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hu14.18-Interleukin-2 Fusion Protein in Treating Young Patients With Recurrent or Refractory Neuroblastoma
This study has been completed.
Sponsors and Collaborators: Children's Oncology Group
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00082758
  Purpose

RATIONALE: Biological therapies such as hu14.18-interleukin-2 fusion protein work in different ways to stimulate the immune system and stop tumor cells from growing.

PURPOSE: This phase II trial is studying how well hu14.18-interleukin-2 fusion protein works in treating young patients with recurrent or refractory neuroblastoma.


Condition Intervention Phase
Neuroblastoma
Drug: hu14.18-IL2 fusion protein
Phase II

MedlinePlus related topics: Cancer Neuroblastoma
Drug Information available for: Interleukin-2 Denileukin diftitox
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase II Study Of hu14.18-IL2 In Children With Recurrent Or Refractory Neuroblastoma

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Best overall response (complete response, very good partial response, or partial response) [ Designated as safety issue: No ]
  • Events (relapse, progressive disease, survival, or secondary malignancy) [ Designated as safety issue: No ]

Estimated Enrollment: 60
Study Start Date: August 2005
Primary Completion Date: February 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Determine the response rate in children with recurrent or refractory neuroblastoma treated with hu14.18-interleukin-2 (hu14.18-IL2) fusion protein.
  • Determine the adverse events of this drug in these patients.
  • Determine the immunologic activation in patients treated with this drug.
  • Determine the induction of anti-hu14.18-IL2 antibody in patients treated with this drug.
  • Correlate antitumor response with measurements of toxicity, immune activation, and anti-hu14.18-IL2 antibody activity in patients treated with this drug.

OUTLINE: This is a multicenter study. Patients are stratified according to measurable/evaluable disease (measurable by standard radiographic criteria vs evaluable by MIBG scanning and/or bone marrow histology vs disease identified and quantified by bone marrow immunohistochemistry).

Patients receive hu14.18-interleukin-2 fusion protein IV over 4 hours on days 1-3. Treatment repeats every 28 days for up to 10 courses in the absence of disease progression or unacceptable toxicity.

Patients are followed for survival.

PROJECTED ACCRUAL: A total of 40-60 patients (20 for strata 1 and 2 and 0-20 for stratum 3) will be accrued for this study within 2 years.

  Eligibility

Ages Eligible for Study:   up to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed neuroblastoma
  • Relapsed or refractory to conventional therapy
  • Measurable or evaluable disease documented by 1 of the following criteria:

    • Clinical
    • Radiographic
    • Histologic
    • MIBG scanning
    • Immunocytochemistry
  • No symptomatic pleural effusions or ascites requiring constant or intermittent drainage
  • No clinical or radiological evidence of CNS disease

PATIENT CHARACTERISTICS:

Age

  • 21 and under

Performance status

  • Karnofsky 50-100% (> 16 years of age)
  • Lansky 50-100% (≤ 16 years of age)

Life expectancy

  • At least 8 weeks

Hematopoietic

  • Absolute neutrophil count > 1,000/mm^3
  • Platelet count ≥ 75,000/mm^3*

    • Must not be refractory to platelet transfusions
  • Hemoglobin ≥ 9.0 g/dL* NOTE: *Transfusion allowed if patient is known to have a history of bone marrow involvement with tumor

Hepatic

  • ALT < 2.5 times upper limit of normal (ULN)
  • Bilirubin ≤ 1.5 times ULN
  • Hepatitis B surface antigen negative

Renal

  • Creatinine adjusted according to age as follows:

    • No greater than 0.4 mg/dL (≤ 5 months)
    • No greater than 0.5 mg/dL (6 months -11 months)
    • No greater than 0.6 mg/dL (1 year-23 months)
    • No greater than 0.8 mg/dL (2 years-5 years)
    • No greater than 1.0 mg/dL (6 years-9 years)
    • No greater than 1.2 mg/dL (10 years-12 years)
    • No greater than 1.4 mg/dL (13 years and over [female])
    • No greater than 1.5 mg/dL (13 years to 15 years [male])
    • No greater than 1.7 mg/dL (16 years and over [male]) OR
  • Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min

Cardiovascular

  • Shortening fraction ≥ 27% by echocardiogram OR
  • Ejection fraction ≥ 50% by MUGA
  • No symptomatic congestive heart failure
  • No uncontrolled cardiac rhythm disturbance

Pulmonary

  • Pulse oximetry > 94% on room air
  • FVC > 80%
  • FEV_1 > 80%
  • No abnormal respiratory function
  • No dyspnea at rest
  • No exercise intolerance
  • No prior history of ventilator support related to lung injury (e.g., pneumonia, hemorrhagic pneumonitis, or capillary leakage)

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • HIV negative
  • No active uncontrolled infection
  • No active uncontrolled peptic ulcer
  • No objective peripheral neuropathy ≥ grade 2
  • No significant psychiatric disabilities
  • No seizure disorders requiring antiseizure medications
  • No other concurrent significant illness

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Recovered from prior immunotherapy
  • Prior in vivo monoclonal antibodies for biologic therapy or tumor imaging allowed provided there is documented absence of detectable antibody to hu14.18 by serology
  • More than 28 days since prior autologous stem cell transplantation

    • Prior autologous marrow or stem cell infusion using monoclonal antibody-purged specimens allowed
  • More than 1 week since prior growth factors
  • At least 7 days since prior nonmyelosuppressive biologic agents
  • No prior allogeneic bone marrow or stem cell transplantation
  • No concurrent immunomodulating agents
  • No concurrent growth factors

Chemotherapy

  • More than 3 weeks since prior myelosuppressive chemotherapy (4 weeks for nitrosoureas) and recovered
  • No concurrent anticancer chemotherapy

Endocrine therapy

  • No concurrent corticosteroids except 100 mg or less of hydrocortisone (or equivalent) as premedication for blood transfusion or treatment for transfusion reaction

    • No other use of systemic steroids

Radiotherapy

  • Recovered from prior radiotherapy
  • At least 2 weeks since prior local palliative radiotherapy (small port)
  • At least 6 months since prior craniospinal radiotherapy
  • At least 6 months since prior total body irradiation
  • At least 6 months since prior radiotherapy to ≥ 50% of the pelvis
  • At least 6 weeks since other prior substantial bone marrow radiotherapy
  • Concurrent radiotherapy to localized painful lesions allowed provided at least 1 measurable or evaluable lesion is not irradiated

Surgery

  • More than 2 weeks since prior major surgery (e.g., laparotomy or thoracotomy)
  • No prior organ allografts

Other

  • No concurrent immunosuppressive drugs
  • No other concurrent myelosuppressive antineoplastic drugs
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00082758

  Show 81 Study Locations
Sponsors and Collaborators
Children's Oncology Group
Investigators
Study Chair: Paul M. Sondel, MD, PhD University of Wisconsin, Madison
Investigator: Suzanne Shusterman, MD Dana-Farber Cancer Institute
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Publications of Results:
Shusterman S, London WB, Gillies SD, et al.: Anti-neuroblastoma activity of hu14.18-IL2 against minimal residual disease in a Children's Oncology Group (COG) phase II study. [Abstract] J Clin Oncol 26 (Suppl 15): A-3002, 2008.

Study ID Numbers: CDR0000360723, COG-ANBL0322
Study First Received: May 14, 2004
Last Updated: July 23, 2008
ClinicalTrials.gov Identifier: NCT00082758  
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
recurrent neuroblastoma

Study placed in the following topic categories:
Neuroectodermal Tumors, Primitive
Neuroblastoma
Recurrence
Antibodies, Monoclonal
Neuroectodermal Tumors
Antibodies
Interleukin-2
Neoplasms, Germ Cell and Embryonal
Denileukin diftitox
Neuroepithelioma
Neuroectodermal Tumors, Primitive, Peripheral
Neoplasms, Glandular and Epithelial
Immunoglobulins

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Immunologic Factors
Antineoplastic Agents
Neoplasms, Nerve Tissue
Physiological Effects of Drugs
Pharmacologic Actions
Neoplasms
Analgesics, Non-Narcotic
Sensory System Agents
Therapeutic Uses
Analgesics
Peripheral Nervous System Agents
Neoplasms, Neuroepithelial
Central Nervous System Agents

ClinicalTrials.gov processed this record on January 15, 2009