- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01393912
PDGFR Inhibitor Crenolanib in Children/Young Adults With Diffuse Intrinsic Pontine Glioma or Recurrent High-Grade Glioma
Platelet Derived Growth Factor Receptor (PDGFR) Inhibitor Crenolanib in Children and Young Adults With Newly Diagnosed Diffuse Intrinsic Pontine Glioma or Recurrent High-Grade Glioma Including Diffuse Intrinsic Pontine Glioma
Study Overview
Status
Intervention / Treatment
Detailed Description
Primary Objectives:
- To estimate the maximum tolerated dose (MTD) of crenolanib administered concurrently with RT in pediatric research participants with DIPG
- To estimate the MTD of crenolanib in children and young adults with recurrent/refractory HGG including DIPG
- To characterize the pharmacokinetics of crenolanib in pediatric patients and relate drug disposition to toxicity
Exploratory Secondary Objectives:
- To characterize toxicities and/or adverse events associated with the chronic use of crenolanib
- To evaluate the association between specific polymorphisms of drug metabolizing enzymes and the pharmacokinetics of crenolanib
- To evaluate changes in phosphorylation of targets of PDGF pathway activation in peripheral blood mononuclear cells and investigate the possible relationship between these changes, plasma drug levels of crenolanib and outcome measures
- To evaluate PDGFR, genotype, protein expression and DNA amplification in tumor tissue where available
- To investigate whether magnetic resonance imaging (MRI) techniques that reflect tumor pathophysiology (metabolism, oxygenation, perfusion and vessel wall integrity) are correlated with clinical response
- To characterize the neural tract involvement and tumor progression routes of pediatric brainstem glioma based upon anatomical magnetic resonance imaging and diffusion tensor imaging
- To assess the pattern of failure in radiation therapy in Stratum A participants.
- To describe the research participants' and parents' perspective of symptoms and the quality of life of children enrolled on this phase I trial
- To describe the quality of life and the impact of self-care activities of parents of pediatric research participants enrolled on this phase I trial
- To assess the impact of therapeutic alliance and social support on peace of mind, hope, anxiety/depression and quality of life among parents of pediatric research participants enrolled on this phase I trial
Stratum A- Appropriate dose RT will be administered in 30-33 fractions over approximately 6 weeks for Stratum A patients. Treatment with crenolanib will start on the same day as RT and continue daily during and after Radiation Therapy for a maximum treatment duration of 2 years. We plan to treat a maximum of 5 cohorts of research participants (dosage levels 0, 1, 2, 3, and 4) with escalating doses of crenolanib. A cycle is defined as 28 days and the first 8 weeks of therapy will constitute the dose-limiting toxicity (DLT)-evaluation period.
Stratum B - Crenolanib will be administered orally on a daily basis continuously for 28 days, which defines one cycle. The maximum treatment duration will be 2 years. We plan to treat a maximum of 5 cohorts of research participants (dosage levels 0, 1, 2, 3, and 4) with escalating doses of crenolanib. Dose escalation will be independent of Stratum A escalation. The DLT evaluation period will be four weeks.
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
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Tennessee
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Memphis, Tennessee, United States, 38105
- St. Jude Children's Research Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age must be ≥ 18 months and < or equal to 21 years
- Body surface Area (BSA) ≥ 0.55 m^2
- Lansky (for research participants ≤ 16 years) or Karnofsky (for research participants > 16 years) performance score ≥ 40 at the time of study enrollment
Adequate organ function at the time of study enrollment as follows:
- Bone marrow: Absolute neutrophil count (ANC) ≥ 1,000/μL, platelet count ≥ 75,000/μL (transfusion independent), hemoglobin concentration ≥ 8g/dL (may be transfused)
Renal: Normal serum creatinine concentration based on age as shown below or glomerular filtration rate (GFR) > 70 ml/min/1.73m^2
- Age (years): < or equal to 5 and the maximum serum creatinine (mg/dL) is 0.8;
- 5 < age < or equal to 10 and the maximum serum creatinine (mg/dL) is 1.0;
- 10< age < or equal to 15 and the maximum serum creatinine (mg/dL) is 1.2;
- >15 and the maximum serum creatinine (mg/dL) is 1.5;
- Hepatic: Total bilirubin concentration < or equal to 1.5 times the institutional upper limit of normal for age; SGPT < or equal to 3 times the institutional upper limit of normal
- Pancreatic: Serum amylase < or equal to 3 times the institutional upper limit of normal for age; lipase < or equal to 3 times the institutional upper limit of normal
- Female research participants of childbearing age must not be pregnant as confirmed by a serum or urine pregnancy test within 1 week of start of treatment. Participants must not be breast-feeding.
- Males or females of reproductive potential may not participate unless they have agreed to use two effective contraceptive methods. Abstinence in a non-sexually active child will be sufficient birth control.
Inclusion Criteria - Stratum A
- Diagnosis of DIPG or high-grade glioma originating from the brainstem.
- Patients have had no previous treatment except corticosteroid use.
Inclusion Criteria - Stratum B
- Patients must have radiologic evidence of recurrent, refractory or progressive high-grade glioma or DIPG. Patients must have either a diagnosis of HGG within the brain and/or spinal cord including DIPG or other high-grade glioma originating from the brainstem. A histologically confirmed diagnosis of anaplastic astrocytoma (WHO grade III), anaplastic oligodendroglioma (WHO grade III), anaplastic oligoastrocytoma (WHO grade III), anaplastic ganglioglioma (WHO grade III), pleomorphic xanthoastrocytoma with anaplastic features (WHO grade III), malignant glioneuronal tumor, glioblastoma multiforme (WHO grade IV) or gliosarcoma (WHO grade IV) is required. For patients with radiologic features of DIPG histologic confirmation of diagnosis is not required.
- Patients must be able to swallow pills or take pills crushed in water based juice or puree (e.g. applesauce, apple juice) by mouth or gastric tube.
- Patients with neurological deficits should have deficits that are stable for a minimum of 1 week prior to registration.
- Patients who are on dexamethasone must be on a stable or decreasing dose for at least one week prior to registration.
- Patients must have fully recovered from the acute toxic effects of chemotherapy, immunotherapy, or radiotherapy prior to entering this study.
- Myelosuppressive chemotherapy: Patients must have received their last dose of known myelosuppressive anticancer chemotherapy at least four weeks prior to study registration or at least six weeks if nitrosourea. At least two weeks must have lapsed if patients received lower dose oral etoposide (50 mg/2) without experiencing evidence of myelosuppression (i.e. neutropenia or requiring transfusion with blood products)
- Biologic agent: Patient must have recovered from any toxicity potentially related to the agent and received their last dose of the biologic agent ≥ 7 days prior to study registration. For biologic agents that have a prolonged half-life, the appropriate interval since last treatment should be discussed with the study chair prior to registration.
- Monoclonal antibody treatment: At least three half-lives must have elapsed prior to registration. Such patients should be discussed with the study chair prior to registration.
- Radiation: Patient has received radiation therapy prior to study registration Patients must have had their last fraction of local irradiation to the primary tumor ≥ 3 months prior to registration and their last fraction of craniospinal irradiation (>24Gy) > or equal to 3 months prior to registration. Patient has not received focal irradiation for symptomatic metastatic sites within 2 weeks prior to registration.
- Bone Marrow Transplant: Patient must be ≥ 3 months since high dose chemotherapy and peripheral blood stem cell rescue prior to registration.
- Growth factors: Patients must be off all colony forming growth factors(s) for at least 1 week prior to registration (filgrastim, sargramostim, erythropoietin) and at least 2 weeks for long-acting formulations (e.g. neupogen).
Exclusion Criteria:
- Metastatic disease outside the CNS.
- Use of enzyme-inducing anticonvulsants (EIACs) within 7 days prior to registration.
- Research participants with uncontrolled infection
- Research participants with any concomitant significant medical illness that in the investigator's opinion cannot be adequately controlled with appropriate therapy, or that would impair the evaluation of side effects related to this treatment, alter drug metabolism or the tolerance to this treatment
- Research participants receiving any other anticancer or investigational drug therapy
- Prior therapy with crenolanib
Of note, the use of any concomitant medication that may affect CYP3A function except for dexamethasone, should be discussed with the principal investigator of this study (or her designee).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Other: Stratum A Patients
The patients are newly diagnosed Diffuse Intrinsic Pontine Glioma patients.
Patients may take crenolanib as an intact tablet or crushed in apple sauce/juice.
Currently accruing to dose level 3 (170 mg/m^2).
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Crenolanib orally administered as whole or crushed tablets once per day with concurrent Radiation Therapy.
Crenolanib will continue at the same dose level post Radiation Therapy
Other Names:
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Other: Stratum B Patients
The patients are recurrent, refractory or progressive high-grade glioma including Diffuse Intrinsic Pontine Glioma patients.
Patients may take crenolanib as an intact tablet or crushed in apple sauce/juice.
Currently accruing to dose level 4 (220 mg/m^2).
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Crenolanib orally administered as whole or crushed tablets once per day with concurrent Radiation Therapy.
Crenolanib will continue at the same dose level post Radiation Therapy
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Estimate the maximum tolerated dose (MTD) of crenolanib in pediatric research participants with newly diagnosed DIPG
Time Frame: 2.5 years
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This is done using rolling 6 -design
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2.5 years
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Estimate the MTD of crenolanib in children and young adults with recurrent/refractory HGG including DIPG
Time Frame: 2.5years
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This is done using rolling 6 design
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2.5years
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Characterize the pharmacokinetics of crenolanib in pediatric patients and relate drug disposition to toxicity
Time Frame: 2.5 years
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Individual pharmacokinetic parameters will be estimated using nonlinear mixed effects modeling methods (NONMEM) to estimate both the inter- and intra-subject variability.
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2.5 years
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Collaborators and Investigators
Investigators
- Principal Investigator: Alberto Broniscer, MD, St. Jude Children's Research Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Neoplasms, Neuroepithelial
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Brain Neoplasms
- Central Nervous System Neoplasms
- Nervous System Neoplasms
- Brain Stem Neoplasms
- Infratentorial Neoplasms
- Glioma
- Diffuse Intrinsic Pontine Glioma
- Antineoplastic Agents
- Crenolanib
Other Study ID Numbers
- SJPDGF
- V Fdn (Other Identifier: V Foundation for Cancer Research)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Diffuse Intrinsic Pontine Glioma
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National Cancer Institute (NCI)RecruitingRecurrent Malignant Glioma | Recurrent Medulloblastoma | Refractory Malignant Glioma | Refractory Medulloblastoma | Recurrent Diffuse Intrinsic Pontine Glioma | Recurrent Primary Central Nervous System Neoplasm | Refractory Primary Central Nervous System Neoplasm | Refractory Diffuse Intrinsic Pontine...United States, Canada
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Sidney Kimmel Comprehensive Cancer Center at Johns...Solving Kids' CancerCompletedDiffuse Intrinsic Pontine Glioma (DIPG)United States
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University of California, San FranciscoTranslational Genomics Research InstituteCompletedDiffuse Intrinsic Pontine Glioma (DIPG)United States
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University of California, San FranciscoNational Institute of Neurological Disorders and Stroke (NINDS); The Chad-Tough... and other collaboratorsRecruitingDiffuse Intrinsic Pontine Glioma | Diffuse Midline Glioma, H3 K27M-Mutant | Recurrent Diffuse Intrinsic Pontine Glioma | Recurrent Diffuse Midline Glioma, H3 K27M-Mutant | Recurrent WHO Grade III Glioma | WHO Grade III GliomaUnited States, Israel, Australia, Netherlands, Switzerland, New Zealand
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Burzynski Research InstituteSuspendedDiffuse, Intrinsic Pontine GliomaUnited States
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University of FloridaAccelerate Brain Cancer Cure; Lyla Nsouli FoundationActive, not recruitingBrain Stem Glioma | Diffuse Intrinsic Pontine Glioma (DIPG)United States
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Shenzhen Geno-Immune Medical InstituteShenzhen Children's Hospital; Shenzhen Hospital of Southern Medical UniversityUnknownDiffuse Intrinsic Pontine Glioma or GlioblastomaChina
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Hadassah Medical OrganizationCompletedPediatric Malignant Brain Tumor -Diffuse Intrinsic Pontine GliomaIsrael
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Pediatric Brain Tumor ConsortiumNational Cancer Institute (NCI)CompletedMalignant Glioma | Recurrent Childhood Ependymoma | Recurrent Medulloblastoma | Recurrent Diffuse Intrinsic Pontine Glioma | Recurrent Atypical Teratoid/Rhabdoid Tumor | Refractory Diffuse Intrinsic Pontine Glioma | CNS Embryonal Tumor, Not Otherwise SpecifiedUnited States
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Cheng-Chia (Fred) WuFocused Ultrasound FoundationActive, not recruitingDiffuse Intrinsic Pontine Glioma | Diffuse Midline Glioma, H3 K27M-Mutant | Diffuse Pontine and Thalamic GliomasUnited States
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