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Erlotinib Alone or in Combination With Radiation Therapy in Treating Young Patients With Refractory or Relapsed Malignant Brain Tumors or Newly Diagnosed Brain Stem Glioma

19 settembre 2013 aggiornato da: Children's Cancer and Leukaemia Group

Phase I Studies of TARCEVA™ (ERLOTINIB HYDROCHLORIDE, OSI-774) as Single Agent in Children With Refractory and Relapsed Malignant Brain Tumors and in Combination With Irradiation in Newly Diagnosed Brain Stem Glioma

RATIONALE: Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving erlotinib together with radiation therapy may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of erlotinib when given alone or together with radiation therapy in treating young patients with refractory or relapsed malignant brain tumors or newly diagnosed brain stem glioma.

Panoramica dello studio

Descrizione dettagliata

OBJECTIVES:

Primary

  • Establish the maximum tolerated dose of single-agent erlotinib hydrochloride in pediatric patients with refractory or relapsed malignant brain tumors and in combination with radiotherapy in pediatric patients with newly diagnosed brain stem glioma.

Secondary

  • Determine dose-limiting toxicities of these regimens.
  • Define the safety profile of these regimens.
  • Characterize the pharmacokinetic behavior of erlotinib hydrochloride in these patients.
  • Evaluate the efficacy of these regimens.
  • Correlate expression and mutations of epidermal growth factor receptor with treatment response.

OUTLINE: This is a multicenter, nonrandomized, open-label, dose-escalation study of erlotinib hydrochloride. Patients are assigned to 1 of 2 treatment groups according to disease.

  • Group 1 (refractory or relapsed malignant brain tumors): Patients receive oral erlotinib hydrochloride once daily on days 1-21. Treatment repeats every 21 days in the absence of unacceptable toxicity or disease progression.

Cohorts of 3-6 patients receive escalating doses of erlotinib hydrochloride until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity (DLT).

  • Group 2 (newly diagnosed brain stem glioma): Patients receive oral erlotinib hydrochloride once daily on days 1-21. Treatment repeats every 21 days in the absence of unacceptable toxicity or disease progression. Beginning on day 1, patients also undergo radiotherapy 5 days a week for 6 weeks .

Cohorts of 1-2 patients receive escalating doses of erlotinib hydrochloride until the MTD is determined. The MTD is defined as the dose resulting in 25% of patients experiencing DLT at 6 weeks.

Blood is collected for pharmacokinetic assessments and pharmacogenetic genotyping for analysis of enzyme polymorphisms. Tumor tissue may be assessed for epidermal growth factor receptor mutations.

After completion of study treatment, patients are followed every 3 months.

PROJECTED ACCRUAL: A total of 48 patients will be accrued for this study.

Tipo di studio

Interventistico

Iscrizione (Anticipato)

48

Fase

  • Fase 1

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

      • Dublin, Irlanda, 12
        • Our Lady's Hospital for Sick Children Crumlin
    • England
      • Birmingham, England, Regno Unito, B4 6NH
        • Birmingham Children's Hospital
      • Bristol, England, Regno Unito, BS2 8AE
        • Institute of Child Health at University of Bristol
      • Cambridge, England, Regno Unito, CB2 2QQ
        • Addenbrooke's Hospital at Cambridge University Hospitals NHS Foundation Trust
      • Leeds, England, Regno Unito, LS9 7TF
        • Leeds Cancer Centre at St. James's University Hospital
      • Leicester, England, Regno Unito, LE1 5WW
        • Leicester Royal Infirmary
      • Liverpool, England, Regno Unito, L12 2AP
        • Royal Liverpool Children's Hospital, Alder Hey
      • London, England, Regno Unito, WC1N 3JH
        • Great Ormond street Hospital for Children NHS Trust
      • London, England, Regno Unito, W1T 3AA
        • Middlesex Hospital
      • Manchester, England, Regno Unito, M27 4HA
        • Central Manchester and Manchester Children's University Hospitals NHS Trust
      • Newcastle-Upon-Tyne, England, Regno Unito, NE1 4LP
        • Sir James Spence Institute of Child Health
      • Nottingham, England, Regno Unito, NG7 2UH
        • Queen's Medical Centre
      • Oxford, England, Regno Unito, 0X3 9DU
        • Oxford Radcliffe Hospital
      • Sheffield, England, Regno Unito, S10 2TH
        • Children's Hospital - Sheffield
      • Southampton, England, Regno Unito, SO16 6YD
        • Southampton University Hospital NHS Trust
      • Sutton, England, Regno Unito, SM2 5PT
        • Royal Marsden NHS Foundation Trust - Surrey
    • Northern Ireland
      • Belfast, Northern Ireland, Regno Unito, BT12 6BE
        • Royal Belfast Hospital for Sick Children
    • Scotland
      • Aberdeen, Scotland, Regno Unito, AB25 2ZG
        • Royal Aberdeen Children's Hospital
      • Edinburgh, Scotland, Regno Unito, EH9 1LF
        • Royal Hospital for Sick Children
      • Glasgow, Scotland, Regno Unito, G3 8SJ
        • Royal Hospital for Sick Children
    • Wales
      • Cardiff, Wales, Regno Unito, CF14 4XW
        • Childrens Hospital for Wales

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 1 anno a 21 anni (Bambino, Adulto)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

DISEASE CHARACTERISTICS:

  • Diagnosis of 1 of the following:

    • Histologically or cytologically confirmed malignant brain tumor

      • Refractory to first-line therapy or relapsed after conventional therapy
      • No effective conventional therapy exists
    • Histologically confirmed brain stem glioma

      • Newly diagnosed disease
      • No pilocytic glioma
  • Measurable or evaluable disease

PATIENT CHARACTERISTICS:

  • WHO performance status 0-2 OR Lansky play scale 50-100%

    • Patients with motor paresis due to disease are eligible
    • Neurological deficits must be stable for ≥ 1 week
  • Life expectancy ≥ 8 weeks
  • Absolute neutrophil count > 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 8 g/dL
  • AST/ALT ≤ 2.5 times upper limit of normal (ULN)
  • Bilirubin ≤ 1.5 times ULN
  • Creatinine < 1.5 times ULN OR creatinine clearance ≥ 70 mL/min
  • No other serious, uncontrolled illness
  • No active infection
  • No organ toxicity ≥ grade 2 except alopecia and neurological symptoms due to disease
  • Must be able to take oral medication

    • Patients with newly diagnosed brain stem glioma with difficulty swallowing may be eligible
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No evidence of pulmonary dysfunction or pre-existing lung disease
  • No myocardial infarction within the past year
  • No severe cardiac pathology
  • No significant ophthalmologic abnormality including, but not limited to, any of the following:

    • Severe dry eye syndrome
    • Keratoconjunctivitis sicca
    • Sjögren's syndrome
    • Severe exposure keratitis
    • Any other disorder likely to increase the risk of corneal epithelial lesions

PRIOR CONCURRENT THERAPY:

  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas)
  • More than 6 weeks since prior radiotherapy
  • No concurrent warfarin
  • No other concurrent anticancer or investigational agents

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Non randomizzato
  • Mascheramento: Nessuno (etichetta aperta)

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Maximum tolerated dose of erlotinib hydrochloride when given alone and in combination with radiotherapy

Misure di risultato secondarie

Misura del risultato
Sicurezza
Efficacia
Tossicità dose-limitanti
Pharmacokinetic behavior of erlotinib hydrocloride
Correlation of expression and mutations of epidermal growth factor receptor with treatment response

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Investigatori

  • Darren Hargrave, MD, Royal Marsden NHS Foundation Trust

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 maggio 2005

Date di iscrizione allo studio

Primo inviato

3 agosto 2006

Primo inviato che soddisfa i criteri di controllo qualità

3 agosto 2006

Primo Inserito (Stima)

7 agosto 2006

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Stima)

20 settembre 2013

Ultimo aggiornamento inviato che soddisfa i criteri QC

19 settembre 2013

Ultimo verificato

1 giugno 2007

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • CDR0000481539
  • CCLG-NAG-2005-09
  • ITCC-003
  • EU-20617
  • CCLG-CPP-05-07
  • ROCHE-MO18461
  • EUDRACT-2004-005247-10

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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