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Naxitamab and Granulocyte-Macrophage Colony Stimulating Factor (GMCSF) and Isotretinoin for Consolidation of Patients With High-Risk Neuroblastoma in First Remission.

Phase 2
Withdrawn
Conditions
Neuroblastoma
Interventions
Registration Number
NCT04909515
Lead Sponsor
Y-mAbs Therapeutics
Brief Summary

This is a single-arm, uncontrolled, international, multi-center, clinical,phase 2 trial, in patients ≥ 12 months of age with high-risk neuroblastoma in first remission. 120 patients will be enrolled to receive naxitamab + GM-CSF in combination with isotretinoin.

Detailed Description

Not available

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  1. Documentet neuroblastoma at time of diagnosis defined as

    1. Histopathology of solid tumor biopsy, or
    2. Bone marrow aspirate or biopsy indicative of neuroblastoma plus high blood or urine catecholamine metabolite levels
  2. Documented high-risk disease at time of initial diagnosis defined as

    1. MYNC-amplified at stage L2, M or MS (according to International Neuroblastoma Risk Group (INRG)) of any age or
    2. MYCN-nonamplified with stage M (according to INRG) and diagnosed at ≥ 18 months of age or
  3. Patient must have completed frontline therapy, and achieved one of the following:

    1. verified complete response according to INRC (bone marrow positive minimal residual disease is allowed as assessed by RTqPCR at site) after completion of induction and consolidation with or without autologous stem cell transplantation
    2. Verified partial response according to INRC for primary site and soft tissue, bone, and bone marrow metastases at pre-autologous stem cell transplantation evaluation (i.e., myeloablative chemotherapy + autologous stem cell transplantation required as part of frontline regimen). Furthermore, bone marrow response must be with ≤ 5% tumor (of total nucleated cellular content) seen on any specimen from a bilateral bone marrow aspirate/biopsy and bone response must be with ≤ 3 areas of abnormal uptake on 123I-MIBG scintigraphy
  4. Age ≥ 12 months at trial enrollment

Exclusion Criteria
  1. Verified progressive disease during induction or consolidation therapy
  2. Any systemic anti-cancer therapy, including chemotherapy, within 3 weeks prior to enrollment
  3. Autologous stem cell transplantation within 6 weeks prior to enrollment or ongoing toxicity caused by the autologous stem cell transplantation at the discretion of the Investigator
  4. Therapeutic 131I-MIBG within 6 weeks prior to enrollment
  5. Prior anti-GD2 therapy
  6. Performance status of < 50% as per the Lansky scale (patients less than 16 years of age) or Karnofsky scale (patients aged 16 years or older)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
naxitamab + GM-CSF + isotretinoinGM-CSF8 cycles. Cycles 1+2 naxitamab + GM-CSF, cycles 3-5 naxitamab + GM-CSF + isotretinoin, cycles 6-8 isotretinoin
naxitamab + GM-CSF + isotretinoinNaxitamab8 cycles. Cycles 1+2 naxitamab + GM-CSF, cycles 3-5 naxitamab + GM-CSF + isotretinoin, cycles 6-8 isotretinoin
naxitamab + GM-CSF + isotretinoinIsotretinoin8 cycles. Cycles 1+2 naxitamab + GM-CSF, cycles 3-5 naxitamab + GM-CSF + isotretinoin, cycles 6-8 isotretinoin
Primary Outcome Measures
NameTimeMethod
2-year progression free survival (PFS)2 years

2-year PFS defined as the proportion of patients alive and without progressive disease (PD) or relapse 2 years after enrollment

Secondary Outcome Measures
NameTimeMethod
1-year and 2-year overall survival2 years

1-year and 2-year overall survival defined as the proportion of patients alive 1 year and 2 years after enrollment, respectively

2-year event-free survival2 years

2-year event-free survival, defined as the proportion of patients alive and without progressive disease, relapse, secondary malignancy or until last contact if no event occurred, 2 years after enrollment

Proportion of positive to negative minimal residual disease (MRD) after 2 cycles6 weeks

Proportion of patients changing from minimal residual disease positive in bone marrow at enrollment (defined as patients assessed as minimal residual disease positive by RTqPCR of bone marrow at enrollment) to minimal residual disease negative at completion of Cycle 2

1-year progression free survival1 year

1-year progression free survival defined as the proportion of patients alive and without progressive disease or relapse 1 year after enrollment

Proportion of patients with MD positive convert to MRD negative6 weeks

Proportion of patients with disease in bone marrow at enrollment (i.e., minimal disease according to INRC) and convert to minimal residual disease negative (assessed by RTqPCR) at completion of Cycle 2

Progression free survival128 weeks

Progression free survival (defined as time from enrollment until progressive disease/relapse or death, whichever comes first)

Trial Locations

Locations (9)

National Medical Research Center Pediatric Hematology, Oncology and Immunology n.a Dmitry Rogachev

🇷🇺

Moscow, Russian Federation

ICON Cancer Centre Novena

🇸🇬

Singapore, Singapore

Research Institute of Pediatric Oncology ad Hematology of N.N. Blokhin National Medical Research Center of Oncology

🇷🇺

Moscow, Russian Federation

Raisa Gorbacheva Memorial Institute of Children Hematology and Transplantation Bone marrow Transplant Clinic

🇷🇺

Saint Petersburg, Russian Federation

KK Women's and Children's Hospital

🇸🇬

Singapore, Singapore

Asan Medical Center Childrens Hospital

🇰🇷

Seoul, Korea, Republic of

Seoul National University Hospital

🇰🇷

Soeul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Hong Kong Children's Hospital

🇭🇰

Kowloon, Hong Kong

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