Temozolomide,Thiotepa and Carboplatin With Autologous Stem Cell Rescue Followed by 13-cis-retinoic Acid in Patients With Recurrent/Refractory Malignant Brain Tumors
Information source: New York University School of Medicine
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Brain Tumors
Intervention: temozolomide, thiotepa, carboplatin, 13-cis-retinoic acid (Drug)
Phase: Phase 2
Status: Active, not recruiting
Sponsored by: New York University School of Medicine Official(s) and/or principal investigator(s):
Sharon L Gardner, M.D., Principal Investigator, Affiliation: New York University School of Medicine
Summary
The purpose of this study is to:
Find out how safe and effective (by monitoring the good and/or bad effects) treatment with
high dose temozolomide, thiotepa and carboplatin with stem cell rescue followed by
13-cis-retinoic acid has on children and adolescents with recurrent/refractory brain tumors
Find out how the body uses 13-cis-retinoic acid by studying the your blood levels and
proteins in the blood that break down the 13-cis-retinoic acid
Determine how well 13-cis-retinoic acid penetrates into the spinal fluid.
Clinical Details
Official title: NYU 05-40 PBMTC ONC-032P:High Dose Temozolomide,Thiotepa and Carboplatin With Autologous Stem Cell Rescue (ASCR) Followed by Continuation Therapy With 13-cis-retinoic Acid in Patients With Recurrent/Refractory Malignant Brain Tumors
Study design: Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Primary outcome: • To assess the event-free survival and overall survival of patients with recurrent or refractory medulloblastoma/ primitive neuroectodermal tumors
Secondary outcome: To evaluate the toxicity of of 13-cis-retinoic acid following high dose temozolomide, thiotepa and carboplatin with ASCR.
Detailed description:
Researchers have used high doses of combination chemotherapy followed by a stem cell rescue
to treat recurrent brain tumors with moderate success. High dose chemotherapy with stem cell
rescue has resulted in long term survival of about 25% in patients with several different
types of recurrent brain tumors. Stem cells are cells in the bone marrow that produce blood
cells. The stem cells are collected from the blood of the patient before the high dose
chemotherapy. Patients are given high doses of chemotherapy to kill every brain tumor cell,
but in the process the cells of the bone marrow are also killed. The previously collected
stem cells are then infused into the patient to rescue the bone marrow and allow for healthy
blood cells to re-populate and grow in the bone marrow. Initial studies used the drug
etoposide along with carboplatin and thiotepa for the high dose chemotherapy. Patients had
severe side effects, especially severe mouth-sores, thought mainly due to the etoposide, and
some patients died from these side effects.
Recent studies have shown that a new drug, temozolomide, is active against some types of
brain tumors. When it was given as a single drug to children with solid tumors, the side
effects were considered to be tolerable. Temozolomide is given by mouth. In this study,
researchers want to give high dose chemotherapy that includes the drugs temozolomide in
place of etoposide, along with thiotepa and carboplatin. Patients will then be given their
own stem cells back to rescue the bone marrow from the chemotherapy. A preliminary trial
using this new drug combination was performed and has shown that patients tolerate this drug
combination, even at the very high doses that will be used in this protocol.
Another drug that is being used in pediatric cancer treatment is called 13-cis-retinoic
acid. This drug is closely related to vitamin A. It is taken by mouth. Cancer cells are
immature cells that have not "grown up" into adult cells that do work in the body.
13-cis-retinoic acid is thought to act on some types of cancer cells to make them mature
into cells that function in the body. It has also been shown in the laboratory to cause some
brain tumor cells to undergo apoptosis. It has been used in other types of pediatric cancers
and research is just beginning to use it for treatment of recurrent brain tumors. In this
study researchers want to give you 13-cis-retinoic acid for 6 months after you recover from
the high dose chemotherapy with stem cell rescue.
Eligibility
Minimum age: 6 Months.
Maximum age: 21 Years.
Gender(s): Both.
Criteria:
Inclusion Criteria:
1. Patients with recurrent or refractory medulloblastoma/PNET, CNS germ cell tumors,
ependymomas, AT/RT, high grade glioma and other malignant brain tumors. Brainstem
gliomas are eligible if residual disease is < 1. 5cc and if the patient is off
decadron.
2. Patients must have recurrent or refractory disease following at least one prior
course of therapy and must have minimal residual disease defined as < 1. 5 cm2 of
enhancement. Patients with + CSF cytology, linear or fine nodular leptomeningeal
disease are eligible.
3. Adequate hematologic, renal, liver, and cardiac function as demonstrated by
laboratory values performed within 21 days, inclusive, prior to administration of
temozolomide.
4. Patients must have an adequate number of autologous stem cells available defined as a
minimum of 2 x 106 CD 34+ cells/kg and preferably at least 5 x 106 CD 34+ cells/kg.
Exclusion Criteria:
1. Previous myeloablative therapy
2. Frequent vomiting or medical condition that could interfere with oral medication
intake (e. g., partial bowel obstruction)
3. Previous or concurrent malignancies at other sites with the exception of surgically
cured carcinoma in-situ of the cervix and basal or squamous cell carcinoma of the
skin. Patients with prior malignancies which have not required anti-tumor treatment
within the preceding 24 months are eligible.
Locations and Contacts
Phoenix Children's Hospital, Pheonix, Arizona 85016, United States
Emory University, Altanta, Georgia 30322, United States
Hawaii Pacific Health, Lihue, Hawaii 96766, United States
Children's Memorial Hospital, Chicago, Illinois 60614, United States
Riley Hospital for Children, Indianapolis, Indiana 46202, United States
Children's Hospital and Clinics of Minnesota, Minneapolis, Minnesota 55404, United States
Roswell Park Cancer Institute, Buffalo, New York 14263, United States
Steven and Alexandra Cohen Children's Medical Center of New York- North Shore LIJ, New Hyde Park, New York 11040, United States
NYU Hassenfeld Center, New York, New York 10016, United States
Nationwide Children's Hospital, Columbus, Ohio 43205, United States
Princess Margaret Hospital, Toronto, Ontario M5G 2M9, Canada
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, United States
Medical Univ. of South Carolina, Charleston, South Carolina 29425, United States
Vanderbilt Univ., Nashville, Tennessee 37240, United States
Children's Medical Center of Dallas, Dallas, Texas 75235, United States
MD Anderson Cancer Center (MDACC), Houston, Texas 77030, United States
Virginia Commonwealth Univ., Richmond, Virginia 23284, United States
Additional Information
Starting date: October 2005
Last updated: May 27, 2014
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