Phase I Clinical Study of the Safety of Photodynamic Therapy (PDT) Using LS11 in Children With Plexiform Neurofibromas

This study has been terminated.
(The study is terminated due to expiration of study materials.)
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Michael Fisher, Children's Hospital of Philadelphia
ClinicalTrials.gov Identifier:
NCT00716469
First received: July 14, 2008
Last updated: July 6, 2012
Last verified: July 2012
  Purpose

Plexiform neurofibromas (PN) represent one of the most significant complications of NF1. They are a significant cause of morbidity in neurofibromatosis type 1 (NF1) by causing pain, impaired function, and disfigurement. They may become life-threatening through mechanical compression of vital organs such as the trachea, great vessels, or spinal cord, and may significantly interfere with normal function when located in the extremities or orbit. The only effective therapy for PN is total surgical excision. However, due to local infiltration of normal tissue, gross total resection is usually not feasible, and often PN are completely unresectable due to their location, size, and multiplicity. To date, other therapeutic modalities, including radiotherapy and chemotherapy, have not shown efficacy in PN.

In the present study, local photodynamic therapy will be investigated. Photodynamic therapy (PDT) utilizes a drug, called a photosensitizer or photosensitizing agent, and a particular type of light. When photosensitizers are exposed to a specific wavelength of light, they produce a form of oxygen that kills nearby cells. PDT is expected to result in treatment response with shrinkage of tumor. The main purpose of the study is to determine the maximum amount of light that can be safely used with LS11 for PDT in children with plexiform neurofibromas.


Condition Intervention Phase
Neurofibroma
Drug: LS11
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: CHP-856: Phase I Clinical Study of the Safety of Photodynamic Therapy (PDT) Using Intratumoral Delivery of Non-coherent Light for Photoactivation of LS11 in Children With Plexiform Neurofibromas

Resource links provided by NLM:


Further study details as provided by Children's Hospital of Philadelphia:

Primary Outcome Measures:
  • To determine the safety and tolerability of photodynamic therapy (PDT) for the treatment of plexiform neurofibromas in children. [ Time Frame: Week 4 and 12 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To evaluate the change in quality of life of treated patients. [ Time Frame: Week 4 and 12 ] [ Designated as safety issue: Yes ]

Enrollment: 7
Study Start Date: July 2008
Estimated Study Completion Date: July 2012
Estimated Primary Completion Date: July 2012 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: LS11

    LS11 is supplied as 100mg/vial. Two dosages (30 and 40 mg/m2) will be used in this study.

    Escalating doses 50, 100, 150 and 200 J/cm of light will be used.

    Other Name: Talaporfin sodium
  Show Detailed Description

  Eligibility

Ages Eligible for Study:   3 Years to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age: Patients must be ≥ 3 and ≤ 21 years of age.
  • Tumor: Patients must have a debilitating, severely disfiguring, life-threatening, or progressive plexiform neurofibroma (PN), which is not surgically resectable and for which there is no other standard medical management.
  • Measurable Disease: Patients must have a measurable PN assessed by MRI within 2 weeks prior to starting therapy.
  • Tumor Size/Shape/Location:All tumors must:

    1. have a minimum dimension that is ≥ 5 cm in the plane of intended 25mm length Light Source insertion
    2. have a minimum dimension that is ≥ 3.15 cm perpendicular to the plane of intended 25mm length Light Source insertion
    3. be accessible for percutaneous CT (and ultrasound if needed) guided Light Source insertion;
    4. have a shape and location such that the minimum distance between the Light Source and any "critical structure" (defined in section 4.3.4) will be as follows:
  • Minimum radial distance = 2.5 cm
  • Minimum distance from proximal end of Light Source = 2.5 cm
  • Minimum distance from distal end of Light Source = 2 cm
  • For patients with NF1: In addition to PN, all study subjects must have at least one other diagnostic criteria for NF1.
  • Performance Status: Patients should have a life expectancy of at least 6 months and a Karnofsky (≥ 16 years of age) or Lansky (≤16 years of age) Performance Score ≥ 60.
  • Prior/Concurrent Therapy: Patients must have recovered from any specific acute toxicity associated with prior therapy. No concurrent anti-tumor therapy is allowed.
  • Laboratory: Patients must have adequate bone marrow, renal, and hepatic function assessed within 7 days prior to start of therapy.

    1. Hematologic:

      Absolute neutrophil count ≥ 1000/ul Platelet count ≥ 100,000/ul Hemoglobin ≥ 8 g/dL PT/PTT ≤ 1.2 times institutional upper limit of normal

    2. Renal: Serum creatinine within upper limit of institutional norm
    3. Hepatic:

Bilirubin ≤ 1.5 times upper limit of normal for age ALT ≤ 2.5 times institutional upper limit of normal for age Albumin ≥ 2 g/dL

  • Pregnancy: Female patients of childbearing potential must have negative serum or urine pregnancy test. Patient must not be pregnant or breast-feeding. Patients of childbearing or child fathering potential must be willing to use a medically acceptable form of birth control, which includes abstinence, while being treated on this study.
  • Informed Consent: All patients or their legal guardians (if the patient is less than 18 years old) must sign an IRB approved document of informed consent indicating their understanding of the investigational nature and the risks of this study before beginning therapy. When appropriate, pediatric patients will be included in all discussions in order to obtain verbal assent.

Exclusion Criteria:

  • Patients < 3 or > 21 years of age.
  • Tumors that are not debilitating, severely disfiguring, life-threatening, or progressive
  • Patients with baseline pain or neuropathy related to their target lesion that is so severe that it effects activities of daily living (i.e. grade 3 or 4).
  • Tumors that would require Light Source placement such that a "critical structure" is within the minimum distance required between a "critical structure" and Light Source.
  • Tumor that is inaccessible for percutaneous implantation of light source by interventional radiology.
  • Patients with a history of porphyria.
  • Concomitant use of other drugs known to produce skin photosensitivity (e.g. tetracyclines, sulfonamides, phenothiazines, sulfonylureas, thiazide diuretics, and griseofulvin)
  • Patients with any serious medical illnesses that, in the investigator's opinion, would compromise a patient's ability to tolerate this therapy.
  • Patients receiving any other chemotherapeutics or investigational agents.
  • Patients with uncontrolled infections.
  • Patients taking NSAIDs or anti-coagulants.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00716469

Locations
United States, Pennsylvania
The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104
Sponsors and Collaborators
Children's Hospital of Philadelphia
Investigators
Principal Investigator: Michael J Fisher, M.D. Children's Hospital of Philadelphia
  More Information

No publications provided

Responsible Party: Michael Fisher, Assoc. Prof., Children's Hospital of Philadelphia
ClinicalTrials.gov Identifier: NCT00716469     History of Changes
Other Study ID Numbers: CHP-856 PDT, 2006-10-5008
Study First Received: July 14, 2008
Last Updated: July 6, 2012
Health Authority: United States: Food and Drug Administration

Keywords provided by Children's Hospital of Philadelphia:
Neurofibroma
Plexiform
NF1
Photo dynamic therapy

Additional relevant MeSH terms:
Neurofibroma
Neurofibroma, Plexiform
Neoplasms
Neoplasms by Histologic Type
Neoplasms, Nerve Tissue
Nerve Sheath Neoplasms
Nervous System Diseases
Nervous System Neoplasms
Neuromuscular Diseases
Peripheral Nervous System Diseases
Peripheral Nervous System Neoplasms

ClinicalTrials.gov processed this record on October 22, 2014