Iodobenzylguanidine Meta-I131 and Topotecan in Young Patients With Refractory or Relapsed Metastatic Neuroblastoma (MIITOP)
Neuroblastoma

About this trial
This is an interventional treatment trial for Neuroblastoma focused on measuring disseminated neuroblastoma, localized unresectable neuroblastoma, recurrent neuroblastoma, stage 4S neuroblastoma
Eligibility Criteria
Inclusion criteria:
- Histologically confirmed neuroblastoma
- Metastatic disease that is recurrent or refractory to induction therapy
- Primary or metastatic tumor target with MIBG fixation (tumor/soft tissue) > 2
- Autologous bone marrow or peripheral blood stem cells must be available
- WHO performance status (PS) 0-1 OR Lansky PS 70-100%
- Life expectancy > 2 months
- ANC ≥ 1,000/mm³
- Platelet count ≥ 100,000/mm³
- Creatinine clearance normal for age
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No prior hypersensitivity to topotecan or its excipients
- No toxicity to other organs ≥ NCI-CTCAE v3.0 grade 2
- No other debilitating disease
- No HIV positivity
- More than 30 days since prior external-beam radiation (6 weeks if cranio-spinal, abdominal, or pulmonary)
- At least 3 weeks since prior chemotherapy (6 weeks for mitomycin C or nitrosoureas)
- No other contraindicated biologic therapy that cannot be discontinued for ≥ 4 courses during MIBG therapy
Exclusion criteria:
- Pregnancy or breastfeeding women
- HIV positive
- Participation to another phase I,II or III clinical trial
- Other invalidating pathology
- Concomitant treatment interfering with MIBG
- Hypersensibility to Topotecan
Sites / Locations
- Centre Oscar Lambret
- Centre Léon Bérard
- Hôpital des Enfants
Arms of the Study
Arm 1
Experimental
Topotecan / 131-iodine MIBG association
The topotecan hydrochloride is administered intravenously over five days to dose of 0.7 mg/ m²/day from day 1 to day 5 (first cycle), then from day 21 to day 25 (second cycle). * Iobenguane I 131: 444 MBq / kg of 131-iodine MIBG is administered on day 1 with activity up to 11,100 MBq per injection. * A dosimetry is performed during hospitalization. A second dose of 131-iodine MIBG (maximum 11 100 MBq) is administered to D21 so as to obtain a total body irradiation of 4 Gy. * Autologous hematopoietic stem cell transplantation : Hematopoietic stem cells are reinjected 10 days after the second injection of 131-iodine MIBG. If the dose of total-body irradiation of 4 Gy is reached during the first cycle, the second cycle is canceled.