A Phase II Study of Cixutumumab (IMC-A12; IND# 100947) in Combination With Temsirolimus (IND# 61010) in Pediatric Patients With Recurrent or Refractory Solid Tumors
PRIMARY OBJECTIVES:
I. To determine the objective response rate to the combination of cixutumumab and
temsirolimus in patients with relapsed or refractory osteosarcoma, Ewing sarcoma,
rhabdomyosarcoma, or non-rhabdomyosarcoma soft tissue sarcoma.
II. To further describe the toxicities (including dose-limiting toxicities) of cixutumumab
and temsirolimus administered on this schedule.
SECONDARY OBJECTIVES:
I. To assess the progression-free survival for patients treated in each disease stratum with
this drug combination.
II. To assess the incidence of insulin-like growth factor 1 receptor (IGF-1R), insulin
receptor, ERK, RON, and mammalian target of rapamycin (mTOR) pathway activation in archival
tumor material, and correlate with response.
III. To evaluate minimal residual disease and IGF-1R tumor cell expression in the blood and
bone marrow of Ewing sarcoma patients using flow cytometry.
OUTLINE: This is a multicenter study. Patients are stratified according to diagnosis
(osteosarcoma vs Ewing sarcoma/PNET vs rhabdomyosarcoma vs non-rhabdomyosarcoma soft tissue
sarcoma).
Patients receive cixutumumab IV over 1 hour and temsirolimus IV over 30 minutes on days 1,
8, 15, and 22. Treatment repeats every 28 days for up to 25 courses in the absence of
disease progression or unacceptable toxicity.
Archived tumor tissue samples from most recent biopsy are collected and analyzed for IGF-1R,
insulin receptor, AKT, ERK, mTOR, and S6 kinase pathway activation by immunohistochemistry
(IHC) and banked for future correlative studies. Blood and bone marrow samples, from
patients with Ewing sarcoma, may be collected at baseline and periodically during treatment
for minimal residual disease analysis by flow cytometry.
After completion of study treatment, patients are followed up periodically for 5 years.
Interventional
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Objective response rate (PR or CR) by Response Evaluation Criteria in Solid Tumors (RECIST)
We will consider the combination of sufficient activity if the true response rate is 35% or greater.
Up to 5 years
No
Lars Wagner
Principal Investigator
Children's Oncology Group
United States: Food and Drug Administration
NCI-2012-01971
NCT01614795
June 2012
Name | Location |
---|---|
Baylor College of Medicine | Houston, Texas 77030 |
Memorial Sloan Kettering Cancer Center | New York, New York 10021 |
Mayo Clinic | Rochester, Minnesota 55905 |
Children's Hospital of Philadelphia | Philadelphia, Pennsylvania 19104 |
University of Mississippi Medical Center | Jackson, Mississippi 39216-4505 |
Washington University School of Medicine | Saint Louis, Missouri 63110 |
Midwest Children's Cancer Center | Milwaukee, Wisconsin 53226 |
Sinai Hospital of Baltimore | Baltimore, Maryland 21225 |
Massachusetts General Hospital Cancer Center | Boston, Massachusetts 02114 |
Morristown Memorial Hospital | Morristown, New Jersey 07962-1956 |
Marshfield Clinic | Marshfield, Wisconsin 54449 |
Loma Linda University Medical Center | Loma Linda, California 92354 |
Dana-Farber Cancer Institute | Boston, Massachusetts 02115 |
University of Arkansas for Medical Sciences | Little Rock, Arkansas 72205 |
Hackensack University Medical Center | Hackensack, New Jersey 07601 |
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 |
Ochsner Clinic Foundation | New Orleans, Louisiana 70121 |
Carolinas Medical Center | Charlotte, North Carolina 28232-2861 |
University of Oklahoma Health Sciences Center | Oklahoma City, Oklahoma 73104 |
Scott and White Memorial Hospital | Temple, Texas 76508 |
Children's Hospital Medical Center of Akron | Akron, Ohio 44308 |
Cincinnati Children's Hospital Medical Center | Cincinnati, Ohio 45229-3039 |
University of New Mexico Cancer Center | Albuquerque, New Mexico 87131-5636 |
Nationwide Children's Hospital | Columbus, Ohio 43205-2696 |
Children's Hospital and Research Center at Oakland | Oakland, California 94609-1809 |
Mary Bridge Children's Hospital and Health Center | Tacoma, Washington 98415-0299 |
Presbyterian Hospital | Charlotte, North Carolina 28233-3549 |
Lee Memorial Health System | Fort Myers, Florida 33902 |
Children's Hospital of Alabama | Birmingham, Alabama 35233 |
Connecticut Children's Medical Center | Hartford, Connecticut 06106 |
Vanderbilt University | Nashville, Tennessee 37232-6305 |
University of North Carolina | Chapel Hill, North Carolina 27599 |
Nemours Children's Clinic - Pensacola | Pensacola, Florida 32504 |
Yale University | New Haven, Connecticut 06520 |
Wayne State University | Detroit, Michigan 48202 |
Mercy Children's Hospital | Toledo, Ohio 43608 |
Legacy Emanuel Children's Hospital | Portland, Oregon 97227 |
BI-LO Charities Children's Cancer Center | Greenville, South Carolina 29605 |
University of Texas Southwestern Medical Center | Dallas, Texas |
University of Kentucky | Lexington, Kentucky 40536-0098 |
Oregon Health and Science University | Portland, Oregon 97201 |
Virginia Commonwealth University | Richmond, Virginia |
Florida Hospital | Orlando, Florida 32803 |
Memorial Health University Medical Center | Savannah, Georgia 31404 |
University of Chicago Comprehensive Cancer Center | Chicago, Illinois 60637-1470 |
M D Anderson Cancer Center | Houston, Texas 77030 |
Seattle Children's Hospital | Seattle, Washington 98105 |
University of Hawaii | Honolulu, Hawaii 96813 |
Saint Vincent Hospital and Health Services | Indianapolis, Indiana 46260 |
Saint John's Mercy Medical Center | Saint Louis, Missouri 63141 |
Columbia University Medical Center | New York, New York 10032 |
Stony Brook University Medical Center | Stony Brook, New York 11794 |
Cook Children's Medical Center | Fort Worth, Texas 76104 |
University of Minnesota Medical Center-Fairview | Minneapolis, Minnesota 55455 |
University of California San Francisco Medical Center | San Francisco, California 94143 |
Riley Hospital for Children | Indianapolis, Indiana 46202 |
Miller Children's Hospital | Long Beach, California 90806 |
Childrens Hospital of Orange County | Orange, California 92868-3874 |
Alfred I duPont Hospital for Children | Wilmington, Delaware 19803 |
Nemours Children's Clinic - Jacksonville | Jacksonville, Florida 32207-8426 |
Nemours Childrens Clinic - Orlando | Orlando, Florida 32806 |
Children's Healthcare of Atlanta - Egleston | Atlanta, Georgia 30322 |
The Childrens Mercy Hospital | Kansas City, Missouri 64108 |
Palmetto Health Richland | Columbia, South Carolina 29203 |
East Tennessee Childrens Hospital | Knoxville, Tennessee 37916 |
Children's Hospital and Medical Center of Omaha | Omaha, Nebraska 68114 |
Lucile Packard Children's Hospital Stanford University | Palo Alto, California 94304 |
Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center | Denver, Colorado 80218 |
Providence Sacred Heart Medical Center and Children's Hospital | Spokane, Washington 99204 |