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PEG-Interferon Alfa-2b in Treating Young Patients With Plexiform Neurofibroma

Primary Purpose

Neoplasm of Uncertain Malignant Potential, Unspecified Childhood Solid Tumor, Protocol Specific

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
PEG-interferon alfa-2a
Sponsored by
National Institutes of Health Clinical Center (CC)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neoplasm of Uncertain Malignant Potential focused on measuring neoplasm of uncertain malignant potential, unspecified childhood solid tumor, protocol specific

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Diagnosis of plexiform neurofibroma which is progressive, symptomatic, or life threatening and for which there is no other standard medical management or surgical option Histologic confirmation of tumor is not required in the presence of consistent clinical and radiographic findings provided the following are true: No clinical observation or scan suggestive of malignant transformation Meets ≥ 1 of the following diagnostic criteria for neurofibroma type 1 (NF1): Six or more cafe-au-lait spots (> 0.5 cm in prepubertal patients or > 1.5 cm in post pubertal patients) Freckling in axilla or groin Optic glioma Two or more Lisch nodules A distinctive bony lesion (e.g., dysplasia of the sphenoid bone, dysplasia, or thinning of long bone cortex) A first degree relative with NF1 No history of malignant peripheral nerve sheath tumor No active visual pathway glioma No active brain tumor or brain metastases PATIENT CHARACTERISTICS: Performance status ECOG 0-2 Life expectancy At least 12 months Hematopoietic Absolute neutrophil count > 1,500/mm^3 Hemoglobin > 10 g/dL Platelet count > 100,000/mm^3 Hepatic Bilirubin < 1.5 mg/dL SGPT ≤ 2 times upper limit of normal No significant hepatic dysfunction Renal Creatinine based on age as follows: ≤ 0.8 mg/dL (for patients age 5 years and under) ≤ 1.0 mg/dL (for patients age 6 to 10 years) ≤ 1.2 mg/dL (for patients age 11 to 15 years) ≤ 1.5 mg/dL (for patients age 16 to 21 years) OR Creatinine clearance ≥ 70 mL/min Cardiovascular No significant cardiac dysfunction No severe cardiovascular disease No cardiac arrhythmia requiring chronic treatment No congestive heart failure No symptomatic ischemic heart disease Pulmonary No significant pulmonary dysfunction Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No serious infection No other significant unrelated systemic illness No significant organ dysfunction No other malignancy except surgically cured nonmelanoma skin cancer or carcinoma in situ of the cervix No history of severe psychiatric condition or psychiatric disorder requiring hospitalization No history of suicidal ideation or attempt No thyroid dysfunction unresponsive to therapy No uncontrolled diabetes mellitus No history of HIV positivity No alcohol or drug abuse PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent immunotherapy No concurrent colony-stimulating factors (e.g., erythropoietin or filgrastim [G-CSF]) Chemotherapy No concurrent chemotherapy for this disease Endocrine therapy No concurrent chronic systemic corticosteroids No concurrent hormonal therapy for this disease Radiotherapy No concurrent radiotherapy for this disease Surgery Prior surgery allowed provided it has been at least 21 days since surgery and there is presence of residual tumor Other Recovered from prior therapy More than 30 days since prior investigational agents

Sites / Locations

  • Children's National Medical Center
  • Children's Memorial Hospital - Chicago
  • Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
  • Children's Hospital of Pittsburgh

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 11, 2005
Last Updated
March 28, 2012
Sponsor
National Institutes of Health Clinical Center (CC)
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00253474
Brief Title
PEG-Interferon Alfa-2b in Treating Young Patients With Plexiform Neurofibroma
Official Title
A Phase I Trial of Peginterferon Alfa-2b (PEG-Intron) for Plexiform Neurofibromas
Study Type
Interventional

2. Study Status

Record Verification Date
March 2012
Overall Recruitment Status
Completed
Study Start Date
September 2005 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
January 2011 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Institutes of Health Clinical Center (CC)
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: PEG-interferon alfa-2b may interfere with the growth of tumor cells. PURPOSE: This phase I trial is studying the side effects and best dose of PEG-interferon alfa-2b in treating young patients with plexiform neurofibroma.
Detailed Description
OBJECTIVES: Primary Determine the maximum tolerated dose of PEG-interferon alfa-2b in patients with unresectable plexiform neurofibroma. (Dose escalation portion of study closed to accrual as of 2/2005.) Determine the toxicity profile of this drug in these patients. Secondary Obtain, preliminary, information about the efficacy of this drug in these patients. Evaluate the growth rate of plexiform neurofibroma using volumetric MRI analysis in patients treated with this drug. Evaluate the impact of this drug, in terms of "worst symptom" score, in these patients. OUTLINE: This is a dose-escalation, multicenter study. (Dose-escalation portion of the study closed to accrual as of 2/2005.) Patients receive PEG-interferon alfa-2b subcutaneously once weekly for 2 years in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of PEG-interferon alfa-2b until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 1 of 6 patients experience dose-limiting toxicity. A total of 12 patients receive treatment at the MTD. After completion of study treatment, patients are followed every 6 months. PROJECTED ACCRUAL: A total of 36 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
Neoplasm of Uncertain Malignant Potential, Unspecified Childhood Solid Tumor, Protocol Specific
Keywords
neoplasm of uncertain malignant potential, unspecified childhood solid tumor, protocol specific

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Enrollment
36 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
PEG-interferon alfa-2a

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of plexiform neurofibroma which is progressive, symptomatic, or life threatening and for which there is no other standard medical management or surgical option Histologic confirmation of tumor is not required in the presence of consistent clinical and radiographic findings provided the following are true: No clinical observation or scan suggestive of malignant transformation Meets ≥ 1 of the following diagnostic criteria for neurofibroma type 1 (NF1): Six or more cafe-au-lait spots (> 0.5 cm in prepubertal patients or > 1.5 cm in post pubertal patients) Freckling in axilla or groin Optic glioma Two or more Lisch nodules A distinctive bony lesion (e.g., dysplasia of the sphenoid bone, dysplasia, or thinning of long bone cortex) A first degree relative with NF1 No history of malignant peripheral nerve sheath tumor No active visual pathway glioma No active brain tumor or brain metastases PATIENT CHARACTERISTICS: Performance status ECOG 0-2 Life expectancy At least 12 months Hematopoietic Absolute neutrophil count > 1,500/mm^3 Hemoglobin > 10 g/dL Platelet count > 100,000/mm^3 Hepatic Bilirubin < 1.5 mg/dL SGPT ≤ 2 times upper limit of normal No significant hepatic dysfunction Renal Creatinine based on age as follows: ≤ 0.8 mg/dL (for patients age 5 years and under) ≤ 1.0 mg/dL (for patients age 6 to 10 years) ≤ 1.2 mg/dL (for patients age 11 to 15 years) ≤ 1.5 mg/dL (for patients age 16 to 21 years) OR Creatinine clearance ≥ 70 mL/min Cardiovascular No significant cardiac dysfunction No severe cardiovascular disease No cardiac arrhythmia requiring chronic treatment No congestive heart failure No symptomatic ischemic heart disease Pulmonary No significant pulmonary dysfunction Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No serious infection No other significant unrelated systemic illness No significant organ dysfunction No other malignancy except surgically cured nonmelanoma skin cancer or carcinoma in situ of the cervix No history of severe psychiatric condition or psychiatric disorder requiring hospitalization No history of suicidal ideation or attempt No thyroid dysfunction unresponsive to therapy No uncontrolled diabetes mellitus No history of HIV positivity No alcohol or drug abuse PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent immunotherapy No concurrent colony-stimulating factors (e.g., erythropoietin or filgrastim [G-CSF]) Chemotherapy No concurrent chemotherapy for this disease Endocrine therapy No concurrent chronic systemic corticosteroids No concurrent hormonal therapy for this disease Radiotherapy No concurrent radiotherapy for this disease Surgery Prior surgery allowed provided it has been at least 21 days since surgery and there is presence of residual tumor Other Recovered from prior therapy More than 30 days since prior investigational agents
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Brigitte C. Widemann, MD
Organizational Affiliation
National Cancer Institute (NCI)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Children's National Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010-2970
Country
United States
Facility Name
Children's Memorial Hospital - Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60614
Country
United States
Facility Name
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-1182
Country
United States
Facility Name
Children's Hospital of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
21242495
Citation
Jakacki RI, Dombi E, Potter DM, Goldman S, Allen JC, Pollack IF, Widemann BC. Phase I trial of pegylated interferon-alpha-2b in young patients with plexiform neurofibromas. Neurology. 2011 Jan 18;76(3):265-72. doi: 10.1212/WNL.0b013e318207b031.
Results Reference
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PEG-Interferon Alfa-2b in Treating Young Patients With Plexiform Neurofibroma

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