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Haploidentical Natural Killer (NK) Cells in Patients With Relapsed Neuroblastoma Post Autologous Stem Cell Transplant
This study is currently recruiting participants.
Verified by M.D. Anderson Cancer Center, December 2008
Sponsored by: M.D. Anderson Cancer Center
Information provided by: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00698009
  Purpose

Primary Objective:

1. Evaluate safety, feasibility, persistence, and anti-tumor effect of infused haploidentical donor-derived natural killer (NK) cells and low-dose interleukin-2 (IL-2).

Secondary Objectives:

  1. Quantification of cytokine levels.
  2. Assessment of NK cell immunophenotype and function.

Condition Intervention Phase
Neuroblastoma
Drug: Fludarabine
Drug: Cyclophosphamide
Biological: Natural Killer Cell Infusion
Phase II

MedlinePlus related topics: Cancer Neuroblastoma
Drug Information available for: Cyclophosphamide Fludarabine Fludarabine monophosphate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title: Study to Infuse Haploidentical Natural Killer Cells in Patients With Relapsed Neuroblastoma Post Autologous Stem Cell Transplant

Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • To find if infusing relative's NK cells into patient body can be done safely. [ Time Frame: 1 Year ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To find if infused cells will survive after the infusion, and if the NK cell infusion can help to destroy neuroblastoma cells. [ Time Frame: 1 Year ] [ Designated as safety issue: No ]

Estimated Enrollment: 10
Study Start Date: June 2008
Estimated Primary Completion Date: June 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
Fludarabine + Cyclophosphamide + Natural Killer Cell Infusion
Drug: Fludarabine
25 mg/m^2 IV Daily Over 30 minutes.
Drug: Cyclophosphamide
60 mg/kg IV Daily Over 2 Hours
Biological: Natural Killer Cell Infusion
Natural Killer Cell Infusion on Day 0.

  Show Detailed Description

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Minimal eligibility: See the following (2 to 3).
  • KIR typing will be undertaken after informed consent is signed.
  • HLA typing will be undertaken independent of consent.
  • Inclusion criteria for recipient (within 4 weeks prior to lymphodepleting conditioning regimen and after consent-signing). As following (5 to 18).
  • HLA-haploidentical relative is predicted to be alloreactive based upon the presence of the relevant KIR genes and incompatibility with the recipient. Three conditions must be met simultaneously: a) The KIR-ligand (HLA molecule) for the KIR-receptor gene in question must be ABSENT in the recipient. b) The KIR-receptor gene in question must be PRESENT,that is, not deleted in the DONOR. c) The KIR-ligand (HLA molecule) for the KIR-receptor gene in question must be PRESENT in the donor.
  • Progression of neuroblastoma after autologous peripheral blood stem-cell transplantation
  • Measurable neuroblastoma disease as defined by at least one radiographic (using any/all of the following modalities CT, MRI, PET, MIBG, Bone scan), abnormality attributed to malignancy
  • Platelets >/= 50,000 x 10^ 9/L and hemoglobin (Hgb) >/= 9 g/dL, unsupported by transfusions in last seven days.
  • ANC >/= 1,000 x 10^ 9/L, unsupported by cytokines in last seven days.
  • Off prednisone or other immunosuppressive medications for at least 3 days
  • Zubrod performance scale </= 2 or Lansky >/= 60.
  • Adequate renal function defined as: Serum creatinine (Cr), for adults </=2 mg/dL, for children </=2 mg/dL or </=2 times upper limit of normal (ULN) for age (whichever is less). If abnormal renal function then Cr clearance >60 mL/min/1.73m^2.
  • Adequate liver function defined as: Total bilirubin </=2 mg/dL and SGPT (ALT) </= 2.5 x ULN for age (unless Gilbert's disease or abnormal liver function due to primary disease).
  • Pulmonary symptoms controlled by medication and pulse oximetry >/= 92% room air.
  • Negative serum test to rule out pregnancy within 2 weeks prior to registration in females post menarche of childbearing potential (non childbearing is defined as greater than one year post-menopausal or surgically sterilized).
  • Requirement of males and females of childbearing potential to use any form of contraception considered effective and medically acceptable by the Investigator.
  • Negative serology for (HIV)human immunodeficiency virus.
  • Not a breast-feeding female.
  • Inclusion criteria for recipient to receive NK infusion(s) as assessed on Day 0. As following (20 to 29).
  • Not currently using a ventilator.
  • Not currently undergoing dialysis.
  • Not currently using a Phase I, II, or III investigational agent. These agents should be stopped within 21 days of NK infusion.
  • No requirement for supplemental oxygen.
  • No new detected cardiac arrhythmia not controlled with medical management within prior 72 hour period.
  • No hypotension requiring pressor support within prior 72 hour period.
  • No uncontrolled infection defined as daily fever >/= 38.2 degrees Celsius and no new positive culture for bacteria, fungus, or virus within 72 hours prior to NK-cell infusion, if clinically indicated.
  • No ascites requiring paracentesis within prior 72 hour period.
  • No seizure activity or clinically detectable encephalopathy or new focal neurologic deficits within prior 72 hour period.
  • Not taking corticosteroids by mouth or intravenously within prior 72 hour period.
  • Inclusion criteria for donor (within 7 days of apheresis). See following (31 to 40).
  • Related to recipient.
  • Able and willing to undergo apheresis.
  • Willing (but not required) to donate blood for NK cell studies.
  • Willing to donate blood for baseline chimerism studies.
  • Willing to donate blood for baseline fluorescence in situ hybridization studies.
  • Screening infectious disease panel that meets standard medical eligibility criteria for allogeneic blood stem cell donation.
  • CBC, differential and platelet studies that meet standard medical eligibility criteria for allogeneic blood stem cell donation.
  • Negative serum test to rule out pregnancy within two weeks prior to registration in females of childbearing potential (non-childbearing is defined as greater than one year post-menopause or surgically sterilized).
  • Meet standard medical eligibility criteria for allogeneic blood stem cell donation.
  • The first two patients enrolled in this protocol will need to have prior cryopreserved autologous peripheral blood stem cells collected within 6 months and/or they are at least 6 months after autologous peripheral blood stem cell rescue. This criterion safeguards against the possibility that the lymphodepletion regimen may lead to prolonged myelosuppression.

Exclusion Criteria:

  • Exclusion criteria for donor:(within 7 days of apheresis). As following 2) to 3)
  • Active infection.

    1. Febrile
    2. on antibiotics.
  • Breast-feeding female.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00698009

Contacts
Contact: Laurence Cooper, MD, PhD 713-792-9860

Locations
United States, Texas
U.T.M.D. Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Principal Investigator: Laurence Cooper, MD, PhD            
Sponsors and Collaborators
M.D. Anderson Cancer Center
Investigators
Principal Investigator: Laurence Cooper, MD, PhD U.T.M.D. Anderson Cancer Center
  More Information

UT MD Anderson Cancer Center  This link exits the ClinicalTrials.gov site

Responsible Party: U.T.M.D. Anderson Cancer Center ( Laurence Cooper, MD, PhD/Associate Professor )
Study ID Numbers: 2006-0752
Study First Received: June 12, 2008
Last Updated: December 29, 2008
ClinicalTrials.gov Identifier: NCT00698009  
Health Authority: United States: Food and Drug Administration

Keywords provided by M.D. Anderson Cancer Center:
Neuroblastoma
Natural Killer Cell
NK Cell Infusion
Haploidentical Natural Killer (NK) Cells
Fludarabine
Fludarabine Phosphate
Cyclophosphamide
Cytoxan
Neosar
Infusion of NK cells
Pediatric NK Cell Infusion
Pediatric Neuroblastoma
Pediatric NK
Pediatric

Study placed in the following topic categories:
Neuroectodermal Tumors
Neuroectodermal Tumors, Primitive
Neoplasms, Germ Cell and Embryonal
Neuroepithelioma
Fludarabine
Fludarabine monophosphate
Cyclophosphamide
Neuroectodermal Tumors, Primitive, Peripheral
Neuroblastoma
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Antimetabolites
Antimetabolites, Antineoplastic
Neoplasms by Histologic Type
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Neoplasms, Nerve Tissue
Physiological Effects of Drugs
Immunosuppressive Agents
Pharmacologic Actions
Neoplasms
Therapeutic Uses
Myeloablative Agonists
Antineoplastic Agents, Alkylating
Neoplasms, Neuroepithelial
Antirheumatic Agents
Alkylating Agents

ClinicalTrials.gov processed this record on January 16, 2009