A Phase I Study of Zoledronic Acid (Zometa) With Cyclophosphamide in Children With Recurrent or Refractory Neuroblastoma and Cortical Bone Involvement (NANT 2004-01)
Zoledronic Acid (Zometa), a new generation, highly potent bisphosphonate used to treat
osteoporosis and hypercalcemia of malignancy, is widely used in adult malignancies with
potential for bone metastasis such as breast cancer, multiple myeloma and prostate cancer.
Bisphosphonates modulate the bone environment by toxicity to osteoclasts resulting in
decreased bone resorption. Zometa is the first bisphosphonate to affect both osteolytic and
osteoblastic metastatic lesions. In several large randomized studies in adults with
recurrent or advanced malignancies, patients randomized to Zometa had delay in progression
of bone metastases and less morbidity (skeletal related events) when compared to either
placebo or pamidronate. The toxicity profile of Zometa in adults has been tolerable and
includes hypocalcemia, temperature rise, and nausea. The most concerning toxicity is
decline in renal function that appears to be related to cumulative dose and the dose rate of
administration. In our pre-clinical studies bisphosphonates delayed progression of
osteolytic lesions in neuroblastoma tumors xenografted into immunocompromised mice while the
combination of Zometa with low dose cyclophosphamide appeared to prolong overall survival.
The primary aim of this study is to evaluate the maximum tolerated dose of Zometa combined
with low dose oral cyclophosphamide in children with recurrent or refractory neuroblastoma.
We will also evaluate the pharmacokinetics of Zometa in children with neuroblastoma and
examine the effect of Zometa on markers of bone resorption, cytokines and bone-related
growth factors.
Interventional
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Toxicity
28 days, lifetime for delayed toxicities
Yes
Peter Zage, MD
Principal Investigator
Baylor College of Medicine
United States: Food and Drug Administration
16758
NCT00206388
April 2005
August 2014
Name | Location |
---|---|
Children's Hospital of Philadelphia | Philadelphia, Pennsylvania 19104 |
Children's Hospital Los Angeles | Los Angeles, California 90027-0700 |
Texas Children's Cancer Center | Houston, Texas 77030-2399 |
University of Wisconsin Medical Center | Madison, Wisconsin 53792 |
USCF School of Medicine | San Francisco, California 94143 |
Lucille Salter Packer Children's Hospital | Stanford, California 94305 |
Indiana University-Riley Children's Hospital | Indianapolis, Indiana 46202 |
Cincinnati Children's Hospital | Cincinnati, Ohio 45229 |