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Interleukin-12 and Interleukin-2 in Treating Patients With Refractory or Recurrent Neuroblastoma

Primary Purpose

Recurrent Neuroblastoma

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
recombinant interleukin-12
aldesleukin
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Neuroblastoma

Eligibility Criteria

3 Years - 21 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Diagnosis of neuroblastoma Histologically confirmed disease AND/OR disease defined by tumor cells in the bone marrow and elevated urinary catecholamine metabolites Persistent and/or refractory disease, with at least 1 of the following: Biopsy-proven residual disease at least 12 weeks after myeloablative therapy Progressive disease after nonmyeloablative or myeloablative therapy Recurrent disease, evidenced by any of the following: Biopsy-proven recurrent soft tissue disease Metaiodobenzylguanidine (MIBG)-positive lesions visible on any other imaging modality or repeat MIBG obtained 2-4 weeks or more apart Histologically confirmed bone marrow disease Progressive or stable disease after at least 1 prior standard salvage regime No clinically significant pleural effusion ECOG 0-1 Life expectancy >= 12 weeks Hepatitis A antibody negative Hepatitis B surface antigen negative Positive hepatitis B titer allowed if patient has been immunized and has no history of disease Hepatitis C virus negative No history of congenital or acquired coagulation disorder Cardiac function normal by ECG No dyspnea at rest No exercise intolerance Oxygen saturation at least 94% by pulse oximetry DLCO greater than 60% of predicted FEV1 greater than 70% of predicted Negative pregnancy test Skull-based bony lesions without space-occupying intracranial extension are allowed No prior or concurrent intracranial metastatic disease to the brain parenchyma Not pregnant or nursing Fertile patients must use effective barrier contraception during and for at least 2 months after study No prior hematologic malignancy (including leukemia or lymphoma) No history of malignant hyperthermia No prior or concurrent autoimmune disease No positive direct Coombs testing No history of ongoing or intermittent bowel obstruction No active infection or other significant systemic illness More than 2 weeks since prior fenretinide More than 2 weeks since prior 13-cis-retinoic acid More than 2 weeks since prior filgrastim (G-CSF) or sargramostim (GM-CSF) More than 2 weeks since prior interferons or interleukins More than 2 weeks since prior cytokine-fusion proteins More than 2 weeks since prior IV immunoglobulin (IVIG) No prior interleukin-12 No concurrent cytokines No concurrent fenretinide No concurrent 13-cis-retinoic acid No other concurrent immunomodulators, including: G-CSF and GM-CSF Interferons Other interleukins IVIG More than 4 weeks since prior chemotherapy No other unstable medical condition or critical illness that would preclude study participation More than 12 weeks since prior myeloablative chemotherapy followed by autologous stem cell transplantation: No prior myeloablative chemotherapy followed by allogeneic bone marrow transplantation More than 2 weeks since prior growth hormones More than 4 weeks since prior systemic corticosteroids More than 2 weeks since prior non-corticosteroid hormonal therapy (including oral birth control pills) No concurrent hormonal therapy (including oral birth control pills) No concurrent growth hormones No concurrent systemic corticosteroids, except for use in life-threatening complications More than 4 weeks since prior radiotherapy No prior solid organ transplantation More than 4 weeks since prior investigational agents No other concurrent investigational agents No prior enrollment on COG-A3973, unless disease has progressed No history of hemolytic anemia Absolute neutrophil count at least 1,500/mm^3 [Note: Independent of growth factor or transfusion support] Platelet count at least 75,000/mm^3 [Note: Independent of growth factor or transfusion support] AST and ALT less than 2.5 times upper limit of normal Bilirubin less than 2.0 mg/dL Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min OR creatinine normal HIV negative Ejection fraction at least 50% by echocardiogram or MUGA OR Fractional shortening at least 30% by echocardiogram No congestive heart failure No uncontrolled cardiac arrhythmia

Sites / Locations

  • New Approaches to Neuroblastoma Treatment (NANT)
  • Children's Hospital Los Angeles
  • Lucile Packard Children's Hospital Stanford University
  • University of California at San Francisco - Comprehensive Cancer Center
  • AFLAC Cancer Center and Blood Disorders Service
  • Childrens Memorial Hospital
  • Riley Hospital for Children
  • Children's Hospital Boston
  • University of Michigan University Hospital
  • Cincinnati Children's Hospital Medical Center
  • Children's Hospital of Philadelphia
  • Texas Children's Hospital
  • Seattle Children's Hospital
  • University of Wisconsin Hospital and Clinics

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (IL-12, aldesleukin)

Arm Description

Cohort A: Patients receive interleukin-12 (IL-12) IV over 5-15 seconds on days 1, 3, 5, 8, 10, and 12. Cohort B: Patients receive interleukin-2 (IL-2) IV over 15 minutes twice daily on days 1 and 8 and IL-12 IV as in cohort A. Treatment in both cohorts repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Some patients may receive additional courses at the discretion of the principal investigator. Cohorts of 3-6 patients in both cohorts receive escalating doses of IL-2 and IL-12 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. Once the MTD is determined, an additional cohort of 8 patients receives IL-12 and IL-2 at the MTD.

Outcomes

Primary Outcome Measures

Maximum tolerated dose (MTD) assessed by Common Toxicity Criteria (CTC)

Secondary Outcome Measures

Overall response assessed by Response Evaluation Criteria for Solid Tumors (RECIST)

Full Information

First Posted
February 5, 2003
Last Updated
April 8, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00054405
Brief Title
Interleukin-12 and Interleukin-2 in Treating Patients With Refractory or Recurrent Neuroblastoma
Official Title
A Phase I Investigation of IL-12 (NSC 672423)/Pulse IL-2 (Aldesleukin) in Children With Persistent and/or Refractory Neuroblastoma (13623)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2013
Overall Recruitment Status
Terminated
Why Stopped
Administratively complete.
Study Start Date
December 2002 (undefined)
Primary Completion Date
May 2009 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Phase I trial to compare the effectiveness of interleukin-12 with or without interleukin-2 in treating young patients who have refractory or recurrent neuroblastoma. Biological therapies use different ways to stimulate the immune system and stop cancer cells from growing. Combining interleukin-2 with interleukin-12 may kill more tumor cells.
Detailed Description
OBJECTIVES: I. Define the maximum tolerated dose and dose-limiting toxicity of interleukin-12 with or without interleukin-2 in patients with refractory or recurrent neuroblastoma. II. Determine, preliminarily, the antitumor effect of interleukin-12 with or without interleukin-2 in these patients. III. Evaluate the immunoregulatory activity of interleukin-12 with or without interleukin-2 in these patients. IV. Evaluate the antiangiogenic activity of interleukin-12 with or without interleukin-2 in these patients. OUTLINE: This is a dose-escalation, multicenter study. Patients are assigned to 1 of 2 treatment cohorts. COHORT A: Patients receive interleukin-12 (IL-12) IV over 5-15 seconds on days 1, 3, 5, 8, 10, and 12. COHORT B: Patients receive interleukin-2 (IL-2) IV over 15 minutes twice daily on days 1 and 8 and IL-12 IV as in cohort A. Treatment in both cohorts repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Some patients may receive additional courses at the discretion of the principal investigator. Cohorts of 3-6 patients in both cohorts receive escalating doses of IL-2 and IL-12 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. Once the MTD is determined, an additional cohort of 8 patients receives IL-12 and IL-2 at the MTD. Patients are followed at 3 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Neuroblastoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (IL-12, aldesleukin)
Arm Type
Experimental
Arm Description
Cohort A: Patients receive interleukin-12 (IL-12) IV over 5-15 seconds on days 1, 3, 5, 8, 10, and 12. Cohort B: Patients receive interleukin-2 (IL-2) IV over 15 minutes twice daily on days 1 and 8 and IL-12 IV as in cohort A. Treatment in both cohorts repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Some patients may receive additional courses at the discretion of the principal investigator. Cohorts of 3-6 patients in both cohorts receive escalating doses of IL-2 and IL-12 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. Once the MTD is determined, an additional cohort of 8 patients receives IL-12 and IL-2 at the MTD.
Intervention Type
Biological
Intervention Name(s)
recombinant interleukin-12
Other Intervention Name(s)
cytotoxic lymphocyte maturation factor, IL-12, interleukin-12, natural killer cell stimulatory factor, Ro 24-7472
Intervention Description
Given IV
Intervention Type
Biological
Intervention Name(s)
aldesleukin
Other Intervention Name(s)
IL-2, Proleukin, recombinant human interleukin-2, recombinant interleukin-2
Intervention Description
Given IV
Primary Outcome Measure Information:
Title
Maximum tolerated dose (MTD) assessed by Common Toxicity Criteria (CTC)
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Overall response assessed by Response Evaluation Criteria for Solid Tumors (RECIST)
Time Frame
Up to 3 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Years
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of neuroblastoma Histologically confirmed disease AND/OR disease defined by tumor cells in the bone marrow and elevated urinary catecholamine metabolites Persistent and/or refractory disease, with at least 1 of the following: Biopsy-proven residual disease at least 12 weeks after myeloablative therapy Progressive disease after nonmyeloablative or myeloablative therapy Recurrent disease, evidenced by any of the following: Biopsy-proven recurrent soft tissue disease Metaiodobenzylguanidine (MIBG)-positive lesions visible on any other imaging modality or repeat MIBG obtained 2-4 weeks or more apart Histologically confirmed bone marrow disease Progressive or stable disease after at least 1 prior standard salvage regime No clinically significant pleural effusion ECOG 0-1 Life expectancy >= 12 weeks Hepatitis A antibody negative Hepatitis B surface antigen negative Positive hepatitis B titer allowed if patient has been immunized and has no history of disease Hepatitis C virus negative No history of congenital or acquired coagulation disorder Cardiac function normal by ECG No dyspnea at rest No exercise intolerance Oxygen saturation at least 94% by pulse oximetry DLCO greater than 60% of predicted FEV1 greater than 70% of predicted Negative pregnancy test Skull-based bony lesions without space-occupying intracranial extension are allowed No prior or concurrent intracranial metastatic disease to the brain parenchyma Not pregnant or nursing Fertile patients must use effective barrier contraception during and for at least 2 months after study No prior hematologic malignancy (including leukemia or lymphoma) No history of malignant hyperthermia No prior or concurrent autoimmune disease No positive direct Coombs testing No history of ongoing or intermittent bowel obstruction No active infection or other significant systemic illness More than 2 weeks since prior fenretinide More than 2 weeks since prior 13-cis-retinoic acid More than 2 weeks since prior filgrastim (G-CSF) or sargramostim (GM-CSF) More than 2 weeks since prior interferons or interleukins More than 2 weeks since prior cytokine-fusion proteins More than 2 weeks since prior IV immunoglobulin (IVIG) No prior interleukin-12 No concurrent cytokines No concurrent fenretinide No concurrent 13-cis-retinoic acid No other concurrent immunomodulators, including: G-CSF and GM-CSF Interferons Other interleukins IVIG More than 4 weeks since prior chemotherapy No other unstable medical condition or critical illness that would preclude study participation More than 12 weeks since prior myeloablative chemotherapy followed by autologous stem cell transplantation: No prior myeloablative chemotherapy followed by allogeneic bone marrow transplantation More than 2 weeks since prior growth hormones More than 4 weeks since prior systemic corticosteroids More than 2 weeks since prior non-corticosteroid hormonal therapy (including oral birth control pills) No concurrent hormonal therapy (including oral birth control pills) No concurrent growth hormones No concurrent systemic corticosteroids, except for use in life-threatening complications More than 4 weeks since prior radiotherapy No prior solid organ transplantation More than 4 weeks since prior investigational agents No other concurrent investigational agents No prior enrollment on COG-A3973, unless disease has progressed No history of hemolytic anemia Absolute neutrophil count at least 1,500/mm^3 [Note: Independent of growth factor or transfusion support] Platelet count at least 75,000/mm^3 [Note: Independent of growth factor or transfusion support] AST and ALT less than 2.5 times upper limit of normal Bilirubin less than 2.0 mg/dL Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min OR creatinine normal HIV negative Ejection fraction at least 50% by echocardiogram or MUGA OR Fractional shortening at least 30% by echocardiogram No congestive heart failure No uncontrolled cardiac arrhythmia
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jon Wigginton
Organizational Affiliation
New Approaches to Neuroblastoma Treatment (NANT)
Official's Role
Principal Investigator
Facility Information:
Facility Name
New Approaches to Neuroblastoma Treatment (NANT)
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027-6016
Country
United States
Facility Name
Children's Hospital Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
Lucile Packard Children's Hospital Stanford University
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
Country
United States
Facility Name
University of California at San Francisco - Comprehensive Cancer Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94143-0875
Country
United States
Facility Name
AFLAC Cancer Center and Blood Disorders Service
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Childrens Memorial Hospital
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60614
Country
United States
Facility Name
Riley Hospital for Children
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Children's Hospital Boston
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
University of Michigan University Hospital
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Texas Children's Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Seattle Children's Hospital
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
University of Wisconsin Hospital and Clinics
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States

12. IPD Sharing Statement

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Interleukin-12 and Interleukin-2 in Treating Patients With Refractory or Recurrent Neuroblastoma

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