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Lexatumumab With or Without Recombinant Interferon Gamma in Treating Young Patients With Solid Tumors or Lymphoma That Have Relapsed or Not Responded to Treatment
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), April 2008
First Received: January 25, 2007   Last Updated: January 20, 2010   History of Changes
Sponsor: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00428272
  Purpose

RATIONALE: Monoclonal antibodies, such as lexatumumab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Biological therapies, such as recombinant interferon-gamma, may stimulate the immune system in different ways and stop cancer cells from growing. Giving recombinant interferon-gamma together with lexatumumab may kill more cancer cells.

PURPOSE: This phase I trial is studying the side effects and best dose of lexatumumab alone and together with recombinant interferon gamma in treating young patients with solid tumors or lymphoma that have relapsed or not responded to treatment.


Condition Intervention Phase
Kidney Cancer
Lymphoma
Neuroblastoma
Sarcoma
Unspecified Childhood Solid Tumor, Protocol Specific
Biological: lexatumumab
Biological: recombinant interferon gamma
Genetic: protein expression analysis
Other: flow cytometry
Other: immunoenzyme technique
Other: immunohistochemistry staining method
Other: laboratory biomarker analysis
Other: pharmacological study
Phase I

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Trial of Monoclonal Antibody HGS-ETR2 (Lexatumumab) With or Without Interferon Gamma in Patients With Refractory Pediatric Solid Tumors

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Tolerability [ Designated as safety issue: Yes ]
  • Maximum tolerated dose of lexatumumab alone [ Designated as safety issue: Yes ]
  • Maximum tolerated dose of lexatumumab in combination with recombinant interferon gamma [ Designated as safety issue: Yes ]
  • Pharmacokinetics [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Tumor response [ Designated as safety issue: No ]
  • Immunohistochemical expression of pro-apoptotic proteins in pre-therapy tumor tissue [ Designated as safety issue: No ]
  • Anti-lexatumumab antibody response [ Designated as safety issue: No ]

Estimated Enrollment: 73
Study Start Date: July 2006
Detailed Description:

OBJECTIVES:

Primary

  • Determine the tolerability of the adult maximum tolerated dose (MTD) and dose-limiting toxicities of lexatumumab in pediatric patients with relapsed or refractory solid tumors or lymphoma.
  • Determine the MTD of lexatumumab in combination with recombinant interferon gamma in these patients.
  • Assess the pharmacokinetics of this regimen in these patients.

Secondary

  • Quantify tumor response to this regimen in these patients.
  • Correlate immunohistochemical expression of pro-apoptotic proteins in pre-therapy tumor tissue with response in patients treated with this regimen.
  • Determine whether anti-lexatumumab antibodies are produced in response to this regimen in these patients.

OUTLINE: This is a multicenter, open-label, dose-escalation study of lexatumumab.

  • Group I (lexatumumab alone): Patients receive lexatumumab IV over 1 hour on days 1 and 15. Treatment repeats every 28 days until the maximum tolerated dose (MTD) is determined.
  • Group II (lexatumumab and recombinant interferon gamma): Patients receive lexatumumab as in group I at the MTD. Patients also receive recombinant interferon gamma subcutaneously 3 times a week beginning on day -7 for 2 weeks and then once every 14 days until the MTD is determined. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo blood collection periodically for pharmacokinetic studies. Blood serum is analyzed for concentration of lexatumumab via immunoenzyme techniques; anti-lexatumumab antibodies, TNF-related apoptosis-inducing ligand expression and caspase 8 expression, recombinant interferon gamma activity, lymphocyte storage, and immunogenicity via flow cytometry. Previously collected tissue samples are examined by immunohistochemistry for TR1, TR2, caspase 8, survivin, and bcl-2 expression.

After completion of study therapy, patients are followed periodically.

PROJECTED ACCRUAL: A total of 68 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   1 Year to 30 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed malignancy, including, but not limited to, any of the following:

    • Rhabdomyosarcoma and other soft tissue sarcoma
    • Ewing's sarcoma family of tumors
    • Osteosarcoma
    • Neuroblastoma
    • Wilms tumor
    • Hodgkin's lymphoma
    • Non-Hodgkin's lymphoma
  • Measurable or evaluable disease
  • Must have relapsed after or failed to respond to prior standard therapy
  • No known curative therapy or therapy proven to prolong survival with an acceptable quality of life exists
  • No primary or metastatic hepatic tumors
  • No primary or untreated metastatic CNS tumors

    • Patients with prior CNS metastases must meet the following criteria:

      • Metastases have been treated with surgery and/or radiotherapy
      • Clinically stable as evidenced by no requirement for corticosteroids
      • No evolving neurologic deficits and no change in residual brain abnormalities without specific therapy within the past 6 weeks

PATIENT CHARACTERISTICS:

  • Karnofsky performance status (PS) 50-100% (patients > 10 years of age) OR Lansky PS 50-100% (patients ≤ 10 years of age)
  • Absolute granulocyte count ≥ 1,000/mm^3
  • Platelet count ≥ 75,000/mm^3 (transfusion independent)
  • Hemoglobin ≥ 8 g/dL
  • AST and ALT ≤ 2.5 times upper limit of normal
  • Bilirubin (direct) normal
  • Creatinine clearance ≥ 60 mL/min OR creatinine normal
  • Ejection fraction > 40% by MUGA scan or ECHO OR shortening fraction > 27% by ECHO
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 60 days (females) or 30 days (males) after completion of study therapy
  • No history of congestive heart failure
  • No clinically significant unrelated systemic illness (e.g., serious infection or organ dysfunction) that would preclude study treatment
  • No history of any infection requiring hospitalization or parenteral antibiotics within the past 2 weeks
  • No co-existing medical illness that would place the patient at undue risk
  • No known HIV infection
  • No immune deficiency
  • No hepatitis B or C

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from prior therapy
  • At least 4 weeks since prior radiotherapy, chemotherapy, or monoclonal antibody therapy (6 weeks for nitrosoureas [e.g., lomustine or carmustine])
  • At least 7 days since prior biological therapy or investigational therapy
  • At least 72 hours since prior and no concurrent colony-stimulating growth factors (e.g., filgrastim [G-CSF], sargramostim [GM-CSF], or epoetin alfa)
  • At least 3 months since prior autologous stem cell transplantation
  • No prior allogeneic bone marrow transplantation
  • No other concurrent immunotherapy or chemotherapy
  • No concurrent immunosuppressant therapy (prednisone ≤ 10 mg/day or dexamethasone ≤ 4 mg/day allowed)
  • No other concurrent investigational therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00428272

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office Recruiting
Bethesda, Maryland, United States, 20892-1182
Contact: Clinical Trials Office - Warren Grant Magnusen Clinical Center     888-NCI-1937        
United States, New York
Memorial Sloan-Kettering Cancer Center Recruiting
New York, New York, United States, 10065
Contact: Alexander J. Chou, MD     212-639-8895        
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        
Sponsors and Collaborators
Investigators
Principal Investigator: Crystal Mackall, MD NCI - Pediatric Oncology Branch
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000526212, NCI-07-C-0040, NCI-P6981
Study First Received: January 25, 2007
Last Updated: January 20, 2010
ClinicalTrials.gov Identifier: NCT00428272     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
previously treated childhood rhabdomyosarcoma
recurrent childhood rhabdomyosarcoma
metastatic childhood soft tissue sarcoma
recurrent childhood soft tissue sarcoma
recurrent/refractory childhood Hodgkin lymphoma
stage IV childhood Hodgkin lymphoma
recurrent Wilms tumor and other childhood kidney tumors
stage IV Wilms tumor
stage V Wilms tumor
metastatic osteosarcoma
recurrent osteosarcoma
disseminated neuroblastoma
recurrent neuroblastoma
metastatic Ewing sarcoma/peripheral primitive neuroectodermal tumor
recurrent Ewing sarcoma/peripheral primitive neuroectodermal tumor
unspecified childhood solid tumor, protocol specific
recurrent childhood large cell lymphoma
stage IV childhood large cell lymphoma
recurrent childhood lymphoblastic lymphoma
stage IV childhood lymphoblastic lymphoma
Burkitt lymphoma
recurrent childhood small noncleaved cell lymphoma
stage IV childhood small noncleaved cell lymphoma
childhood grade III lymphomatoid granulomatosis
recurrent childhood grade III lymphomatoid granulomatosis
childhood nasal type extranodal NK/T-cell lymphoma
childhood diffuse large cell lymphoma
childhood immunoblastic large cell lymphoma

Additional relevant MeSH terms:
Anti-Infective Agents
Neuroectodermal Tumors, Primitive
Interferon Type II
Antineoplastic Agents
Neoplasms, Nerve Tissue
Urogenital Neoplasms
Urologic Neoplasms
Neuroblastoma
Neoplasms, Connective and Soft Tissue
Neoplasms by Site
Urologic Diseases
Kidney Neoplasms
Therapeutic Uses
Neoplasms, Germ Cell and Embryonal
Kidney Diseases
Lymphoma
Neoplasms by Histologic Type
Immunoproliferative Disorders
Immune System Diseases
Interferons
Antiviral Agents
Pharmacologic Actions
Carcinoma
Lymphatic Diseases
Neuroectodermal Tumors
Neoplasms
Sarcoma
Carcinoma, Renal Cell
Adenocarcinoma
Lymphoproliferative Disorders

ClinicalTrials.gov processed this record on March 18, 2010