A Phase I Study of the Chemoprotectant Amifostine With Autologous Stem Cell Transplantation for High Risk or Relapsed Pediatric Solid Tumors and Brain Tumors
试验速览
- 阶段
- 1 期
- 状态
- 终止
- 入组人数
- 13
- 试验地点
- 1
研究概览
简要总结
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining chemotherapy with peripheral stem cell transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells. Chemoprotective drugs such as amifostine may protect normal cells from the side effects of high-dose chemotherapy.
PURPOSE: Phase I trial to study the effectiveness of amifostine in protecting from the side effects of peripheral stem cell transplantation in treating patients who have high-risk or relapsed solid tumors.
详细描述
OBJECTIVES:
- Determine the dose-limiting toxicity of amifostine chemoprotection with peripheral blood stem cell transplantation plus chemotherapy in patients with high-risk or relapsed solid tumors or brain tumors.
- Determine response or time to disease progression in patients treated with this regimen.
OUTLINE: This is a dose-escalation study of amifostine. Patients are stratified according to age (1 to 18 vs 19 to 45 years).
All patients receive filgrastim (G-CSF) IV for 1 week. On day 6 of G-CSF administration, patients undergo peripheral blood stem cell (PBSC) harvest followed by chemotherapy.
Patients receive oral busulfan every 6 hours on days -8 to -6 followed by melphalan IV over 30 minutes on days -5 and -4 and thiotepa IV over 2 hours on days -3 and -2. Patients receive amifostine IV over 5 minutes beginning 30 minutes prior to melphalan and thiotepa administration on days -5 to -1. PBSC are reinfused on day 0.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 1 Year 至 45 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Histologically confirmed high-risk or relapsed solid tumors or brain tumors, including:
- •Metastatic or relapsed Ewing's sarcoma
- •Metastatic or relapsed rhabdomyosarcoma
- •Refractory Wilms' tumor
- •Diffuse anaplastic Wilms' tumor
- •Stage III or IV neuroblastoma
- •Recurrent retinoblastoma
- •Metastatic or relapsed germ cell tumors
- •Metastatic or relapsed other soft tissue sarcomas
- •Small cell ovarian sarcoma
- •Metastatic or relapsed primitive neuroectodermal tumors of the bone
- •Recurrent brain tumors
- •Desmoplastic small round cell tumors
- •Recurrent or metastatic chordomas
- •Metastatic or relapsed hepatoblastoma
- •Patients receive peripheral blood stem cell transplantation only if in complete remission or in very good partial remission with no disease progression
- •Must have radiologic, nuclear image, or histologic verification of relapse
- •Age 1 to 45
- •Performance status:Karnofsky 70-100%
- •Absolute neutrophil count greater than 1,000/mm^3
- •Platelet count greater than 100,000/mm^3
- •Hemoglobin count at least 10 g/dL
- •Bilirubin less than 2 times upper limit of normal (ULN)
- •SGOT or SGPT less than 2.5 times ULN
- •Creatinine less than 2 times ULN
- •Creatinine clearance greater than 70 mL/min
- •Cardiac shortening fraction greater than 30%
- •Cardiac ejection fraction greater than 45%
- •At least 1 week since prior hematopoietic growth factor and recovered
- •At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas) and recovered
- •Recovered from any prior therapy
排除标准
- •Osteogenic sarcoma
- •Less than 4 months
- •Uncontrolled bleeding
- •Congestive heart failure
- •Uncontrolled hypertension
- •Pregnant or nursing
- •Uncontrolled metabolic disease
- •Active severe infection
- •Allergy to aminothiol compounds
- •Prior bone marrow transplantation
- •Other concurrent investigational agents
研究组 & 干预措施
Solid/brain tumor patients (1-18 years)
Patients with solid tumor or brain tumor in the 1-18 years old stratum.
干预措施: amifostine trihydrate (Drug)
Solid/brain tumor patients (1-18 years)
Patients with solid tumor or brain tumor in the 1-18 years old stratum.
干预措施: busulfan (Drug)
Solid/brain tumor patients (1-18 years)
Patients with solid tumor or brain tumor in the 1-18 years old stratum.
干预措施: filgrastim (Drug)
Solid/brain tumor patients (1-18 years)
Patients with solid tumor or brain tumor in the 1-18 years old stratum.
干预措施: melphalan (Drug)
Solid/brain tumor patients (1-18 years)
Patients with solid tumor or brain tumor in the 1-18 years old stratum.
干预措施: thiotepa (Drug)
Solid/brain tumor patients (1-18 years)
Patients with solid tumor or brain tumor in the 1-18 years old stratum.
干预措施: peripheral blood stem cell transplantation (PBSC) (Procedure)
Solid/brain tumor patients (19-45 years)
Patients with solid tumor or brain tumor in the 19-45 years old stratum.
干预措施: amifostine trihydrate (Drug)
Solid/brain tumor patients (19-45 years)
Patients with solid tumor or brain tumor in the 19-45 years old stratum.
干预措施: busulfan (Drug)
Solid/brain tumor patients (19-45 years)
Patients with solid tumor or brain tumor in the 19-45 years old stratum.
干预措施: filgrastim (Drug)
Solid/brain tumor patients (19-45 years)
Patients with solid tumor or brain tumor in the 19-45 years old stratum.
干预措施: melphalan (Drug)
Solid/brain tumor patients (19-45 years)
Patients with solid tumor or brain tumor in the 19-45 years old stratum.
干预措施: thiotepa (Drug)
Solid/brain tumor patients (19-45 years)
Patients with solid tumor or brain tumor in the 19-45 years old stratum.
干预措施: peripheral blood stem cell transplantation (PBSC) (Procedure)