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진행성, 재발성 또는 불응성 랑게르한스 세포 조직구증의 치료 옵션으로서 토보라페닙(DAY101)을 사용한 연구

2026년 10월 29일 업데이트: National Cancer Institute (NCI)

재발성 및 불응성 랑게르한스 세포 조직구증에서 토보라페닙(DAY101)의 2상 연구

This phase II trial tests the safety, side effects, best dose and activity of tovorafenib (DAY101) in treating patients with Langerhans cell histiocytosis that is growing, spreading, or getting worse (progressive), has come back (relapsed) after previous treatment, or does not respond to therapy (refractory). Langerhans cell histiocytosis is a type of disease that occurs when the body makes too many immature Langerhans cells (a type of white blood cell). When these cells build up, they can form tumors in certain tissues and organs including bones, skin, lungs and pituitary gland and can damage them. This tumor is more common in children and young adults. DAY101 may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Using DAY101 may be effective in treating patients with relapsed or refractory Langerhans cell histiocytosis.

연구 개요

상태

모병

정황

개입 / 치료

상세 설명

PRIMARY OBJECTIVE:

I. To determine overall response rate (ORR) for children and young adults with relapsed or refractory BRAFV600E positive (cohort 1) and BRAFV600E negative (cohort 2) Langerhans cell histiocytosis (LCH) treated with tovorafenib (DAY101) after 2 cycles and must be maintained 4 weeks later.

SECONDARY OBJECTIVES:

I. To determine nature and severity of adverse events in patients treated with tovorafenib (DAY101) for relapsed or refractory LCH.

II. To describe event-free survival (EFS) at 1 year in children and young adults with relapsed and refractory LCH treated with tovorafenib (DAY 101) for up to 1 year.

III. To determine durability of response in children and young adults with relapsed or refractory LCH treated with tovorafenib (DAY101) following cessation of therapy in patients with complete response (CR) at 1 year.

IV. To describe progression-free (and relapse-free) survival (PFS) and overall survival (OS) in children and young adults with relapsed or refractory LCH treated with tovorafenib (DAY101) for up to 1 year.

EXPLORATORY OBJECTIVES:

I. To determine potential role of pathogenic tumor mutation in response to tovorafenib (DAY101), and to evaluate changes in bone marrow and peripheral blood cell populations carrying pathogenic mutations in response to tovorafenib (DAY101) therapy.

Ia. To define somatic mutations in LCH lesion biopsies; Ib. To determine impact of tovorafenib (DAY101) on bone marrow and blood BRAFV600E+ mononuclear cells; Ic. To determine impact of tovorafenib (DAY101) on cerebral spinal fluid and disease response; Id. To determine the performance of standardized immunohistochemical analysis of LCH lesion biopsies.

II. To compare performance of LCH-specific response criteria to Response Evaluation Criteria in Solid Tumors (RECIST) criteria.

III. To describe the pharmacokinetics of tovorafenib (DAY101) when administered to pediatric and young adult patients with relapse or refractory LCH.

OUTLINE: This is a dose escalation study of tovorafenib followed by a phase II trial.

Patients receive tovorafenib orally (PO) once weekly (QW) on days 1, 8, 15, and 22 of each cycle. Cycles repeat every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo multi-gated acquisition (MUGA) or echocardiography (ECHO) scans, and fludeoxyglucose F-18 (FDG)-positron emission tomography (PET) or computed tomography (CT) throughout the trial, and collection of blood and urine samples on study. Patients with suspicion of bone marrow and/or central nervous system involvement will also undergo bone marrow biopsy and aspiration and lumbar puncture on study and during follow up.

After completion of study treatment, patients are followed up at 28 days, months 3, 6, 9, and 12, and then at 2 years post cycle 12.

연구 유형

중재적

등록 (추정된)

48

단계

  • 2 단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Alabama
      • Birmingham, Alabama, 미국, 35233
        • 모병
        • Children's Hospital of Alabama
        • 연락하다:
        • 수석 연구원:
          • Matthew A. Kutny
    • Arkansas
      • Little Rock, Arkansas, 미국, 72202-3591
        • 모병
        • Arkansas Children's Hospital
        • 수석 연구원:
          • Michael W. Bishop
        • 연락하다:
          • Site Public Contact
          • 전화번호: 501-364-7373
    • California
      • Downey, California, 미국, 90242
        • 모병
        • Kaiser Permanente Downey Medical Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 626-564-3455
        • 수석 연구원:
          • Robert M. Cooper
      • Loma Linda, California, 미국, 92354
        • 모병
        • Loma Linda University Medical Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 909-558-4050
        • 수석 연구원:
          • Albert Kheradpour
      • Long Beach, California, 미국, 90806
        • 모병
        • Miller Children's and Women's Hospital Long Beach
        • 연락하다:
          • Site Public Contact
          • 전화번호: 562-933-5600
        • 수석 연구원:
          • Jacqueline N. Casillas
      • Los Angeles, California, 미국, 90027
        • 모병
        • Children's Hospital Los Angeles
        • 연락하다:
          • Site Public Contact
          • 전화번호: 323-361-4110
        • 수석 연구원:
          • Rebecca S. Parker
      • Madera, California, 미국, 93636
        • 모집하지 않고 적극적으로
        • Valley Children's Hospital
      • Oakland, California, 미국, 94611
        • 모병
        • Kaiser Permanente-Oakland
        • 연락하다:
          • Site Public Contact
          • 전화번호: 877-642-4691
          • 이메일: Kpoct@kp.org
        • 수석 연구원:
          • Aarati V. Rao
      • Oakland, California, 미국, 94609
        • 모병
        • UCSF Benioff Children's Hospital Oakland
        • 수석 연구원:
          • Jennifer G. Michlitsch
        • 연락하다:
      • Orange, California, 미국, 92868
        • 모병
        • Children's Hospital of Orange County
        • 연락하다:
        • 수석 연구원:
          • Elyssa M. Rubin
      • Palo Alto, California, 미국, 94304
        • 모병
        • Lucile Packard Children's Hospital Stanford University
        • 연락하다:
        • 수석 연구원:
          • Jay Michael S. Balagtas
      • San Francisco, California, 미국, 94158
        • 모병
        • UCSF Medical Center-Mission Bay
        • 연락하다:
        • 수석 연구원:
          • Natalie L. Wu
    • Colorado
      • Aurora, Colorado, 미국, 80045
        • 모병
        • Children's Hospital Colorado
        • 연락하다:
        • 수석 연구원:
          • Timothy P. Garrington
      • Denver, Colorado, 미국, 80218
        • 모병
        • Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
        • 연락하다:
        • 수석 연구원:
          • Florence Choo
    • Connecticut
      • Hartford, Connecticut, 미국, 06106
        • 모병
        • Connecticut Children's Medical Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 860-545-9981
        • 수석 연구원:
          • Michael S. Isakoff
      • New Haven, Connecticut, 미국, 06520
        • 모병
        • Yale University
        • 연락하다:
        • 수석 연구원:
          • Farzana Pashankar
    • Delaware
      • Wilmington, Delaware, 미국, 19803
        • 모병
        • Alfred I duPont Hospital for Children
        • 연락하다:
        • 수석 연구원:
          • Vibhuti Agarwal
    • District of Columbia
      • Washington D.C., District of Columbia, 미국, 20010
        • 모병
        • Children's National Medical Center
        • 수석 연구원:
          • Jeffrey S. Dome
        • 연락하다:
    • Florida
      • Fort Myers, Florida, 미국, 33908
        • 모병
        • Golisano Children's Hospital of Southwest Florida
        • 연락하다:
        • 수석 연구원:
          • Emad K. Salman
      • Gainesville, Florida, 미국, 32610
        • 모병
        • UF Health Cancer Institute - Gainesville
        • 수석 연구원:
          • Brian Stover
        • 연락하다:
          • Site Public Contact
          • 전화번호: 352-273-8010
      • Hollywood, Florida, 미국, 33021
        • 모병
        • Memorial Regional Hospital/Joe DiMaggio Children's Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 954-265-1847
          • 이메일: OHR@mhs.net
        • 수석 연구원:
          • Iftikhar Hanif
      • Jacksonville, Florida, 미국, 32207
        • 모병
        • Nemours Children's Clinic-Jacksonville
        • 연락하다:
        • 수석 연구원:
          • Vibhuti Agarwal
      • Miami, Florida, 미국, 33155
        • 모병
        • Nicklaus Children's Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 888-624-2778
        • 수석 연구원:
          • Ziad A. Khatib
      • Miami, Florida, 미국, 33136
        • 정지된
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Orlando, Florida, 미국, 32806
        • 모병
        • Arnold Palmer Hospital for Children
        • 연락하다:
        • 수석 연구원:
          • Zhongbo Hu
      • Orlando, Florida, 미국, 32827
        • 모병
        • Nemours Children's Hospital
        • 연락하다:
        • 수석 연구원:
          • Vibhuti Agarwal
      • Pensacola, Florida, 미국, 32504
      • St. Petersburg, Florida, 미국, 33701
        • 모병
        • Johns Hopkins All Children's Hospital
        • 연락하다:
        • 수석 연구원:
          • Jennifer B. Dean
      • Tampa, Florida, 미국, 33607
        • 모병
        • Saint Joseph's Hospital/Children's Hospital-Tampa
        • 연락하다:
        • 수석 연구원:
          • Don E. Eslin
    • Georgia
      • Atlanta, Georgia, 미국, 30329
        • 모병
        • Children's Healthcare of Atlanta - Arthur M Blank Hospital
        • 수석 연구원:
          • Kathryn S. Sutton
        • 연락하다:
      • Savannah, Georgia, 미국, 31404
        • 모병
        • Memorial Health University Medical Center
        • 연락하다:
        • 수석 연구원:
          • James N. Yarnall
    • Hawaii
      • Honolulu, Hawaii, 미국, 96826
        • 모병
        • Kapiolani Medical Center for Women and Children
        • 연락하다:
          • Site Public Contact
          • 전화번호: 808-983-6090
        • 수석 연구원:
          • Wade T. Kyono
    • Illinois
      • Chicago, Illinois, 미국, 60611
        • 모병
        • Lurie Children's Hospital-Chicago
        • 연락하다:
          • Site Public Contact
          • 전화번호: 773-880-4562
        • 수석 연구원:
          • Joanna L. Weinstein
      • Chicago, Illinois, 미국, 60637
        • 모병
        • University of Chicago Comprehensive Cancer Center
        • 연락하다:
        • 수석 연구원:
          • Perry C. Morocco
      • Peoria, Illinois, 미국, 61637
    • Indiana
      • Indianapolis, Indiana, 미국, 46202
        • 모병
        • Riley Hospital for Children
        • 연락하다:
          • Site Public Contact
          • 전화번호: 800-248-1199
        • 수석 연구원:
          • Jennifer A. Belsky
    • Iowa
      • Des Moines, Iowa, 미국, 50309
        • 모병
        • Blank Children's Hospital
        • 연락하다:
        • 수석 연구원:
          • Samantha L. Mallory
      • Iowa City, Iowa, 미국, 52242
        • 모병
        • University of Iowa/Holden Comprehensive Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 800-237-1225
        • 수석 연구원:
          • Andrew P. Groves
    • Kentucky
      • Lexington, Kentucky, 미국, 40536
        • 모병
        • University of Kentucky/Markey Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 859-257-3379
        • 수석 연구원:
          • James T. Badgett
    • Louisiana
      • New Orleans, Louisiana, 미국, 70118
        • 모병
        • Children's Hospital New Orleans
        • 수석 연구원:
          • Maria C. Velez-Yanguas
        • 연락하다:
          • Site Public Contact
          • 전화번호: 504-894-5377
      • New Orleans, Louisiana, 미국, 70121
        • 모병
        • Ochsner Medical Center Jefferson
        • 연락하다:
        • 수석 연구원:
          • Craig Lotterman
    • Maryland
      • Baltimore, Maryland, 미국, 21287
        • 모병
        • Johns Hopkins University/Sidney Kimmel Cancer Center
        • 연락하다:
        • 수석 연구원:
          • Elias Zambidis
      • Baltimore, Maryland, 미국, 21215
        • 모병
        • Sinai Hospital of Baltimore
        • 수석 연구원:
          • Jason M. Fixler
        • 연락하다:
          • Site Public Contact
          • 전화번호: 410-601-9083
    • Michigan
      • East Lansing, Michigan, 미국, 48823
        • 정지된
        • Michigan State University
      • Grand Rapids, Michigan, 미국, 49503
        • 모병
        • Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
        • 연락하다:
        • 수석 연구원:
          • Kathleen Y. Butler
      • Kalamazoo, Michigan, 미국, 49007
        • 모병
        • Bronson Methodist Hospital
        • 연락하다:
        • 수석 연구원:
          • Kathleen Y. Butler
    • Minnesota
      • Minneapolis, Minnesota, 미국, 55404
        • 모병
        • Children's Hospitals and Clinics of Minnesota - Minneapolis
        • 수석 연구원:
          • Michael K. Richards
        • 연락하다:
      • Minneapolis, Minnesota, 미국, 55455
        • 모집하지 않고 적극적으로
        • University of Minnesota/Masonic Cancer Center
    • Mississippi
      • Jackson, Mississippi, 미국, 39216
        • 모병
        • University of Mississippi Medical Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 601-815-6700
        • 수석 연구원:
          • Amanda Strobel
    • Missouri
      • St Louis, Missouri, 미국, 63110
        • 모병
        • Washington University School of Medicine
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Sisk
      • St Louis, Missouri, 미국, 63141
        • 모병
        • Mercy Hospital Saint Louis
        • 연락하다:
          • Site Public Contact
          • 전화번호: 314-251-7066
        • 수석 연구원:
          • Robin D. Hanson
      • St Louis, Missouri, 미국, 63104
        • 모병
        • Cardinal Glennon Children's Medical Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 314-268-4000
        • 수석 연구원:
          • William S. Ferguson
    • Nebraska
      • Omaha, Nebraska, 미국, 68114
        • 모병
        • Children's Hospital and Medical Center of Omaha
        • 연락하다:
          • Site Public Contact
          • 전화번호: 402-955-3949
        • 수석 연구원:
          • Jill C. Beck
      • Omaha, Nebraska, 미국, 68198
        • 모병
        • University of Nebraska Medical Center
        • 연락하다:
        • 수석 연구원:
          • Jill C. Beck
    • Nevada
      • Las Vegas, Nevada, 미국, 89135
        • 모병
        • Alliance for Childhood Diseases/Cure 4 the Kids Foundation
        • 연락하다:
        • 수석 연구원:
          • Joseph L. Lasky
      • Las Vegas, Nevada, 미국, 89144
        • 모병
        • Summerlin Hospital Medical Center
        • 연락하다:
        • 수석 연구원:
          • Joseph L. Lasky
    • New Jersey
      • Hackensack, New Jersey, 미국, 07601
        • 모병
        • Hackensack University Medical Center
        • 수석 연구원:
          • Katharine Offer
        • 연락하다:
          • Site Public Contact
          • 전화번호: 551-996-2897
      • Morristown, New Jersey, 미국, 07960
        • 모병
        • Morristown Medical Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 973-971-5900
        • 수석 연구원:
          • Kathryn L. Laurie
      • New Brunswick, New Jersey, 미국, 08903
        • 모병
        • Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
        • 수석 연구원:
          • Marissa Botwinick
        • 연락하다:
          • Site Public Contact
          • 전화번호: 732-235-8675
      • Paterson, New Jersey, 미국, 07503
        • 모병
        • Saint Joseph's Regional Medical Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 973-754-2207
          • 이메일: HallL@sjhmc.org
        • 수석 연구원:
          • Alissa Kahn
    • New York
      • Albany, New York, 미국, 12208
        • 모병
        • Albany Medical Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 518-262-5513
        • 수석 연구원:
          • Lauren R. Weintraub
      • Brooklyn, New York, 미국, 11219
        • 모병
        • Maimonides Medical Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 718-765-2500
        • 수석 연구원:
          • Mahmut Y. Celiker
      • New Hyde Park, New York, 미국, 11040
        • 모병
        • The Steven and Alexandra Cohen Children's Medical Center of New York
        • 연락하다:
          • Site Public Contact
          • 전화번호: 718-470-3460
        • 수석 연구원:
          • Julie I. Krystal
      • New York, New York, 미국, 10032
        • 모병
        • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
        • 수석 연구원:
          • Nobuko Hijiya
        • 연락하다:
      • New York, New York, 미국, 10065
        • 모병
        • Memorial Sloan Kettering Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 212-639-7592
        • 수석 연구원:
          • Christopher J. Forlenza
      • New York, New York, 미국, 10016
        • 모병
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
        • 수석 연구원:
          • Elizabeth A. Raetz
        • 연락하다:
      • New York, New York, 미국, 10029
        • 모병
        • Mount Sinai Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 212-824-7309
          • 이메일: CCTO@mssm.edu
        • 수석 연구원:
          • Pamela R. Merola
      • New York, New York, 미국, 10065
        • 모병
        • NYP/Weill Cornell Medical Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 212-746-1848
        • 수석 연구원:
          • Nitya Gulati
      • Syracuse, New York, 미국, 13210
        • 모병
        • State University of New York Upstate Medical University
        • 연락하다:
          • Site Public Contact
          • 전화번호: 315-464-5476
        • 수석 연구원:
          • Melanie A. Comito
      • The Bronx, New York, 미국, 10467
        • 모병
        • Montefiore Medical Center - Moses Campus
        • 연락하다:
        • 수석 연구원:
          • Alice Lee
      • Valhalla, New York, 미국, 10595
        • 모집하지 않고 적극적으로
        • New York Medical College
    • North Carolina
      • Asheville, North Carolina, 미국, 28801
      • Durham, North Carolina, 미국, 27710
        • 모병
        • Duke University Medical Center
        • 수석 연구원:
          • Jessica M. Sun
        • 연락하다:
          • Site Public Contact
          • 전화번호: 888-275-3853
      • Greenville, North Carolina, 미국, 27834
        • 모병
        • East Carolina University
        • 연락하다:
        • 수석 연구원:
          • Andrea R. Whitfield
      • Winston-Salem, North Carolina, 미국, 27157
        • 모병
        • Wake Forest University Health Sciences
        • 연락하다:
          • Site Public Contact
          • 전화번호: 336-713-6771
        • 수석 연구원:
          • Sarah Supples
    • Ohio
      • Cleveland, Ohio, 미국, 44106
        • 모병
        • Rainbow Babies and Childrens Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 216-844-5437
        • 수석 연구원:
          • Duncan S. Stearns
      • Columbus, Ohio, 미국, 43205
      • Dayton, Ohio, 미국, 45404
        • 모병
        • Dayton Children's Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 800-228-4055
        • 수석 연구원:
          • Jordan M. Wright
    • Oklahoma
      • Oklahoma City, Oklahoma, 미국, 73104
        • 모병
        • University of Oklahoma Health Sciences Center
        • 연락하다:
        • 수석 연구원:
          • Rene Y. McNall-Knapp
    • Oregon
      • Portland, Oregon, 미국, 97239
        • 모병
        • Oregon Health and Science University
        • 연락하다:
          • Site Public Contact
          • 전화번호: 503-494-1080
          • 이메일: trials@ohsu.edu
        • 수석 연구원:
          • Katrina Winsnes
    • Pennsylvania
      • Danville, Pennsylvania, 미국, 17822
        • 모병
        • Geisinger Medical Center
        • 수석 연구원:
          • Jagadeesh Ramdas
        • 연락하다:
      • Philadelphia, Pennsylvania, 미국, 19104
        • 모병
        • Children's Hospital of Philadelphia
        • 수석 연구원:
          • Michael D. Hogarty
        • 연락하다:
      • Philadelphia, Pennsylvania, 미국, 19134
        • 모병
        • Saint Christopher's Hospital for Children
        • 연락하다:
          • Site Public Contact
          • 전화번호: 215-427-8991
        • 수석 연구원:
          • Gregory E. Halligan
      • Pittsburgh, Pennsylvania, 미국, 15224
        • 모병
        • Children's Hospital of Pittsburgh of UPMC
        • 연락하다:
        • 수석 연구원:
          • Julia E. Segal
    • South Carolina
      • Columbia, South Carolina, 미국, 29203
        • 모병
        • Prisma Health Richland Hospital
        • 수석 연구원:
          • Stuart L. Cramer
        • 연락하다:
      • Greenville, South Carolina, 미국, 29605
        • 모병
        • BI-LO Charities Children's Cancer Center
        • 수석 연구원:
          • Aniket Saha
        • 연락하다:
    • South Dakota
      • Sioux Falls, South Dakota, 미국, 57117-5134
    • Tennessee
      • Knoxville, Tennessee, 미국, 37916
        • 모병
        • East Tennessee Childrens Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 865-541-8266
        • 수석 연구원:
          • Susan E. Spiller
      • Nashville, Tennessee, 미국, 37232
        • 모병
        • Vanderbilt University/Ingram Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 800-811-8480
        • 수석 연구원:
          • Devang J. Pastakia
      • Nashville, Tennessee, 미국, 37203
        • 모병
        • The Children's Hospital at TriStar Centennial
        • 연락하다:
          • Site Public Contact
          • 전화번호: 615-342-1919
        • 수석 연구원:
          • Clinton M. Carroll
    • Texas
      • Austin, Texas, 미국, 78723
      • Dallas, Texas, 미국, 75390
        • 모병
        • UT Southwestern/Simmons Cancer Center-Dallas
        • 연락하다:
        • 수석 연구원:
          • Erin B. Butler
      • El Paso, Texas, 미국, 79905
        • 모병
        • El Paso Children's Hospital
        • 연락하다:
        • 수석 연구원:
          • Benjamin Carcamo
      • Houston, Texas, 미국, 77030
        • 모병
        • Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
        • 연락하다:
          • Site Public Contact
          • 전화번호: 713-798-1354
          • 이메일: burton@bcm.edu
        • 수석 연구원:
          • Olive S. Eckstein
      • Houston, Texas, 미국, 77030
        • 모병
        • UT MD Anderson Cancer Center
        • 연락하다:
        • 수석 연구원:
          • Najat C. Daw
      • San Antonio, Texas, 미국, 78207
        • 모병
        • Children's Hospital of San Antonio
        • 연락하다:
        • 수석 연구원:
          • Julie Voeller
      • San Antonio, Texas, 미국, 78229
        • 모병
        • University of Texas Health Science Center at San Antonio
        • 연락하다:
        • 수석 연구원:
          • Allison C. Grimes
      • San Antonio, Texas, 미국, 78229
        • 모병
        • Methodist Children's Hospital of South Texas
        • 연락하다:
        • 수석 연구원:
          • Jose M. Esquilin
      • Temple, Texas, 미국, 76508
        • 모병
        • Scott and White Memorial Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 254-724-5407
        • 수석 연구원:
          • Nicholas W. McGregor
    • Utah
      • Salt Lake City, Utah, 미국, 84113
        • 모병
        • Primary Children's Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 801-585-5270
        • 수석 연구원:
          • Taumoha Ghosh
    • Virginia
      • Charlottesville, Virginia, 미국, 22908
      • Norfolk, Virginia, 미국, 23507
        • 모병
        • Children's Hospital of The King's Daughters
        • 연락하다:
        • 수석 연구원:
          • Melissa S. Mark
      • Richmond, Virginia, 미국, 23298
        • 모병
        • VCU Massey Comprehensive Cancer Center
        • 수석 연구원:
          • Nadirah El-Amin
        • 연락하다:
    • Washington
      • Seattle, Washington, 미국, 98105
        • 모병
        • Seattle Children's Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 866-987-2000
        • 수석 연구원:
          • Sarah E. Leary
      • Spokane, Washington, 미국, 99204
        • 모병
        • Providence Sacred Heart Medical Center and Children's Hospital
        • 연락하다:
        • 수석 연구원:
          • Judy L. Felgenhauer
    • West Virginia
      • Charleston, West Virginia, 미국, 25304
        • 모병
        • Vandalia Health/CAMC Institute for Academic Medicine
        • 수석 연구원:
          • Mohamad H. Badawi
        • 연락하다:
    • Wisconsin
      • Green Bay, Wisconsin, 미국, 54301
        • 모병
        • Saint Vincent Hospital Cancer Center Green Bay
        • 수석 연구원:
          • Catherine A. Long
        • 연락하다:
      • Milwaukee, Wisconsin, 미국, 53226
        • 모병
        • Children's Hospital of Wisconsin
        • 수석 연구원:
          • Peter H. Shaw
        • 연락하다:
          • Site Public Contact
          • 전화번호: 414-955-4727
          • 이메일: MACCCTO@mcw.edu
      • Québec, 캐나다, G1V 4G2
        • 모병
        • CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)
        • 수석 연구원:
          • Bruno Michon
        • 연락하다:
    • Alberta
      • Edmonton, Alberta, 캐나다, T6G 2B7
        • 모병
        • University of Alberta Hospital
        • 연락하다:
        • 수석 연구원:
          • Sarah J. McKillop
    • British Columbia
      • Vancouver, British Columbia, 캐나다, V6H 3V4
        • 모병
        • British Columbia Children's Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 6477 604-875-2345
        • 수석 연구원:
          • Rebecca J. Deyell
    • Nova Scotia
      • Halifax, Nova Scotia, 캐나다, B3K 6R8
        • 모병
        • IWK Health Centre
        • 연락하다:
        • 수석 연구원:
          • Chelsea Ash
    • Ontario
      • Hamilton, Ontario, 캐나다, L8N 3Z5
        • 정지된
        • McMaster Children's Hospital at Hamilton Health Sciences
      • London, Ontario, 캐나다, N6A 5W9
        • 모병
        • Children's Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 519-685-8306
        • 수석 연구원:
          • Shayna M. Zelcer
      • Toronto, Ontario, 캐나다, M5G 1X8
        • 모병
        • Hospital for Sick Children
        • 연락하다:
        • 수석 연구원:
          • Oussama A. Abla
    • Quebec
      • Montreal, Quebec, 캐나다, H3H 1P3
        • 모병
        • The Montreal Children's Hospital of the MUHC
        • 연락하다:
        • 수석 연구원:
          • Stephanie Mourad
      • Montreal, Quebec, 캐나다, H3T 1C5
        • 모병
        • Centre Hospitalier Universitaire Sainte-Justine
        • 수석 연구원:
          • Monia Marzouki
        • 연락하다:
      • Sherbrooke, Quebec, 캐나다, J1H 5N4
        • 모병
        • Centre Hospitalier Universitaire de Sherbrooke-Fleurimont
        • 연락하다:
        • 수석 연구원:
          • Stephanie Vairy
    • New South Wales
      • Hunter Regional Mail Centre, New South Wales, 호주, 2310
        • 모병
        • John Hunter Children's Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: (02) 4985 5180
        • 수석 연구원:
          • Kristy McCarthy
      • Randwick, New South Wales, 호주, 2031
        • 모병
        • Sydney Children's Hospital
        • 수석 연구원:
          • Draga Barbaric
        • 연락하다:
          • Site Public Contact
          • 전화번호: (02) 9382-1721
    • Queensland
      • South Brisbane, Queensland, 호주, 4101
        • 모병
        • Queensland Children's Hospital
        • 수석 연구원:
          • Steven A. Foresto
        • 연락하다:
          • Site Public Contact
          • 전화번호: 61 7 3068 1111
    • Victoria
      • Parkville, Victoria, 호주, 3052
        • 모병
        • Royal Children's Hospital
        • 수석 연구원:
          • Martin A. Campbell
        • 연락하다:
    • Western Australia
      • Perth, Western Australia, 호주, 6009

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

5개월 (어린이, 성인)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Inclusion Criteria:

  • 180 days- < 22 years (at time of study enrollment)

  • Patient must have a body surface area of ≥ 0.3 m^2

  • Patients with progressive, relapsed, or recurrent LCH with measurable disease at study entry

    • Patients must have had histologic verification of LCH (from either original diagnosis or relapse/progression) at the time of study entry

      • Tissue confirmation of relapse is recommended but not required.
      • Pathology report must be submitted for central confirmation of diagnosis within 7 days of enrollment.
      • Formalin-fixed paraffin-embedded (FFPE) blocks or unstained slides (initial diagnosis and/or subsequent biopsies) will be required for retrospective central confirmation of diagnosis and molecular studies
      • Patients with mixed histiocytic disorders (e.g. LCH with juvenile xanthogranuloma) may be included
    • Patients must have measurable disease

    • Patients must have progressive or refractory disease or experience relapse after at least one previous systemic treatment strategy

    • Pathogenic somatic mutation detected in genes encoding tyrosine kinase receptors (CSFR1, ERBB3 or ALK), RAS or RAF (may be from original or subsequent biopsy or peripheral blood/bone marrow aspirate). Clinical mutation reports may include quantitative polymerase chain reaction (PCR) (e.g. BRAFV600E) and/or Sanger or next generation sequencing. Immunohistochemistry (e.g. VE1 antibody for BRAFV600E) alone is not sufficient

  • Participant must be able to take an enteral dose and formulation of medication. Study medication is only available as an oral suspension or tablet, which may be taken by mouth or other enteral route such as nasogastric, jejunostomy, or gastric tube

  • Karnofsky >= 50% for patients > 16 years of age and Lansky >= 50% for patients =< 16 years of age

  • Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1 or 2. Use Karnofsky for patients > 16 years of age and Lansky for patients =< 16 years of age

  • Myelosuppressive chemotherapy: Patients must not have received within 14 days of entry onto this study

  • Investigational agent or any other anticancer therapy not defined above: Patients must not have received any investigational agent or any other anticancer therapy (including MAPK pathway inhibitor) for at least 14 days prior to planned start of tovorafenib (DAY101)

  • Radiation therapy (RT): Patient must not have received RT within 2 weeks after the last dose fraction of RT

  • Patients must have fully recovered from any prior surgery

  • Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, targeted inhibitor, and/or radiotherapy with toxicities reduced to grade 1 or less (Common Terminology Criteria for Adverse Events [CTCAE] version 5.0)

  • Steroids: =< 0.5 mg/kg/day of prednisone equivalent (maximum 20 mg/day) averaged during the month prior to study enrollment is permissible

  • Strong inducers or inhibitors of CYP2C8 are prohibited for 14 days before the first dose of tovorafenib (DAY101) and from planned administration for the duration of study participation

  • Medications that are breast cancer resistant protein (BCRP) substrates that have a narrow therapeutic index are prohibited for 14 days before the first dose of tovorafenib (DAY101) and for the duration of study participation

  • Peripheral absolute neutrophil count (ANC) >= 750/uL unless secondary to bone marrow involvement, in such cases bone marrow involvement must be documented (must be performed within 7 days prior to enrollment, must be repeated prior to the start of protocol therapy if > 7 days have elapsed from their most recent prior assessment)

  • Platelet count >= 75,000/uL (unsupported/without transfusion within the past 7 days) (must be performed within 7 days prior to enrollment, must be repeated prior to the start of protocol therapy if > 7 days have elapsed from their most recent prior assessment)

  • Patients with marrow disease must have platelet count of >= 75,000/uL (transfusion support allowed) and must not be refractory to platelet transfusions. Bone marrow involvement must be documented

  • Hemoglobin >= 8 g/dL (unsupported/without transfusion within the past 7 days). Patients with marrow disease must have hemoglobin >= 8 g/dL (transfusion support allowed). Bone marrow involvement must be documented

  • Hematopoietic growth factors: At least 14 days after the last dose of a long-acting growth factor (e.g., Neulasta [registered trademark]) or 7 days for short-acting growth factor

  • A serum creatinine based on age/sex as follows (must be performed within 7 days prior to enrollment, must be repeated prior to the start of protocol therapy if > 7 days have elapsed from their most recent prior assessment)

    • Age: 6 months to < 1 year; Maximum Serum Creatinine (mg/dL):= 0.5 mg/dl (male and female)
    • Age: 1 to < 2 years; Maximum Serum Creatinine (mg/dL): = 0.6 mg/dl (male and female)
    • Age: 2 to < 6 years; Maximum Serum Creatinine (mg/dL): = 0.8 mg/dl (male and female)
    • Age: 6 to < 10 years; Maximum Serum Creatinine (mg/dL): = 1.0 mg/dl (male and female)
    • Age: 10 to < 13 years; Maximum Serum Creatinine (mg/dL): = 1.2 mg/dl (male and female)
    • Age: 13 to < 16 years; Maximum Serum Creatinine (mg/dL): = 1.5 mg/dl (male) and 1.4 mg/dl (female)
    • Age: >= 16 years; Maximum Serum Creatinine (mg/dL): = 1.7 mg/dl (male) and 1.4 mg/dl (female)
    • OR- a 24 hour urine creatinine clearance >= 50 mL/min/1.73 m^2
    • OR- a glomerular filtration rate (GFR) >= 50 mL/min/1.73 m^2. GFR must be performed using direct measurement with a nuclear blood sampling method OR direct small molecule clearance method (iothalamate or other molecule per institutional standard)
    • Note: Estimated GFR (eGFR) from serum creatinine, cystatin C or other estimates are not acceptable for determining eligibility
  • Bilirubin (sum of conjugated + unconjugated) =< 1.5 x upper limit of normal (ULN) for age (must be performed within 7 days prior to enrollment, must be repeated prior to the start of protocol therapy if > 7 days have elapsed from their most recent prior assessment)

  • Alanine aminotransferase (ALT) =< 3 x ULN for age (must be performed within 7 days prior to enrollment, must be repeated prior to the start of protocol therapy if > 7 days have elapsed from their most recent prior assessment)

  • Serum albumin >= 2 g/dl must be performed within 7 days prior to enrollment, must be repeated prior to the start of protocol therapy if > 7 days have elapsed from their most recent prior assessment)

  • For patients with liver disease caused by their histiocytic disorder (as evaluated on radiographic imaging or biopsy): patients may be enrolled with abnormal bilirubin, aspartate aminotransferase (AST), ALT and albumin with documentation of histiocytic liver disease

  • Fractional shortening (FS) of >= 25% or ejection fraction of >= 50%, as determined by echocardiography or multigated acquisition scan (MUGA) within 28 days prior to study enrollment. Depending on institutional standard, either FS or left ventricular ejection fraction (LVEF) is adequate for enrollment if only one value is measured; if both values are measured, then both values must meet criteria above (must be obtained within 28 days prior to enrollment and start of protocol therapy) (repeat if necessary)

  • No evidence of dyspnea at rest, no exercise intolerance, and a pulse oximetry > 94% if there is clinical indication for determination; unless it is due to underlying pulmonary LCH

  • Central Nervous System Function Defined As:

    • Patients with seizure disorder may be enrolled if well controlled
    • Central nervous system (CNS) toxicity =< Grade 2
  • Human immunodeficiency virus (HIV) infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial unless antiretroviral therapy interacts with the metabolism of tovorafenib (DAY101) and cannot safely be changed to antivirals that do not interact with study medication

  • All patients and/or their parent(s) or legal guardians must sign a written informed consent

  • All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met.

Exclusion Criteria:

  • LCH arising along with other hematologic malignancy (e.g. mixed LCH with acute lymphoblastic leukemia) or any history of non-histiocytic malignancy

  • Disease scenarios as below will be excluded

    • Skin-limited disease
    • Gastrointestinal (GI) tract involvement only (those that have disease that can be determined by endoscopic biopsies only)
    • LCH-associated neurodegeneration (LCH-ND) without parenchymal lesions or other systemic lesions
  • Patients with activating mutations in MAP2K1 are not eligible for this study due to drug target specificity. Mutation status will be submitted to study team within 7 days of enrollment

  • Refractory nausea and vomiting, malabsorption, or external biliary shunt that would preclude adequate absorption of tovorafenib (DAY101)

  • Uncontrolled systemic bacterial, viral, or fungal infection

  • Major surgical procedure or significant traumatic injury within 14 days prior to study enrollment, or anticipation of need for major surgical procedure during the course of the study. Placement of a vascular access device or minor surgery is permitted within fourteen (14) days of study enrollment (provided that the wound has healed)

  • History of significant bowel resection that would preclude adequate absorption or other significant malabsorptive disease

  • Ophthalmologic considerations: Patients with known significant ophthalmologic conditions or known risk factors for retinal vein occlusion (RVO) or central serous retinopathy (CSR) are not eligible

  • History of solid organ or hematopoietic bone marrow transplantation

  • Clinically significant active cardiovascular disease, or history of myocardial infarction, or deep vein thrombosis/pulmonary embolism within 6 months prior to enrollment, ongoing cardiomyopathy, or current prolonged QT interval > 440 ms based on triplicate electrocardiogram (ECG) average

  • History of Grade >= 2 CNS hemorrhage or history of any CNS hemorrhage within 28 days of study entry

  • History of any drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome or Stevens Johnsons syndrome (SJS) or who are allergic to tovorafenib (DAY101) or any of its components

  • CTCAE version (V.) 5.0 Grade 3 symptomatic creatinine kinase (CPK) elevation (> 5 x ULN)

  • Female patients who are pregnant are ineligible. A pregnancy test is required for female patients of childbearing potential

  • Lactating females who plan to breastfeed their infants are ineligible

  • Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation are ineligible. Women of childbearing potential must use non-hormonal contraception during tovorafenib treatment and for at least 28 days after the last dose. Men should use effective contraception and must not father a child while taking tovorafenib and for 14 days after the last dose

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 해당 없음
  • 중재 모델: 순차적 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Treatment (tovorafenib)

Patients receive tovorafenib PO QW on days 1, 8, 15, and 22 of each cycle. Cycles repeat every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo MUGA or ECHO scans, and FDG-PET or CT throughout the trial, and collection of blood and urine samples on study. Patients with suspicion of bone marrow and/or central nervous system involvement will also undergo bone marrow biopsy and aspiration and lumbar puncture on study and during follow up.

Undergo bone marrow biopsy

다른 이름들:
  • 골수 생검
  • 생검, 골수

Undergo CT

다른 이름들:
  • CT
  • 고양이
  • 고양이 스캔
  • 컴퓨터 축 단층 촬영
  • 전산화 단층 촬영
  • CT 스캔
  • 단층 촬영
  • 컴퓨터 축 단층 촬영(시술)
  • 컴퓨터 단층촬영(CT) 스캔
  • 진단 CAT 스캔
  • 진단 CAT 스캔 서비스 유형

Undergo ECHO

다른 이름들:
  • 심초음파
  • EC

Undergo MUGA

다른 이름들:
  • 혈액 풀 스캔
  • 평형 방사성핵종 혈관조영술
  • 게이티드 혈액 풀 이미징
  • 무가
  • 방사성핵종 뇌실조영술
  • RNVG
  • SYMA 스캐닝
  • 동기화된 다중 게이트 수집 스캐닝
  • 무가 스캔
  • 다중 게이트 획득 스캔
  • 방사성핵종 뇌실도 스캔
  • 게이트 하트 풀 스캔
  • RNV 스캔

Undergo bone marrow aspiration

Undergo lumbar puncture

다른 이름들:
  • LP
  • 척추 천자

Undergo collection of blood and urine samples

다른 이름들:
  • 생물학적 샘플 수집
  • 생체 표본 수집
  • 표본 수집
  • 샘플 수집

Undergo FDG-PET imaging

다른 이름들:
  • FDG PET/CT

Given PO

다른 이름들:
  • TAK-580
  • MLN2480
  • BIIB-024
  • 101일차
  • DAY-101
  • 데이101
  • MLN-2480
  • pan-RAF 키나제 억제제 DAY101
  • TAK580
  • 오젬다
  • BIIB 024
  • BIIB024
  • MLN 2480
  • 타크 580

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Frequency of dose limiting toxicity (dose finding phase)
기간: Up to 28 days

Will be analyzed descriptively.

Up to 28 days
Overall response rate (phase II)
기간: After 2 cycles of therapy (each cycle is 28 days)

Will be assessed using minimax Simon's two-stage designs in each of the BRAFV600E and non-BRAFV600E cohorts separately. The two arms will not be directly compared. The 95% confidence interval for the overall response rate will be adjusted for the two-stage design.

After 2 cycles of therapy (each cycle is 28 days)

2차 결과 측정

결과 측정
측정값 설명
기간
Event free survival rate
기간: At 1 and 2 years

Will be estimated by the Kaplan-Meier method beginning at study enrollment. Will be evaluated two years after enrollment of the last patient on the trial and estimates at specific timepoints will be presented along with log-log transformed 95% confidence intervals. Events are defined as relapse/progression, second malignant neoplasm, or death.

At 1 and 2 years
Progression free survival rate
기간: Up to 2 years

Will be estimated by the Kaplan-Meier method beginning at study enrollment. Will be evaluated by two years after enrollment of the last patient on the trial and estimates at specific timepoints will be presented along with log-log transformed 95% confidence intervals.

Up to 2 years
Duration of response rate
기간: After 12 months of therapy. From the scan confirming the complete response or partial response (whichever is recorded first), until the first occurrence of recurrent or progressive disease or death (event) or last known status on trial

Response is based on modified Response Evaluation Criteria for Solid Tumors (RECIST)/Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) consistent with other recent pediatric Langerhans Cell Histiocytosis trials (NCT02670707 and NCT04079179) and adult histiocytosis trials with MAPK inhibitors. Comparison of response assessed via RECIST versus (vs.) PERCIST will be analyzed by displaying two-way tables of the responses with no formal statistical testing.

After 12 months of therapy. From the scan confirming the complete response or partial response (whichever is recorded first), until the first occurrence of recurrent or progressive disease or death (event) or last known status on trial
Overall survival rate
기간: Up to 2 years

Will be estimated by the Kaplan-Meier method beginning at study enrollment. Will be evaluated two years after enrollment of the last patient on the trial and estimates at specific timepoints will be presented along with log-log transformed 95% confidence intervals.

Up to 2 years

기타 결과 측정

결과 측정
측정값 설명
기간
Percent peripheral blood mononuclear cells with mutated allele
기간: Up to 2 years

Will be analyzed descriptively using logistic regression with complete response/progressive response vs. stable disease/progressive disease as the response variable.

Up to 2 years

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

수사관

  • 수석 연구원: Carl E Allen, Children's Oncology Group

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2024년 3월 28일

기본 완료 (추정된)

2028년 9월 30일

연구 완료 (추정된)

2028년 9월 30일

연구 등록 날짜

최초 제출

2023년 4월 21일

QC 기준을 충족하는 최초 제출

2023년 4월 21일

처음 게시됨 (실제)

2023년 4월 25일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 10월 30일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 10월 29일

마지막으로 확인됨

2026년 7월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • NCI-2022-06282
  • U10CA180886 (미국 NIH 보조금/계약)
  • ANHL2121 (기타 식별자: CTEP)
  • NCI-2022-06282 (레지스트리 식별자: CTRP (Clinical Trial Reporting Program))
  • ANHL2121 (기타 식별자: Children's Oncology Group)

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

예

IPD 계획 설명

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

예

미국 FDA 규제 기기 제품 연구

아니

미국에서 제조되어 미국에서 수출되는 제품

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .