Melanoma Clinical Trial

Biological Therapy in Treating Children With Refractory or Recurrent Neuroblastoma or Other Tumors

Summary

RATIONALE: Biological therapies such as hu14.18-interleukin-2 fusion protein use different ways to stimulate the immune system and stop cancer cells from growing.

PURPOSE: Phase I trial to study the effectiveness of hu14.18-interleukin-2 fusion protein in treating children who have refractory or recurrent neuroblastoma or other tumors.

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Full Description

OBJECTIVES:

Determine the maximum tolerated dose of hu14.18-interleukin-2 fusion protein in children with refractory or recurrent neuroblastoma or other GD2-positive tumors.
Determine the toxicity and pharmacokinetics of the fusion protein in these patients.
Determine the effect of the fusion protein on systemic immune modulation in these patients.
Quantitate the antifusion protein antibodies in patients treated with fusion protein.
Evaluate antitumor responses resulting from this fusion protein regimen in these patients.

OUTLINE: This is a dose-escalation study.

Patients receive hu14.18-interleukin-2 (hu14.18-IL2) fusion protein IV over 4 hours once daily on days 1-3. Treatment repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of hu14.18-IL2 fusion protein until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

Patients are followed every 2 months for 1 year, every 6 months for 3 years, and then annually for 5 years.

PROJECTED ACCRUAL: A total of 18-24 patients will be accrued for this study within 1 year.

View Eligibility Criteria

Eligibility Criteria

DISEASE CHARACTERISTICS:

Histologically confirmed neuroblastoma or melanoma at original diagnosis

Refractory to chemotherapy or recurrence after prior multiagent chemotherapy
Measurable or evaluable (detectable by bone scan) metastatic disease OR
No evidence of disease if complete response to prior surgical resection, radiotherapy, and/or chemotherapy OR

Histologically confirmed tumor expressing GD2 antigen at original diagnosis or relapse

Refractory to standard treatment
Measurable or evaluable disease by clinical assessments or laboratory markers OR
No evidence of disease after prior surgical resection of metastatic, recurrent disease
Histologically confirmed recurrent osteogenic sarcoma after prior chemotherapy allowed
Soft tissue sarcoma allowed
No primary CNS tumors

Prior CNS metastases allowed, provided:

Disease previously treated
Disease clinically stable for 4 weeks before study
At least 4 weeks since prior steroids for CNS metastases
No clinically detectable pleural effusions or ascites

PATIENT CHARACTERISTICS:

Age:

21 and under

Performance status:

Karnofsky 60-100% for children over age 10
Lansky 60-100% for children age 10 and under

Life expectancy:

At least 12 weeks

Hematopoietic:

Absolute neutrophil count greater than 1,000/mm^3
Platelet count at least 75,000/mm^3 (transfusion allowed)
Hemoglobin at least 9.0 g/dL (transfusion allowed)

Hepatic:

Bilirubin less than 1.5 mg/dL
ALT or AST no greater than 2.5 times normal
Hepatitis B surface antigen negative

Renal:

Creatinine no greater than 1.5 mg/dL OR
Creatinine clearance or radioisotope glomerular filtration rate at least 60 mL/min

Cardiovascular:

Shortening fraction at least 27% by echocardiogram OR
Ejection fraction more than 50% by MUGA scan
No congestive heart failure
No uncontrolled cardiac rhythm disturbance

Pulmonary:

FEV_1 and FVC more than 60% of predicted OR
No dyspnea at rest
No exercise intolerance
Oxygen saturation more than 94% by pulse oximetry on room air

Neurologic:

No seizure disorders requiring antiseizure medications
No significant neurologic deficit or grade 2 or greater objective peripheral neuropathy

Other:

Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
HIV negative
No significant concurrent illnesses unrelated to cancer or its treatment
No significant psychiatric disabilities
No uncontrolled active infections
No uncontrolled active peptic ulcer

PRIOR CONCURRENT THERAPY:

Biologic therapy:

At least 1 week since prior growth factors
At least 1 week since prior immunomodulatory therapy
Prior monoclonal antibodies allowed if no detectable antibody to hu14.18
Prior autologous bone marrow transplantation (BMT) or stem cell transplantation (SCT) allowed
Prior autologous BMT or SCT with monoclonal antibody-purged specimens allowed
No concurrent growth factors
No concurrent interferon

Chemotherapy:

See Disease Characteristics
At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas, mitomycin, or melphalan)
No concurrent palliative chemotherapy

Endocrine therapy:

See Disease Characteristics
At least 2 weeks since prior glucocorticoids, except for life-threatening symptoms
No concurrent corticosteroids
No concurrent glucocorticoids, except for life-threatening symptoms

Radiotherapy:

See Disease Characteristics
At least 3 weeks since prior radiotherapy
No concurrent palliative radiotherapy

Surgery:

See Disease Characteristics
At least 2 weeks since prior major surgery (e.g., laparotomy or thoracotomy)
No prior organ allografts
No concurrent palliative surgery

Other:

Recovered from prior therapy
At least 1 week since prior tretinoin
At least 3 weeks since prior immunosuppressive therapy
No other concurrent immunosuppressive drugs

Study is for people with:

Melanoma

Phase:

Phase 1

Estimated Enrollment:

28

Study ID:

NCT00003750

Recruitment Status:

Completed

Sponsor:

Children's Oncology Group

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There are 58 Locations for this study

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Arkansas Children's Hospital
Little Rock Arkansas, 72202, United States
University of Arkansas for Medical Sciences
Little Rock Arkansas, 72205, United States
City of Hope Comprehensive Cancer Center
Duarte California, 91010, United States
Rebecca and John Moores UCSD Cancer Center
La Jolla California, 92093, United States
Children's Hospital Los Angeles
Los Angeles California, 90027, United States
Jonsson Comprehensive Cancer Center, UCLA
Los Angeles California, 90095, United States
Children's Hospital of Orange County
Orange California, 92868, United States
UCSF Comprehensive Cancer Center
San Francisco California, 94115, United States
Stanford Cancer Center at Stanford University Medical Center
Stanford California, 94305, United States
Children's National Medical Center
Washington District of Columbia, 20010, United States
Shands Cancer Center at the University of Florida Health Science Center
Gainesville Florida, 32610, United States
AFLAC Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta - Scottish RiteCampus
Atlanta Georgia, 30342, United States
Children's Memorial Hospital - Chicago
Chicago Illinois, 60614, United States
Indiana University Cancer Center
Indianapolis Indiana, 46202, United States
Kansas Cancer Institute at the University of Kansas Medical Center
Kansas City Kansas, 66160, United States
MBCCOP - LSU Health Sciences Center
New Orleans Louisiana, 70112, United States
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Baltimore Maryland, 21231, United States
Floating Hospital for Children
Boston Massachusetts, 02111, United States
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
Boston Massachusetts, 02115, United States
University of Michigan Comprehensive Cancer Center
Ann Arbor Michigan, 48109, United States
Children's Hospital of Michigan
Detroit Michigan, 48201, United States
University of Minnesota Cancer Center
Minneapolis Minnesota, 55455, United States
Mayo Clinic Cancer Center
Rochester Minnesota, 55905, United States
University of Mississippi Medical Center
Jackson Mississippi, 39216, United States
Children's Mercy Hospital
Kansas City Missouri, 64108, United States
Cardinal Glennon Children's Hospital
Saint Louis Missouri, 63104, United States
Washington University Medical Center
Saint Louis Missouri, 63105, United States
Cancer Center at Hackensack University Medical Center
Hackensack New Jersey, 07601, United States
Robert Wood Johnson Medical School
New Brunswick New Jersey, 08901, United States
NYU School of Medicine's Kaplan Comprehensive Cancer Center
New York New York, 10016, United States
Memorial Sloan-Kettering Cancer Center
New York New York, 10021, United States
Herbert Irving Comprehensive Cancer Center at Columbia University
New York New York, 10032, United States
University Hospital at State University of New York - Upstate Medical University
Syracuse New York, 13210, United States
Duke Comprehensive Cancer Center
Durham North Carolina, 27710, United States
Cincinnati Children's Hospital Medical Center
Cincinnati Ohio, 45229, United States
Children's Hospital of Columbus
Columbus Ohio, 43205, United States
Oklahoma University Medical Center at University of Oklahoma Health Sciences Center
Oklahoma City Oklahoma, 73126, United States
CCOP - Columbia River Oncology Program
Portland Oregon, 97225, United States
Children's Hospital of Philadelphia
Philadelphia Pennsylvania, 19104, United States
Children's Hospital of Pittsburgh
Pittsburgh Pennsylvania, 15213, United States
Hollings Cancer Center at Medical University of South Carolina
Charleston South Carolina, 29425, United States
St. Jude Children's Research Hospital
Memphis Tennessee, 38105, United States
Vanderbilt-Ingram Cancer Center at Vanderbilt Medical Center
Nashville Tennessee, 37232, United States
Simmons Cancer Center at University of Texas Southwestern Medical Center - Dallas
Dallas Texas, 75390, United States
Cook Children's Medical Center - Fort Worth
Fort Worth Texas, 76104, United States
Texas Children's Cancer Center
Houston Texas, 77030, United States
University of Texas - MD Anderson Cancer Center
Houston Texas, 77030, United States
University of Texas Health Science Center at San Antonio
San Antonio Texas, 78207, United States
CCOP - Scott and White Hospital
Temple Texas, 76508, United States
Huntsman Cancer Institute
Salt Lake City Utah, 84112, United States
Children's Hospital and Regional Medical Center - Seattle
Seattle Washington, 98105, United States
University of Wisconsin Comprehensive Cancer Center
Madison Wisconsin, 53792, United States
CCOP - Marshfield Clinic Research Foundation
Marshfield Wisconsin, 54449, United States
Midwest Children's Cancer Center
Milwaukee Wisconsin, 53226, United States
Royal Children's Hospital
Parkville Victoria, 3052, Australia
Princess Margaret Hospital for Children
Perth Western Australia, 6001, Australia
Hospital for Sick Children
Toronto Ontario, M5G 1, Canada
McGill University Health Center - Montreal Children's Hospital
Montreal Quebec, H3G 1, Canada
Hopital Sainte Justine
Montreal Quebec, H3T 1, Canada

How clear is this clinincal trial information?

Study is for people with:

Melanoma

Phase:

Phase 1

Estimated Enrollment:

28

Study ID:

NCT00003750

Recruitment Status:

Completed

Sponsor:


Children's Oncology Group

How clear is this clinincal trial information?

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