Radiolabeled Monoclonal Antibody Therapy in Treating Patients With Refractory, Recurrent, or Advanced CNS or Leptomeningeal Cancer
Brain and Central Nervous System Tumors, Neuroblastoma, Sarcoma
About this trial
This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring leptomeningeal metastases, recurrent neuroblastoma, disseminated neuroblastoma, recurrent adult brain tumor, recurrent childhood medulloblastoma, recurrent childhood rhabdomyosarcoma, recurrent childhood soft tissue sarcoma, recurrent osteosarcoma, recurrent Ewing sarcoma/peripheral primitive neuroectodermal tumor, childhood atypical teratoid/rhabdoid tumor, adult medulloblastoma, previously treated childhood rhabdomyosarcoma, metastatic Ewing sarcoma/peripheral primitive neuroectodermal tumor, metastatic osteosarcoma, childhood desmoplastic small round cell tumor, metastatic childhood soft tissue sarcoma, adult rhabdomyosarcoma, recurrent adult soft tissue sarcoma, stage IV adult soft tissue sarcoma
Eligibility Criteria
Subject Inclusion Criteria: Patients must have a histologically confirmed diagnosis of a malignancy known to be 8H9 reactive. 8H9 expression must be confirmed by immunohistochemical staining of tumor and assessed by the Department of Pathology or by immunofluorescence of bone marrow except for patients confirmed to have neuroblastoma. Patients must have CNS/ leptomeningeal disease which is refractory to conventional therapies or for which no conventional therapy exists OR a recurrent brain tumors with a predilection for leptomeningeal dissemination (medulloblastoma, PNET, rhabdoid tumor). Patients must have no rapidly progressing or deteriorating neurologic examination. Patients must have an absolute neutrophil count (ANC) > 1000/ul and a platelet count > 50,000/ul. Patients may have active malignancy outside the central nervous system. Both pediatric and adult patients of any age are eligible. Patients or a legal guardian will sign an informed consent form approved by the IRB and obtained by the Principal or a Co- Investigator before patient entry. Minors will provide assent. Patients with stored stem cells will be treated at the escalating dose while patients with no stem cells will be treated at the 50 mCi dose. Neuroblastoma patients can be treated at the 50 mCi dose with or without stored stem cells. Subject Exclusion Criteria: Patients with obstructive or symptomatic communicating hydrocephalus. Patients with an uncontrolled life-threatening infection. Patients who are pregnant: Pregnant women are excluded for fear of danger to the fetus. Therefore negative pregnancy test is required for all women of child-bearing age, and appropriate contraception is required during the study period. Patients who have received cranial or spinal irradiation less than 3 weeks prior to the start of this protocol. Patients who have received systemic chemotherapy (corticosteroids not included) less than 3 weeks prior to the start of this protocol. Severe major organ toxicity. Specifically, renal, cardiac, hepatic, pulmonary, and gastrointestinal system toxicity should all be less than grade 2. Patients with stable neurological deficits (because of their brain tumor) are not excluded. Patients with <= 3 hearing loss are not excluded.
Sites / Locations
- Memorial Sloan Kettering Cancer Center
Arms of the Study
Arm 1
Experimental
Radiolabeled Monoclonal Antibody Therapy
This is a Phase I trial designed to evaluate the Maximally Tolerated Dose (MTD) of intrathecal 131I-8H9. In order to find the MTD, a dose escalation scheme will be employed with patients entering in cohorts of 3 at each dose level from 10 mCi to 60 mCi and a cohort of 6 at each dose level from 70 mCi to 100 mCi.