Fenretinide in Treating Children With Recurrent or Resistant Neuroblastoma
A Phase II Study of Fenretinide (NSC# 374551, IND# 40294) in Children With Recurrent/Resistant High Risk Neuroblastoma
調査の概要
詳細な説明
OBJECTIVES:
Determine the response rate in pediatric patients with recurrent or resistant high-risk neuroblastoma treated with fenretinide.
Determine the toxic effects of this drug in these patients. Determine the proportion of patients with disease detected only by bone marrow immunocytology, who clear all evidence of disease during treatment with this drug.
Determine minimal residual disease response by marrow and meta-iodobenzylguanidine (MIBG) I 123 scan in patients treated with this drug.
OUTLINE: Patients are stratified according to presence of measurable disease on CT scan/MRI (yes vs no). A third stratum of patients with tumor cells in bone marrow by immunocytology only is enrolled but is not evaluated for response.
Patients receive oral fenretinide 3 times daily (or 2 times daily if over 18 years of age) on days 1-7. Treatment repeats every 3 weeks for up to 30 courses in the absence of disease progression or unacceptable toxicity. Patients in stratum III who fail to achieve a complete response after 8 courses of therapy are removed from study.
Patients are followed monthly until blood counts and visual acuity are stable or normalized and then every 6 months for 2 years and annually for 3 years.
PROJECTED ACCRUAL: A total of 70 patients (25 each for strata I and II, 20 for stratum III) will be accrued for this study within 1-2 years.
研究の種類
入学 (予想される)
段階
- フェーズ2
連絡先と場所
研究場所
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California
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Arcadia、California、アメリカ、91006-3776
- Children's Oncology Group
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
Diagnosis of recurrent or resistant/refractory high-risk neuroblastoma by one or both of the following:
- Histological confirmation
- Demonstration of tumor cells in bone marrow with increased urinary catecholamines
Stratum I:
At least 1 unidimensionally measurable lesion*
- At least 20 mm by MRI and/or CT scan OR at least 10 mm by spiral CT scan
Stratum II: Meets one or both of the following criteria:
- At least 1 site with positive uptake on meta-iodobenzylguanidine (MIBG) I 123 scan
- Tumor in bilateral bone marrow aspirate/biopsy by routine morphology (no NSE staining only)
Stratum III:
- At least 5 tumor cells/10^6 mononuclear cells in the bone marrow by immunocytology only (on 2 successive bone marrows performed from 1 day to 4 weeks apart)
- Patients in first response (i.e., patients with persistent tumor at end of frontline therapy, but who have never had disease relapse or progression) must have histological* or morphological (by bone marrow) confirmation** of viable tumor on CT scan, MRI, or MIBG scan after completion of myeloablative therapy (for strata I and II)
- No catecholamine elevation only
- Performance status - 0-2
- At least 2 months
- Hemoglobin greater than 7.5 g/dL (transfusion allowed)
- Bilirubin no greater than 1.5 times normal
- SGPT and SGOT less than 2.5 times normal
- Creatinine normal for age
- No hematuria or proteinuria greater than 1+ on urinalysis
- Calcium less than 11.6 mg/dL
- Triglycerides less than 300 mg/dL
- Not pregnant
- Negative pregnancy test
- Fertile patients must use effective contraception
- No seizure disorders unless on anticonvulsants and well controlled
- No skin toxicity greater than grade 1
- Must be able to consume entire intact study capsule in the dosage prescribed for body surface area
- Recovered from prior immunotherapy
- At least 7 days since prior anticancer biologic therapy
- At least 2 days since prior growth factors
- Prior autologous stem cell transplantation allowed
- No prior allogeneic stem cell transplantation
- No concurrent immunomodulating agents
- At least 2 weeks since prior myelosuppressive chemotherapy (4 weeks for nitrosoureas) and recovered
- No concurrent anticancer chemotherapy
- No concurrent steroids
- Recovered from prior radiotherapy
- At least 4 weeks since prior radiotherapy to target lesion
- Prior radiotherapy to non target lesions allowed
- No concurrent radiotherapy to sole measurable lesion for symptom relief
- Concurrent palliative radiotherapy to non target or localized painful lesions allowed
- Prior tretinoin or isotretinoin allowed
- At least 2 weeks since other prior retinoids
- No prior fenretinide
- No concurrent supplemental oral or IV vitamin A, ascorbic acid, or vitamin E (except if contained in routine total parenteral nutrition [TPN] vitamin supplements)
- No concurrent drugs suspected of causing pseudotumor cerebri (e.g., tetracycline, nalidixic acid, nitrofurantoin, phenytoin, sulfonamides, lithium, amiodarone, or vitamin A [except as part of routine TPN supplements])
- No other concurrent anticancer agents
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的:Treatment (fenretinide)
Patients receive oral fenretinide 3 times daily (or 2 times daily if over 18 years of age) on days 1-7.
Treatment repeats every 3 weeks for up to 30 courses in the absence of disease progression or unacceptable toxicity.
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経口投与
オプションの相関研究
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Response rate
時間枠:Up to 8 courses of therapy
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A responder is defined to be a patient who achieves a best overall response of complete response (CR), very good partial response (VGPR) or partial response (PR).
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Up to 8 courses of therapy
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Toxicity as assessed by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0
時間枠:Up to 5 years
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Assessed via a descriptive tabulation of the toxicity rates, overall and by stratum.
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Up to 5 years
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Levels of fenretinide
時間枠:At baseline and during courses 1, 2, and 5
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Assessed via descriptive analysis of the steady state levels of fenretinide overall and by stratum
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At baseline and during courses 1, 2, and 5
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Plasma retinol levels
時間枠:At baseline and during courses 1, 2, and 5
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Assessed via descriptive analysis of the plasma retinol levels overall and by stratum.
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At baseline and during courses 1, 2, and 5
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Minimal residual disease (MRD) (Stratum 3)
時間枠:Up to 5 years
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Assessed by descriptive calculation of the proportion of responders.
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Up to 5 years
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協力者と研究者
捜査官
- 主任研究者:Judith Villablanca、Children's Oncology Group
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- NCI-2012-01802 (レジストリ識別子:CTRP (Clinical Trial Reporting Program))
- U10CA098543 (米国 NIH グラント/契約)
- COG-ADVL0024
- COG-A0996
- CDR0000269408
- COG-ANBL0321
- ADVL0024 (その他の識別子:Children's Oncology Group)
- ANBL0321 (その他の識別子:CTEP)
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