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Interleukin-12 and Interleukin-2 in Treating Patients With Refractory or Recurrent Neuroblastoma

8 april 2013 bijgewerkt door: National Cancer Institute (NCI)

A Phase I Investigation of IL-12 (NSC 672423)/Pulse IL-2 (Aldesleukin) in Children With Persistent and/or Refractory Neuroblastoma (13623)

Phase I trial to compare the effectiveness of interleukin-12 with or without interleukin-2 in treating young patients who have refractory or recurrent neuroblastoma. Biological therapies use different ways to stimulate the immune system and stop cancer cells from growing. Combining interleukin-2 with interleukin-12 may kill more tumor cells.

Studie Overzicht

Toestand

Beëindigd

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

OBJECTIVES:

I. Define the maximum tolerated dose and dose-limiting toxicity of interleukin-12 with or without interleukin-2 in patients with refractory or recurrent neuroblastoma.

II. Determine, preliminarily, the antitumor effect of interleukin-12 with or without interleukin-2 in these patients.

III. Evaluate the immunoregulatory activity of interleukin-12 with or without interleukin-2 in these patients.

IV. Evaluate the antiangiogenic activity of interleukin-12 with or without interleukin-2 in these patients.

OUTLINE: This is a dose-escalation, multicenter study. Patients are assigned to 1 of 2 treatment cohorts.

COHORT A: Patients receive interleukin-12 (IL-12) IV over 5-15 seconds on days 1, 3, 5, 8, 10, and 12.

COHORT B: Patients receive interleukin-2 (IL-2) IV over 15 minutes twice daily on days 1 and 8 and IL-12 IV as in cohort A.

Treatment in both cohorts repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Some patients may receive additional courses at the discretion of the principal investigator.

Cohorts of 3-6 patients in both cohorts receive escalating doses of IL-2 and IL-12 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.

Once the MTD is determined, an additional cohort of 8 patients receives IL-12 and IL-2 at the MTD.

Patients are followed at 3 weeks.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

40

Fase

  • Fase 1

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Verenigde Staten
    • California
      • Los Angeles, California, Verenigde Staten, 90027
        • Children's Hospital Los Angeles
      • Los Angeles, California, Verenigde Staten, 90027-6016
        • New Approaches to Neuroblastoma Treatment (NANT)
      • Palo Alto, California, Verenigde Staten, 94304
        • Lucile Packard Children's Hospital Stanford University
      • San Francisco, California, Verenigde Staten, 94143-0875
        • University of California at San Francisco - Comprehensive Cancer Center
    • Georgia
      • Atlanta, Georgia, Verenigde Staten, 30322
        • AFLAC Cancer Center and Blood Disorders Service
    • Illinois
      • Chicago, Illinois, Verenigde Staten, 60614
        • Childrens Memorial Hospital
    • Indiana
      • Indianapolis, Indiana, Verenigde Staten, 46202
        • Riley Hospital for Children
    • Massachusetts
      • Boston, Massachusetts, Verenigde Staten, 02115
        • Children's Hospital Boston
    • Michigan
      • Ann Arbor, Michigan, Verenigde Staten, 48109
        • University of Michigan University Hospital
    • Ohio
      • Cincinnati, Ohio, Verenigde Staten, 45229
        • Cincinnati Children's Hospital Medical Center
    • Pennsylvania
      • Philadelphia, Pennsylvania, Verenigde Staten, 19104
        • Children's Hospital of Philadelphia
    • Texas
      • Houston, Texas, Verenigde Staten, 77030
        • Texas Children's Hospital
    • Washington
      • Seattle, Washington, Verenigde Staten, 98105
        • Seattle Children's Hospital
    • Wisconsin
      • Madison, Wisconsin, Verenigde Staten, 53792
        • University of Wisconsin Hospital and Clinics

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

3 jaar tot 21 jaar (Kind, Volwassen)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Diagnosis of neuroblastoma

    • Histologically confirmed disease AND/OR disease defined by tumor cells in the bone marrow and elevated urinary catecholamine metabolites

  • Persistent and/or refractory disease, with at least 1 of the following:

    • Biopsy-proven residual disease at least 12 weeks after myeloablative therapy
    • Progressive disease after nonmyeloablative or myeloablative therapy

  • Recurrent disease, evidenced by any of the following:

    • Biopsy-proven recurrent soft tissue disease
    • Metaiodobenzylguanidine (MIBG)-positive lesions visible on any other imaging modality or repeat MIBG obtained 2-4 weeks or more apart
    • Histologically confirmed bone marrow disease
    • Progressive or stable disease after at least 1 prior standard salvage regime
  • No clinically significant pleural effusion
  • ECOG 0-1
  • Life expectancy >= 12 weeks
  • Hepatitis A antibody negative

  • Hepatitis B surface antigen negative

    • Positive hepatitis B titer allowed if patient has been immunized and has no history of disease
  • Hepatitis C virus negative
  • No history of congenital or acquired coagulation disorder
  • Cardiac function normal by ECG
  • No dyspnea at rest
  • No exercise intolerance
  • Oxygen saturation at least 94% by pulse oximetry
  • DLCO greater than 60% of predicted
  • FEV1 greater than 70% of predicted
  • Negative pregnancy test
  • Skull-based bony lesions without space-occupying intracranial extension are allowed
  • No prior or concurrent intracranial metastatic disease to the brain parenchyma
  • Not pregnant or nursing
  • Fertile patients must use effective barrier contraception during and for at least 2 months after study
  • No prior hematologic malignancy (including leukemia or lymphoma)
  • No history of malignant hyperthermia
  • No prior or concurrent autoimmune disease
  • No positive direct Coombs testing
  • No history of ongoing or intermittent bowel obstruction
  • No active infection or other significant systemic illness
  • More than 2 weeks since prior fenretinide
  • More than 2 weeks since prior 13-cis-retinoic acid
  • More than 2 weeks since prior filgrastim (G-CSF) or sargramostim (GM-CSF)
  • More than 2 weeks since prior interferons or interleukins
  • More than 2 weeks since prior cytokine-fusion proteins
  • More than 2 weeks since prior IV immunoglobulin (IVIG)
  • No prior interleukin-12
  • No concurrent cytokines
  • No concurrent fenretinide
  • No concurrent 13-cis-retinoic acid

  • No other concurrent immunomodulators, including:

    • G-CSF and GM-CSF
    • Interferons
    • Other interleukins
    • IVIG
  • More than 4 weeks since prior chemotherapy
  • No other unstable medical condition or critical illness that would preclude study participation
  • More than 12 weeks since prior myeloablative chemotherapy followed by autologous stem cell transplantation:

No prior myeloablative chemotherapy followed by allogeneic bone marrow transplantation

  • More than 2 weeks since prior growth hormones
  • More than 4 weeks since prior systemic corticosteroids
  • More than 2 weeks since prior non-corticosteroid hormonal therapy (including oral birth control pills)
  • No concurrent hormonal therapy (including oral birth control pills)
  • No concurrent growth hormones
  • No concurrent systemic corticosteroids, except for use in life-threatening complications
  • More than 4 weeks since prior radiotherapy
  • No prior solid organ transplantation
  • More than 4 weeks since prior investigational agents
  • No other concurrent investigational agents
  • No prior enrollment on COG-A3973, unless disease has progressed
  • No history of hemolytic anemia
  • Absolute neutrophil count at least 1,500/mm^3 [Note: Independent of growth factor or transfusion support]
  • Platelet count at least 75,000/mm^3 [Note: Independent of growth factor or transfusion support]
  • AST and ALT less than 2.5 times upper limit of normal
  • Bilirubin less than 2.0 mg/dL
  • Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min OR creatinine normal
  • HIV negative
  • Ejection fraction at least 50% by echocardiogram or MUGA OR Fractional shortening at least 30% by echocardiogram
  • No congestive heart failure
  • No uncontrolled cardiac arrhythmia

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Treatment (IL-12, aldesleukin)

Cohort A: Patients receive interleukin-12 (IL-12) IV over 5-15 seconds on days 1, 3, 5, 8, 10, and 12.

Cohort B: Patients receive interleukin-2 (IL-2) IV over 15 minutes twice daily on days 1 and 8 and IL-12 IV as in cohort A.

Treatment in both cohorts repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Some patients may receive additional courses at the discretion of the principal investigator.

Cohorts of 3-6 patients in both cohorts receive escalating doses of IL-2 and IL-12 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.

Once the MTD is determined, an additional cohort of 8 patients receives IL-12 and IL-2 at the MTD.
Biologisch: aldesleukine
IV gegeven
Andere namen:
  • Proleukin
  • IL-2
  • recombinant humaan interleukine-2
  • recombinant interleukine-2
Biologisch: recombinant interleukine-12
IV gegeven
Andere namen:
  • cytotoxische rijpingsfactor voor lymfocyten
  • IL-12
  • interleukine-12
  • natural killer cel stimulerende factor
  • Ro 24-7472

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
Maximum tolerated dose (MTD) assessed by Common Toxicity Criteria (CTC)
Tijdsspanne: 28 days
28 days

Secundaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
Overall response assessed by Response Evaluation Criteria for Solid Tumors (RECIST)
Tijdsspanne: Up to 3 weeks
Up to 3 weeks

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

National Cancer Institute (NCI)

Onderzoekers

  • Hoofdonderzoeker: Jon Wigginton, New Approaches to Neuroblastoma Treatment (NANT)

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 december 2002

Primaire voltooiing (Werkelijk)

1 mei 2009

Studieregistratiedata

Eerst ingediend

5 februari 2003

Eerst ingediend dat voldeed aan de QC-criteria

5 februari 2003

Eerst geplaatst (Schatting)

6 februari 2003

Updates van studierecords

Laatste update geplaatst (Schatting)

9 april 2013

Laatste update ingediend die voldeed aan QC-criteria

8 april 2013

Laatst geverifieerd

1 april 2013

Meer informatie

Termen gerelateerd aan deze studie

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • NCI-2009-00024
  • P01CA081403 (Subsidie/contract van de Amerikaanse NIH)
  • NANT 2001-01
  • CDR0000270447 (Register-ID: PDQ (Physician Data Query))

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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