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A Phase II Study Of hu14.18-IL2 In Children With Recurrent Or Refractory Neuroblastoma


Phase 2
N/A
21 Years
Not Enrolling
Both
Neuroblastoma

Thank you

Trial Information

A Phase II Study Of hu14.18-IL2 In Children With Recurrent Or Refractory Neuroblastoma


OBJECTIVES:

- Determine the response rate in children with recurrent or refractory neuroblastoma
treated with hu14.18-interleukin-2 (hu14.18-IL2) fusion protein.

- Determine the adverse events of this drug in these patients.

- Determine the immunologic activation in patients treated with this drug.

- Determine the induction of anti-hu14.18-IL2 antibody in patients treated with this
drug.

- Correlate antitumor response with measurements of toxicity, immune activation, and
anti-hu14.18-IL2 antibody activity in patients treated with this drug.

OUTLINE: This is a multicenter study. Patients are stratified according to
measurable/evaluable disease (measurable by standard radiographic criteria vs evaluable by
MIBG scanning and/or bone marrow histology vs disease identified and quantified by bone
marrow immunohistochemistry).

Patients will be enrolled in 3 strata, and evaluated for antitumor response following 2
monthly courses (treatment on Days 1-3, followed by 25 days of observation,). Patients with
progressive disease will be taken off protocol therapy. Patients with stabilization or
regression of disease will be eligible to receive 2 more monthly courses of treatment.
Additional treatment following course 4 will be allowed for patients showing a continued
clinical response, up to a maximum of 10 courses of treatment.

Patients are followed for survival.

PROJECTED ACCRUAL: A total of 40-60 patients (20 for strata 1 and 2 and 0-20 for stratum 3)
will be accrued for this study within 2 years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed neuroblastoma

- Relapsed or refractory to conventional therapy

- Measurable or evaluable disease documented by 1 of the following criteria:

- Clinical

- Radiographic

- Histologic

- MIBG scanning

- Immunocytochemistry

- No symptomatic pleural effusions or ascites requiring constant or intermittent
drainage

- No clinical or radiological evidence of CNS disease

PATIENT CHARACTERISTICS:

Age

- 21 and under

Performance status

- Karnofsky 50-100% (> 16 years of age)

- Lansky 50-100% (≤ 16 years of age)

Life expectancy

- At least 8 weeks

Hematopoietic

- Absolute neutrophil count > 1,000/mm^3

- Platelet count ≥ 75,000/mm^3*

- Must not be refractory to platelet transfusions

- Hemoglobin ≥ 9.0 g/dL* NOTE: *Transfusion allowed if patient is known to have a
history of bone marrow involvement with tumor

Hepatic

- ALT < 2.5 times upper limit of normal (ULN)

- Bilirubin ≤ 1.5 times ULN

- Hepatitis B surface antigen negative

Renal

- Creatinine adjusted according to age as follows:

- No greater than 0.4 mg/dL (≤ 5 months)

- No greater than 0.5 mg/dL (6 months -11 months)

- No greater than 0.6 mg/dL (1 year-23 months)

- No greater than 0.8 mg/dL (2 years-5 years)

- No greater than 1.0 mg/dL (6 years-9 years)

- No greater than 1.2 mg/dL (10 years-12 years)

- No greater than 1.4 mg/dL (13 years and over [female])

- No greater than 1.5 mg/dL (13 years to 15 years [male])

- No greater than 1.7 mg/dL (16 years and over [male]) OR

- Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min

Cardiovascular

- Shortening fraction ≥ 27% by echocardiogram OR

- Ejection fraction ≥ 50% by MUGA

- No symptomatic congestive heart failure

- No uncontrolled cardiac rhythm disturbance

Pulmonary

- Pulse oximetry > 94% on room air

- FVC > 80%

- FEV_1 > 80%

- No abnormal respiratory function

- No dyspnea at rest

- No exercise intolerance

- No prior history of ventilator support related to lung injury (e.g., pneumonia,
hemorrhagic pneumonitis, or capillary leakage)

Other

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- HIV negative

- No active uncontrolled infection

- No active uncontrolled peptic ulcer

- No objective peripheral neuropathy ≥ grade 2

- No significant psychiatric disabilities

- No seizure disorders requiring antiseizure medications

- No other concurrent significant illness

PRIOR CONCURRENT THERAPY:

Biologic therapy

- Recovered from prior immunotherapy

- Prior in vivo monoclonal antibodies for biologic therapy or tumor imaging allowed
provided there is documented absence of detectable antibody to hu14.18 by serology

- More than 28 days since prior autologous stem cell transplantation

- Prior autologous marrow or stem cell infusion using monoclonal antibody-purged
specimens allowed

- More than 1 week since prior growth factors

- At least 7 days since prior nonmyelosuppressive biologic agents

- No prior allogeneic bone marrow or stem cell transplantation

- No concurrent immunomodulating agents

- No concurrent growth factors

Chemotherapy

- More than 3 weeks since prior myelosuppressive chemotherapy (4 weeks for
nitrosoureas) and recovered

- No concurrent anticancer chemotherapy

Endocrine therapy

- No concurrent corticosteroids except 100 mg or less of hydrocortisone (or equivalent)
as premedication for blood transfusion or treatment for transfusion reaction

- No other use of systemic steroids

Radiotherapy

- Recovered from prior radiotherapy

- At least 2 weeks since prior local palliative radiotherapy (small port)

- At least 6 months since prior craniospinal radiotherapy

- At least 6 months since prior total body irradiation

- At least 6 months since prior radiotherapy to ≥ 50% of the pelvis

- At least 6 weeks since other prior substantial bone marrow radiotherapy

- Concurrent radiotherapy to localized painful lesions allowed provided at least 1
measurable or evaluable lesion is not irradiated

Surgery

- More than 2 weeks since prior major surgery (e.g., laparotomy or thoracotomy)

- No prior organ allografts

Other

- No concurrent immunosuppressive drugs

- No other concurrent myelosuppressive antineoplastic drugs

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Best overall response (complete response, very good partial response, or partial response)

Outcome Description:

Proportion of responders within each stratum. Patients deemed inevaluable for response will have available response data tabulated and reported descriptively, but will not be counted in the target accrual for response for each strata. Stratum 03 patients will not be included in the statistical analysis to determine activity of hu14.18-IL2, since there is not sufficient data to support the significance of immunocytologic responses. Such responses will be tabulated and reported

Outcome Time Frame:

Up to 30 weeks

Safety Issue:

No

Principal Investigator

Paul M Sondel, MD, PhD

Investigator Role:

Study Chair

Investigator Affiliation:

University of Wisconsin, Madison

Authority:

United States: Federal Government

Study ID:

ANBL0322

NCT ID:

NCT00082758

Start Date:

August 2005

Completion Date:

May 2012

Related Keywords:

  • Neuroblastoma
  • recurrent neuroblastoma
  • Neuroblastoma

Name

Location

Roswell Park Cancer Institute Buffalo, New York  14263
Children's Hospital of Philadelphia Philadelphia, Pennsylvania  19104
University of Chicago Cancer Research Center Chicago, Illinois  60637
Barbara Ann Karmanos Cancer Institute Detroit, Michigan  48201
Medical City Dallas Hospital Dallas, Texas  75230
University of Texas Health Science Center at San Antonio San Antonio, Texas  78284-7811
Midwest Children's Cancer Center Milwaukee, Wisconsin  53226
Geisinger Medical Center Danville, Pennsylvania  17822-0001
Penn State Cancer Institute at Milton S. Hershey Medical Center Hershey, Pennsylvania  17033-0850
Vanderbilt-Ingram Cancer Center Nashville, Tennessee  37232-6838
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center Madison, Wisconsin  53792-6164
New York Medical College Valhalla, New York  10595
Siteman Cancer Center at Barnes-Jewish Hospital Saint Louis, Missouri  63110
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Chapel Hill, North Carolina  27599-7570
Cleveland Clinic Taussig Cancer Center Cleveland, Ohio  44195
Sutter Cancer Center Sacramento, California  95816
Children's Hospital of Orange County Orange, California  92668
Children's National Medical Center Washington, District of Columbia  20010-2970
Children's Mercy Hospital Kansas City, Missouri  64108
Children's Hospital of Pittsburgh Pittsburgh, Pennsylvania  15213
Children's Memorial Hospital - Chicago Chicago, Illinois  60614
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute Boston, Massachusetts  02115
University of New Mexico Cancer Research and Treatment Center Albuquerque, New Mexico  87131
St. Jude Children's Research Hospital Memphis, Tennessee  38105-2794
Cook Children's Medical Center - Fort Worth Fort Worth, Texas  76104
UCSF Comprehensive Cancer Center San Francisco, California  94115
Children's Hospital Central California Madera, California  93638-8762
Southern Illinois University School of Medicine Springfield, Illinois  62794-9658
Kosair Children's Hospital Louisville, Kentucky  40202-3830
Sunrise Hospital and Medical Center Las Vegas, Nevada  89109-2306
Children's Hospital Medical Center of Akron Akron, Ohio  44308
Palmetto Health South Carolina Cancer Center Columbia, South Carolina  29203
East Tennessee Children's Hospital Knoxville, Tennessee  37901
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Markey Cancer Center at University of Kentucky Chandler Medical Center Lexington, Kentucky  40536-0084
Blumenthal Cancer Center at Carolinas Medical Center Charlotte, North Carolina  28232-2861
Overlook Hospital Summit, New Jersey  07902-0220
University of Florida Shands Cancer Center Gainesville, Florida  32610-0232
Sacred Heart Cancer Center at Sacred Heart Hospital Pensacola, Florida  32504
St. Joseph's Cancer Institute at St. Joseph's Hospital Tampa, Florida  33607
Kaplan Cancer Center at St. Mary's Medical Center West Palm Beach, Florida  33407
CancerCare of Maine at Eastern Maine Medial Center Bangor, Maine  04401
Floating Hospital for Children at Tufts - New England Medical Center Boston, Massachusetts  02111
Breslin Cancer Center at Ingham Regional Medical Center Lansing, Michigan  48910
Hackensack University Medical Center Cancer Center Hackensack, New Jersey  07601
Presbyterian Cancer Center at Presbyterian Hospital Charlotte, North Carolina  28233-3549
Cincinnati Children's Hospital Medical Center Cincinnati, Ohio  45229-3039
Texas Tech University Health Sciences Center School of Medicine - Amarillo Amarillo, Texas  79106
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas Dallas, Texas  75390
Primary Children's Medical Center Salt Lake City, Utah  84113-1100
Carilion Cancer Center of Western Virginia Roanoke, Virginia  24029
Providence Cancer Center at Sacred Heart Medical Center Spokane, Washington  99220-2555
Childrens Hospital Los Angeles Los Angeles, California  90027
MBCCOP - Medical College of Georgia Cancer Center Augusta, Georgia  30912-3730
Indiana University Melvin and Bren Simon Cancer Center Indianapolis, Indiana  46202-5289
Tulane Cancer Center Office of Clinical Research Alexandria, Louisiana  71315-3198
Children's Hospitals and Clinics of Minnesota - Minneapolis Minneapolis, Minnesota  55404
University of Mississippi Cancer Clinic Jackson, Mississippi  39216-4505
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School New Brunswick, New Jersey  08903
Oklahoma University Cancer Institute Oklahoma City, Oklahoma  73104
Virginia Commonwealth University Massey Cancer Center Richmond, Virginia  23298-0037
Spectrum Health Hospital - Butterworth Campus Grand Rapids, Michigan  49503
Children's Hospital Cancer Center Denver, Colorado  80218
Columbus Children's Hospital Columbus, Ohio  43205-2696
Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham Birmingham, Alabama  35294
Stanford Comprehensive Cancer Center - Stanford Stanford, California  94305
Norris Cotton Cancer Center at Dartmouth - Hitchcock Medical Center Lebanon, New Hampshire  03756-0002
T.C. Thompson Children's Hospital Chattanooga, Tennessee  37403
University of Minnesota Cancer Center at University of Minnesota Minneapolis, Minnesota  55455