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Iodine I 131 Monoclonal Antibody 3F8 and Bevacizumab in Treating Patients With Relapsed or Refractory Neuroblastoma
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
First Received: March 20, 2007   Last Updated: April 8, 2009   History of Changes
Sponsors and Collaborators: Memorial Sloan-Kettering Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00450827
  Purpose

RATIONALE: Monoclonal antibodies, such as iodine I 131 monoclonal antibody 3F8 and bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of neuroblastoma by blocking blood flow to the tumor. Giving iodine I 131 monoclonal antibody 3F8 together with bevacizumab may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of iodine I 131 monoclonal antibody 3F8 when given together with bevacizumab in treating patients with relapsed or refractory neuroblastoma.


Condition Intervention Phase
Neuroblastoma
Biological: bevacizumab
Biological: filgrastim
Procedure: autologous hematopoietic stem cell transplantation
Radiation: iodine I 131 monoclonal antibody 3F8
Phase I

MedlinePlus related topics: Cancer Neuroblastoma
Drug Information available for: Cadexomer iodine Filgrastim Bevacizumab Immunoglobulins Iodine Sodium iodide I 131 Globulin, Immune
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: Combination of Targeted I -3F8-Mediated Radioimmunotherapy and Bevacizumab in Patients With Relapsed or Refractory Neuroblastoma: A Phase I Study

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

Primary Outcome Measures:
  • Maximum tolerated dose (MTD) [ Designated as safety issue: Yes ]

Estimated Enrollment: 24
Study Start Date: August 2006
Estimated Primary Completion Date: August 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the toxicity of iodine I 131 monoclonal antibody 3F8 (^131I-3F8) and bevacizumab in patients with relapsed or refractory neuroblastoma.
  • Determine the hematopoietic recovery after autologous stem cell rescue in patients treated with this regimen.

Secondary

  • Determine the clinical response rates in patients treated with this regimen.
  • Assess whole body dosimetry for ^131I-3F8.
  • Assess tumor targeting of ^131I-3F8 before and after bevacizumab.

OUTLINE: This is a dose-escalation study of iodine I 131 monoclonal antibody 3F8 (^131I-3F8).

Patients receive ^131I-3F8 IV over 20-30 minutes on day 0 and bevacizumab IV over 30-90 minutes on days 1 and 15. Treatment repeats every 28 days for up to 4 courses. Patients whose blood counts do not recover and whose human antimouse antibody (HAMA) titer < 1,000 U/mL after course 1 receive one dose of ^131I-3F8 alone followed by autologous stem cell rescue (ASCR) and filgrastim (G-CSF). Patients whose blood counts do not recover and whose HAMA titer

  • 1,000 U/mL after course 1 undergo ASCR followed by G-CSF. Patients whose blood counts recover and whose HAMA titer < 1,000 U/mL after course 1 receive 3 more courses of ^131I-3F8 and bevacizumab in the absence of disease progression or unacceptable toxicity.

Cohorts of 6 patients receive escalating doses of ^131I-3F8 and bevacizumab until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity.

After completion of study treatment, patients are followed at 3-4 weeks and then every 3-6 months thereafter.

PROJECTED ACCRUAL: A total of 24 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   1 Year and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of neuroblastoma meeting 1 of the following criteria:

    • Histopathologically confirmed disease
    • Bone marrow involvement AND elevated urinary catecholamines
  • Must meet ≥ 1 of the following criteria:

    • History of tumor progression
    • Recurrent disease
    • Failed to achieve complete response to standard therapy
  • Measurable disease by CT scan or MRI OR evaluable disease (i.e., microscopic marrow metastasis) by iodine I 131 metaiodobenzylguanidine (MIBG) or positron emission tomography scans
  • Autologous hematopoietic stem cell product cryopreserved and available for reinfusion after study treatment

    • Hematopoietic stem cells ≥ 2 times 10^6 CD34+ cells/kg
  • No pulmonary or CNS metastases by CT scan or MRI of the head and chest

PATIENT CHARACTERISTICS:

  • Life expectancy ≥ 4 weeks
  • Bilirubin ≤ 3 times upper limit of normal (ULN)
  • AST and ALT ≤ 5 times ULN
  • Absolute neutrophil count ≥ 500/μL
  • Platelet count > 50,000/μL (transfusions to maintain platelet count allowed)
  • Hemoglobin > 8 g/dL (transfusions to maintain hemoglobin allowed)
  • Creatinine ≤ 3 times ULN
  • Urine protein:creatinine ratio < 1.0
  • Human antimouse antibodies (HAMA) ≤ 1,000 U/mL
  • Left ventricular shortening fraction ≥ 15%
  • No severe major organ toxicity (i.e., renal, cardiac, hepatic, pulmonary, gastrointestinal, or neurologic toxicity ≤ grade 2)
  • No cerebrovascular accident or transient ischemic attack within the past 6 months
  • No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
  • No deep venous or arterial thrombosis (non-central venous catheter-related) within the past 3 months
  • No history of peripheral vascular disease, myocardial infarction, or unstable angina
  • No history of allergy to mouse proteins, Chinese hamster ovary cells products, or other recombinant human antibodies
  • No chronic nonhealing wound, ulcer, or bone fracture
  • No known bleeding diathesis or coagulopathy
  • No uncontrolled hypertension
  • No active serious infection not controlled by antibiotics
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

  • At least 4 weeks since prior major surgery
  • At least 1 week since prior minor surgery (e.g., fine needle or core biopsies) and recovered
  • At least 24 hours since other prior surgical procedures (e.g., placement of central venous catheter)
  • At least 3 weeks since prior chemotherapy or radioimmunotherapy
  • At least 2 weeks since prior biologic therapy
  • No concurrent anticoagulants, except for heparin flushes for central venous catheter maintenance
  • No concurrent major surgery (e.g., abdominal or thoracic surgery for resection of tumor)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00450827

Locations
United States, New York
Memorial Sloan-Kettering Cancer Center Recruiting
New York, New York, United States, 10065
Contact: Shakeel Modak, MD     212-639-7623     modaks@mskcc.org    
Sponsors and Collaborators
Memorial Sloan-Kettering Cancer Center
Investigators
Study Chair: Shakeel Modak, MD Memorial Sloan-Kettering Cancer Center
Principal Investigator: Nai-Kong V. Cheung, MD, PhD Memorial Sloan-Kettering Cancer Center
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000534398, MSKCC-06072
Study First Received: March 20, 2007
Last Updated: April 8, 2009
ClinicalTrials.gov Identifier: NCT00450827     History of Changes
Health Authority: Unspecified

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

Study placed in the following topic categories:
Neuroectodermal Tumors, Primitive
Immunologic Factors
Trace Elements
Bevacizumab
Angiogenesis Inhibitors
Neuroblastoma
Recurrence
Antibodies, Monoclonal
Anti-Infective Agents, Local
Neuroectodermal Tumors
Antibodies
Neoplasms, Germ Cell and Embryonal
Neuroepithelioma
Iodine
Micronutrients
Neuroectodermal Tumors, Primitive, Peripheral
Neoplasms, Glandular and Epithelial
Immunoglobulins

Additional relevant MeSH terms:
Anti-Infective Agents
Neuroectodermal Tumors, Primitive
Immunologic Factors
Antineoplastic Agents
Neoplasms, Nerve Tissue
Physiological Effects of Drugs
Bevacizumab
Neuroblastoma
Antibodies, Monoclonal
Neoplasms, Germ Cell and Embryonal
Therapeutic Uses
Iodine
Growth Inhibitors
Micronutrients
Angiogenesis Modulating Agents
Neoplasms by Histologic Type
Growth Substances
Trace Elements
Angiogenesis Inhibitors
Pharmacologic Actions
Neuroectodermal Tumors
Anti-Infective Agents, Local
Antibodies
Neoplasms
Neoplasms, Neuroepithelial
Neuroectodermal Tumors, Primitive, Peripheral
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on May 07, 2009