Intraperitoneal Radioimmunotherapy With 131I-8H9 for Patients With Desmoplastic Small Round Cell Tumors and Other Solid Tumors Involving the Peritoneum

Study Description

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Brief Summary:

The purpose of this study is to test the safety of a new medicine called antibody 8H9 injected into the lining of the abdomen or peritoneum, where the tumor is. This medicine is an antibody or protein which binds to certain tumors, including DSCRT. There is a small number of DSCRT which do not bind with 8H9. If the tumor does not bind with 8H9, you might not benefit from this treatment. The investigators want to find out what effects, good and/or bad, it has.

This antibody is made in mice. Radioactive iodine can be bound to this antibody to deliver radiation to the tumor. The investigators wish to determine the safety of radiolabeled 8H9 at different dose levels. This is the first study using 131I-8H9 in the peritoneum.

Condition or disease	Intervention/treatment	Phase
Peritoneal Cancer	Biological: 131 I-8H9	Phase 1

Study Design

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Study Type :	Interventional (Clinical Trial)
Estimated Enrollment :	45 participants
Intervention Model:	Single Group Assignment
Masking:	None (Open Label)
Primary Purpose:	Treatment
Official Title:	Phase I Study of Intraperitoneal Radioimmunotherapy With 131I-8H9 for Patients With Desmoplastic Small Round Cell Tumors and Other Solid Tumors Involving the Peritoneum
Actual Study Start Date :	April 2010
Estimated Primary Completion Date :	April 2018
Estimated Study Completion Date :	April 2018

Arms and Interventions

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Arm	Intervention/treatment
Experimental: 131 I-8H9; This is a phase I study of 131I-8H9 for patients with DSRCT and other 8H9-reactive solid tumors metastatic to the peritoneum.	Biological: 131 I-8H9; Patients will be administered therapeutic dose of IP 131I-8H9 per the dose escalation regimen. 131I-8H9 pharmacokinetics will be studied by serial blood draws from indwelling venous lines. 131I-8H9 biodistribution will be studied by a single gamma camera scan about 5 days after IP injection where feasible.

Outcome Measures

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Primary Outcome Measures :

1. Define the toxicity of 131I-8H9 administered intraperitoneally. [ Time Frame: weekly ]

Secondary Outcome Measures :

1. Define maximal tolerated dose (MTD) of 131I-8H9 administered intraperitoneally [ Time Frame: 5 years ]
2. Assess pharmacokinetics for IP 131I-8H9 [ Time Frame: 0 hrs, 60 mins, 2 hrs, 8 hrs, 18hrs, 30 hrs, 42hr, 66hrs, 90 hrs, and 114hrs. ]
3. Assess response of DSRCT and other solid tumors to IP 131 I-8H9. [ Time Frame: between days 24 and 38 ]

Eligibility Criteria

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Ages Eligible for Study:	1 Year and older (Child, Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• Patients must have the diagnosis of (a) DSRCT with peritoneal involvement or (b) other Burtomab-positive solid tumors involving the peritoneum (e.g. adrenocortical carcinoma, Wilm's tumor).
• For tumors other than DSRCT, patients must have a history of tumor progression or recurrence or failure to achieve complete response with standard therapy or <20% chance of long term disease-free survival.
• For tumors other than DSRCT, Burtomab reactivity must be confirmed by immunohistochemistry.
• Patients with DSCRT are not required to have measurable or evaluable disease.
• Patients with tumors other than DSRCT without measurable or evaluable disease will only be considered if they have <20% chance of long term disease-free survival.
• Prior Therapy: At least 4 weeks should have elapsed since any biologic therapy, or immunotherapy. Three weeks should have elapsed since last dose of chemotherapy or radiotherapy.
• Age >1 year and able to cooperate with radiation safety restrictions during therapy period.
• Stem cells: Patients must have an autologous hematopoietic stem cell product cryopreserved and available for re-infusion after 131 I-Burtomab treatment. The minimum dose for hematopoietic stem cells is 2 x 106 CD34+ cells/kg.
• Minimum life expectancy of six weeks as determined by consenting professional.
• Signed informed consent indicating awareness of the investigational nature of this program.

Exclusion Criteria:

• Severe major organ toxicity. Renal, cardiac, hepatic, pulmonary, gastrointestinal and neurologic toxicity should all be grade 1 or less (per NCI CTC version 3 criteria) with the following exceptions: serum AST,ALT and alkaline phosphatase should be ≤5 x upper limit of normal (ULN), serum bilirubin ≤ 3 x ULN and nausea and vomiting should be ≤ grade 2 Patients with myelosuppression are not excluded if ANC ≥ 500/uL.
• Platelet count should be > 50,000/ul and hemoglobin should be > 8gm/dl. Patients may receive platelet or red blood cell transfusions to maintain hemoglobin and platelets at clinical appropriate levels.
• Patients with clinically suspected dense intraperitoneal adhesions preventing adequate IP distribution.
• History of allergy to mouse proteins.
• Patients previously treated with murine monoclonal antibodies will be excluded if they have a HAMA level of >1000U/ml.
• Active serious infections not controlled by antibiotics.
• Pregnant women and women who are breast feeding are excluded for fear of danger to the fetus/infant. Therefore negative pregnancy test is required for all women of child-bearing age, and appropriate contraception is used during the study period. Pregnancy testing will be carried out within two weeks prior to administration of radioiodinated Burtomab in females of childbearing age.
• Inability or unwillingness to comply with radiation safety procedures or protocol requirements.

Contacts and Locations

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Contacts

Contact: Shakeel Modak, MD	212-639-7623
Contact: Michael LaQuaglia, M.D	212-639-7003

Locations

United States, New York
Memorial Sloan Kettering Cancer Center	Recruiting
New York, New York, United States, 10021
Contact: Shakeel Modak, MD 212-639-7623

Sponsors and Collaborators

Memorial Sloan Kettering Cancer Center

Investigators

Principal Investigator:	Shakeel Modak, MD	Memorial Sloan Kettering Cancer Center

More Information

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Additional Information:

Memorial Sloan Kettering Cancer Center 

Responsible Party:	Memorial Sloan Kettering Cancer Center
ClinicalTrials.gov Identifier:	NCT01099644 History of Changes
Other Study ID Numbers:	09-090
First Posted:	April 7, 2010
Last Update Posted:	January 12, 2018
Last Verified:	May 2017

Keywords provided by Memorial Sloan Kettering Cancer Center:

Peritoneum; Desmoplastic Small Round Cell Tumors; Intraperitoneal Radioimmunotherapy; 131 I-8H9; 09-090

Additional relevant MeSH terms:

Desmoplastic Small Round Cell Tumor; Sarcoma; Neoplasms, Connective and Soft Tissue; Neoplasms by Histologic Type; Neoplasms