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Combination Chemotherapy Followed by Peripheral Stem Cell Transplantation or Bone Marrow Transplantation in Treating Patients With Brain Cancer

Primary Purpose

Brain and Central Nervous System Tumors

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
filgrastim
carboplatin
temozolomide
thiotepa
autologous bone marrow transplantation
peripheral blood stem cell transplantation
Sponsored by
NYU Langone Health
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring childhood central nervous system germ cell tumor, recurrent adult brain tumor, adult medulloblastoma, adult glioblastoma, adult anaplastic astrocytoma, adult anaplastic oligodendroglioma, adult mixed glioma, adult central nervous system germ cell tumor, adult pineoblastoma, recurrent childhood supratentorial primitive neuroectodermal tumor, recurrent childhood medulloblastoma, recurrent childhood ependymoma, adult giant cell glioblastoma, adult gliosarcoma, adult anaplastic ependymoma, adult supratentorial primitive neuroectodermal tumor (PNET)

Eligibility Criteria

1 Year - 49 Years (Child, Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Diagnosis of one of the following malignant brain tumors: Anaplastic astrocytoma Glioblastoma multiforme Anaplastic oligodendroglioma Medulloblastoma High-grade ependymoma Germ cell tumors Pineoblastoma Other primitive neuroectodermal tumors Recurrent disease or resistant to conventional therapy (e.g., surgery, radiotherapy, or standard chemotherapy) No prior myeloablative doses of thiotepa OR Newly diagnosed malignant glioma with minimal residual disease after prior radiotherapy Minimal residual disease is defined as tumor with maximum diameter of less than 1.5 cm by MRI and no corticosteroid dependency PATIENT CHARACTERISTICS: Age: Over 1 to under 50 Performance status: Karnofsky 70-100% OR Lansky 70-100% Life expectancy: More than 12 weeks Hematopoietic: Absolute neutrophil count at least 1,500/mm3 Platelet count at least 100,000/mm3 Hemoglobin at least 10 g/dL (transfusion allowed) Hepatic: Bilirubin less than 1.5 times upper limit of normal (ULN) SGOT/SGPT less than 2.5 times ULN Alkaline phosphatase less than 2.5 times ULN Renal: Creatinine less than 1.5 times ULN Creatinine clearance at least 70 mL/min BUN less than 1.5 times ULN Cardiovascular: Ejection fraction greater than 50% OR Shortening fraction greater than 27% No evidence of myocardial ischemia on EKG if over 40 years of age Other: HIV negative No AIDS-related illness No frequent vomiting or medical condition that would preclude oral medication (e.g., partial bowel obstruction) No other malignancy within the past 2 years except surgically cured carcinoma in situ of the cervix or basal cell or squamous cell skin cancer Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: At least 2 weeks since prior biologic therapy or immunotherapy Chemotherapy: See Disease Characteristics At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered Endocrine therapy: See Disease Characteristics Radiotherapy: See Disease Characteristics At least 6 weeks since prior radiotherapy and recovered At least 6 weeks since prior brachytherapy or radiosurgery Surgery: See Disease Characteristics Recovered from prior major surgery

Sites / Locations

  • NYU Cancer Institute at New York University Medical Center
  • Columbus Children's Hospital
  • Children's Hospital of Philadelphia
  • Princess Margaret Hospital for Children

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
October 11, 2001
Last Updated
March 25, 2011
Sponsor
NYU Langone Health
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00025558
Brief Title
Combination Chemotherapy Followed by Peripheral Stem Cell Transplantation or Bone Marrow Transplantation in Treating Patients With Brain Cancer
Official Title
Dose Escalation of Temozolomide in Combination With Thiotepa and Carboplatin With Autologous Stem Cell Rescue in Patients With Malignant Brain Tumors With Minimal Residual Disease
Study Type
Interventional

2. Study Status

Record Verification Date
March 2011
Overall Recruitment Status
Completed
Study Start Date
October 2000 (undefined)
Primary Completion Date
May 2007 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
NYU Langone Health
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Peripheral stem cell transplantation or bone marrow transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells. PURPOSE: Phase I trial to study the effectiveness of combining temozolomide, thiotepa, and carboplatin followed by peripheral stem cell transplantation or bone marrow transplantation in treating patients who have brain cancer.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose of temozolomide in combination with thiotepa and carboplatin followed by autologous peripheral blood stem cell or bone marrow transplantation in patients with recurrent high-grade brain tumors with minimal residual disease or newly-diagnosed malignant glioma with minimal residual disease following irradiation. OUTLINE: This is a dose-escalation study of temozolomide. Patients receive filgrastim (G-CSF) subcutaneously (SC) once daily for 3 consecutive days. After the third dose of G-CSF, patients undergo leukapheresis to collect peripheral blood stem cells (PBSC). Patients who do not have adequate PBSC may undergo bone marrow harvest. Patients then receive oral temozolomide every 12 hours on days -10 to -6 and thiotepa IV over 3 hours and carboplatin IV over 4 hours on days -5 to -3. PBSC or bone marrow are reinfused on day 0. Beginning on day 1, patients receive G-CSF SC or IV until blood counts recover. Cohorts of 3-6 patients receive escalating doses of temozolomide until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Patients are followed at day 42, at 3 months, every 3 months for 2 years, every 4 months for 1 year, every 6 months for 1 year, and then annually thereafter. PROJECTED ACCRUAL: A total of 18-30 patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain and Central Nervous System Tumors
Keywords
childhood central nervous system germ cell tumor, recurrent adult brain tumor, adult medulloblastoma, adult glioblastoma, adult anaplastic astrocytoma, adult anaplastic oligodendroglioma, adult mixed glioma, adult central nervous system germ cell tumor, adult pineoblastoma, recurrent childhood supratentorial primitive neuroectodermal tumor, recurrent childhood medulloblastoma, recurrent childhood ependymoma, adult giant cell glioblastoma, adult gliosarcoma, adult anaplastic ependymoma, adult supratentorial primitive neuroectodermal tumor (PNET)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
filgrastim
Intervention Type
Drug
Intervention Name(s)
carboplatin
Intervention Type
Drug
Intervention Name(s)
temozolomide
Intervention Type
Drug
Intervention Name(s)
thiotepa
Intervention Type
Procedure
Intervention Name(s)
autologous bone marrow transplantation
Intervention Type
Procedure
Intervention Name(s)
peripheral blood stem cell transplantation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
49 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of one of the following malignant brain tumors: Anaplastic astrocytoma Glioblastoma multiforme Anaplastic oligodendroglioma Medulloblastoma High-grade ependymoma Germ cell tumors Pineoblastoma Other primitive neuroectodermal tumors Recurrent disease or resistant to conventional therapy (e.g., surgery, radiotherapy, or standard chemotherapy) No prior myeloablative doses of thiotepa OR Newly diagnosed malignant glioma with minimal residual disease after prior radiotherapy Minimal residual disease is defined as tumor with maximum diameter of less than 1.5 cm by MRI and no corticosteroid dependency PATIENT CHARACTERISTICS: Age: Over 1 to under 50 Performance status: Karnofsky 70-100% OR Lansky 70-100% Life expectancy: More than 12 weeks Hematopoietic: Absolute neutrophil count at least 1,500/mm3 Platelet count at least 100,000/mm3 Hemoglobin at least 10 g/dL (transfusion allowed) Hepatic: Bilirubin less than 1.5 times upper limit of normal (ULN) SGOT/SGPT less than 2.5 times ULN Alkaline phosphatase less than 2.5 times ULN Renal: Creatinine less than 1.5 times ULN Creatinine clearance at least 70 mL/min BUN less than 1.5 times ULN Cardiovascular: Ejection fraction greater than 50% OR Shortening fraction greater than 27% No evidence of myocardial ischemia on EKG if over 40 years of age Other: HIV negative No AIDS-related illness No frequent vomiting or medical condition that would preclude oral medication (e.g., partial bowel obstruction) No other malignancy within the past 2 years except surgically cured carcinoma in situ of the cervix or basal cell or squamous cell skin cancer Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: At least 2 weeks since prior biologic therapy or immunotherapy Chemotherapy: See Disease Characteristics At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered Endocrine therapy: See Disease Characteristics Radiotherapy: See Disease Characteristics At least 6 weeks since prior radiotherapy and recovered At least 6 weeks since prior brachytherapy or radiosurgery Surgery: See Disease Characteristics Recovered from prior major surgery
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sharon L. Gardner, MD
Organizational Affiliation
NYU Langone Health
Official's Role
Study Chair
Facility Information:
Facility Name
NYU Cancer Institute at New York University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Columbus Children's Hospital
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43205-2696
Country
United States
Facility Name
Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Princess Margaret Hospital for Children
City
Perth
State/Province
Western Australia
ZIP/Postal Code
6001
Country
Australia

12. IPD Sharing Statement

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Combination Chemotherapy Followed by Peripheral Stem Cell Transplantation or Bone Marrow Transplantation in Treating Patients With Brain Cancer

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