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Tipifarnib in Preventing Cancer in Children With Neurofibromatosis Type 1 and Progressive Plexiform Neurofibromas
This study is ongoing, but not recruiting participants.
Sponsored by: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00029354
  Purpose

RATIONALE: Chemoprevention therapy is the use of certain drugs to try to prevent the development or recurrence of cancer. Tipifarnib may be effective in preventing the development of cancer in patients who have neurofibromatosis type 1 and plexiform neurofibromas.

PURPOSE: This randomized phase II trial is studying tipifarnib to see how well it works in preventing cancer in young patients who have neurofibromatosis type 1 and progressive plexiform neurofibromas.


Condition Intervention Phase
Neurofibromatosis Type 1 (nf1)
Precancerous/Nonmalignant Condition
Sarcoma
Drug: placebo
Drug: tipifarnib
Phase II

Genetics Home Reference related topics: familial encephalopathy with neuroserpin inclusion bodies neurofibromatosis type 1 neurofibromatosis type 2
MedlinePlus related topics: Cancer Neurofibromatosis Soft Tissue Sarcoma
Drug Information available for: Tipifarnib
U.S. FDA Resources
Study Type: Interventional
Study Design: Prevention, Randomized, Double-Blind, Placebo Control
Official Title: A Phase II Randomized, Cross-Over, Double-Blinded, Placebo-Controlled Trial Of The Farnesyltransferase Inhibitor R115777 In Pediatric Patients With Neurofibromatosis Type I And Progressive Plexiform Neurofibromas

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

Primary Outcome Measures:
  • Time to progression at 6 and 12 months [ Designated as safety issue: No ]

Estimated Enrollment: 63
Study Start Date: July 2001
Estimated Primary Completion Date: February 2004 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Arm I: Experimental
Patients receive oral tipifarnib every 12 hours on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: tipifarnib
Given orally
Arm II: Placebo Comparator
Patients receive oral placebo every 12 hours on days 1-21. Courses repeat as in arm I.
Drug: placebo
Given orally

Detailed Description:

OBJECTIVES:

  • Determine the effect of tipifarnib on the time to disease progression in pediatric patients with neurofibromatosis type 1 and progressive plexiform neurofibromas.
  • Determine the objective response rate in patients treated with this regimen.
  • Determine the toxic effects of this regimen in these patients.
  • Assess the quality of life of patients treated with this regimen.
  • Determine the circulating levels of nerve growth factor and correlate these levels with the development of clinical neurotoxicity in patients treated with this regimen.

OUTLINE: This is a randomized, cross-over, double-blind, placebo-controlled, multicenter study. Patients are randomized to 1 of 2 arms.

  • Arm I: Patients receive oral tipifarnib every 12 hours on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients receive oral placebo every 12 hours on days 1-21. Courses repeat as in arm I.

After documentation of disease progression, patients on both arms cross over to the other arm and (after a 2-week washout period) receive treatment as above in the absence of further disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, prior to courses 4, 7, and 10, and then after every 6 courses thereafter.

PROJECTED ACCRUAL: A total of 63 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   3 Years to 25 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of one of the following:

    • Neurofibromatosis type 1 (NF1)
    • Progressive plexiform neurofibromas

      • Neurofibromas that have grown along the length of a nerve and may involve multiple fascicles and branches (spinal neurofibromas involve 2 or more levels with connection between the levels or extending laterally along the nerve)
      • Potential to cause significant morbidity such as:

        • Head and neck lesions that could compromise airway or great vessels
        • Brachial or lumbar plexus lesions that could cause nerve compression and loss of function
        • Lesions that could result in major deformity (e.g., orbital lesions)
        • Lesions of the limb that cause limb hypertrophy or loss of function
        • Painful lesions
  • Meets at least 1 other diagnostic criteria for NF1

    • 6 or more cafe-au-lait spots (at least 0.5 cm in prepubertal patients or at least 1.5 cm in postpubertal patients)
    • Freckling in the axilla or groin
    • Optic glioma
    • 2 or more Lisch nodules
    • Distinctive bony lesion (dysplasia of the sphenoid bone or dysplasia or thinning of long bone cortex)
    • First-degree relative with NF1
  • Measurable plexiform neurofibromas

    • At least 3 cm in one dimension
  • Evidence of recurrent or progressive disease as documented by an increase in size or the presence of new plexiform neurofibromas on MRI
  • No evidence of an optic glioma, malignant glioma, malignant peripheral nerve sheath tumor, or other cancer requiring chemotherapy or radiotherapy
  • Prior surgery for progressive plexiform neurofibroma allowed provided neurofibroma was incompletely resected and is measurable
  • Complete tumor resection not feasible or patient refused surgery

PATIENT CHARACTERISTICS:

Age:

  • 3 to 25

Performance status:

  • ECOG 0-2

Life expectancy:

  • At least 12 months

Hematopoietic:

  • Absolute granulocyte count at least 1,500/mm^3
  • Hemoglobin at least 9.0 g/dL
  • Platelet count at least 150,000/mm^3
  • Fibrinogen normal

Hepatic:

  • Bilirubin normal unless due to Gilbert's syndrome
  • SGPT no greater than 2 times upper limit of normal
  • No significant hepatic dysfunction

Renal:

  • Creatinine normal for age OR
  • Creatinine clearance at least 70 mL/min

Cardiovascular:

  • No significant cardiac dysfunction

Pulmonary:

  • No significant pulmonary dysfunction

Other:

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No clinically significant unrelated systemic illness that would preclude study participation
  • No serious infections
  • No significant organ dysfunction
  • No metal implanted prostheses (e.g., vascular clamps or pacemakers) that would contraindicate an MRI

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • At least 1 week since prior filgrastim (G-CSF)
  • No concurrent anticancer immunotherapy

Chemotherapy:

  • See Disease Characteristics
  • No more than 1 prior myelosuppressive chemotherapy regimen
  • At least 4 weeks since prior chemotherapy and recovered
  • No concurrent anticancer chemotherapy

Endocrine therapy:

  • No concurrent anticancer hormonal therapy

Radiotherapy:

  • See Disease Characteristics
  • At least 6 weeks since prior radiotherapy and recovered
  • No concurrent anticancer radiotherapy

Surgery:

  • See Disease Characteristics

Other:

  • No prior tipifarnib
  • At least 30 days since prior investigational agents
  • No concurrent proton pump inhibitors (e.g., omeprazole, lansoprazole, pantoprazole, rabeprazole, or esomeprazole)
  • No other concurrent investigational anticancer agents
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00029354

Locations
United States, Alabama
Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham
Birmingham, Alabama, United States, 35294
United States, California
Hospital for Sick Children
Los Angeles, California, United States, 90027-0700
United States, Maryland
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Baltimore, Maryland, United States, 21231-2410
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
Bethesda, Maryland, United States, 20892-1182
United States, Missouri
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
Saint Louis, Missouri, United States, 63110
United States, Pennsylvania
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104
Sponsors and Collaborators
Investigators
Study Chair: Brigitte C. Widemann, MD NCI - Pediatric Oncology Branch
  More Information

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

Study ID Numbers: CDR0000068922, NCI-01-C-0222, NCI-T99-0090
Study First Received: January 10, 2002
Last Updated: January 14, 2009
ClinicalTrials.gov Identifier: NCT00029354  
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
childhood neurofibrosarcoma
childhood soft tissue sarcoma
neurofibromatosis type 1 (NF1)
plexiform neurofibroma

Study placed in the following topic categories:
Precancerous Conditions
Malignant mesenchymal tumor
Neurodegenerative Diseases
Neurofibromatosis type 1
Soft tissue sarcomas
Neurofibromatosis 1
Neoplasms, Connective and Soft Tissue
Heredodegenerative Disorders, Nervous System
Neoplastic Syndromes, Hereditary
Genetic Diseases, Inborn
Neurofibroma
Neuromuscular Diseases
Peripheral Nervous System Diseases
Sarcoma
Neurofibromatoses
Peripheral Nervous System Neoplasms
Neurofibroma, Plexiform
Nerve Sheath Neoplasms
Nervous System Neoplasms
Tipifarnib
Neurocutaneous Syndromes

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Histologic Type
Antineoplastic Agents
Therapeutic Uses
Nervous System Diseases
Neoplasms, Nerve Tissue
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009