeafName":"Rhabdomyosarcoma", "ConditionBrowseLeafAsFound":"Rhabdomyosarcoma", "ConditionBrowseLeafRelevance":"high" },{ "ConditionBrowseLeafId":"M13913", "ConditionBrowseLeafName":"Sarcoma, Ewing", "ConditionBrowseLeafAsFound":"Ewing Sarcoma", "ConditionBrowseLeafRelevance":"high" },{ "ConditionBrowseLeafId":"M18933", "ConditionBrowseLeafName":"Neoplasms, Connective and Soft Tissue", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M10898", "ConditionBrowseLeafName":"Neoplasms by Histologic Type", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M18428", "ConditionBrowseLeafName":"Neuroectodermal Tumors", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M18971", "ConditionBrowseLeafName":"Neuroectodermal Tumors, Primitive", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M18970", "ConditionBrowseLeafName":"Neuroectodermal Tumors, Primitive, Peripheral", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M19030", "ConditionBrowseLeafName":"Neoplasms, Neuroepithelial", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M10901", "ConditionBrowseLeafName":"Neoplasms, Germ Cell and Embryonal", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M10903", "ConditionBrowseLeafName":"Neoplasms, Glandular and Epithelial", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M10908", "ConditionBrowseLeafName":"Neoplasms, Nerve Tissue", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M18942", "ConditionBrowseLeafName":"Neoplasms, Bone Tissue", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M10900", "ConditionBrowseLeafName":"Neoplasms, Connective Tissue", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"M10752", "ConditionBrowseLeafName":"Myosarcoma", "ConditionBrowseLeafRelevance":"low" },{ "ConditionBrowseLeafId":"T5309", "ConditionBrowseLeafName":"Soft Tissue Sarcoma", "ConditionBrowseLeafAsFound":"Soft Tissue Sarcoma", "ConditionBrowseLeafRelevance":"high" },{ "ConditionBrowseLeafId":"T4368", "ConditionBrowseLeafName":"Osteosarcoma", "ConditionBrowseLeafAsFound":"Osteosarcoma", "ConditionBrowseLeafRelevance":"high" },{ "ConditionBrowseLeafId":"T4112", "ConditionBrowseLeafName":"Neuroblastoma", "ConditionBrowseLeafAsFound":"Neuroblastoma", "ConditionBrowseLeafRelevance":"high" },{ "ConditionBrowseLeafId":"T2160", "ConditionBrowseLeafName":"Ewing Sarcoma", "ConditionBrowseLeafAsFound":"Ewing Sarcoma", "ConditionBrowseLeafRelevance":"high" },{ "ConditionBrowseLeafId":"T4119", "ConditionBrowseLeafName":"Neuroepithelioma", "ConditionBrowseLeafRelevance":"low" } ] }, "ConditionBrowseBranchList":{ "ConditionBrowseBranch":[ { "ConditionBrowseBranchAbbrev":"BC04", "ConditionBrowseBranchName":"Cancers and Other Neoplasms" },{ "ConditionBrowseBranchAbbrev":"All", "ConditionBrowseBranchName":"All Conditions" },{ "ConditionBrowseBranchAbbrev":"BC10", "ConditionBrowseBranchName":"Nervous System Diseases" },{ "ConditionBrowseBranchAbbrev":"BC17", "ConditionBrowseBranchName":"Skin and Connective Tissue Diseases" },{ "ConditionBrowseBranchAbbrev":"Rare", "ConditionBrowseBranchName":"Rare Diseases" } ] } } } } } }