Seneca Valley Virus-001 and Cyclophosphamide in Treating Young Patients With Relapsed or Refractory Neuroblastoma, Rhabdomyosarcoma, or Rare Tumors With Neuroendocrine Features

This study is currently recruiting participants.
Verified October 2012 by National Cancer Institute (NCI)
Sponsor:
Collaborator:
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT01048892
First received: January 13, 2010
Last updated: October 11, 2012
Last verified: October 2012
  Purpose

RATIONALE: Seneca Valley virus-001 may be able to kill certain kinds of tumor cells without damaging normal cells. Adding low dose cyclophosphamide (in part B of study) may help to kill even more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of Seneca Valley virus-001 in treating young patients with relapsed or refractory neuroblastoma, rhabdomyosarcoma, or rare tumors with neuroendocrine features.


Condition Intervention Phase
Adrenocortical Carcinoma
Gastrointestinal Carcinoid Tumor
Kidney Cancer
Neuroblastoma
Retinoblastoma
Sarcoma
Biological: Seneca Valley virus-001
Drug: cyclophosphamide
Other: laboratory biomarker analysis
Other: pharmacological study
Phase 1

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase 1 Dose Escalation Study of Seneca Valley Virus (NTX-010), A Replication-Competent Picornavirus, in Relapsed/Refractory Pediatric Patients With Neuroblastoma, Rhabdomyosarcoma, or Rare Tumors With Neuroendocrine Features

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Safety and tolerability [ Designated as safety issue: Yes ]
  • Recommended phase II dose of Seneca Valley virus-001 (NTX-010) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Tumor response [ Designated as safety issue: No ]
  • Viral titers in blood and stool [ Designated as safety issue: No ]
  • Development of antibodies to NTX-010 [ Designated as safety issue: No ]

Estimated Enrollment: 51
Study Start Date: September 2009
Estimated Primary Completion Date: October 2013 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To estimate the maximum-tolerated dose and/or recommended phase II dose of Seneca Valley virus-001 (NTX-010) when administered as a single infusion to pediatric patients with relapsed or refractory neuroblastoma, rhabdomyosarcoma, or rare tumors with neuroendocrine features (Wilms tumor, retinoblastoma, adrenocortical carcinoma, or carcinoid tumors). (Part A [completed])
  • To confirm that there is viral replication in these patients following NTX-010 administration. (Part A [completed])
  • To define and describe the toxicities of NTX-010 when administered on this schedule. (Part A [completed])
  • To determine whether the number of regulatory T cells (as measured by flow cytometry) can effectively be reduced following administration of NTX-010 plus low-dose metronomic and intravenous cyclophosphamide. (Part B)
  • To characterize the pharmacokinetics (time course of viral clearance) following NTX-010 administration in these patients.

Secondary

  • To preliminarily define the antitumor activity of NTX-010 within the confines of a phase I study. (Part A [completed])
  • To evaluate the development of neutralizing antibodies to NTX-010 following IV administration of NTX-010. (Part A [completed])
  • To evaluate development of neutralizing antibodies to NTX-010 following the combination of NTX-010 and cyclophosphamide. (Part B)
  • To investigate the presence and permissivity of occult circulating tumor cells prior to and after the initial intravenous administration of NTX-010.

OUTLINE: This is a multicenter study.

Part A (completed): Patients receive Seneca Valley virus-001 (NTX-010) IV over 1 hour on day 1.

Part B: Patients receive cyclophosphamide IV orally (PO) on days 1-14 and NTX-010 IV over 1 hour on day 8. In the absence of disease progression or unacceptable toxicity, patients then receive cyclophosphamide orally (PO) on days 22-35, plus cyclophosphamide IV over 1 hour and NTX-010 IV over 1 hour on day 29.

Tumor tissue samples are collected at baseline for biomarker studies. Blood and stool samples are collected periodically for neutralizing antibody and viral clearance studies. Additional blood samples may also be collected for the presence and permissivity of occult tumor cells.

After completion of study treatment, patients are followed up periodically for up to 1 year.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed diagnosis of 1 of the following:

    • Neuroblastoma
    • Rhabdomyosarcoma
    • Wilms tumor
    • Retinoblastoma
    • Adrenocortical carcinoma
    • Carcinoid tumor
  • Relapsed or refractory disease
  • Measurable or evaluable disease
  • No known curative therapy or therapy proven to prolong survival with an acceptable quality of life
  • No known pulmonary tumors or metastases > 5 cm, as evaluated by chest CT scan
  • No clinically significant pulmonary and/or pericardial effusions (≥ grade 3), as evaluated by ECHO
  • No primary CNS tumors or known metastatic CNS disease involvement

PATIENT CHARACTERISTICS:

  • Karnofsky performance status (PS) 50-100% (for patients > 16 years of age)
  • Lansky PS 50-100% (for patients ≤ 16 years of age)
  • Peripheral ANC ≥ 1,000/mm^3
  • Platelet count ≥ 100,000/mm^3 (transfusion independent, defined as no platelet transfusions within a 7-day period before study enrollment)
  • Hemoglobin ≥ 8.0 g/dL (RBC transfusions allowed)
  • Creatine clearance or radioisotope GFR ≥ 70 mL/min OR serum creatinine based on age/gender as follows:

    • ≤ 0.8 mg/dL (for patients 3 to 5 years of age)
    • ≤ 1.0 mg/dL (for patients 6 to 9 years of age)
    • ≤ 1.2 mg/dL (for patients 10 to 12 years of age)
    • ≤ 1.4 mg/dL (for female patients ≥ 13 years of age)
    • ≤ 1.5 mg/dL (for male patients 13 to 15 years of age)
    • ≤ 1.7 mg/dL (for male patients ≥ 16 years of age)
  • Bilirubin (sum of conjugated and unconjugated) ≤ 1.5 times upper limit of normal (ULN)
  • SGPT ≤ 110 U/L (for the purpose of this study, the ULN for SGPT is 45 U/L)
  • Serum albumin ≥ 2 g/dL
  • Oxygen saturation > 92% on room air
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able to comply with the safety monitoring requirements of the study, in the opinion of the investigator
  • Completely toilet trained
  • No chronic diarrhea or urinary incontinence during the day or night, , and no in-dwellling urinary catheters
  • No uncontrolled infection
  • No known pregnant member of the household

PRIOR CONCURRENT THERAPY:

  • Fully recovered from the acute toxic effects of all prior anti-cancer chemotherapy
  • At least 6 months since prior total-body irradiation (TBI), craniospinal radiotherapy, or radiotherapy to ≥ 50% of the pelvis
  • At least 3 months since prior stem cell transplantation or rescue (without TBI)

    • No evidence of active graft-vs-host disease
  • At least 6 weeks since other prior substantial bone marrow radiotherapy or treatment with therapeutic doses of MIBG
  • More than 3 weeks since prior myelosuppressive chemotherapy
  • At least 2 weeks since prior local palliative radiotherapy (small port)
  • More than 7 days since prior growth factor(s) that support platelet or white blood cell number or function
  • At least 7 days since prior biologic agents
  • At least 3 half-lives since prior monoclonal antibodies
  • More than 7 days since prior viral immunizations, including influenza
  • At least 42 days since the completion of any type of immunotherapy, e.g., tumor vaccines
  • No other viral immunizations after enrolling on study until 28 days after their last planned Seneca Valley virus-001 infusion or until documented viral clearance, whichever is longest
  • Concurrent corticosteroids allowed provided the patient has been on a stable or decreasing dose for the past 7 days
  • No other concurrent investigational drugs
  • No other concurrent anticancer agents (e.g., chemotherapy, radiotherapy, immunotherapy, or biologic therapy)
  • Prior treatment with Seneca Valley virus-001 is not allowed
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01048892

Locations
United States, Alabama
UAB Comprehensive Cancer Center Recruiting
Birmingham, Alabama, United States, 35294
Contact: Clinical Trials Office - UAB Comprehensive Cancer Center     205-934-0309        
United States, California
Children's Hospital of Orange County Recruiting
Orange, California, United States, 92868
Contact: Violet Shen     714-532-8636        
UCSF Helen Diller Family Comprehensive Cancer Center Recruiting
San Francisco, California, United States, 94115
Contact: Clinical Trials Office - UCSF Helen Diller Family Comprehensi     877-827-3222        
United States, District of Columbia
Children's National Medical Center Recruiting
Washington, District of Columbia, United States, 20010-2970
Contact: Clinical Trials Office - Children's National Medical Center     202-884-2549        
United States, Illinois
Children's Memorial Hospital - Chicago Recruiting
Chicago, Illinois, United States, 60611
Contact: Stewart Goldman     312-227-4844        
United States, Indiana
Riley's Children Cancer Center at Riley Hospital for Children Recruiting
Indianapolis, Indiana, United States, 46202
Contact: James M. Croop     317-944-8784        
United States, Massachusetts
Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute Recruiting
Boston, Massachusetts, United States, 2115
Contact: Carlos Rodriguez-Galindo     617-632-4580        
United States, Michigan
C.S. Mott Children's Hospital at University of Michigan Medical Center Recruiting
Ann Arbor, Michigan, United States, 48109-0286
Contact: Clinical Trials Office - C.S. Mott Children's Hospital     800-865-1125        
United States, Minnesota
Masonic Cancer Center at University of Minnesota Recruiting
Minneapolis, Minnesota, United States, 55455
Contact: Clinical Trials Office - Masonic Cancer Center at University o     612-624-2620        
United States, Missouri
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis Recruiting
St. Louis, Missouri, United States, 63110
Contact: Robert J. Hayashi     314-454-2041        
United States, New York
Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center Recruiting
New York, New York, United States, 10032
Contact: Clinical Trials Office - Herbert Irving Comprehensive Cancer C     212-305-8615        
United States, Ohio
Cincinnati Children's Hospital Medical Center Recruiting
Cincinnati, Ohio, United States, 45229-3039
Contact: Clinical Trials Office - Cincinnati Children's Hospital Medica     513-636-2799        
United States, Pennsylvania
Children's Hospital of Pittsburgh of UPMC Recruiting
Pittsburgh, Pennsylvania, United States, 15213
Contact: Clinical Trials Office - Children's Hospital of Pittsburgh     412-692-7056        
United States, Tennessee
St. Jude Children's Research Hospital Recruiting
Memphis, Tennessee, United States, 38105
Contact: Clinical Trials Office - St. Jude Children's Research Hospital     901-595-4644        
United States, Texas
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas Recruiting
Dallas, Texas, United States, 75390
Contact: Clinical Trials Office - Simmons Comprehensive Cancer Center a     866-460-4673; 214-648-7097        
Baylor University Medical Center - Houston Recruiting
Houston, Texas, United States, 77030-2399
Contact: Patrick A. Thompson     832-824-4029        
United States, Washington
Children's Hospital and Regional Medical Center - Seattle Recruiting
Seattle, Washington, United States, 98105
Contact: Julie R. Park     206-987-2106        
United States, Wisconsin
Midwest Children's Cancer Center at Children's Hospital of Wisconsin Recruiting
Milwaukee, Wisconsin, United States, 53226
Contact: Michael E. Kelly     414-456-4170        
Sponsors and Collaborators
Children's Oncology Group
Investigators
Study Chair: Michael J. Burke, MD Masonic Cancer Center, University of Minnesota
  More Information

Additional Information:
No publications provided

Responsible Party: Susan M. Blaney, Texas Children's Cancer Center and Hematology Service at Texas Children's Hospital
ClinicalTrials.gov Identifier: NCT01048892     History of Changes
Other Study ID Numbers: CDR0000663520, COG-ADVL0911
Study First Received: January 13, 2010
Last Updated: October 11, 2012
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
recurrent neuroblastoma
previously treated childhood rhabdomyosarcoma
recurrent childhood rhabdomyosarcoma
recurrent Wilms tumor and other childhood kidney tumors
recurrent retinoblastoma
recurrent adrenocortical carcinoma
recurrent gastrointestinal carcinoid tumor

Additional relevant MeSH terms:
Carcinoid Tumor
Carcinoma
Carcinoma, Renal Cell
Kidney Neoplasms
Neuroblastoma
Retinoblastoma
Rhabdomyosarcoma
Adrenocortical Carcinoma
Malignant Carcinoid Syndrome
Gastrointestinal Neoplasms
Sarcoma
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Adenocarcinoma
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Kidney Diseases
Urologic Diseases
Neuroectodermal Tumors, Primitive, Peripheral
Neuroectodermal Tumors, Primitive
Neoplasms, Neuroepithelial
Retinal Neoplasms
Eye Neoplasms
Eye Diseases

ClinicalTrials.gov processed this record on May 21, 2013