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PEG-Interferon Alfa-2b in Treating Young Patients With Unresectable Plexiform Neurofibromas Associated With Neurofibromatosis Type 1
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), January 2009
Sponsored by: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00678951
  Purpose

RATIONALE: PEG-interferon alfa-2b may interfere with the growth of tumor cells. It may also stop the growth of tumor cells by blocking blood flow to the tumor.

PURPOSE: This phase II trial is studying how well PEG-interferon alfa-2b works in treating patients with unresectable plexiform neurofibromas associated with neurofibromatosis type 1.


Condition Intervention Phase
Neurofibromatosis Type 1 (nf1)
Precancerous/Nonmalignant Condition
Drug: PEG-interferon alfa-2b
Phase II

Genetics Home Reference related topics: familial encephalopathy with neuroserpin inclusion bodies neurofibromatosis type 1 neurofibromatosis type 2
MedlinePlus related topics: Cancer Neurofibromatosis
Drug Information available for: Interferon alfa-n1 Interferon alfa-2a Interferon alfa-2b Peginterferon Alfa-2b Interferons
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase II Trial of Peginterferon Alfa-2b (Pegintron) for Neurofibromatosis Type I Related Unresectable, Symptomatic or Life-Threatening Plexiform Neurofibromas

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

Primary Outcome Measures:
  • Radiographic response (stratum 1) [ Designated as safety issue: No ]
  • Radiographic and clinical response (stratum 2) [ Designated as safety issue: No ]
  • Progression-free survival (stratum 3) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Clinical and radiographic response (stratum 3) [ Designated as safety issue: No ]

Estimated Enrollment: 87
Study Start Date: April 2008
Estimated Primary Completion Date: March 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Strata 1 and 2: Experimental
Patients receive PEG-interferon alfa-2b subcutaneously once a week for 4 weeks. Courses repeat every 4 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients who achieve a partial or complete response may continue treatment for up to 2 years.
Drug: PEG-interferon alfa-2b
Given subcutaneously
Stratum 3: Experimental
Patients receive PEG-interferon alfa-2b as in strata 1 and 2. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.
Drug: PEG-interferon alfa-2b
Given subcutaneously

Detailed Description:

OBJECTIVES:

Primary

  • To determine the radiographic and clinical response rate and/or progression-free survival of young patients with unresectable progressive, symptomatic (i.e., interfering with performance status), or life-threatening plexiform neurofibromas treated with PEG-interferon alfa-2b.
  • To describe and define the toxicities of PEG-interferon alfa-2b when given for prolonged time periods in these patients.

Secondary

  • To compare volumetric analysis of plexiform neurofibromas using 3-dimensional MRI (3-D MRI) vs conventional 2-D MRI and 1-D MRI data analysis.

OUTLINE: This is a multicenter study. Patients are stratified according to disease status (plexiform neurofibromas [PN] with no clinical symptoms and no documented radiographic progression [stratum 1] vs PN with clinical symptoms but no documented radiographic progression [stratum 2] vs PN with documented radiographic progression with or without clinical symptoms [stratum 3]).

  • Strata 1 and 2: Patients receive PEG-interferon alfa-2b subcutaneously once a week for 4 weeks. Courses repeat every 4 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients who achieve a partial or complete response may continue treatment for up to 2 years.
  • Stratum 3: Patients receive PEG-interferon alfa-2b as in strata 1 and 2. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.

Patients undergo 3-dimensional MRI (3-D MRI) at baseline, at 4, 8, and 12 months, and then every 6 months thereafter for volumetric analysis of their plexiform neurofibromas. Volume measurements will be compared with conventional 2-D MRI analysis and 1-D MRI analysis to assess the reproducibility and sensitivity of 3-D MRI in determining disease status of plexiform neurofibromas.

  Eligibility

Ages Eligible for Study:   1 Year to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed* neurofibromatosis type 1 (NF1)-associated plexiform neurofibromas (PN) that are inoperable AND have the potential to cause significant morbidity including, but not limited to, any of the following:

    • Head and neck lesions that could compromise the 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) or significant cosmetic problems
    • Lesions of the extremity that could cause limb hypertrophy or loss of function
    • Painful lesions NOTE: *Histologic confirmation of tumor is not required in the presence of consistent clinical and radiographic findings, but is required if any clinical observation or scan suggests possible malignant transformation.
  • Patients with PN that has not been histologically confirmed must have ≥ 1 other diagnostic criteria for NF1 (according to NIH Consensus Conference criteria), including any of the following:

    • Six or more café-au-lait spots (> 0.5 cm in prepubertal patients or > 1.5 cm in postpubertal patients)
    • Freckling in the axilla or groin
    • Optic glioma
    • Two 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
  • Meets 1 of the following criteria:

    • Progressive PN (with or without clinical symptoms), as defined by 1 of the following (stratum 3):

      • Presence of new PN on MRI within the past 12 months
      • Measurable increase of the PN (≥ 20% increase in volume, ≥ 13% increase in the product of the two longest perpendicular diameters, or ≥ 6% increase in the longest diameter) on the last two consecutive MRI or CT scans or over a time period of approximately 1 year prior to study entry
    • PN with no clinical symptoms and no documented radiographic progression (stratum 1)
    • PN with clinical symptoms but no documented radiographic progression (stratum 2)
  • Complete tumor resection is not feasible OR patient refuses surgery
  • Measurable residual tumor

    • Measurable lesion is defined as a lesion that measures ≥ 3 cm in one dimension
  • No evidence of an optic glioma requiring treatment with chemotherapy or radiotherapy
  • No history of malignant peripheral nerve sheath tumor

PATIENT CHARACTERISTICS:

  • Karnofsky or Lansky performance status 50-100%
  • Life expectancy ≥ 12 months
  • Absolute granulocyte count > 1,500/μL
  • Hemoglobin > 10 g/dL
  • Platelet count > 100,000/μL
  • Bilirubin < 1.5 mg/dL
  • SGPT ≤ 2 times upper limit of normal
  • Creatinine clearance ≥ 70 mL/min OR serum creatinine normal based on age as follows:

    • 0.8 mg/dL (for patients 5 years of age and under)
    • 1.0 mg/dL (for patients 6-10 years of age)
    • 1.2 mg/dL (for patients 11-15 years of age)
    • 1.5 mg/dL (for patients over 15 years of age)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able to return for follow-up visits or obtain follow-up studies required to assess toxicity and response to therapy
  • No clinically significant unrelated systemic illness (i.e., serious infections or significant cardiac, pulmonary, hepatic, or other organ dysfunction) that, in the judgment of the Principal or Associate Investigator, would compromise the patient's ability to tolerate PEG-interferon alfa-2b or that would likely interfere with the study procedures or results
  • No other cancer except surgically cured nonmelanoma skin cancer or carcinoma in situ of the cervix
  • No severe cardiovascular disease, including any of the following:

    • Arrhythmias requiring chronic treatment
    • Congestive heart failure
    • Symptomatic ischemic heart disease
  • No pre-existing severe psychiatric condition or history of a psychiatric disorder requiring hospitalization
  • No history of suicidal ideation or attempt
  • No thyroid dysfunction not responsive to therapy
  • No uncontrolled diabetes mellitus
  • No history of seropositivity for HIV
  • No medical condition requiring chronic systemic corticosteroids
  • No known active alcohol or drug abuse

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from all prior therapy
  • No prior interferon alfa-2b or PEG-interferon alfa-2b
  • More than 30 days since prior investigational agents
  • At least 21 days since prior surgery
  • No other concurrent immunotherapy, biologic therapy, chemotherapy, hormonal therapy, or radiotherapy
  • No other concurrent investigational drugs
  • No concurrent colony-stimulating factors, including epoetin alfa and filgrastim (G-CSF)
  • No concurrent chronic systemic corticosteroid therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00678951

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office Recruiting
Bethesda, Maryland, United States, 20892-1182
Contact: Clinical Trials Office - Warren Grant Magnusen Clinical Center     888-NCI-1937        
Sponsors and Collaborators
Investigators
Principal Investigator: 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

Study ID Numbers: CDR0000595749, NCI-08-C-0130, NCI-P06096
Study First Received: May 14, 2008
Last Updated: January 14, 2009
ClinicalTrials.gov Identifier: NCT00678951  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
plexiform neurofibroma
neurofibromatosis type 1 (NF1)

Study placed in the following topic categories:
Interferon-alpha
Precancerous Conditions
Interferons
Neurodegenerative Diseases
Neurofibromatosis type 1
Neurofibromatosis 1
Neoplastic Syndromes, Hereditary
Heredodegenerative Disorders, Nervous System
Genetic Diseases, Inborn
Neurofibroma
Neuromuscular Diseases
Peripheral Nervous System Diseases
Peginterferon alfa-2b
Neurofibromatoses
Peripheral Nervous System Neoplasms
Interferon Alfa-2a
Neurofibroma, Plexiform
Interferon Alfa-2b
Nerve Sheath Neoplasms
Nervous System Neoplasms
Neurocutaneous Syndromes

Additional relevant MeSH terms:
Anti-Infective Agents
Neoplasms by Histologic Type
Immunologic Factors
Antineoplastic Agents
Growth Substances
Neoplasms, Nerve Tissue
Nervous System Diseases
Physiological Effects of Drugs
Antiviral Agents
Angiogenesis Inhibitors
Pharmacologic Actions
Neoplasms
Therapeutic Uses
Growth Inhibitors
Angiogenesis Modulating Agents

ClinicalTrials.gov processed this record on January 16, 2009