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Liposomal Doxorubicin in Treating Children With Refractory Solid Tumors

Primary Purpose

Childhood Soft Tissue Sarcoma, Childhood Liver Cancer, Bone Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
doxorubicin HCl liposome
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Childhood Soft Tissue Sarcoma focused on measuring Ewing's family of tumors, Wilms' tumor, adult solid tumor, body system/site cancer, bone cancer, brain tumor, cancer, central nervous system cancer, childhood brain stem glioma, childhood brain tumor, childhood cancer, childhood central nervous system germ cell tumor, childhood cerebellar astrocytoma, childhood cerebral astrocytoma, childhood choroid plexus tumor, childhood craniopharyngioma, childhood ependymoma, childhood extracranial germ cell tumor, childhood extragonadal malignant germ cell tumor, childhood liver cancer, childhood malignant ovarian germ cell tumor, childhood malignant testicular germ cell tumor, childhood mature and immature teratomas, childhood medulloblastoma, childhood meningioma, childhood oligodendroglioma, childhood rhabdomyosarcoma, childhood soft tissue sarcoma, childhood solid tumor, childhood supratentorial primitive neuroectodermal and pineal tumors, childhood visual pathway and hypothalamic glioma, endocrine cancer, gastrointestinal cancer, genetic condition, kidney tumor, kidney/urinary cancer, liver and intrahepatic biliary tract cancer, muscle cancer, musculoskeletal cancer, neuroblastoma, osteosarcoma, osteosarcoma/malignant fibrous histiocytoma of bone, pediatric germ cell tumor, previously treated childhood rhabdomyosarcoma, recurrent Wilms' tumor, recurrent childhood brain stem glioma, recurrent childhood brain tumor, recurrent childhood cerebellar astrocytoma, recurrent childhood cerebral astrocytoma, recurrent childhood ependymoma, recurrent childhood liver cancer, recurrent childhood malignant germ cell tumor, recurrent childhood medulloblastoma, recurrent childhood rhabdomyosarcoma, recurrent childhood soft tissue sarcoma, recurrent childhood supratentorial primitive neuroectodermal and pineal tumors, recurrent childhood visual pathway and hypothalamic glioma, recurrent neuroblastoma, recurrent osteosarcoma, recurrent tumors of the Ewing's family, solid tumor, stage, Ewing's family of tumors, stage, Wilms' tumor, stage, childhood extracranial germ cell tumor, stage, childhood liver cancer, stage, childhood medulloblastoma, stage, childhood rhabdomyosarcoma, stage, childhood soft tissue sarcoma, stage, neuroblastoma, stage, osteosarcoma, stage/type, childhood brain tumor, unspecified childhood solid tumor, protocol specific

Eligibility Criteria

undefined - 21 Years (Child, Adult)

PROTOCOL ENTRY CRITERIA: --Disease Characteristics-- Histologically confirmed solid tumor, including but not limited to: Rhabdomyosarcoma and other soft tissue sarcomas Ewing's family tumors Osteosarcoma Neuroblastoma Wilms' tumor Hepatic tumors Germ cell tumors Primary brain tumors Histological confirmation for brain stem gliomas may be waived Refractory to standard treatment and no curative therapy available Measurable or evaluable disease Evidence of progressive disease on prior chemotherapy or radiotherapy or persistent disease after prior surgery --Prior/Concurrent Therapy-- Biologic therapy: At least 1 week since prior colony-stimulating factors (e.g., filgrastim (G-CSF), sargramostim (GM-CSF), or epoetin alfa) At least 4 months since prior bone marrow transplantation No concurrent anticancer immunotherapy Chemotherapy: See Disease Characteristics At least 3 weeks since prior chemotherapy (4 weeks for nitrosoureas) and recovered Prior anthracyclines as adjuvant front-line therapy allowed provided: No relapse during therapy At least 6 months since last dose Cumulative dose is no greater than 400 mg/m2 for patients who received bolus administration without a concurrent cardioprotectant (e.g., dexrazoxane) or received cardiac irradiation and no greater than 450 mg/m2 for patients who received either continuous infusion or administration with a concurrent cardioprotectant and have not received cardiac irradiation No other concurrent anticancer chemotherapy Endocrine therapy: Concurrent corticosteroids for brain tumor-associated edema allowed (must be on stable or decreasing dose for at least 1 week prior to study) Radiotherapy: See Disease Characteristics At least 4 weeks since prior radiotherapy and recovered No more than 1,500 cGy of prior cardiac radiotherapy No prior extensive radiotherapy (e.g., craniospinal radiation, total body radiation, or radiation to more than half of the pelvis) No concurrent anticancer radiotherapy Surgery: See Disease Characteristics Other: No other concurrent anticancer investigational agents No other concurrent liposomal formulations of any drug (e.g., liposomal amphotericin B) --Patient Characteristics-- Age: 21 and under Performance status: ECOG 0-2 Life expectancy: At least 2 months Hematopoietic: Absolute granulocyte count greater than 1,500/mm3 Hemoglobin greater than 8 g/dL Platelet count greater than 100,000/mm3 Hepatic: Bilirubin normal SGPT no greater than 2 times upper limit of normal No significant hepatic dysfunction Renal: Creatinine normal OR Creatinine clearance at least 60 mL/min Cardiovascular: Cardiac ejection fraction at least 45% on MUGA (National Cancer Institute patients) OR Shortening fraction at least 28% on echocardiogram (Children's Hospital of Philadelphia patients) No significant or preexisting cardiac dysfunction (e.g., recurrent or persistent cardiac dysrhythmia or an ejection fraction below the lower limit of normal on MUGA or echocardiogram) Pulmonary: No significant pulmonary dysfunction Other: Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No clinically significant unrelated systemic illness (e.g., serious infections or organ dysfunction) No allergy to doxorubicin or other anthracyclines, eggs, egg products, or other liposomal drug formulations

Sites / Locations

  • Pediatric Oncology Branch
  • Children's Hospital of Philadelphia

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
March 1, 2007
Last Updated
April 27, 2015
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00019630
Brief Title
Liposomal Doxorubicin in Treating Children With Refractory Solid Tumors
Official Title
Phase I Study of Doxorubicin HCl Liposome in Pediatric Patients With Refractory Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
June 2002
Overall Recruitment Status
Completed
Study Start Date
July 1999 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase I trial to study the effectiveness of liposomal doxorubicin in treating children who have refractory solid tumors.
Detailed Description
OBJECTIVES: I. Determine the tolerance to and toxicity profile of doxorubicin HCl liposome (Lipodox) at standard doxorubicin doses and doses of Lipodox that were tolerable in adults administered every 3 weeks in pediatric patients with refractory solid tumors. II. Determine the maximum tolerated dose of this drug in these patients if dose-limiting toxicity is observed at doses of 105 mg/m2 or less. III. Determine the pharmacokinetics of this drug in these patients. IV. Assess the cardiotoxicity of this drug in children who have previously been treated with free doxorubicin and in children who have not previously received doxorubicin. V. Evaluate the feasibility of using cardiac MRI functional imaging as a screening tool for the quantitative assessment of doxorubicin-induced cardiotoxicity. VI. Determine if serum troponin t levels are a useful biomarker for doxorubicin-induced myocardial damage. PROTOCOL OUTLINE: This is a dose-escalation, multicenter study. Patients receive doxorubicin HCl liposome IV over 60 minutes. Treatment repeats every 4 weeks for a maximum of 10 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 4-6 patients receive escalating doses of doxorubicin HCl liposome until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 4 or 2 of 6 patients experience dose-limiting toxicity. Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter. PROJECTED ACCRUAL: A total of 21-36 patients will be accrued for this study within 1-2 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Childhood Soft Tissue Sarcoma, Childhood Liver Cancer, Bone Cancer, Brain Tumor, Kidney Tumor
Keywords
Ewing's family of tumors, Wilms' tumor, adult solid tumor, body system/site cancer, bone cancer, brain tumor, cancer, central nervous system cancer, childhood brain stem glioma, childhood brain tumor, childhood cancer, childhood central nervous system germ cell tumor, childhood cerebellar astrocytoma, childhood cerebral astrocytoma, childhood choroid plexus tumor, childhood craniopharyngioma, childhood ependymoma, childhood extracranial germ cell tumor, childhood extragonadal malignant germ cell tumor, childhood liver cancer, childhood malignant ovarian germ cell tumor, childhood malignant testicular germ cell tumor, childhood mature and immature teratomas, childhood medulloblastoma, childhood meningioma, childhood oligodendroglioma, childhood rhabdomyosarcoma, childhood soft tissue sarcoma, childhood solid tumor, childhood supratentorial primitive neuroectodermal and pineal tumors, childhood visual pathway and hypothalamic glioma, endocrine cancer, gastrointestinal cancer, genetic condition, kidney tumor, kidney/urinary cancer, liver and intrahepatic biliary tract cancer, muscle cancer, musculoskeletal cancer, neuroblastoma, osteosarcoma, osteosarcoma/malignant fibrous histiocytoma of bone, pediatric germ cell tumor, previously treated childhood rhabdomyosarcoma, recurrent Wilms' tumor, recurrent childhood brain stem glioma, recurrent childhood brain tumor, recurrent childhood cerebellar astrocytoma, recurrent childhood cerebral astrocytoma, recurrent childhood ependymoma, recurrent childhood liver cancer, recurrent childhood malignant germ cell tumor, recurrent childhood medulloblastoma, recurrent childhood rhabdomyosarcoma, recurrent childhood soft tissue sarcoma, recurrent childhood supratentorial primitive neuroectodermal and pineal tumors, recurrent childhood visual pathway and hypothalamic glioma, recurrent neuroblastoma, recurrent osteosarcoma, recurrent tumors of the Ewing's family, solid tumor, stage, Ewing's family of tumors, stage, Wilms' tumor, stage, childhood extracranial germ cell tumor, stage, childhood liver cancer, stage, childhood medulloblastoma, stage, childhood rhabdomyosarcoma, stage, childhood soft tissue sarcoma, stage, neuroblastoma, stage, osteosarcoma, stage/type, childhood brain tumor, unspecified childhood solid tumor, protocol specific

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
doxorubicin HCl liposome

10. Eligibility

Maximum Age & Unit of Time
21 Years
Eligibility Criteria
PROTOCOL ENTRY CRITERIA: --Disease Characteristics-- Histologically confirmed solid tumor, including but not limited to: Rhabdomyosarcoma and other soft tissue sarcomas Ewing's family tumors Osteosarcoma Neuroblastoma Wilms' tumor Hepatic tumors Germ cell tumors Primary brain tumors Histological confirmation for brain stem gliomas may be waived Refractory to standard treatment and no curative therapy available Measurable or evaluable disease Evidence of progressive disease on prior chemotherapy or radiotherapy or persistent disease after prior surgery --Prior/Concurrent Therapy-- Biologic therapy: At least 1 week since prior colony-stimulating factors (e.g., filgrastim (G-CSF), sargramostim (GM-CSF), or epoetin alfa) At least 4 months since prior bone marrow transplantation No concurrent anticancer immunotherapy Chemotherapy: See Disease Characteristics At least 3 weeks since prior chemotherapy (4 weeks for nitrosoureas) and recovered Prior anthracyclines as adjuvant front-line therapy allowed provided: No relapse during therapy At least 6 months since last dose Cumulative dose is no greater than 400 mg/m2 for patients who received bolus administration without a concurrent cardioprotectant (e.g., dexrazoxane) or received cardiac irradiation and no greater than 450 mg/m2 for patients who received either continuous infusion or administration with a concurrent cardioprotectant and have not received cardiac irradiation No other concurrent anticancer chemotherapy Endocrine therapy: Concurrent corticosteroids for brain tumor-associated edema allowed (must be on stable or decreasing dose for at least 1 week prior to study) Radiotherapy: See Disease Characteristics At least 4 weeks since prior radiotherapy and recovered No more than 1,500 cGy of prior cardiac radiotherapy No prior extensive radiotherapy (e.g., craniospinal radiation, total body radiation, or radiation to more than half of the pelvis) No concurrent anticancer radiotherapy Surgery: See Disease Characteristics Other: No other concurrent anticancer investigational agents No other concurrent liposomal formulations of any drug (e.g., liposomal amphotericin B) --Patient Characteristics-- Age: 21 and under Performance status: ECOG 0-2 Life expectancy: At least 2 months Hematopoietic: Absolute granulocyte count greater than 1,500/mm3 Hemoglobin greater than 8 g/dL Platelet count greater than 100,000/mm3 Hepatic: Bilirubin normal SGPT no greater than 2 times upper limit of normal No significant hepatic dysfunction Renal: Creatinine normal OR Creatinine clearance at least 60 mL/min Cardiovascular: Cardiac ejection fraction at least 45% on MUGA (National Cancer Institute patients) OR Shortening fraction at least 28% on echocardiogram (Children's Hospital of Philadelphia patients) No significant or preexisting cardiac dysfunction (e.g., recurrent or persistent cardiac dysrhythmia or an ejection fraction below the lower limit of normal on MUGA or echocardiogram) Pulmonary: No significant pulmonary dysfunction Other: Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No clinically significant unrelated systemic illness (e.g., serious infections or organ dysfunction) No allergy to doxorubicin or other anthracyclines, eggs, egg products, or other liposomal drug formulations
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elizabeth Lowe
Organizational Affiliation
National Cancer Institute (NCI)
Official's Role
Study Chair
Facility Information:
Facility Name
Pediatric Oncology Branch
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States
Facility Name
Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

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Liposomal Doxorubicin in Treating Children With Refractory Solid Tumors

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