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Phase I Pilot Study of Induction Chemotherapy Including Cyclophosphamide and Topotecan in Patients With Newly Diagnosed or Progressive High-Risk Neuroblastoma Undergoing Autologous Peripheral Blood Stem Cell Transplantation
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outline Trial Contact Information Registry Information
Alternate Title
Induction Chemotherapy Using Cyclophosphamide and Topotecan in Treating Patients Who Are Undergoing Autologous Peripheral Stem Cell Transplantation for Newly Diagnosed or Progressive Neuroblastoma
Basic Trial Information
Phase | Type | Status | Age | Protocol IDs |
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Phase I | Treatment | Completed | 30 and under at initial diagnosis | COG-ANBL02P1 NCT00070200, ANBL02P1 |
Objectives Primary - Determine the toxicity and feasibility of adding cyclophosphamide and topotecan to induction therapy in patients with newly diagnosed or progressive high-risk neuroblastoma undergoing autologous peripheral blood stem cell (PBSC) transplantation.
- Determine the feasibility of PBSC mobilization and in vivo PBSC tumor purging in these patients after treatment with this regimen.
Secondary - Determine tumor response rate in patients treated with this regimen.
- Determine the pharmacokinetics of this regimen in these patients.
- Determine whether topotecan affects cyclophosphamide pharmacokinetics in these patients.
- Correlate host DNA with toxicity and cyclophosphamide and topotecan pharmacokinetics in patients treated with this regimen.
- Determine toxicity in patients treated with this regimen.
Entry Criteria Disease Characteristics:
- Histologically or cytologically confirmed neuroblastoma or ganglioneuroblastoma meeting 1 of the following staging criteria:
- Newly diagnosed disease, at least 1 year of age, and meets criteria for 1 of the following:
- International Neuroblastoma Staging System (INSS) stage 2a/2b with MYCN amplification (greater than 10) AND unfavorable pathology
- INSS stage 3 with MYCN amplification OR unfavorable pathology
- Newly diagnosed INSS stage 4 disease meeting criteria for 1 of the following:
- Over 18 months of age
- Age 12 to 18 months with any unfavorable biologic feature (MYCN amplification, unfavorable pathology, and/or DNA index=1) or any biologic feature that is indeterminant, unsatisfactory, or unknown
- No INSS stage 4 disease and age 12 to 18 months with all 3 favorable biologic features (i.e., nonamplified MYCN, favorable pathology, and DNA index greater than 1)
- Newly diagnosed INSS stage 3, 4, or 4S disease AND under 1 year of age with MYCN amplification
- At least 1 year of age and initially diagnosed with INSS stage 1, 2, or 4S disease that progressed to stage 4 without interval chemotherapy
- Must have been enrolled on COG-ANBL00B1 at initial diagnosis
Prior/Concurrent Therapy:
Biologic therapy Chemotherapy - See Disease Characteristics
- No more than 1 prior chemotherapy course on the low- or intermediate-risk neuroblastoma studies (COG-P9641, COG-A3961) prior to determination of MYCN amplification and Shimada histology
Endocrine therapy Radiotherapy - Prior localized emergency radiotherapy to sites of life-threatening or function-threatening disease allowed
Surgery Other - No other prior systemic therapy
Patient Characteristics:
Age - 30 and under at initial diagnosis
Performance status Life expectancy Hematopoietic - Absolute neutrophil count at least 1,000/mm3*
- Platelet count at least 100,000/mm3* (transfusion independent)
- Hemoglobin at least 10.0 g/dL* (red blood cell transfusions allowed)
[Note: *Granulocytopenia, anemia, and/or thrombocytopenia allowed for patients with tumor metastatic to the bone marrow] Hepatic - Bilirubin no greater than 1.5 mg/dL
- ALT less than 300 IU/L
Renal - Creatinine no greater than 1.5 mg/dL
- Creatinine clearance or radioisotope glomerular filtration rate at least 60 mL/min
Cardiovascular - ECG normal
- Shortening fraction at least 27% by echocardiogram
OR - Ejection fraction at least 50% by MUGA
Other - Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- HIV negative
Expected Enrollment A total of 10-29 patients will be accrued for this study within 2 years. Outline This is a pilot, multicenter study. Patients are stratified according to diagnosis (newly diagnosed vs initially stage 1, 2, or 4S that progressed to stage 4 without interval chemotherapy). Patients are followed every 3 months for 1 year, every 6 months for 4 years, and then annually thereafter.
Trial Contact Information
Trial Lead Organizations Children's Oncology Group | | | Julie Park, MD, Protocol chair | | | |
Registry Information | | Official Title | | A Pilot Induction Regimen Incorporating Topotecan for Treatment of Newly Diagnosed High Risk Neuroblastoma | | Trial Start Date | | 2004-03-29 | | Registered in ClinicalTrials.gov | | NCT00070200 | | Date Submitted to PDQ | | 2003-08-14 | | Information Last Verified | | 2005-12-05 | | NCI Grant/Contract Number | | CA98543 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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