[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100492387":3},{"organization":4,"armGroups":7,"interventions":39,"overallOfficials":241,"centralContacts":246,"locations":247,"responsibleParty":3007,"collaborators":246,"id":3009,"slug":3010,"hasResults":3011,"nctId":3012,"briefTitle":3013,"officialTitle":3014,"acronym":246,"eligibilityCriteria":3015,"healthyVolunteers":3011,"sex":3016,"minAge":246,"maxAge":3017,"enrollmentInfo":3018,"targetDuration":246,"studyType":3021,"phases":3022,"briefSummary":3025,"conditions":3026,"keywords":246,"overallStatus":250,"whyStopped":246,"lastUpdateSubmitDate":3031,"lastUpdatePostDateStruct":3032,"startDateStruct":3035,"completionDateStruct":3037,"leadSponsor":3039,"locationsCount":3040},{"fullName":5,"class":6},"National Cancer Institute (NCI)","NIH",[8,21,27,31,35],{"label":9,"type":10,"description":11,"interventionNames":12},"Efficacy Phase Arm A (MAP)","ACTIVE_COMPARATOR","Standard risk patients receive methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day \"induction\" cycles, followed by appropriate local control. Patients then receive \"consolidation\" with methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day cycles and methotrexate IV and doxorubicin IV for two additional 35-day cycles. Patients also undergo X-ray, CT, MRI, and PET or bone scintigraphy at diagnosis and additional time points throughout the trial. All patients also undergo collection of blood samples during screening and on study.",[13,14,15,16,17,18,19,20],"Procedure: Bone Scan","Drug: Cisplatin","Procedure: Computed Tomography","Drug: Doxorubicin Hydrochloride","Procedure: Magnetic Resonance Imaging","Drug: Methotrexate","Procedure: Surgical Procedure","Procedure: X-Ray Imaging",{"label":22,"type":23,"description":24,"interventionNames":25},"Efficacy Phase Arm B (cabozantinib, MAP)","EXPERIMENTAL","Standard risk patients receive cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day \"induction\" cycles, followed by appropriate local control. Patients then receive one 35-day \"consolidation\" cycle with methotrexate IV, doxorubicin IV, and cisplatin IV, then a second 35-day \"consolidation\" cycle with cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV, followed by two additional 35-day \"consolidation\" cycles with cabozantinib PO, methotrexate IV, and doxorubicin IV. Patients then receive cabozantinib PO for six 28-day \"maintenance\" cycles. Patients also undergo X-ray, CT, MRI, and PET or bone scintigraphy at diagnosis and additional time points throughout the trial. All patients also undergo collection of blood samples during screening and on study.",[13,26,14,15,16,17,18,19,20],"Drug: Cabozantinib S-malate",{"label":28,"type":10,"description":29,"interventionNames":30},"Efficacy Phase Arm C (MAP)","High risk patients receive methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day \"induction\" cycles, followed by appropriate local control. Patients then receive \"consolidation\" with methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day cycles and methotrexate IV and doxorubicin IV for two additional 35-day cycles. Patients also undergo X-ray, CT, MRI, and PET or bone scintigraphy at diagnosis and additional time points throughout the trial. All patients also undergo collection of blood samples during screening and on study.",[13,14,15,16,17,18,19,20],{"label":32,"type":23,"description":33,"interventionNames":34},"Efficacy Phase Arm D (cabozantinib, MAP)","High risk patients receive cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV for two 35-day \"induction\" cycles, followed by appropriate local control. Patients then receive one 35-day \"consolidation\" cycle with methotrexate IV, doxorubicin IV, and cisplatin IV, then a second 35-day \"consolidation\" cycle with cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV, followed by two additional 35-day \"consolidation\" cycles with cabozantinib PO, methotrexate IV, and doxorubicin IV. Patients then receive cabozantinib PO for six 28-day \"maintenance\" cycles. Patients also undergo X-ray, CT, MRI, and PET or bone scintigraphy at diagnosis and additional time points throughout the trial. All patients also undergo collection of blood samples during screening and on study.",[13,26,14,15,16,17,18,20],{"label":36,"type":23,"description":37,"interventionNames":38},"Feasibility phase (cabozantinib, MAP)","(CLOSED TO ACCRUAL 05\u002F09\u002F2025): Patients receive cabozantinib orally (PO), methotrexate intravenously (IV), doxorubicin IV, and cisplatin IV for two 35-day \"induction\" cycles. Patients are then considered for appropriate local control. Then they receive \"consolidation\" with methotrexate IV, doxorubicin IV, and cisplatin IV for one 35-day cycle, followed by cabozantinib PO, methotrexate IV, doxorubicin IV, and cisplatin IV for one 35-day cycle, and cabozantinib PO, methotrexate IV, and doxorubicin IV for two 35-day cycles. 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Hospital of Alabama","RECRUITING","Birmingham","Alabama","35233","United States","US",{"type":257,"coordinates":258},"Point",[259,260],-86.80249,33.52066,{"lat":260,"lon":259},[263,268],{"name":264,"role":265,"phone":266,"phoneExt":246,"email":267},"Site Public Contact","CONTACT","205-638-9285","oncologyresearch@peds.uab.edu",{"name":269,"role":245,"phone":246,"phoneExt":246,"email":246},"Jamie M. Aye",{"facility":271,"status":250,"city":272,"state":273,"zip":274,"country":254,"countryCode":255,"cosmosGeoPoint":275,"geoPoint":279,"contacts":280},"Banner Children's at Desert","Mesa","Arizona","85202",{"type":257,"coordinates":276},[277,278],-111.82264,33.42227,{"lat":278,"lon":277},[281,283],{"name":264,"role":265,"phone":282,"phoneExt":246,"email":246},"480-412-3100",{"name":284,"role":245,"phone":246,"phoneExt":246,"email":246},"Joseph C. Torkildson",{"facility":286,"status":250,"city":287,"state":273,"zip":288,"country":254,"countryCode":255,"cosmosGeoPoint":289,"geoPoint":293,"contacts":294},"Phoenix Childrens Hospital","Phoenix","85016",{"type":257,"coordinates":290},[291,292],-112.07404,33.44838,{"lat":292,"lon":291},[295,297],{"name":264,"role":265,"phone":296,"phoneExt":246,"email":246},"602-546-0920",{"name":298,"role":245,"phone":246,"phoneExt":246,"email":246},"Alok K. Kothari",{"facility":300,"status":250,"city":287,"state":273,"zip":301,"country":254,"countryCode":255,"cosmosGeoPoint":302,"geoPoint":304,"contacts":305},"Mayo Clinic Hospital in Arizona","85054",{"type":257,"coordinates":303},[291,292],{"lat":292,"lon":291},[306,308],{"name":264,"role":265,"phone":307,"phoneExt":246,"email":246},"855-776-0015",{"name":309,"role":245,"phone":246,"phoneExt":246,"email":246},"Wendy Allen-Rhoades",{"facility":311,"status":250,"city":312,"state":273,"zip":313,"country":254,"countryCode":255,"cosmosGeoPoint":314,"geoPoint":318,"contacts":319},"Banner University Medical Center - Tucson","Tucson","85719",{"type":257,"coordinates":315},[316,317],-110.92648,32.22174,{"lat":317,"lon":316},[320,322],{"name":264,"role":265,"phone":246,"phoneExt":246,"email":321},"UACC-IIT@uacc.arizona.edu",{"name":323,"role":245,"phone":246,"phoneExt":246,"email":246},"Monica M. Davini",{"facility":325,"status":250,"city":326,"state":327,"zip":328,"country":254,"countryCode":255,"cosmosGeoPoint":329,"geoPoint":333,"contacts":334},"Arkansas Children's Hospital","Little Rock","Arkansas","72202-3591",{"type":257,"coordinates":330},[331,332],-92.28959,34.74648,{"lat":332,"lon":331},[335,337],{"name":264,"role":265,"phone":336,"phoneExt":246,"email":246},"501-364-7373",{"name":338,"role":245,"phone":246,"phoneExt":246,"email":246},"Michael W. Bishop",{"facility":340,"status":250,"city":341,"state":342,"zip":343,"country":254,"countryCode":255,"cosmosGeoPoint":344,"geoPoint":348,"contacts":349},"Kaiser Permanente Downey Medical Center","Downey","California","90242",{"type":257,"coordinates":345},[346,347],-118.13257,33.94001,{"lat":347,"lon":346},[350,352],{"name":264,"role":265,"phone":351,"phoneExt":246,"email":246},"626-564-3455",{"name":353,"role":245,"phone":246,"phoneExt":246,"email":246},"Robert M. Cooper",{"facility":355,"status":250,"city":356,"state":342,"zip":357,"country":254,"countryCode":255,"cosmosGeoPoint":358,"geoPoint":362,"contacts":363},"City of Hope Comprehensive Cancer Center","Duarte","91010",{"type":257,"coordinates":359},[360,361],-117.97729,34.13945,{"lat":361,"lon":360},[364,367],{"name":264,"role":265,"phone":365,"phoneExt":246,"email":366},"800-826-4673","becomingapatient@coh.org",{"name":368,"role":245,"phone":246,"phoneExt":246,"email":246},"Janet M. Yoon",{"facility":370,"status":250,"city":371,"state":342,"zip":372,"country":254,"countryCode":255,"cosmosGeoPoint":373,"geoPoint":377,"contacts":378},"Loma Linda University Medical Center","Loma Linda","92354",{"type":257,"coordinates":374},[375,376],-117.26115,34.04835,{"lat":376,"lon":375},[379,381],{"name":264,"role":265,"phone":380,"phoneExt":246,"email":246},"909-558-4050",{"name":382,"role":245,"phone":246,"phoneExt":246,"email":246},"Albert Kheradpour",{"facility":384,"status":250,"city":385,"state":342,"zip":386,"country":254,"countryCode":255,"cosmosGeoPoint":387,"geoPoint":391,"contacts":392},"Miller Children's and Women's Hospital Long Beach","Long Beach","90806",{"type":257,"coordinates":388},[389,390],-118.18923,33.76696,{"lat":390,"lon":389},[393,395],{"name":264,"role":265,"phone":394,"phoneExt":246,"email":246},"562-933-5600",{"name":396,"role":245,"phone":246,"phoneExt":246,"email":246},"Jacqueline N. Casillas",{"facility":398,"status":250,"city":399,"state":342,"zip":400,"country":254,"countryCode":255,"cosmosGeoPoint":401,"geoPoint":405,"contacts":406},"Children's Hospital Los Angeles","Los Angeles","90027",{"type":257,"coordinates":402},[403,404],-118.24368,34.05223,{"lat":404,"lon":403},[407,409],{"name":264,"role":265,"phone":408,"phoneExt":246,"email":246},"323-361-4110",{"name":410,"role":245,"phone":246,"phoneExt":246,"email":246},"Fariba Navid",{"facility":412,"status":250,"city":399,"state":342,"zip":413,"country":254,"countryCode":255,"cosmosGeoPoint":414,"geoPoint":416,"contacts":417},"Cedars-Sinai Medical Center","90048",{"type":257,"coordinates":415},[403,404],{"lat":404,"lon":403},[418,421],{"name":264,"role":265,"phone":419,"phoneExt":246,"email":420},"310-423-2133","Cancer.trial.info@cshs.org",{"name":422,"role":245,"phone":246,"phoneExt":246,"email":246},"Leo Mascarenhas",{"facility":424,"status":250,"city":399,"state":342,"zip":425,"country":254,"countryCode":255,"cosmosGeoPoint":426,"geoPoint":428,"contacts":429},"Mattel Children's Hospital UCLA","90095",{"type":257,"coordinates":427},[403,404],{"lat":404,"lon":403},[430,432],{"name":264,"role":265,"phone":431,"phoneExt":246,"email":246},"310-825-6708",{"name":433,"role":245,"phone":246,"phoneExt":246,"email":246},"Satiro N. De Oliveira",{"facility":435,"status":250,"city":436,"state":342,"zip":437,"country":254,"countryCode":255,"cosmosGeoPoint":438,"geoPoint":442,"contacts":443},"Valley Children's Hospital","Madera","93636",{"type":257,"coordinates":439},[440,441],-120.06072,36.96134,{"lat":441,"lon":440},[444,447],{"name":264,"role":265,"phone":445,"phoneExt":246,"email":446},"559-353-3000","Research@valleychildrens.org",{"name":448,"role":245,"phone":246,"phoneExt":246,"email":246},"Ruetima Titapiwatanakun",{"facility":450,"status":250,"city":451,"state":342,"zip":452,"country":254,"countryCode":255,"cosmosGeoPoint":453,"geoPoint":457,"contacts":458},"UCSF Benioff Children's Hospital Oakland","Oakland","94609",{"type":257,"coordinates":454},[455,456],-122.2708,37.80437,{"lat":456,"lon":455},[459,462],{"name":264,"role":265,"phone":460,"phoneExt":246,"email":461},"510-428-3264","PedOncRschOAK@ucsf.edu",{"name":463,"role":245,"phone":246,"phoneExt":246,"email":246},"Jennifer G. Michlitsch",{"facility":465,"status":250,"city":451,"state":342,"zip":466,"country":254,"countryCode":255,"cosmosGeoPoint":467,"geoPoint":469,"contacts":470},"Kaiser Permanente-Oakland","94611",{"type":257,"coordinates":468},[455,456],{"lat":456,"lon":455},[471,474],{"name":264,"role":265,"phone":472,"phoneExt":246,"email":473},"877-642-4691","Kpoct@kp.org",{"name":475,"role":245,"phone":246,"phoneExt":246,"email":246},"Aarati V. Rao",{"facility":477,"status":250,"city":478,"state":342,"zip":479,"country":254,"countryCode":255,"cosmosGeoPoint":480,"geoPoint":484,"contacts":485},"Children's Hospital of Orange County","Orange","92868",{"type":257,"coordinates":481},[482,483],-117.85311,33.78779,{"lat":483,"lon":482},[486,489],{"name":264,"role":265,"phone":487,"phoneExt":246,"email":488},"714-509-8646","oncresearch@choc.org",{"name":490,"role":245,"phone":246,"phoneExt":246,"email":246},"Elyssa M. Rubin",{"facility":492,"status":250,"city":493,"state":342,"zip":494,"country":254,"countryCode":255,"cosmosGeoPoint":495,"geoPoint":499,"contacts":500},"Lucile Packard Children's Hospital Stanford University","Palo Alto","94304",{"type":257,"coordinates":496},[497,498],-122.14302,37.44188,{"lat":498,"lon":497},[501,504],{"name":264,"role":265,"phone":502,"phoneExt":246,"email":503},"800-694-0012","ccto-office@stanford.edu",{"name":505,"role":245,"phone":246,"phoneExt":246,"email":246},"Jay Michael S. Balagtas",{"facility":507,"status":250,"city":508,"state":342,"zip":509,"country":254,"countryCode":255,"cosmosGeoPoint":510,"geoPoint":514,"contacts":515},"University of California Davis Comprehensive Cancer Center","Sacramento","95817",{"type":257,"coordinates":511},[512,513],-121.4944,38.58157,{"lat":513,"lon":512},[516,518],{"name":264,"role":265,"phone":517,"phoneExt":246,"email":246},"916-734-3089",{"name":519,"role":245,"phone":246,"phoneExt":246,"email":246},"Marcio H. 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Lewis",{"facility":2812,"status":250,"city":2813,"state":2796,"zip":2814,"country":2798,"countryCode":2799,"cosmosGeoPoint":2815,"geoPoint":2819,"contacts":2820},"University of Alberta Hospital","Edmonton","T6G 2B7",{"type":257,"coordinates":2816},[2817,2818],-113.46871,53.55014,{"lat":2818,"lon":2817},[2821,2824],{"name":264,"role":265,"phone":2822,"phoneExt":246,"email":2823},"780-407-8798","pedsoncologyresearch@ahs.ca",{"name":2825,"role":245,"phone":246,"phoneExt":246,"email":246},"Sarah J. McKillop",{"facility":2827,"status":250,"city":2828,"state":2829,"zip":2830,"country":2798,"countryCode":2799,"cosmosGeoPoint":2831,"geoPoint":2835,"contacts":2836},"CancerCare Manitoba","Winnipeg","Manitoba","R3E 0V9",{"type":257,"coordinates":2832},[2833,2834],-97.14704,49.8844,{"lat":2834,"lon":2833},[2837,2840],{"name":264,"role":265,"phone":2838,"phoneExt":246,"email":2839},"866-561-1026","ctu_web@cancercare.mb.ca",{"name":2841,"role":245,"phone":246,"phoneExt":246,"email":246},"Stephanie M. Villeneuve",{"facility":2843,"status":250,"city":2844,"state":2845,"zip":2846,"country":2798,"countryCode":2799,"cosmosGeoPoint":2847,"geoPoint":2851,"contacts":2852},"IWK Health Centre","Halifax","Nova Scotia","B3K 6R8",{"type":257,"coordinates":2848},[2849,2850],-63.57688,44.64269,{"lat":2850,"lon":2849},[2853,2856],{"name":264,"role":265,"phone":2854,"phoneExt":246,"email":2855},"902-470-8520","Research@iwk.nshealth.ca",{"name":2857,"role":245,"phone":246,"phoneExt":246,"email":246},"Chelsea Ash",{"facility":2859,"status":250,"city":2860,"state":2861,"zip":2862,"country":2798,"countryCode":2799,"cosmosGeoPoint":2863,"geoPoint":2867,"contacts":2868},"Children's Hospital","London","Ontario","N6A 5W9",{"type":257,"coordinates":2864},[2865,2866],-81.23304,42.98339,{"lat":2866,"lon":2865},[2869,2871],{"name":264,"role":265,"phone":2870,"phoneExt":246,"email":246},"519-685-8306",{"name":2872,"role":245,"phone":246,"phoneExt":246,"email":246},"Shayna M. Zelcer",{"facility":2874,"status":250,"city":2875,"state":2861,"zip":2876,"country":2798,"countryCode":2799,"cosmosGeoPoint":2877,"geoPoint":2881,"contacts":2882},"Children's Hospital of Eastern Ontario","Ottawa","K1H 8L1",{"type":257,"coordinates":2878},[2879,2880],-75.69812,45.41117,{"lat":2880,"lon":2879},[2883,2885],{"name":264,"role":265,"phone":2884,"phoneExt":246,"email":246},"613-737-7600",{"name":2886,"role":245,"phone":246,"phoneExt":246,"email":246},"Donna L. Johnston",{"facility":2888,"status":250,"city":2889,"state":2861,"zip":2890,"country":2798,"countryCode":2799,"cosmosGeoPoint":2891,"geoPoint":2895,"contacts":2896},"Hospital for Sick Children","Toronto","M5G 1X8",{"type":257,"coordinates":2892},[2893,2894],-79.39864,43.70643,{"lat":2894,"lon":2893},[2897,2900],{"name":264,"role":265,"phone":2898,"phoneExt":246,"email":2899},"416-813-7654","ask.CRS@sickkids.ca",{"name":2901,"role":245,"phone":246,"phoneExt":246,"email":246},"Sarah A. Cohen-Gogo",{"facility":2903,"status":250,"city":2904,"state":2905,"zip":2906,"country":2798,"countryCode":2799,"cosmosGeoPoint":2907,"geoPoint":2911,"contacts":2912},"The Montreal Children's Hospital of the MUHC","Montreal","Quebec","H3H 1P3",{"type":257,"coordinates":2908},[2909,2910],-73.58781,45.50884,{"lat":2910,"lon":2909},[2913,2916],{"name":264,"role":265,"phone":2914,"phoneExt":246,"email":2915},"514-412-4445","info@thechildren.com",{"name":2917,"role":245,"phone":246,"phoneExt":246,"email":246},"Stephanie Mourad",{"facility":2919,"status":250,"city":2904,"state":2905,"zip":2920,"country":2798,"countryCode":2799,"cosmosGeoPoint":2921,"geoPoint":2923,"contacts":2924},"Centre Hospitalier Universitaire Sainte-Justine","H3T 1C5",{"type":257,"coordinates":2922},[2909,2910],{"lat":2910,"lon":2909},[2925,2928],{"name":264,"role":265,"phone":2926,"phoneExt":246,"email":2927},"514-345-4931","yvan.samson@umontreal.ca",{"name":2929,"role":245,"phone":246,"phoneExt":246,"email":246},"Monia Marzouki",{"facility":2931,"status":250,"city":2932,"state":2905,"zip":2933,"country":2798,"countryCode":2799,"cosmosGeoPoint":2934,"geoPoint":2938,"contacts":2939},"Centre Hospitalier Universitaire de Sherbrooke-Fleurimont","Sherbrooke","J1H 5N4",{"type":257,"coordinates":2935},[2936,2937],-71.89908,45.40008,{"lat":2937,"lon":2936},[2940,2943],{"name":264,"role":265,"phone":2941,"phoneExt":246,"email":2942},"819-820-6480","crcinformation.chus@ssss.gouv.qc.ca",{"name":2944,"role":245,"phone":246,"phoneExt":246,"email":246},"Josee Brossard",{"facility":2946,"status":250,"city":2947,"state":2948,"zip":2949,"country":2798,"countryCode":2799,"cosmosGeoPoint":2950,"geoPoint":2954,"contacts":2955},"Jim Pattison Children's Hospital","Saskatoon","Saskatchewan","S7N 0W8",{"type":257,"coordinates":2951},[2952,2953],-106.66892,52.13238,{"lat":2953,"lon":2952},[2956,2959],{"name":264,"role":265,"phone":2957,"phoneExt":246,"email":2958},"306-655-3544","Jessica.Marien@saskhealthauthority.ca",{"name":2960,"role":245,"phone":246,"phoneExt":246,"email":246},"Kathleen Felton",{"facility":2962,"status":250,"city":2963,"state":246,"zip":2964,"country":2798,"countryCode":2799,"cosmosGeoPoint":2965,"geoPoint":2969,"contacts":2970},"CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)","Québec","G1V 4G2",{"type":257,"coordinates":2966},[2967,2968],-71.21454,46.81228,{"lat":2968,"lon":2967},[2971,2974],{"name":264,"role":265,"phone":2972,"phoneExt":246,"email":2973},"418-525-4444","rechclinique@crchudequebec.ulaval.ca",{"name":2975,"role":245,"phone":246,"phoneExt":246,"email":246},"Bruno Michon",{"facility":2977,"status":250,"city":2978,"state":2979,"zip":2980,"country":2981,"countryCode":2982,"cosmosGeoPoint":2983,"geoPoint":2987,"contacts":2988},"Starship Children's Hospital","Grafton","Auckland","1145","New Zealand","NZ",{"type":257,"coordinates":2984},[2985,2986],174.76566,-36.86029,{"lat":2986,"lon":2985},[2989,2991],{"name":264,"role":265,"phone":2990,"phoneExt":246,"email":246},"0800 728 436",{"name":2992,"role":245,"phone":246,"phoneExt":246,"email":246},"Mandy PohLui de Silva",{"facility":2994,"status":250,"city":2995,"state":246,"zip":2996,"country":2981,"countryCode":2982,"cosmosGeoPoint":2997,"geoPoint":3001,"contacts":3002},"Christchurch Hospital","Christchurch","8011",{"type":257,"coordinates":2998},[2999,3000],172.63333,-43.53333,{"lat":3000,"lon":2999},[3003,3005],{"name":264,"role":265,"phone":3004,"phoneExt":246,"email":246},"03 364 0640",{"name":3006,"role":245,"phone":246,"phoneExt":246,"email":246},"Tristan Pettit",{"type":3008,"investigatorFullName":246,"investigatorTitle":246,"investigatorAffiliation":246,"oldNameTitle":246,"oldOrganization":246},"SPONSOR","100492387","phase-2-a-study-to-test-the-addition-of-the-drug-cabozantinib-to-chemotherapy-in-patients-with-newly-diagnosed-osteosarcoma-100492387",false,"NCT05691478","A Study to Test the Addition of the Drug Cabozantinib to Chemotherapy in Patients With Newly Diagnosed Osteosarcoma","A Feasibility and Randomized Phase 2\u002F3 Study of the VEGFR2\u002FMET Inhibitor Cabozantinib in Combination With Cytotoxic Chemotherapy for Newly Diagnosed Osteosarcoma","Inclusion Criteria:\n\n* Patients must be \\\u003C 40 years of age at the time of enrollment.\n* Patients must have a body surface area of \\>= 0.8 m\\^2 at the time of enrollment.\n* Patients must have histologic diagnosis (by institutional pathologist) of newly diagnosed high grade osteosarcoma. Primary tumors of all extremity and axial sites are eligible as long as diagnosis of high-grade osteosarcoma is established. Osteosarcoma as a second malignancy is eligible if no prior exposure to systemic chemotherapies.\n* Feasibility Phase (NOTE: as of Amendment #2B, the feasibility phase has been completed) Patients must have metastatic disease and a resectable primary tumor. Designation of a primary tumor as resectable will be determined at the time of diagnosis by the institutional multidisciplinary team.\n\nFor this study, metastatic disease is defined as one or more of the following:\n\n* Lesions which are discontinuous from the primary tumor, are not regional lymph nodes, and do not share a bone or body cavity with the primary tumor. Skip lesions in the same bone as the primary tumor do not constitute metastatic disease. Skip lesions in an adjacent bone are considered bone metastases.\n* Lung metastases: defined as biopsy-proven metastasis or the presence of one or more pulmonary lesions \\>= 5 mm, OR multiple pulmonary lesions \\>= 3 mm or greater in size.\n* Bone metastases: Areas suspicious for bone metastasis based on fludeoxyglucose F-18 (18F-FDG)-positron emission tomography (PET) scan (or whole body technetium-99 bone scan if 18F-FDG-PET is unavailable at the treating institution) require confirmatory biopsy or supportive anatomic imaging of at least one suspicious site with either magnetic resonance imaging (MRI) or computed tomography (CT) (whole body 18F-FDG-PET\u002FCT or 18F-FDG-PET\u002FMR scans are acceptable).\n\n  * Efficacy Phases (Phase 2\u002F3) NOTE: as of Amendment #2B, the efficacy phase is open for enrollment.\n\nPatients with both localized and metastatic disease are eligible for the efficacy phase, regardless of resectability. Patients will be enrolled to two separate cohorts:\n\n* Cohort 1 (Standard Risk): Patients with non-pelvic primary osteosarcoma deemed to be resectable at the time of diagnosis by the institutional multidisciplinary team, without evidence of metastatic lesions.\n* Cohort 2 (High-Risk): Patients with a primary pelvic tumor, a primary tumor designated as unresectable by the institutional multidisciplinary team, AND\u002FOR radiographic evidence of metastatic lesions.\n\n  * A serum creatinine based on age\u002Fsex as follows (within 7 days prior to enrollment unless otherwise indicated):\n* (Age: Maximum Serum Creatinine \\[mg\u002FdL\\]; Sex)\n\n  * 1 month to \\\u003C 6 months: 0.4 (male); 0.4 (female)\n  * 6 months to \\\u003C 1 year: 0.5 (male); 0.5 (female)\n  * 1 to \\\u003C 2 years: 0.6 (male); 0.6 (female)\n  * 2 to \\\u003C 6 years: 0.8 (male); 0.8 (female)\n  * 6 to \\\u003C 10 years: 1 (male); 1 (female)\n  * 10 to \\\u003C 13 years: 1.2 (male); 1.2 (female)\n  * 13 to \\\u003C 16 years: 1.5 (male); 1.4 (female)\n  * \\>= 16 years: 1.7 (male); 1.4 (female)\n* OR - a 24 hour urine creatinine clearance \\>= 70 mL\u002Fmin\u002F1.73 m\\^2\n* OR - a glomerular filtration rate (GFR) \\>= 70 mL\u002Fmin\u002F1.73 m\\^2. GFR must be performed using direct measurement with a nuclear blood sampling method OR direct small molecule clearance method (iothalamate or other molecule per institutional standard).\n\n  * Note: Estimated GFR (eGFR) from serum creatinine, cystatin C or other estimates are not acceptable for determining eligibility.\n\n    * Total bilirubin =\\\u003C 1.5 x upper limit of normal (ULN) for age (within 7 days prior to enrollment unless otherwise indicated)\n    * Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \\[ALT\\]) =\\\u003C 135 U\u002FL (within 7 days prior to enrollment unless otherwise indicated)\n* Note: For the purpose of this study, the ULN for SGPT (ALT) has been set to the value of 45 U\u002FL\n\n  * No history of congenital prolonged corrected QT (QTc) syndrome, New York Heart Association (NYHA) Class III or IV congestive heart failure, unstable angina pectoris, serious cardiac arrhythmias\n* Shortening fraction of \\>= 27%, or\n* Ejection fraction of \\>= 50%\n* Corrected QT interval by Fridericia (QTcF) \\\u003C 480 msec on electrocardiogram. Patients with Grade 1 prolonged QTc (450-480 msec) at time of study enrollment should have correctable causes of prolonged QTc addressed if possible (i.e., electrolytes, medications).\n\n  * Peripheral absolute neutrophil count (ANC) \\>= 1000\u002FuL (within 7 days prior to enrollment unless otherwise indicated)\n  * Platelet count \\>= 100,000\u002FuL (transfusion independent, defined as not receiving platelet transfusions within a 7-day period prior to enrollment) (within 7 days prior to enrollment unless otherwise indicated)\n  * Hemoglobin \\>= 8.0 g\u002FdL (within 7 days prior to enrollment unless otherwise indicated)\n  * International normalized ratio (INR) =\\\u003C 1.5 (within 7 days prior to enrollment unless otherwise indicated)\n  * Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible as long as they are NOT receiving anti-retroviral agents that are strong inhibitors or inducers of CYP3A4, CYP2D6, and\u002For MRP2 transporter protein.\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\nExclusion Criteria:\n\n* Patients who have received previous systemic therapy for osteosarcoma or a prior oncologic diagnosis.\n* Patients who have central nervous system metastases.\n* Patients with central cavitating pulmonary lesions invading or encasing any major blood vessels in the lung.\n* Patients who are unable to swallow tablets. Tablets cannot be crushed or chewed.\n* Patients with gastrointestinal disorders including active disorders associated with a high risk of perforation or fistula formation. Specifically, no clinically significant gastrointestinal (GI) bleeding, GI perforation, bowel obstruction, intra-abdominal abscess or fistula for 6 months prior to enrollment, no hemoptysis or other signs of pulmonary hemorrhage for 3 months prior to enrollment.\n* Patients with active bleeding or bleeding diathesis. No clinically significant hematuria, hematemesis, or hemoptysis or other history of significant bleeding within 3 months prior to enrollment.\n* Patients with uncompensated or symptomatic hypothyroidism. Patients who have hypothyroidism controlled with thyroid replacement hormone are eligible.\n* Patients with moderate to severe hepatic impairment (Child-Pugh B or C).\n* Patients who have had primary tumor resection or attempted curative resection of metastases prior to enrollment.\n* Patients who have undergone other major surgical procedure (eg, laparotomy) within 14 days prior to enrollment. Thoracoscopic procedures for diagnostic purposes (biopsy of lung nodule) and central access such as port-a-cath placement are allowed.\n* Patients with a history of serious or non-healing wound or bone fracture (pathologic fracture of primary tumor is not considered exclusion).\n* Patients with any medical or surgical conditions that would interfere with gastrointestinal absorption of cabozantinib.\n* Patients with previously identify allergy or hypersensitivity to components of the study treatment formulations.\n* Patients who are receiving any other investigational agent not defined within this protocol are not eligible.\n* Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study are not eligible.\n* Patients who received enzyme-inducing anticonvulsants within 14 days prior to enrollment.\n* Patients with a prior history of hypertension (\\> 95th percentile for age, height, and sex for patients \\\u003C 18 years and \\> 140\u002F90 mmHg for patients \\>= 18 years requiring medication for blood pressure control.\n* Patients who are receiving drugs that prolong QTc.\n* Patients receiving anticoagulation with oral coumarin agents (eg warfarin), direct thrombin inhibitors (eg dabigatran), direct factor Xa inhibitor betrixaban, or platelet inhibitors (eg, clopidogrel). Low dose aspirin for cardioprotection (per local applicable guidelines) and low dose, low molecular weight heparins (LMWH) are permitted. Anticoagulation with therapeutic doses of LMWH and direct factor Xa inhibitors rivaroxaban or apixaban are allowed in subjects who are on a stable dose for at least 6 weeks before the first dose of study treatment, and who have had no complications from a thromboembolic event or the anticoagulation regimen.\n* Patients receiving strong CYP3A4 inducers or strong CYP3A4 inhibitors.\n* 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.\n* Lactating females who plan to breastfeed their infants.\n* Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of protocol therapy.","ALL","40 Years",{"count":3019,"type":3020},1122,"ESTIMATED","INTERVENTIONAL",[3023,3024],"PHASE2","PHASE3","This phase II\u002FIII trial tests the safety, side effects, and best dose of the drug cabozantinib in combination with standard chemotherapy, and to compare the effect of adding cabozantinib to standard chemotherapy alone in treating patients with newly diagnosed osteosarcoma. Cabozantinib is in a class of medications called kinase inhibitors which block protein signals affecting new blood vessel formation and the ability to activate growth signaling pathways. This may help slow the growth of tumor cells. The drugs used in standard chemotherapy for this trial are methotrexate, doxorubicin, and cisplatin (MAP). Methotrexate stops cells from making DNA and may kill tumor cells. It is a type of antimetabolite. Doxorubicin is in a class of medications called anthracyclines. It works by slowing or stopping the growth of tumor cells in the body. Cisplatin is in a class of medications known as platinum-containing compounds. It works by killing, stopping or slowing the growth of tumor cells. Adding cabozantinib to standard chemotherapy may work better in treating newly diagnosed osteosarcoma.",[3027,3028,3029,3030],"High Grade Osteosarcoma","Localized Osteosarcoma","Metastatic Osteosarcoma","Secondary Osteosarcoma","2026-06-19",{"date":3033,"type":3034},"2026-06-23","ACTUAL",{"date":3036,"type":3034},"2023-03-03",{"date":3038,"type":3020},"2030-03-20",{"name":5,"class":6},198]