- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01413503
A Phase II Study of 131I- Metaiodobenzylguanidine (MIBG) for Treatment of Metastatic or Unresectable Pheochromocytoma and Related Tumors
A Phase II Study of 131I-labeled Metaiodobenzylguanidine (MIBG) for Treatment of Patients With Metastatic or Unresectable Pheochromocytoma and Related Tumors
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
- To assess the efficacy of high-dose 131I-MIBG in the treatment of patients with malignant pheochromocytoma and related tumors, with the basis of this initial examination being the percentage of patients in CR or PR, and the percentage of patients without PD for 3 years after the initial administration on 131I-MIBG therapy.
- To describe the response rate of malignant pheochromocytoma patients treated with high-dose 131I-MIBG.
- To describe the toxicity of high-dose 131I-MIBG in patients with malignant pheochromocytoma.
- To describe the overall survival and failure-free survival of malignant pheochromocytoma patients treated with high-dose 131I-MIBG.
- To determine the utility of using the serum level of Chromogranin A as a tumor marker for patients with malignant pheochromocytoma.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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California
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San Francisco, California, United States, 94103
- UCSF
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Histologic Documentation: Histologic documentation of malignant pheochromocytoma or related tumors (paraganglioma, neuroblastoma, medullary thyroid carcinoma, carcinoid tumors), not amenable to curative surgery. Any site of origin of malignant pheochromocytoma, including but not limited to: adrenal, neck, thorax, abdominal, or pelvis is allowed.
Prior Treatment:
- No cytotoxic chemotherapy for at least 3 weeks prior to high-dose 131I-MIBG or concurrent with high-dose 131I-MIBG.
- > 2 weeks since major surgery.
- > 4 weeks since completion of prior radiation therapy, as long as measurable disease lies outside the radiation port.
- No treatment with an investigational agent concurrent or within 30 days of high-dose 131I-MIBG.
- Patients who have received previous chemotherapy or radiation therapy must have evidence of persistent disease on 123I-MIBG scan and elevated tumor markers or measurable CT lesions before receiving high-dose 131I-MIBG.
- Metastases Excluding Eligibility: No patients with a known significant MIBG-avid parenchymal brain metastasis; leptomeningeal metastases do not exclude eligibility. Hepatic metastases exclude eligibility if they functionally impair liver function (AST or total bilirubin ≥ 2.5 times the ULN).
Measurable Disease Lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as > 10 mm as measured with CT scanning. Lesions < 10 mm diameter or bone lesions in the presence of demonstrable uptake of 123I-MIBG on diagnostic scanning, plus elevated levels of tumor markers that are specific for malignant pheochromocytoma: plasma catecholamines or metanephrines, urine catecholamines or metanephrines, serum chromogranin A. Lesions whose size is considered non-measurable include the following:
- Bone lesions (see above)
- Leptomeningeal disease
- Ascites
- Pleural/pericardial effusion
- Chylothorax
- Lesions within the chest or abdomen that are not confirmed to be pheochromocytoma by biopsy or 123I-MIBG scanning.
- 131I-MIBG or 123I-MIBG Avidity: All patients must have 123I-MIBG or 131I-MIBG whole-body scanning prior to therapy. Metastases must be avid for the isotope such that their measured gamma radiation measures ≥ twice that of background radiation.
- Subsequent 131I-MIBG Therapies: Patients must have had pain relief or a SD or PR after a prior therapy to be eligible for another therapy. Patients with PD within 9 months of the prior therapy are excluded from receiving subsequent therapy.
- Age: ≥4 years of age.
- Life Expectancy: greater than 9 months.
- Karnofsky Performance Status: 70% or higher.
- Anticoagulation: Heparin, LMW heparin, coumadin, and other anticoagulants may be used only when platelet counts are ≥ 100,000/micronL. Platelet counts will be monitored twice weekly after 131I-MIBG therapy.
- Pregnancy & Nursing: Non-pregnant and non-nursing because the effects of high-dose 131I-MIBG on the fetus/infant are unknown.
Second Malignancies:
- Patients with a "currently active" second malignancy, other than non-melanoma skin cancers, are not eligible.
- Patients are not considered to have a "currently active" second malignancy if they have been cancer-free for ≥5 years.
- Intercurrent Illness: No patients with uncontrolled intercurrent illness including but not limited to: ongoing active infections, grade 3 or 4 congestive heart failure by echocardiogram, nephrotic syndrome, serum albumin < 3, significant ascites or pleural effusion, pulmonary function testing (FVC) less than 70% of predicted for age, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
Required Initial Laboratory Data (Minimum Levels):
- Neutrophil count >/= 1,000/micronL
- Platelet count >/= 80,000/micronL
- AST (SGOT) ≤ 2.5 x ULN
- Total bilirubin ≤ 2.5 x ULN
- Creatinine ≤ 2 x ULN
Exclusion Criteria:
- 1) Pregnancy & Nursing: Non-pregnant and non-nursing because the effects of high-dose 131I-MIBG on the fetus/infant are unknown.
2) Second Malignancies:
- Patients with a "currently active" second malignancy, other than non-melanoma skin cancers, are not eligible.
- Patients are not considered to have a "currently active" second malignancy if they have been cancer-free for ≥5 years
- 3) Intercurrent Illness: No patients with uncontrolled intercurrent illness including but not limited to: ongoing active infections, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: 131I-MIBG
Patients received 131I-MIBG 8-12 mCi/kg (maximum 500 mCi ± 10% at investigator's discretion) diluted in 25 ml of normal saline.
Patients were infused intravenously through a patient's peripheral or central line over 120 minutes
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Therapeutic 131I-MIBG will be synthesized at Nuclear Diagnostic Products (NDP; Rockaway, New Jersey) with specific activities of 9-18 Ci/mmole.
The therapeutic dose: 8-12 mCi/kg (maximum 1200 mCi ± 10% at investigator's discretion) will be diluted in 25 ml of normal saline, and will be infused intravenously through a patient's peripheral or central line over 120 minutes.
The patient will remain in a radiation protected isolation room until radiation emissions are ≤ 2 mr/hr at a 1 meter distance or meets institutional and state guidelines.
This usually takes 4-6 days.
In all cases, special shielding will be equipped in the room to minimize exposure to the outside environment and personnel will observe institutional radiation safety precautions.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Patients With Complete (CR), Partial (PR), or Minor (MR) Response and Without Progressive Disease
Time Frame: After 1 year from initial treatment
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Patients with complete (CR), partial (PR), or minor (MR) response and without progressive disease 1 year from initial treatment, using RECIST RESPONSE CRITERIA for measurable soft tissue tumor: CR=No Tumor (Primary or metastatic); catacholamines, metanephrines and chromogranin A all normal.
PR=Primary and all measurable sites decreased >50%; number of positive bone sites decreased by >50%; bone marrow tumor decreased by 50%.
MR=No new lesions; >50% reduction of any measurable lesion (primary or metastases); <25% increase in any existing lesion.
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After 1 year from initial treatment
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Collaborators and Investigators
Investigators
- Principal Investigator: Paul Fitzgerald, UCSF School of Medicine
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
Keywords
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Neuroendocrine Tumors
- Pheochromocytoma
- Paraganglioma
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Radiopharmaceuticals
- 3-Iodobenzylguanidine
Other Study ID Numbers
- 03991
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 Pheochromocytoma
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National Cancer Institute (NCI)RecruitingMetastatic Adrenal Gland Pheochromocytoma | Metastatic Paraganglioma | Unresectable Adrenal Gland Pheochromocytoma | Unresectable Paraganglioma | Advanced Adrenal Gland Pheochromocytoma | Advanced Paraganglioma | Stage III Adrenal Gland Pheochromocytoma and Sympathetic Paraganglioma AJCC v8 | Stage...United States
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Peking Union Medical College HospitalRecruitingPheochromocytoma, Metastatic | Paraganglioma, Malignant | Pheochromocytoma MalignantChina
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M.D. Anderson Cancer CenterNational Cancer Institute (NCI)Active, not recruitingMetastatic Adrenal Gland Pheochromocytoma | Locally Advanced Paraganglioma | Metastatic Paraganglioma | Unresectable Adrenal Gland Pheochromocytoma | Unresectable Paraganglioma | Regional Adrenal Gland PheochromocytomaUnited States
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Peking Union Medical College HospitalRecruitingUltrasonography | Pheochromocytoma, Metastatic | Paraganglioma, Malignant | Pheochromocytoma MalignantChina
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Abramson Cancer Center of the University of PennsylvaniaCompletedUnresectable Paraganglioma | Recurrent Pheochromocytoma | Advanced Metastatic Paraganglioma | Advanced Metastatic Pheochromocytoma | Recurrent Paraganglioma | Unresectable PheochromocytomaUnited States
-
Peking Union Medical College HospitalCompletedPheochromocytoma, Metastatic | Paraganglioma, Malignant | Pheochromocytoma MalignantChina
-
Mayo ClinicNational Cancer Institute (NCI)CompletedMetastatic Adrenal Gland Pheochromocytoma | Malignant Adrenal Gland Pheochromocytoma | Malignant ParagangliomaUnited States
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Peking Union Medical College HospitalRecruitingParaganglioma, Extra-Adrenal | Malignant Adrenal Gland Pheochromocytoma | Malignant Paraganglioma | Pheochromocytoma, Metastatic | Paraganglioma, MalignantChina
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Kunwu Yan,MMCompletedHemodynamic | Adrenal Pheochromocytoma
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National Cancer Institute (NCI)TerminatedParaganglioma | Metastatic Adrenal Gland Pheochromocytoma | Recurrent Adrenal Gland Pheochromocytoma | Extra-Adrenal ParagangliomaUnited States, Singapore, Hong Kong
Clinical Trials on 131I-MIBG
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National Center for Research Resources (NCRR)UnknownNeuroblastomaUnited States
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Kieuhoa VoCannonball Kids Cancer Foundation, IncAvailableNeuroblastomaUnited States
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University of California, San FranciscoThrasher Research FundCompleted
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University of California, San FranciscoApproved for marketingPheochromocytoma | ParagangliomaUnited States
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University College, LondonAstraZeneca; Cancer Research UKWithdrawnParaganglioma | PhaeochromocytomaUnited Kingdom
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Jubilant DraxImage Inc.RecruitingNeoplasms | Neuroectodermal Tumors | NeuroblastomaUnited States
-
Masonic Cancer Center, University of MinnesotaSuspendedRelapsed Neuroblastoma | Metastatic PheochromocytomaUnited States
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New Approaches to Neuroblastoma Therapy ConsortiumCompleted131I-MIBG Alone VS. 131I-MIBG With Vincristine and Irinotecan VS131I-MIBG With Vorinostat (N2011-01)NeuroblastomaUnited States, Canada
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David BushnellNational Cancer Institute (NCI); National Institutes of Health (NIH); Holden...Active, not recruitingNeuroendocrine Tumor Gastrointestinal, Hormone-Secreting | Neuroendocrine Tumor, MalignantUnited States
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New Approaches to Neuroblastoma Therapy ConsortiumUnited TherapeuticsActive, not recruiting