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Study of Chemoimmunotherapy for High-Risk Neuroblastoma

Early Phase 1
Active, not recruiting
Conditions
Neuroblastoma (NB)
Interventions
Registration Number
NCT03189706
Lead Sponsor
Memorial Sloan Kettering Cancer Center
Brief Summary

The purpose of this study is to find out whether an experimental drug called Hu3F8 can be given with the chemotherapy drugs irinotecan and temozolomide and another drug called GM-CSF. The investigators want to find out if this combination is safe and what effect it has on the participant and the disease.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
48
Inclusion Criteria
  • Diagnosis of NB as defined by international criteria,.e., histopathology (confirmed by the MSK Department of Pathology) or bone marrow metastases plus high urine catecholamine levels

  • High-risk NB as defined as any of the following:

    • Stage 4 with MYCN amplification (any age)
    • Stage 4 without MYCN amplification (>1.5 years of age)
    • Stage 3 with MYCN amplification (unresectable; any age)
    • Stage 4S with MYCN amplification (any age)
  • Patients fulfill one of the following criteria:

    1. Have evidence of soft tissue disease OR

    2. If they only have osteomedullary disease at protocol enrollment, they should have:

      • Had previously received Hu3F8+GMCSF therapy AND have had less than a complete response to it OR
      • Had progressed progressive disease after their most recent anti-neuroblastoma therapeutic regimen
  • Patients must have evaluable (microscopic marrow metastasis, elevated tumor markers, positive MIBG or PET scans) or measurable (CT, MRI) disease documented after completion of prior systemic therapy.

  • Prior treatment with murine and hu3F8 is allowed.

  • Prior treatment with irinotecan or temozolomide is permitted.

  • Patients with prior m3F8, hu3F8, ch14.18 or hu14.18 treatment must have a negative HAHA antibody titer. Human anti-mouse antibody positivity is allowed.

  • Signed informed consent indicating awareness of the investigational nature of this program.

Exclusion Criteria
  • Patients with CR/VGPR disease
  • Existing severe major organ dysfunction, i.e., renal, cardiac, hepatic, neurologic, pulmonary, or gastrointestinal toxicity ≥ grade 3 except for hearing loss, alopecia, anorexia, nausea, and hypomagnesemia from TPN, which may be grade 3
  • ANC < 500/uL
  • Platelet count <30K/uL
  • History of allergy to mouse proteins
  • Active life-threatening infection
  • Inability to comply with protocol requirements
  • Women who are pregnant or breast-feeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Hu3F8, Irinotecan/Temozolomide and Sargramostim (HITS)IrinotecanEach cycle consists of four doses of hu3F8, five doses each of irinotecan and temozolomide and five doses of GM-CSF.
Hu3F8, Irinotecan/Temozolomide and Sargramostim (HITS)temozolomideEach cycle consists of four doses of hu3F8, five doses each of irinotecan and temozolomide and five doses of GM-CSF.
Hu3F8, Irinotecan/Temozolomide and Sargramostim (HITS)Hu3F8Each cycle consists of four doses of hu3F8, five doses each of irinotecan and temozolomide and five doses of GM-CSF.
Hu3F8, Irinotecan/Temozolomide and Sargramostim (HITS)GM-CSFEach cycle consists of four doses of hu3F8, five doses each of irinotecan and temozolomide and five doses of GM-CSF.
Primary Outcome Measures
NameTimeMethod
Number of participants with treatment-related adverse events as assessed by CTCAE v4.02 years

The regimen will be considered safe if there are no toxicities requiring discontinuation of therapy in at least 9/10 patients during the first two cycles.

response rate (CR+PR)2 years

Response assessment will be based on the best response over the course of four cycles. Disease response for NB will use the International NB Response Criteria. Patients who withdraw from the study prior to cycle 4 with \< partial response will also not be considered evaluable for response and will be replaced.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

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