Anti-Angiogenic Therapy Post Transplant (ASCR) for Pediatric Solid Tumors
Last updated on April 2022Recruitment
- Recruitment Status
- Recruiting
- Estimated Enrollment
- 18
Inclusion Criteria
- Total bilirubin ≤ 1.5x upper limit of normal (ULN) for age and
- No evidence of dyspnea at rest.
- Peripheral absolute neutrophil count (ANC) ≥ 750/mm3
- ...
- Total bilirubin ≤ 1.5x upper limit of normal (ULN) for age and
- No evidence of dyspnea at rest.
- Peripheral absolute neutrophil count (ANC) ≥ 750/mm3
- Ejection fraction of ≥ 50% by radionuclide angiogram
- Patient must have a life expectancy > 3 months.
- Pregnancy surveillance:
- Hemoglobin ≥ 8.0 g/dl and
- Patient must have an adequate supply of stem cells for transplant harvested prior to study enrollment, with adequate supply defined as 3 x 10^6 CD34+ cells/kg for peripheral blood stem cells (PBSC). Cell mobilization method will be left up to the treating physician's discretion and may include mobilization growth factor alone or mobilization after chemotherapy. If patient is unable to mobilize the proper amount of peripheral stem cells, bone marrow may be harvested as the source of hematopoietic stem cells. In this instance, 3 x 10^8 mononuclear cells/kg will be considered adequate. If necessary, a combination of peripheral stem cells and bone marrow can be used.
- Shortening fraction of ≥ 27% by echocardiogram or
- Glomerular filtration rate (GFR), calculated via I-125 iothalamate clearance, 24-hour creatinine clearance, or Schwartz formula*, ≥ 70 mL/min and ≥ 50 mL/min/1.73 m2 done within 4 weeks of study entry
- Prior radiation therapy and/or chemotherapy, including cyclophosphamide, are permitted.
- Patient must be ≥ 6 months of age and ≤ 21 years of age at the time of study entry.
- Prior anti-angiogenic therapy, including thalidomide and oral cyclophosphamide, is permitted.
- SGOT (AST) or SGPT (ALT) ≤ 2.5 x ULN (SGOT ≤ 4x ULN if on Zantac)
- Pulse oximetry > 94% on room air or O2 by nasal cannula and
- Serum creatinine < 1.5 mg/dl
- Patient (or legally authorized representative) must be able to understand and willing to sign a written informed consent document.
- The Schwartz formula is an estimated glomerular filtration rate in children based upon serum creatinine and height. Height (Ht) should be measured in cm and serum creatinine (Cr) in mg/dL. Proportionality constant (k) is 0.55 for children and adolescent girls and 0.7 for adolescent boys aged 13-21. This constant is based upon a series of evaluations performed by Schwartz. Formula: GFR= (k x Ht)/Cr
- If on corticosteroids for mass effect and/or edema related to the tumor, patient must be on a stable or decreasing dose for at least 2 weeks prior to study entry.
- If enrolled in Arm III of this study, patient must be registered at the Celgene THALOMID REMSTM Program prior to day +30 post-ASCR.
Exclusion Criteria
- Patient must not be receiving any other investigational agents.
- Patient must not have any active, uncontrolled cardiac, hepatic, renal, or psychiatric disease defined as ≥ grade 3 based on NCI Common Terminology Criteria for Adverse Events v4.0 (CTCAE).
- Patient must not have any active infection or concurrent illness obscuring toxicity or dangerously altering drug metabolism.
- ...
- Patient must not be receiving any other investigational agents.
- Patient must not have any active, uncontrolled cardiac, hepatic, renal, or psychiatric disease defined as ≥ grade 3 based on NCI Common Terminology Criteria for Adverse Events v4.0 (CTCAE).
- Patient must not have any active infection or concurrent illness obscuring toxicity or dangerously altering drug metabolism.
- Patient must not be pregnant or breastfeeding.
- Patient must not have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to any of the agents used in the study.
- Patient must not have any thromboembolic event (deep vein thrombosis or pulmonary embolism) less than 3 weeks prior to enrollment.
Summary
- Conditions
- Glioma
- Neuroectodermal Tumors, Primitive
- Osteosarcoma
- Retinoblastoma
- Rhabdomyosarcoma
- Sarcoma, Ewing
- Wilm's Tumor
- Wilms Tumor
- Type
- Interventional
- Phase
- Phase 1
- Design
- Allocation: Non-Randomized
- Intervention Model: Sequential Assignment
- Masking: None (Open Label)
- Primary Purpose: Treatment
Participation Requirements
- Age
- Younger than 621 years
- Gender
- Both males and females
Inclusion Criteria
- Total bilirubin ≤ 1.5x upper limit of normal (ULN) for age and
- No evidence of dyspnea at rest.
- Peripheral absolute neutrophil count (ANC) ≥ 750/mm3
- ...
- Total bilirubin ≤ 1.5x upper limit of normal (ULN) for age and
- No evidence of dyspnea at rest.
- Peripheral absolute neutrophil count (ANC) ≥ 750/mm3
- Ejection fraction of ≥ 50% by radionuclide angiogram
- Patient must have a life expectancy > 3 months.
- Pregnancy surveillance:
- Hemoglobin ≥ 8.0 g/dl and
- Patient must have an adequate supply of stem cells for transplant harvested prior to study enrollment, with adequate supply defined as 3 x 10^6 CD34+ cells/kg for peripheral blood stem cells (PBSC). Cell mobilization method will be left up to the treating physician's discretion and may include mobilization growth factor alone or mobilization after chemotherapy. If patient is unable to mobilize the proper amount of peripheral stem cells, bone marrow may be harvested as the source of hematopoietic stem cells. In this instance, 3 x 10^8 mononuclear cells/kg will be considered adequate. If necessary, a combination of peripheral stem cells and bone marrow can be used.
- Shortening fraction of ≥ 27% by echocardiogram or
- Glomerular filtration rate (GFR), calculated via I-125 iothalamate clearance, 24-hour creatinine clearance, or Schwartz formula*, ≥ 70 mL/min and ≥ 50 mL/min/1.73 m2 done within 4 weeks of study entry
- Prior radiation therapy and/or chemotherapy, including cyclophosphamide, are permitted.
- Patient must be ≥ 6 months of age and ≤ 21 years of age at the time of study entry.
- Prior anti-angiogenic therapy, including thalidomide and oral cyclophosphamide, is permitted.
- SGOT (AST) or SGPT (ALT) ≤ 2.5 x ULN (SGOT ≤ 4x ULN if on Zantac)
- Pulse oximetry > 94% on room air or O2 by nasal cannula and
- Serum creatinine < 1.5 mg/dl
- Patient (or legally authorized representative) must be able to understand and willing to sign a written informed consent document.
- The Schwartz formula is an estimated glomerular filtration rate in children based upon serum creatinine and height. Height (Ht) should be measured in cm and serum creatinine (Cr) in mg/dL. Proportionality constant (k) is 0.55 for children and adolescent girls and 0.7 for adolescent boys aged 13-21. This constant is based upon a series of evaluations performed by Schwartz. Formula: GFR= (k x Ht)/Cr
- If on corticosteroids for mass effect and/or edema related to the tumor, patient must be on a stable or decreasing dose for at least 2 weeks prior to study entry.
- If enrolled in Arm III of this study, patient must be registered at the Celgene THALOMID REMSTM Program prior to day +30 post-ASCR.
Exclusion Criteria
- Patient must not be receiving any other investigational agents.
- Patient must not have any active, uncontrolled cardiac, hepatic, renal, or psychiatric disease defined as ≥ grade 3 based on NCI Common Terminology Criteria for Adverse Events v4.0 (CTCAE).
- Patient must not have any active infection or concurrent illness obscuring toxicity or dangerously altering drug metabolism.
- ...
- Patient must not be receiving any other investigational agents.
- Patient must not have any active, uncontrolled cardiac, hepatic, renal, or psychiatric disease defined as ≥ grade 3 based on NCI Common Terminology Criteria for Adverse Events v4.0 (CTCAE).
- Patient must not have any active infection or concurrent illness obscuring toxicity or dangerously altering drug metabolism.
- Patient must not be pregnant or breastfeeding.
- Patient must not have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to any of the agents used in the study.
- Patient must not have any thromboembolic event (deep vein thrombosis or pulmonary embolism) less than 3 weeks prior to enrollment.
Tracking Information
- NCT #
- NCT01661400
- Collaborators
- Not Provided
- Investigators
- Principal Investigator: Andrew Cluster, M.D. Washington University School of Medicine
- Andrew Cluster, M.D. Washington University School of Medicine