A Pilot Study on ALK Gene Mutations in Neuroblastoma

This study is currently recruiting participants. (see Contacts and Locations)
Verified November 2013 by National Taiwan University Hospital
Sponsor:
Information provided by (Responsible Party):
National Taiwan University Hospital
ClinicalTrials.gov Identifier:
NCT01986595
First received: November 4, 2013
Last updated: November 11, 2013
Last verified: November 2013
  Purpose

Neuroblastoma (NB) originates from the sympathetic nervous system and is one of the most common cancers in infants and children. In our hospital, nearly 70% of patients are diagnosed with stage 4, metastatic disease with a poor prognosis, despite the use of multimodal therapy including chemotherapy, surgery, autologous stem cell transplantation, radiation therapy, and differentiation therapy. To improve the survival rate and patient care, our NB Study Group has devoted to the research on NB-specific molecular imaging, biomarkers, and target therapy. We have confirmed studies in cancer genetics by showing that N-myc gene (MYCN) amplification and segmental abnormalities on overall genomic profiling both have an adverse effect on treatment outcome. Therefore, there is an unmet need for the development of novel molecular target therapy in NB. Recently, the anaplastic lymphoma kinase (ALK) oncogene has been found to play an important role in the pathogenesis of NB, as well as serving as the driver mutations in approximately 10% of high-risk NB. The availability of ALK inhibitors also enables ALK as a treatment target in NB. In this proposal, we plan to utilize gene sequencing, array-comparative hybridization, and multiplex ligation-dependent probe amplification methods to evaluate the frequencies and characteristics of ALK mutations and amplifications in patients with NB. The gene and protein expression of ALK will also be evaluated by quantitative polymerase chain reaction(PCR) and immunohistochemistry, respectively, and compared with ALK genotype. The overall genomic pattern, clinical characteristics, histopathology, and treatment outcome of ALK-mutated NB patients will be analyzed. The results from this study may serve as the first report on ALK mutations of NB in Taiwan and will be used for the development of standardized genetic diagnosis protocols, as well as the design of future clinical trials targeting ALK.


Condition
Neuroblastoma

Study Type: Observational [Patient Registry]
Study Design: Time Perspective: Cross-Sectional
Target Follow-Up Duration: 5 Years
Official Title: A Pilot Study on ALK Gene Mutations in Neuroblastoma

Resource links provided by NLM:


Further study details as provided by National Taiwan University Hospital:

Primary Outcome Measures:
  • ALK gene mutations of NB in Taiwan [ Time Frame: Baseline ] [ Designated as safety issue: No ]
    We anticipate that 5-15% of NB tumors carry with common ALK mutations. Genome-wide CNAs profiling by aCGH can help us to categorize the genomic types of NB patients based on published guidelines, while the presence of ALK mutation or amplification may or may not be associated with subtypes with worse outcome. Some patients may have high ALK expression level without bearing common mutations on ALK gene locus, and we may identify novel mutation points in this patient cohort. Finally, we will probably find significant prognostic value of ALK gene mutation, which may be independent from other known risk factors, such as age, stage, MYCN amplification, and genomic pattern.


Biospecimen Retention:   Samples With DNA

Biopsy tumor tissue(mail tumor or bone marrow) or Blood


Estimated Enrollment: 100
Study Start Date: August 2013
Estimated Study Completion Date: July 2014
Estimated Primary Completion Date: July 2014 (Final data collection date for primary outcome measure)
Detailed Description:
  • purpose Despite the advance of modern multimodal therapy including surgery, chemotherapy, autologous stem cell transplantation, radiation therapy, and differentiation therapy, most children with NB are diagnosed with metastatic diseases and suffer from a dismal outcome. There is an unmet need for the development of novel target therapy in NB. Among all recently identified targets, ALK gene mutations have been found in approximately 10% of high-risk NB patients and are the treatment target of several promising agents that have already been tested in clinical trials, including crizotinib, which is to be available in Taiwan soon. This study aims to evaluate the prevalence of mutations and copy number aberrations of the ALK oncogene in prospective and previously treated NB patients' tumor sample (from surgical specimens) and germ-line (peripheral blood lymphocytes). The messenger ribonucleic acid(mRNA) and protein expression levels of ALK will also be analyzed. The results will be correlated with the clinical characteristics and pathological findings of this NB cohort.
  • technique Prospective cases: Cryopreservation of tumor samples Retrospective cases: Archived tumor Sequencing: point mutation array-based comparative genomic hybridization(aCGH) & MLPA(multiplex ligation-dependent probe amplification):analyze copy number alterations (CNAs) compare to clinical data
  • expected results The results from this study may serve as the first report on ALK gene mutations of NB in Taiwan. We anticipate that 5-15% of NB tumors carry with common ALK mutations. Genome-wide CNAs profiling by aCGH can help us to categorize the genomic types of NB patients based on published guidelines, while the presence of ALK mutation or amplification may or may not be associated with subtypes with worse outcome. Some patients may have high ALK expression level without bearing common mutations on ALK gene locus, and we may identify novel mutation points in this patient cohort. Finally, we will probably find significant prognostic value of ALK gene mutation, which may be independent from other known risk factors, such as age, stage, MYCN amplification, and genomic pattern.

Based on these results, we are able to develop standardized protocol for diagnosing ALK mutations for Taiwanese NB patients. With the development of ALK genetic testing, a phase II clinical trial of an ALK inhibitor in high-risk NB patients with relapsed or refractory disease may subsequently be conducted and may improve the treatment outcome of the patients.

  Eligibility

Ages Eligible for Study:   up to 50 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population

Neuroblastoma (NB) originates from the sympathetic nervous system and is one of the most common cancers in infants and children. In our hospital, nearly 70% of patients are diagnosed with stage 4, metastatic disease with a poor prognosis, despite the use of multimodal therapy including chemotherapy, surgery, autologous stem cell transplantation, radiation therapy, and differentiation therapy.

Criteria

Inclusion Criteria:

  1. Diagnosed by clinical criteria(one of below)

    Proved or maybe as Neuroblastoma by :

    1. pathological section
    2. Bone meta with 24 hrs urine Vanillylmandelic acid(VMA)or Homovanillic acid(HVA) elevated
    3. CT or MRI found tumor around adrenal gland or Neuroblastic tumor
  2. Have tumor or blood samples to analyze ALK gene:

    1. will operation to remove tumor or biopsy, and will preserve tumor sample;or
    2. after operation and have tumor sample preserved;or
    3. after operation without tumor sample, but agree to take blood sample to analyze ALK mutation
  3. Signed Inform Consent Form

Exclusion Criteria:

(1) After informed but still not consent

  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: NCT01986595

Contacts
Contact: Meng Yao Lu 886-9-72651499 lmy1079@gmail.com
Contact: Charlene Chen 886-9-68663105 907710@ntuh.gov.tw

Locations
Taiwan
National Taiwan University Children Hospital Recruiting
Taipei, Taiwan, 100
Contact: Meng Yao Lu    886-9-72651499    lmy1079@gmail.com   
Contact: Charlene Chen    886-9-68663105    907710@ntuh.gov.tw   
Principal Investigator: Meng Yao Lu         
Sub-Investigator: Chung Yi Hu         
Sub-Investigator: Wen Ming Hsu         
Sponsors and Collaborators
National Taiwan University Hospital
Investigators
Principal Investigator: Meng Yao Lu NTUH
  More Information

No publications provided

Responsible Party: National Taiwan University Hospital
ClinicalTrials.gov Identifier: NCT01986595     History of Changes
Other Study ID Numbers: 201306008RINB
Study First Received: November 4, 2013
Last Updated: November 11, 2013
Health Authority: Taiwan: Department of Health

Keywords provided by National Taiwan University Hospital:
Neuroblastoma
anaplastic lymphoma kinase
cancer genetics
target therapy
RNA and genomic DNA extraction
complementary DNA(cDNA) preparation
Array-comparative genomic hybridization
Multiplex ligation-dependent probe amplification (MLPA)
Sequencing of cDNA prepared from NB
Pyrosequencing
Quantitative real-time polymerase chain reaction(RT-PCR)
Immunohistochemistry

Additional relevant MeSH terms:
Neuroblastoma
Neoplasms
Neoplasms by Histologic Type
Neoplasms, Germ Cell and Embryonal
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neuroectodermal Tumors, Primitive
Neuroectodermal Tumors, Primitive, Peripheral

ClinicalTrials.gov processed this record on October 23, 2014