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Clinical Analysis of Naxitamab (hu3F8) in the Treatment of Pediatric High Risk or Refractory/ Relapsed Neuroblastoma

Primary Purpose

Neuroblastoma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Naxitamab monotherapy
GM-CSF
Irinotecan
Temozolomide
Naxitamab in combination therapy
GM-CSF with combination regimen
Sintilimab
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neuroblastoma

Eligibility Criteria

12 Months - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: 1)Confirmed diagnosis of high-risk NB 2)1 year of age or above 3)Patient or parent/guardian must provide written informed consent to participate 4)If patient is sexually active, the patient agrees to use effective contraception 5)Confirmed negative urine pregnancy test for sexually active female of child-bearing potential (post-menarche) Exclusion Criteria: Significant organ toxicity Known or suspected allergy or hypersensitivity to anti-GD2 antibodies or to GM-CSF or its s components. Patient is pregnant, planning to become pregnant (while being treated with naxitamab) or is currently breastfeeding Patient will undergo treatment with another investigational drug, whilst being treated with naxitamab or has received another investigational drug within the 4 weeks prior to commencing treatment with naxitamab Patient is either eligible and able to participate in or is currently participating in an active interventional Y-mAbs sponsored clinical trial with naxitamab within the indication applied for Patient is unable to comply with the naxitamab treatment or has a medical condition that would potentially increase the severity of the toxicities experienced from naxitamab treatment at the discretion of the treating physician Left ventricular ejection fraction of <50% by echocardiography OR other clinically relevant cardiac disorders at the discretion of the investigator Inadequate pulmonary function defined as evidence of dyspnea at rest, exercise intolerance, and/or chronic oxygen requirement. In addition, room air pulse oximetry < 94% and/or abnormal pulmonary function tests if these assessments are clinically indicated Applicable for treatment with naxitamab in combination with GM-CSF only: Patient has active progression of the NB disease Patient has active NB disease at primary site or soft-tissue metastasis Patient has known CNS metastases when initiating naxitamab treatment

Sites / Locations

  • Sun Yat-sen University Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Other

Other

Other

Arm Label

naxitamab and GM-CSF only

naxitamab and GM-CSF in combination with irinotecan and temozolomide

naxitamab and GM-CSF in combination with irinotecan and temozolomide and PD-1 antibody

Arm Description

Suitable for patients with high risk neuroblastoma who obtain CR after chemotherapy combined with surgery, radiotherapy and/or hematopoietic stem cell transplantation. The treatment cycle is repeated every 4 weeks for a total of 5 courses, and discontinuation of nasetuzumab and GM-CSF should be considered if disease progression or unacceptable toxicity occurs.

Suitable for high-risk group neuroblastoma treated by chemotherapy combined with surgery, radiotherapy and or hematopoietic stem cell transplantation patients with tumor residual or progression during treatment (refractory); Patients who relapse after initial treatment. Repeat every 3 weeks until tumor progression, patient withdrawal, or toxicity becomes intolerable, up to 8 procedures.

Suitable for high-risk group neuroblastoma treated by chemotherapy combined with surgery, radiotherapy and or hematopoietic stem cell transplantation patients with tumor residual or progression during treatment (refractory); Patients who relapse after initial treatment. Repeat every 3 weeks until tumor progression, patient withdrawal, or toxicity becomes intolerable, up to 8 procedures.

Outcomes

Primary Outcome Measures

ORR
The proportion of patients who achieved CR or PR

Secondary Outcome Measures

DCR
The proportion of patients who achieved CR or PR or SD
EFS
The time from from start of naxitamab treatment to disease progression, recurrence
OS
The time from from start of naxitamab treatment to death or loss of follow-up

Full Information

First Posted
August 19, 2023
Last Updated
September 19, 2023
Sponsor
Sun Yat-sen University
Collaborators
Hainan General Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT06013618
Brief Title
Clinical Analysis of Naxitamab (hu3F8) in the Treatment of Pediatric High Risk or Refractory/ Relapsed Neuroblastoma
Official Title
Clinical Analysis of Naxitamab (hu3F8) in the Treatment of Pediatric High Risk or Refractory/ Relapsed Neuroblastoma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 19, 2023 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University
Collaborators
Hainan General Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is an prospective study to evaluate the safety and efficacy of naxitamab monotherapy or combined with chemotherapy or combined with chemotherapy and checkpoint inhibitor in the treatment of pediatric high-risk and refractory/relapsed neuroblastoma in Sun Yat-sen University Cancer Center.
Detailed Description
Patients with high risk neuroblastoma who obtain CR after chemotherapy combined with surgery, radiotherapy and/or hematopoietic stem cell transplantation received axitamab and GM-CSF. Patients with high-risk neuroblastoma treated by chemotherapy combined with surgery, radiotherapy and or hematopoietic stem cell transplantation patients with tumor residual or progression during treatment (refractory) received naxitamab and GM-CSF in combination with irinotecan and temozolomide or naxitamab and GM-CSF in combination with irinotecan and temozolomide and PD-1 antibody.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
naxitamab and GM-CSF only
Arm Type
Other
Arm Description
Suitable for patients with high risk neuroblastoma who obtain CR after chemotherapy combined with surgery, radiotherapy and/or hematopoietic stem cell transplantation. The treatment cycle is repeated every 4 weeks for a total of 5 courses, and discontinuation of nasetuzumab and GM-CSF should be considered if disease progression or unacceptable toxicity occurs.
Arm Title
naxitamab and GM-CSF in combination with irinotecan and temozolomide
Arm Type
Other
Arm Description
Suitable for high-risk group neuroblastoma treated by chemotherapy combined with surgery, radiotherapy and or hematopoietic stem cell transplantation patients with tumor residual or progression during treatment (refractory); Patients who relapse after initial treatment. Repeat every 3 weeks until tumor progression, patient withdrawal, or toxicity becomes intolerable, up to 8 procedures.
Arm Title
naxitamab and GM-CSF in combination with irinotecan and temozolomide and PD-1 antibody
Arm Type
Other
Arm Description
Suitable for high-risk group neuroblastoma treated by chemotherapy combined with surgery, radiotherapy and or hematopoietic stem cell transplantation patients with tumor residual or progression during treatment (refractory); Patients who relapse after initial treatment. Repeat every 3 weeks until tumor progression, patient withdrawal, or toxicity becomes intolerable, up to 8 procedures.
Intervention Type
Drug
Intervention Name(s)
Naxitamab monotherapy
Other Intervention Name(s)
hu3F8
Intervention Description
Naxitamab is administered on days 1, 3, and 5
Intervention Type
Drug
Intervention Name(s)
GM-CSF
Other Intervention Name(s)
Recombinant Human Granulocyte/Macrophage Colony-stimulating Factor
Intervention Description
Each treatment cycle is 28 days and is started with five days (days -4 to 0) of GM-CSF administered at 250 mcg/m2/day in advance of the start of naxitamab infusion. GM-CSF is thereafter administered at 500 mcg/m2/day on days 1 to 5.
Intervention Type
Drug
Intervention Name(s)
Irinotecan
Other Intervention Name(s)
DNA topoisomerase I inhibitor
Intervention Description
Each HITS treatment cycle is 21 days. Irinotecan intravenously (IV) at 50 mg/m2/day will be administered from Day 1-5 concurrently with temozolomide orally at 150 mg/m2/day or 100 mg/m2/day.
Intervention Type
Drug
Intervention Name(s)
Temozolomide
Other Intervention Name(s)
Temozolomide for Injection
Intervention Description
Each HITS treatment cycle is 21 days. Irinotecan intravenously (IV) at 50 mg/m2/day will be administered from Day 1-5 concurrently with temozolomide orally at 150 mg/m2/day or 100 mg/m2/day.
Intervention Type
Drug
Intervention Name(s)
Naxitamab in combination therapy
Other Intervention Name(s)
hu3F8
Intervention Description
Naxitamab 2.25mg/kg IV will be administered on Days 2, 4, 8 and 10.
Intervention Type
Drug
Intervention Name(s)
GM-CSF with combination regimen
Other Intervention Name(s)
Recombinant Human Granulocyte/Macrophage Colony-stimulating Factor
Intervention Description
GM-CSF 250 mcg/m2/day will be administered subcutaneously on Days 6-10.
Intervention Type
Drug
Intervention Name(s)
Sintilimab
Other Intervention Name(s)
PD-1 antibody
Intervention Description
Sintilimab was administerd with 3mg/kg (max 200mg) on day 11 every 3 weeks.
Primary Outcome Measure Information:
Title
ORR
Description
The proportion of patients who achieved CR or PR
Time Frame
from start of naxitamab treatment to 1.5 years after EOT
Secondary Outcome Measure Information:
Title
DCR
Description
The proportion of patients who achieved CR or PR or SD
Time Frame
from start of naxitamab treatment to 1.5 years after EOT
Title
EFS
Description
The time from from start of naxitamab treatment to disease progression, recurrence
Time Frame
from start of naxitamab treatment to 1.5 years after EOT
Title
OS
Description
The time from from start of naxitamab treatment to death or loss of follow-up
Time Frame
from start of naxitamab treatment to 1.5 years after EOT

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Months
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1)Confirmed diagnosis of high-risk NB 2)1 year of age or above 3)Patient or parent/guardian must provide written informed consent to participate 4)If patient is sexually active, the patient agrees to use effective contraception 5)Confirmed negative urine pregnancy test for sexually active female of child-bearing potential (post-menarche) Exclusion Criteria: Significant organ toxicity Known or suspected allergy or hypersensitivity to anti-GD2 antibodies or to GM-CSF or its s components. Patient is pregnant, planning to become pregnant (while being treated with naxitamab) or is currently breastfeeding Patient will undergo treatment with another investigational drug, whilst being treated with naxitamab or has received another investigational drug within the 4 weeks prior to commencing treatment with naxitamab Patient is either eligible and able to participate in or is currently participating in an active interventional Y-mAbs sponsored clinical trial with naxitamab within the indication applied for Patient is unable to comply with the naxitamab treatment or has a medical condition that would potentially increase the severity of the toxicities experienced from naxitamab treatment at the discretion of the treating physician Left ventricular ejection fraction of <50% by echocardiography OR other clinically relevant cardiac disorders at the discretion of the investigator Inadequate pulmonary function defined as evidence of dyspnea at rest, exercise intolerance, and/or chronic oxygen requirement. In addition, room air pulse oximetry < 94% and/or abnormal pulmonary function tests if these assessments are clinically indicated Applicable for treatment with naxitamab in combination with GM-CSF only: Patient has active progression of the NB disease Patient has active NB disease at primary site or soft-tissue metastasis Patient has known CNS metastases when initiating naxitamab treatment
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yizhuo Zhang, MD
Phone
0087342460
Email
zhangyzh@sysucc.org.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Juan Wang
Phone
008687342660
Email
wangjuan@sysucc.org.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yizhuo Zhang
Organizational Affiliation
SunYat Sen University Cancer Center
Official's Role
Study Chair
Facility Information:
Facility Name
Sun Yat-sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yi-Zhuo Zhang, MD
Phone
87342460
Email
zhangyzh@sysucc.org.cn
First Name & Middle Initial & Last Name & Degree
Yi-Zhuo Zhang, MD

12. IPD Sharing Statement

Learn more about this trial

Clinical Analysis of Naxitamab (hu3F8) in the Treatment of Pediatric High Risk or Refractory/ Relapsed Neuroblastoma

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