search
Back to results

Combination Chemotherapy in Treating Young Patients With Advanced Solid Tumors

Primary Purpose

Childhood Central Nervous System Choriocarcinoma, Childhood Central Nervous System Embryonal Tumor, Childhood Central Nervous System Germ Cell Tumor

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
oxaliplatin
fluorouracil
leucovorin calcium
pharmacological study
positron emission tomography
computed tomography
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Childhood Central Nervous System Choriocarcinoma

Eligibility Criteria

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

Inclusion Criteria: Histologically diagnosed malignant solid tumor, including tumors of the CNS, that has progressed despite standard therapy or for which no effective standard therapy is known Patients with brainstem glioma or intrinsic pontine glioma do not need biopsy proof of the diagnosis if imaging studies are consistent with the diagnosis Measurable or nonmeasurable disease No pleural effusion or ascites causing respiratory compromise (≥ grade 2 dyspnea) ECOG performance status (PS) 0-2 for patients ≥ 16 years of age Karnofsky PS ≥ 40% for patients > 10 years of age Lansky Play Scale ≥ 40% for patients ≤ 10 years of age Peripheral absolute neutrophil count (ANC) ≥ 1,000/mm^3 Platelet count ≥ 75,000/mm^3 (transfusion independent) Hemoglobin ≥ 8.5 g/dL (transfusion permitted) Serum creatinine ≤ 1.5 times upper limit of normal (ULN) Creatinine clearance OR radioisotope glomerular filtration rate > 60mL/min Total bilirubin < 1.5 mg/dL ALT and AST ≤ 2.5 times ULN (5 times ULN if liver involvement with primary tumor) Ejection fraction ≥ 50% OR shortening fraction ≥ 28% Life expectancy of > 8 weeks No radiological evidence of pulmonary fibrosis, interstitial pneumonia, or extensive and symptomatic interstitial fibrosis of the lung Room air oxygen saturation ≥ 90% at altitudes ≥ 5,000 feet OR ≥ 93% at altitudes < 5,000 feet DLCO > 50% of predicted (for patients who received prior bleomycin and are able to comply with pulmonary function testing) Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No history of allergic reactions attributed to compounds of similar chemical or biologic composition to platinum or oxaliplatin as well as other agents used in study treatment No other serious or poorly controlled social circumstance, psychiatric illness, or medical condition including, but not limited to, the following: ongoing or active infection, uncontrolled seizure disorder, uncontrolled symptomatic congestive heart failure, or cardiac arrhythmia that could be exacerbated by or complicate compliance with study therapy No HIV-positive patients Recovered from prior therapy No persistent toxicities from previous therapies ≥ grade 2 Stable grade 3 neurotoxicity is allowed in patients with CNS tumors only who have a baseline neurotoxicity due to primary tumor involvement or postoperative complications At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) At least 4 weeks since prior local radiotherapy (small port) At least 6 months since prior craniospinal irradiation, irradiation to ≥ 50% of the pelvis, or other substantial bone marrow irradiation, including total body irradiation No previous treatment with oxaliplatin At least 14 days since prior biological therapy (including monoclonalantibody therapy) At least 7 days since prior retinoids, sargramostim (GM-CSF), or filgrastim (G-CSF) At least 14 days since prior pegfilgrastim No concurrent pegfilgrastim or GM-CSF Patients requiring steroids should be on stable or decreasing dose for ≥ 7 days prior to study entry, and must not be on more than 4 mg of dexamethasone (or equivalent) per day At least 4 weeks since prior major surgical procedure Simple surgical procedures, including biopsy or central line placement or similar procedure, are allowed within 4 weeks of study entry if the patient has recovered to baseline At least 3 months since prior autologous or allogeneic stem cell transplantation No concurrent immunosuppressive therapy No evidence of ongoing graft versus host disease (GVHD) No concurrent use of other investigational agents No other concurrent anticancer therapies or agents No other concurrent chemotherapy, radiation therapy, or herbal medications or supplements

Sites / Locations

  • Memorial Sloan Kettering Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (oxaliplatin, leucovorin calcium, fluorouracil)

Arm Description

Patients receive oxaliplatin IV over 2 hours and leucovorin calcium IV over 2 hours on day 1 followed by fluorouracil IV continuously over 46 hours on days 1-2. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

MTD based on the incidence of DLT as assessed by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v.) 3.0
DLT defined as any grade 3 or greater non-hematologic toxicity attributed to the combination of drugs in this regimen, despite maximal supportive care as assessed by NCI CTCAE v. 3

Secondary Outcome Measures

Safety profile as assessed by NCI CTCAE v. 3.0
Any incidence of adverse events will be recorded and classified according to body region and severity.
Tumor response based on PET or PET/CT scan
Wilcoxon rank sum statistic will be used to assess whether tumor response is associated with the change in the PET SUV value.

Full Information

First Posted
January 24, 2006
Last Updated
May 1, 2013
Sponsor
National Cancer Institute (NCI)
search

1. Study Identification

Unique Protocol Identification Number
NCT00281944
Brief Title
Combination Chemotherapy in Treating Young Patients With Advanced Solid Tumors
Official Title
A Multi-Center Phase Ib Study of Oxaliplatin (NSC #266046) in Combination With Fluorouracil and Leucovorin in Pediatric Patients With Advanced Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
May 2013
Overall Recruitment Status
Completed
Study Start Date
September 2005 (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
This phase I trial is studying the side effects and best dose of oxaliplatin when given together with leucovorin and fluorouracil in treating young patients with advanced solid tumors. Drugs used in chemotherapy, such as oxaliplatin, leucovorin, and fluorouracil, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells.
Detailed Description
PRIMARY OBJECTIVES: I. Determine the dose-limiting toxicities (DLT) and maximum tolerated dose (MTD) of oxaliplatin when given together with fluorouracil and leucovorin calcium in pediatric patients with recurrent or refractory solid tumors, including tumors of the CNS. SECONDARY OBJECTIVES: I. Determine the pharmacokinetic properties of oxaliplatin in this pediatric patient population. II. Correlate alterations in accumulation of fludeoxyglucose F 18 with tumor response in those patients who can readily undergo a positron emission tomography (PET) or PET/CT scan. III. Assess the safety profile of this regimen in these patients. IV. Evaluate any preliminary evidence of anti-tumor activity of this regimen in these patients. OUTLINE: This is an open-label, multicenter, dose-escalation study of oxaliplatin. Patients are stratified according to solid tumor type (non-CNS vs CNS). Patients receive oxaliplatin IV over 2 hours and leucovorin calcium IV over 2 hours on day 1 followed by fluorouracil IV continuously over 46 hours on days 1-2. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of oxaliplatin 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. At least 6 patients are treated at the MTD. After completion of study treatment, patients are followed periodically.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Childhood Central Nervous System Choriocarcinoma, Childhood Central Nervous System Embryonal Tumor, Childhood Central Nervous System Germ Cell Tumor, Childhood Central Nervous System Germinoma, Childhood Central Nervous System Mixed Germ Cell Tumor, Childhood Central Nervous System Teratoma, Childhood Central Nervous System Yolk Sac Tumor, Recurrent Childhood Brain Stem Glioma, Recurrent Childhood Central Nervous System Embryonal Tumor, Unspecified Childhood Solid Tumor, Protocol Specific

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment (oxaliplatin, leucovorin calcium, fluorouracil)
Arm Type
Experimental
Arm Description
Patients receive oxaliplatin IV over 2 hours and leucovorin calcium IV over 2 hours on day 1 followed by fluorouracil IV continuously over 46 hours on days 1-2. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
oxaliplatin
Other Intervention Name(s)
1-OHP, Dacotin, Dacplat, Eloxatin, L-OHP
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
fluorouracil
Other Intervention Name(s)
5-fluorouracil, 5-Fluracil, 5-FU
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
leucovorin calcium
Other Intervention Name(s)
CF, CFR, LV
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
pharmacological study
Other Intervention Name(s)
pharmacological studies
Intervention Description
Correlative studies
Intervention Type
Procedure
Intervention Name(s)
positron emission tomography
Other Intervention Name(s)
FDG-PET, PET, PET scan, tomography, emission computed
Intervention Description
Undergo PET scan
Intervention Type
Procedure
Intervention Name(s)
computed tomography
Other Intervention Name(s)
tomography, computed
Intervention Description
Undergo PET/CT scan
Primary Outcome Measure Information:
Title
MTD based on the incidence of DLT as assessed by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v.) 3.0
Time Frame
14 days
Title
DLT defined as any grade 3 or greater non-hematologic toxicity attributed to the combination of drugs in this regimen, despite maximal supportive care as assessed by NCI CTCAE v. 3
Time Frame
14 days
Secondary Outcome Measure Information:
Title
Safety profile as assessed by NCI CTCAE v. 3.0
Description
Any incidence of adverse events will be recorded and classified according to body region and severity.
Time Frame
14 days
Title
Tumor response based on PET or PET/CT scan
Description
Wilcoxon rank sum statistic will be used to assess whether tumor response is associated with the change in the PET SUV value.
Time Frame
From baseline to 6 weeks

10. Eligibility

Sex
All
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically diagnosed malignant solid tumor, including tumors of the CNS, that has progressed despite standard therapy or for which no effective standard therapy is known Patients with brainstem glioma or intrinsic pontine glioma do not need biopsy proof of the diagnosis if imaging studies are consistent with the diagnosis Measurable or nonmeasurable disease No pleural effusion or ascites causing respiratory compromise (≥ grade 2 dyspnea) ECOG performance status (PS) 0-2 for patients ≥ 16 years of age Karnofsky PS ≥ 40% for patients > 10 years of age Lansky Play Scale ≥ 40% for patients ≤ 10 years of age Peripheral absolute neutrophil count (ANC) ≥ 1,000/mm^3 Platelet count ≥ 75,000/mm^3 (transfusion independent) Hemoglobin ≥ 8.5 g/dL (transfusion permitted) Serum creatinine ≤ 1.5 times upper limit of normal (ULN) Creatinine clearance OR radioisotope glomerular filtration rate > 60mL/min Total bilirubin < 1.5 mg/dL ALT and AST ≤ 2.5 times ULN (5 times ULN if liver involvement with primary tumor) Ejection fraction ≥ 50% OR shortening fraction ≥ 28% Life expectancy of > 8 weeks No radiological evidence of pulmonary fibrosis, interstitial pneumonia, or extensive and symptomatic interstitial fibrosis of the lung Room air oxygen saturation ≥ 90% at altitudes ≥ 5,000 feet OR ≥ 93% at altitudes < 5,000 feet DLCO > 50% of predicted (for patients who received prior bleomycin and are able to comply with pulmonary function testing) Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No history of allergic reactions attributed to compounds of similar chemical or biologic composition to platinum or oxaliplatin as well as other agents used in study treatment No other serious or poorly controlled social circumstance, psychiatric illness, or medical condition including, but not limited to, the following: ongoing or active infection, uncontrolled seizure disorder, uncontrolled symptomatic congestive heart failure, or cardiac arrhythmia that could be exacerbated by or complicate compliance with study therapy No HIV-positive patients Recovered from prior therapy No persistent toxicities from previous therapies ≥ grade 2 Stable grade 3 neurotoxicity is allowed in patients with CNS tumors only who have a baseline neurotoxicity due to primary tumor involvement or postoperative complications At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) At least 4 weeks since prior local radiotherapy (small port) At least 6 months since prior craniospinal irradiation, irradiation to ≥ 50% of the pelvis, or other substantial bone marrow irradiation, including total body irradiation No previous treatment with oxaliplatin At least 14 days since prior biological therapy (including monoclonalantibody therapy) At least 7 days since prior retinoids, sargramostim (GM-CSF), or filgrastim (G-CSF) At least 14 days since prior pegfilgrastim No concurrent pegfilgrastim or GM-CSF Patients requiring steroids should be on stable or decreasing dose for ≥ 7 days prior to study entry, and must not be on more than 4 mg of dexamethasone (or equivalent) per day At least 4 weeks since prior major surgical procedure Simple surgical procedures, including biopsy or central line placement or similar procedure, are allowed within 4 weeks of study entry if the patient has recovered to baseline At least 3 months since prior autologous or allogeneic stem cell transplantation No concurrent immunosuppressive therapy No evidence of ongoing graft versus host disease (GVHD) No concurrent use of other investigational agents No other concurrent anticancer therapies or agents No other concurrent chemotherapy, radiation therapy, or herbal medications or supplements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lia Gore
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Combination Chemotherapy in Treating Young Patients With Advanced Solid Tumors

We'll reach out to this number within 24 hrs