Feasibility/Phase II Study of hu14.18-IL2 Immunocytokine + GM-CSF and Isotretinoin in Patients With Relapsed or Refractory Neuroblastoma
PRIMARY OBJECTIVES:
I. To evaluate the safety and tolerability of sargramostim (GM-CSF) and isotretinoin given
in combination with hu14.18-IL-2 (hu14.18-IL2 fusion protein), as a test of feasibility for
a future Phase III study.
II. To evaluate the anti-tumor activity of hu14.18-IL2 given in combination with GM-CSF and
isotretinoin in patients with recurrent or refractory neuroblastoma with disease measurable
by standard radiographic criteria (stratum-1).
III. To evaluate the anti-tumor activity of hu14.18-IL2 given in combination with GM-CSF and
isotretinoin in patients with recurrent or refractory neuroblastoma evaluable only by
meta-iodobenzyl guanidine I 123 (MIBG) scintigraphy and/or bone marrow histology
(stratum-2).
SECONDARY OBJECTIVES:
I. To describe the disease burden of stratum-2 patients by semi-quantitative assessment of
bone marrow and MIBG scintigraphy and determine whether there is an association between
lower disease burden and response to hu14.18-IL2.
II. To assess molecular parameters of response (reverse-transcriptase polymerase chain
reaction [RT-PCR]) for patients meeting complete response (CR) criteria.
III. To evaluate the immunologic activation induced in vivo by hu14.18-IL2. IV. To determine
the induction of anti-hu14.18-IL2 antibody by treatment with hu14.18-IL2.
V. To test for associations between tumor response versus immune activation and
anti-hu14.18-IL2 activity, and between measurements of toxicity versus immune activation and
anti-hu14.18-IL2 activity.
OUTLINE: This is a multicenter study. Patients are stratified according to measurable
disease (disease measurable by standard radiographic criteria [stratum-1] vs disease
evaluable only by 123I-MIBG and/or bone marrow histology [stratum-2]).
Patients receive sargramostim subcutaneously (SC [preferred]) or IV over 2 hours on days 1-2
and 8-14, hu14.18-IL2 fusion protein IV over 4 hours on days 4-6, and isotretinoin orally
(PO) twice daily on days 11-24. Treatment repeats every 28 days for 4-10 courses in the
absence of disease progression or unacceptable toxicity. Patients in stratum-1 who achieve
stable disease (SD) after course 4 are removed from protocol therapy. Patients in stratum-2
who achieve SD after course 4 receive 2 additional courses of study treatment. Patients may
undergo blood and bone marrow sample collection periodically for correlative studies.
After completion of study therapy, patients are followed up every 3 months for 1 year, every
6 months for 2 years, and then yearly for 2 years.
Interventional
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Incidence of adverse events, utilizing version 4.0 of the Common Terminology Criteria for Adverse Events (CTCAE) of the National Cancer Institute (NCI)
Up to 10 courses
Yes
Suzanne Shusterman
Principal Investigator
Children's Oncology Group
United States: Food and Drug Administration
ANBL1021
NCT01334515
September 2011
Name | Location |
---|---|
Cleveland Clinic Foundation | Cleveland, Ohio 44195 |
Roswell Park Cancer Institute | Buffalo, New York 14263 |
Mayo Clinic | Rochester, Minnesota 55905 |
Children's Hospital of Philadelphia | Philadelphia, Pennsylvania 19104 |
Washington University School of Medicine | Saint Louis, Missouri 63110 |
Medical City Dallas Hospital | Dallas, Texas 75230 |
Sinai Hospital of Baltimore | Baltimore, Maryland 21225 |
Bronson Methodist Hospital | Kalamazoo, Michigan 49007 |
Vanderbilt-Ingram Cancer Center | Nashville, Tennessee 37232-6838 |
Morristown Memorial Hospital | Morristown, New Jersey 07962-1956 |
Loma Linda University Medical Center | Loma Linda, California 92354 |
New York Medical College | Valhalla, New York 10595 |
Dana-Farber Cancer Institute | Boston, Massachusetts 02115 |
University of Arkansas for Medical Sciences | Little Rock, Arkansas 72205 |
Children's Hospital Los Angeles | Los Angeles, California 90027-0700 |
Children's National Medical Center | Washington, District of Columbia 20010-2970 |
Miami Children's Hospital | Miami, Florida 33155-4069 |
All Children's Hospital | St. Petersburg, Florida 33701 |
Carolinas Medical Center | Charlotte, North Carolina 28232-2861 |
University of Oklahoma Health Sciences Center | Oklahoma City, Oklahoma 73104 |
St. Jude Children's Research Hospital | Memphis, Tennessee 38105-2794 |
Children's Hospital Central California | Madera, California 93638-8762 |
Kosair Children's Hospital | Louisville, Kentucky 40202-3830 |
Children's Hospital Medical Center of Akron | Akron, Ohio 44308 |
University of Wisconsin Hospital and Clinics | Madison, Wisconsin 53792-0001 |
Overlook Hospital | Summit, New Jersey 07902-0220 |
Cincinnati Children's Hospital Medical Center | Cincinnati, Ohio 45229-3039 |
Primary Children's Medical Center | Salt Lake City, Utah 84113-1100 |
Rady Children's Hospital - San Diego | San Diego, California 92123-4282 |
Children's Hospitals and Clinics of Minnesota - Minneapolis | Minneapolis, Minnesota 55404 |
University of New Mexico Cancer Center | Albuquerque, New Mexico 87131-5636 |
Lehigh Valley Hospital - Muhlenberg | Bethlehem, Pennsylvania 18017 |
Presbyterian Hospital | Charlotte, North Carolina 28233-3549 |
Lee Memorial Health System | Fort Myers, Florida 33902 |
University of Alabama at Birmingham | Birmingham, Alabama 35294-3300 |
Connecticut Children's Medical Center | Hartford, Connecticut 06106 |
University of North Carolina | Chapel Hill, North Carolina 27599 |
Duke University Medical Center | Durham, North Carolina 27710 |
University of Kentucky | Lexington, Kentucky 40536-0098 |
Oregon Health and Science University | Portland, Oregon 97201 |
Tulane University Health Sciences Center | New Orleans, Louisiana 70112 |
Virginia Commonwealth University | Richmond, Virginia |
Florida Hospital | Orlando, Florida 32803 |
University of Chicago Comprehensive Cancer Center | Chicago, Illinois 60637-1470 |
Seattle Children's Hospital | Seattle, Washington 98105 |
University of Hawaii | Honolulu, Hawaii 96813 |
Kalamazoo Center for Medical Studies | Kalamazoo, Michigan 49008 |
Columbia University Medical Center | New York, New York 10032 |
State University of New York Upstate Medical University | Syracuse, New York 13210 |
Natalie W Bryant Cancer Center | Tulsa, Oklahoma 74136 |
Saint Vincent Hospital | Green Bay, Wisconsin 54301 |
University of Illinois | Chicago, Illinois 60612 |
Cook Children's Medical Center | Fort Worth, Texas 76104 |
The Children's Medical Center of Dayton | Dayton, Ohio 45404 |
Children's Oncology Group | Arcadia, California 91006-3776 |
Southern Illinois University | Springfield, Illinois 62702 |
Riley Hospital for Children | Indianapolis, Indiana 46202 |
Cardinal Glennon Children's Medical Center | St. Louis, Missouri 63104 |
Childrens Hospital of Orange County | Orange, California 92868-3874 |
Nemours Children's Clinic - Jacksonville | Jacksonville, Florida 32207-8426 |
Children's Healthcare of Atlanta - Egleston | Atlanta, Georgia 30322 |
Rainbow Babies and Childrens Hospital | Cleveland, Ohio 44106 |
Penn State Hershey Children's Hospital | Hershey, Pennsylvania 17033 |
Childrens Hospital-King's Daughters | Norfolk, Virginia 23507 |
Children's Hospital Colorado | Aurora, Colorado 80045 |
University of California San Francisco Medical Center-Parnassus | San Francisco, California 94143 |
Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center | Denver, Colorado 80218 |
Raymond Blank Children's Hospital | Des Moines, Iowa 50309 |
Children's Hospital-Main Campus | New Orleans, Louisiana 70118 |
The Toledo Hospital/Toledo Children's Hospital | Toledo, Ohio 43606 |
Sanford USD Medical Center - Sioux Falls | Sioux Falls, South Dakota 57117-5134 |