Biological Therapy in Treating Patients With Neuroblastoma That Has Not Responded to Previous Treatment
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Purpose
RATIONALE: Monoclonal antibodies, such as monoclonal antibody 3F8, can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Beta-glucan, isotretinoin, and sargramostim may increase the effectiveness of monoclonal antibody 3F8 by making tumor cells more sensitive to the monoclonal antibody. Combining different types of biological therapy may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving beta-glucan, isotretinoin, and sargramostim together with monoclonal antibody 3F8 works in treating patients with neuroblastoma that has not responded to previous treatment.
| Condition | Intervention | Phase |
|---|---|---|
|
Neuroblastoma |
Biological: beta-glucan Biological: monoclonal antibody 3F8 Biological: sargramostim Drug: isotretinoin |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase II Study of Anti-GD2 3F8 Antibody and Biologic Response Modifiers for High-risk Neuroblastoma |
- Disease response as assessed by PT-PC at the end of 4 courses [ Designated as safety issue: No ]
| Estimated Enrollment: | 74 |
| Study Start Date: | July 2004 |
| Primary Completion Date: | November 2006 (Final data collection date for primary outcome measure) |
OBJECTIVES:
- Determine the efficacy of beta-glucan, isotretinoin, and sargramostim (GM-CSF) in enhancing monoclonal antibody 3F8-mediated ablation in patients with high-risk refractory neuroblastoma.
- Determine the antitumor activity of this regimen, in terms of assessing disease status in the bone marrow by real-time quantitative reverse transcription polymerase chain reaction, in these patients.
- Determine the toxicity of this regimen in these patients.
OUTLINE: This is an open-label study. Patients are stratified according to refractory disease (primary refractory [never had disease progression or disease recurrence] vs secondary refractory [recurrent disease that did not respond completely to reinduction therapy]).
- Courses 1 and 2: Patients receive sargramostim (GM-CSF) subcutaneously once daily on days -5 to 11. Patients also receive oral beta-glucan once daily on days -2 to 11 and monoclonal antibody (MOAB) 3F8 IV over 30-90 minutes on days 0-4 and 7-11.
- Courses 3 and 4: Patients receive GM-CSF, beta-glucan, and MOAB 3F8 as above. Patients also receive oral isotretinoin twice daily on days -2 to 11.
Treatment repeats every 2-4 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.
Patients are followed every 3 months for 2 years.
PROJECTED ACCRUAL: A total of 27-74 patients (10-33 for stratum 1 and 17-41 for stratum 2) will be accrued for this study.
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Diagnosis of neuroblastoma, as defined by 1 of the following:
- Histologically confirmed disease
- Bone marrow metastases plus high urine catecholamines
High-risk disease meeting 1 of the following stage criteria:
Stage IV, with 1 of the following:
- Any age with MYCN amplification
- > 18 months of age without MYCN amplification
Stage III, with both of the following:
- Any age with MYCN amplification
- Unresectable disease
- Stage 4S with MYCN amplification
- Measurable or evaluable soft tissue disease
- Relapsed disease resistant to standard induction chemotherapy and salvage therapy
PATIENT CHARACTERISTICS:
Age
- Any age
Performance status
- Not specified
Life expectancy
- Not specified
Hematopoietic
- Not specified
Hepatic
- No severe hepatic toxicity ≥ grade 3
Renal
- No severe renal toxicity ≥ grade 3
Cardiovascular
- No severe cardiac toxicity ≥ grade 3
Pulmonary
- No severe pulmonary toxicity ≥ grade 3
Other
- Not pregnant
- Negative pregnancy test
- No severe neurologic toxicity ≥ grade 3
- No severe gastrointestinal toxicity ≥ grade 3
- No other severe major organ dysfunction except ototoxicity
- No history of allergy to mouse proteins
- No active life-threatening infection
- No human anti-mouse antibody titer > 1,000 ELISA units/mL
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- See Disease Characteristics
Endocrine therapy
- Not specified
Radiotherapy
- Not specified
Surgery
- Not specified
Contacts and Locations| United States, New York | |
| Memorial Sloan-Kettering Cancer Center | |
| New York, New York, United States, 10021 | |
| Study Chair: | Nai-Kong V. Cheung, MD, PhD | Memorial Sloan-Kettering Cancer Center |
More Information
Additional Information:
No publications provided
| ClinicalTrials.gov Identifier: | NCT00089258 History of Changes |
| Other Study ID Numbers: | 04-050, MSKCC-04050 |
| Study First Received: | August 4, 2004 |
| Last Updated: | January 15, 2013 |
| Health Authority: | United States: Federal Government |
Keywords provided by Memorial Sloan-Kettering Cancer Center:
|
localized unresectable neuroblastoma disseminated neuroblastoma regional neuroblastoma stage 4S neuroblastoma recurrent neuroblastoma |
Additional relevant MeSH terms:
|
Neuroblastoma Neuroectodermal Tumors, Primitive, Peripheral Neuroectodermal Tumors, Primitive Neoplasms, Neuroepithelial Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms Neoplasms, Glandular and Epithelial |
Neoplasms, Nerve Tissue Antibodies Antibodies, Monoclonal Isotretinoin Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Dermatologic Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 23, 2013