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A Study of Lymphoseek® as a Lymphoid Tissue Targeting Agent in Pediatric Patients With Melanoma, Rhabdomyosarcoma, or Other Solid Tumors Who Are Undergoing Lymph Node Mapping

Phase 2
Completed
Conditions
Rhabdomyosarcoma
Melanoma
Interventions
Drug: Vital Blue Dye (optional)
Procedure: Lymph Node Mapping
Registration Number
NCT02509598
Lead Sponsor
Cardinal Health 414, LLC
Brief Summary

Open label, non-randomized, multi-center, within-subject comparative study to evaluate the tolerability and the diagnostic utility of Lymphoseek with optional comparison to VBD in pediatric subjects with melanoma, rhabdomyosarcoma, or other solid tumor. Subject age will range from neonatal through 17 years.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
24
Inclusion Criteria
  • The subject's parent(s)/legal guardian(s) understand(s) and voluntarily signed an informed consent document prior to any study-related assessments/procedures being conducted. Where locally applicable, the subject also understands and voluntarily provides his/her assent prior to any study-related assessments/procedures being conducted
  • Subject has been diagnosed with melanoma, rhabdomyosarcoma, or other tumor where tumor resection or biopsy is planned and lymph node mapping is appropriate
  • The subject is clinically node negative (cN0) at the time of screening
  • Age < 18 years
  • Male subjects of childbearing potential must be willing to use a condom during sexual intercourse and shall not father a child during the course of the study or will practice complete abstinence while on study
  • Female subjects of childbearing potential must agree to the use of two physician-approved contraceptive methods simultaneously or practice complete abstinence while on study
Exclusion Criteria
  • The subject has had preoperative radiation therapy
  • Has had previous surgery or radiation to node basins that would be involved in the intraoperative lymph node mapping (ILM) procedure
  • Has a known allergy to dextran or VBD (if intended to be used)
  • Has a history of alcohol abuse or alcohol dependency in the 3 years before study entry, or is an alcoholic or drug addict, as determined by the investigator
  • Before the administration of Lymphoseek, has received any radiopharmaceutical within 7 radioactive half-lives of that radiopharmaceutical

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Tc99m tilmanocept and Vital Blue Dye (optional)Vital Blue Dye (optional)0.5 mCi, 50 ug of Tc99m tilmanocept single administration. Optionally, 1-3 mL of vital blue dye, single administration (per institution's standard of care).
Tc99m tilmanocept and Vital Blue Dye (optional)Lymph Node Mapping0.5 mCi, 50 ug of Tc99m tilmanocept single administration. Optionally, 1-3 mL of vital blue dye, single administration (per institution's standard of care).
Tc99m tilmanocept and Vital Blue Dye (optional)Tc99m tilmanocept0.5 mCi, 50 ug of Tc99m tilmanocept single administration. Optionally, 1-3 mL of vital blue dye, single administration (per institution's standard of care).
Primary Outcome Measures
NameTimeMethod
Average Number of Lymph Nodes Identified Intraoperatively Per Subject1 Day
Subject Localization Rates1 Day

The proportion of subjects with Lymphoseek-identified lymph nodes

Secondary Outcome Measures
NameTimeMethod
Average Number of Lymph Nodes Identified Preoperatively Using SPECT or SPECT/CT Per Subject1 Day
Proportion of Subjects Who Underwent Preoperative SPECT or SPECT/CT1 Day
Agreement of the Number of Nodes Identified by Preoperative SPECT or SPECT/CT to Intraoperative Localization1 Day

Average difference in number of LNs identified preoperatively with SPECT/CR and number of LNs identified intraoperatively per subject

Proportion of Subjects With a Lymph Node Identified Preoperatively Using SPECT or SPECT/CT1 day
Upstaging1 Day

The proportion of patients with pathology-positive lymph nodes who had at least one pathology-positive lymph node that was identified by Lymphoseek and had no other pathology-positive lymph nodes (i.e., identified by any other method)

Nodal False Negative Rate for Nodes Identified1 Day

The number of pathology-positive lymph nodes that were missed intraoperatively by mapping agent divided by the total number of pathology-positive lymph nodes for that mapping agent. Population is all subjects with pathology-positive nodes. False negative rate represents the failure rate of the mapping agent to identify sentinel lymph nodes.

Number of Changes in Postsurgical Treatment Plan in Relation to Nodes Identified by Lymphoseek1 Day

Changes to postsurgical treatment plan will be compared to baseline treatment plan.

Nodal Sensitivity1 Day

The number of pathology-positive lymph nodes that were identified intraoperatively by mapping agent divided by the total number of pathology-positive lymph nodes for that mapping agent. Population is all subjects with pathology-positive nodes. Sensitivity rate represents the success rate of the mapping agent to identify sentinel lymph nodes.

Nodal Agreement of Central Pathology Assessment With Local Pathology Assessment of the Excised Lymph Node(s) to Confirm the Presence/Absence of Tumor Metastases1 Day

Number of nodes whose local and central pathology results agree divided by the number of nodes with nonmissing local and central pathology results

Change in Subject Nodal Staging Before and After Surgery Based Upon Nodes Identified1 Day

Change in subject nodal staging was assessed via shift tables to show the number of subjects with each combination of presurgery and postsurgery nodal staging. Presurgery staging was based on standard-of-care clinical assessment. Postsurgery staging was based on the pathology results of the nodes identified.

Trial Locations

Locations (6)

Children's Hospital of Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

Nemours Children's Specialty Care

🇺🇸

Jacksonville, Florida, United States

Nationwide Children's Hospital

🇺🇸

Columbus, Ohio, United States

The University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Nemours Children's Hopsital

🇺🇸

Orlando, Florida, United States

Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

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