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Trial of TPI 287 as a Single Agent and in Combination With Temozolomide in Patients With Refractory or Recurrent Neuroblastoma or Medulloblastoma
This study is currently recruiting participants.
Verified by University of Vermont, March 2009
First Received: March 23, 2009   No Changes Posted
Sponsors and Collaborators: University of Vermont
Archer Biosciences, Inc.
Information provided by: University of Vermont
ClinicalTrials.gov Identifier: NCT00867568
  Purpose

The purpose of this research study is to evaluate a new investigational drug (TPI 287) for neuroblastoma and medulloblastoma both alone and in combination with temozolomide (a currently approved drug). An investigational drug is one that has not yet been approved by the Food and Drug Administration. This investigational drug is called TPI 287. This study will look at the safety and tolerability of TPI 287 both alone and in combination with temozolomide, and look to establish a safe dose of this agent. The study will also look at the tumor's response to these drugs, but this is not the primary objective of this study. TPI 287 was shown to be effective in stopping tumor growth and was also shown to be safe in three different animal species. TPI 287 has been tested in humans in four clinical trials, and approximately 100 subjects with various types of cancers have received the drug. All of these subjects that have received TPI 287 have been adults. TPI 287 has not been tested in a pediatric population before this study.

Temozolomide was tested in recurrent neuroblastoma and showed activity in a recently published study. Preclinical studies of TPI in combination with temozolomide have shown at minimum an additive effect. The ability of temozolomide and TPI 287 to be effective in combination is suggested by these two drugs showing even greater activity when used together.


Condition Intervention Phase
Relapsed Neuroblastoma
Refractory Neuroblastoma
Relapsed Medulloblastoma
Refractory Medulloblastoma
Drug: TPI 287
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label, Single Group Assignment
Official Title: A Phase 1 Trial of TPI 287 as a Single Agent and in Combination With Temozolomide in Patients With Refractory or Recurrent Neuroblastoma or Medulloblastoma

Resource links provided by NLM:


Further study details as provided by University of Vermont:

Primary Outcome Measures:
  • To determine the safety, tolerability and maximum tolerated dose (MTD) of TPI 287 as a single agent and in combination with temozolomide (TMZ) in pediatric and young adult patients with refractory or recurrent neuroblastoma or medulloblastoma [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To determine the activity of TPI 287 as a single agent and in combination with TMZ in these tumor types based on: •Overall response rate (ORR) •Duration of response (DR) •Progression free survival (PFS) •Median overall survival (OS) [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • To evaluate the pharmacokinetics (PK) of these drugs as single agents and in combination [ Time Frame: 1 year ] [ Designated as safety issue: No ]

Estimated Enrollment: 24
Study Start Date: March 2009
Estimated Study Completion Date: March 2011
Estimated Primary Completion Date: March 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
TPI 287: Experimental Drug: TPI 287
Three patients will be enrolled to receive single agent TPI 287 IV administered on Days 1, 8 and 15 of the first and second 28-day cycle. The starting dose of 90 mg/m2 (Dose Level 1) is 75% of the established adult MTD for this schedule in adults, which is 125 mg/m2. Dose escalation will take place in a standard 3+3 design, in which doses will increase by approximately 20 to 25% in successive 3-patient cohorts.

  Show Detailed Description

  Eligibility

Ages Eligible for Study:   12 Months to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have histologically proven neuroblastoma and confirmation of refractory or recurrent disease or medulloblastoma with histologic confirmation at diagnosis or at the time of recurrence/progression
  • Patients must be age >12 months and diagnosed before the age of 21;
  • Life expectancy must be more than 3 months
  • If measurable disease, this must be demonstrated by residual abnormal tissue at a primary or metastatic site measuring more than 1 cm in any dimension by standardized imaging (CT or MRI). For patients with neuroblastoma, there must be at least two persisting skeletal foci on meta-iodobenzylguanidine (MIBG) follow-up scans
  • Current disease state must be one for which there is currently no known curative therapy
  • Lansky Play Score must be more than 30 and/or ECOG performance status must be 0 to 2
  • For patients with medulloblastoma receiving steroids, the dose must be stable (i.e. not increasing) for at least one week before starting study
  • Patients without bone marrow metastases must have an ANC > 750/μl and platelet count >50,000/μl
  • Adequate liver function must be demonstrated, defined as:

    • Total bilirubin ≤ 1.5 x upper limit of normal (ULN) for age AND
    • SGPT (ALT) < 10 x upper limit of normal (ULN) for age
  • No other significant organ toxicity defined as >Grade 2 by National Cancer Institute Common Toxicity Criteria for Adverse Events version 3 (NCI-CTCAE V3.0 (http://ctep.cancer.gov/forms/CTCAEv3.pdf))
  • A negative urine pregnancy test is required for female participants of child bearing potential (≥13 years of age or after the onset of menses)
  • Both male and female post-pubertal study subjects need to agree to use one of the more effective birth control methods during treatment and for six months after treatment is stopped. These methods include total abstinence (no sex), oral contraceptives ("the pill"), an intrauterine device (IUD), levonorgestrol implants (Norplant), or medroxyprogesterone acetate injections (Depo-provera shots). If one of these can not be used, contraceptive foam with a condom is recommended.
  • Informed Consent: All patients and/or legal guardians must sign informed written consent. Assent, when appropriate, will be obtained according to institutional guidelines
  • Patients may have received microtubulin inhibitors and/or temozolomide during previous therapies.

Exclusion Criteria:

  • Patients who have received any chemotherapy administered within the last 21 days
  • Patients who have received radiotherapy within the last 30 days.
  • Patients who have received myeloablative therapy within the previous 3 months
  • Patients receiving anti-tumor therapy for their disease or any investigational drug concurrently
  • Patients with serious infection or a life-threatening illness (unrelated to tumor) that is > Grade 2 (NCI CTCAE V3.0), or active, serious infections requiring parenteral antibiotic therapy within 4 weeks prior to screening
  • Any other medical condition, including malabsorption syndromes, mental illness or substance abuse, deemed by the Investigator to be likely to interfere with the interpretation of the results or which would interfere with a patient's ability to sign or the legal guardian's ability to sign the informed consent, and patient's ability to cooperate and participate in the study
  • Patients with known hypersensitivity to any of the components of the drugs to be administered on study
  • Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00867568

Contacts
Contact: Genevieve Bergendahl, RN 803-656-4511 genevieve.bergendahl@uvm.edu

Locations
United States, California
Rady Children's Hospital Not yet recruiting
San Diego, California, United States, 92123
Contact: Lori Murphy     800-788-9029        
Principal Investigator: William Roberts, MD            
United States, Missouri
St. Louis University Not yet recruiting
St. Louis, Missouri, United States, 63104
Contact: Katherine Maxwell, RN     314-268-4000        
Principal Investigator: William Ferguson, MD            
United States, Vermont
UVM/FAHC Recruiting
Burlington, Vermont, United States, 05401
Contact: Genevieve Bergendahl, RN     802-656-4511     genevieve.bergendahl@uvm.edu    
Principal Investigator: Giselle Sholler, MD            
Sub-Investigator: Alan Homans, MD            
Sponsors and Collaborators
University of Vermont
Archer Biosciences, Inc.
Investigators
Principal Investigator: Giselle Sholler, MD University of Vermont
  More Information

No publications provided

Responsible Party: University of Vermont ( Giselle Sholler, MD, Assistant Professor of Pediatrics )
Study ID Numbers: TPI-287
Study First Received: March 23, 2009
Last Updated: March 23, 2009
ClinicalTrials.gov Identifier: NCT00867568     History of Changes
Health Authority: United States: Food and Drug Administration

Study placed in the following topic categories:
Neuroectodermal Tumors, Primitive
Temozolomide
Neuroblastoma
Recurrence
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Medulloblastoma
Neuroepithelioma
Glioma
Antineoplastic Agents, Alkylating
Alkylating Agents
Neuroectodermal Tumors, Primitive, Peripheral
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Neuroectodermal Tumors, Primitive
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Neoplasms, Nerve Tissue
Temozolomide
Pharmacologic Actions
Neuroblastoma
Neuroectodermal Tumors
Neoplasms
Therapeutic Uses
Neoplasms, Germ Cell and Embryonal
Medulloblastoma
Antineoplastic Agents, Alkylating
Glioma
Neoplasms, Neuroepithelial
Alkylating Agents
Neuroectodermal Tumors, Primitive, Peripheral
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on August 25, 2009