Convection-Enhanced Delivery of 124I-8H9 for Patients With Non-Progressive Diffuse Pontine Gliomas Previously Treated With External Beam Radiation Therapy
The purpose of this study is to test the safety of a new method to treat Diffuse Intrinsic Pontine Glioma (DIPG). The researchers will use "convection-enhanced delivery" (CED) to deliver an agent called 124I-8H9. CED is performed during surgery. The study agent is infused through a small tube placed into the tumor in the brain. Many studies have shown this can safely be done in animals but this study is the first time 124I-8H9 will be given by CED in humans. This will be one of the first times that CED has been performed in the brain stem.
8H9 is something called an antibody. Antibodies are made by the body to fight infections and sometimes cancer. The antibody 8H9 is produced by mice and can attack many kinds of tumors. A radioactive substance, 124I, is attached to 8H9. 124I-8H9 sticks to parts of tumor cells and can cause the tumor cells to die from radiation. Studies have also been done on humans using 124I-8H9 to treat other kinds of cancer. Our studies of some DPG and related tumors suggest that 8H9 will bind to the tumor, but the investigators don't know that for sure.
In this study, the researchers want to find out how safe 124I-8H9 given by CED is at different dose levels. They will look to see what effects (both good and bad) it has on the patient. The dose of 124I-8H9 will increase for each new group of patients. The procedure has already been safely performed with lower doses and infusion volumes in a number of patients here at MSKCC. The amount they get will depend on when they enter the study. If too many serious side effects are seen with a certain dose, no one will be treated with a higher dose, and some more patients may be treated with a lower dose to make sure that dose is safe.
|Brain Cancer Brain Stem Glioma||Radiation: Radioactive iodine-labeled monoclonal antibody 8H9||Phase 1|
|Study Design:||Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
|Official Title:||A Phase I Study of Convection-Enhanced Delivery of 124I-8H9 for Patients With Non-Progressive Diffuse Pontine Gliomas Previously Treated With External Beam Radiation Therapy|
- maximum tolerated dose [ Time Frame: 2 years ]Determination that a dose is safe will be made following the treatment of at least 3 but no more than 6 patients at a particular dose level. The dose levels are DL1 (0.25 mCi), DL2 (0.5 mCi), DL3 (0.75 mCi), DL4 (1.0 mCi) DL5 (2.5mCi), DL6 (3.25mCi), DL7 (4.0mCi), DL 7.1(4.0mCi), DL 7.2 (4.0mCi), DL 8 (6.0mCi), DL 9 (8.0mCi), DL 10 (10.0mCi), DL 11 (12.0mCi) ,fallback DL0 (0.125 mCi) FB1 (1.50mCi) and FB2 (2.0mCi). An incidence of dose-limiting toxicity (DLT) in the range of 25% is considered acceptable in this population. A maximum tolerated dose (MTD) will be defined as the dose level below that at which 2 DLTs have occurred.
- safety [ Time Frame: 2 years ]Adverse events (toxicity) will be assessed and classified according to the Clinical Terminology Criteria for Adverse Events version 4.0 (CTCAE). Generally, grade 3 toxicities interfere with activities of daily living (ADLs) and grade 4 toxicities are life-threatening. Grade 5 toxicities cause death.
- overall survival [ Time Frame: 2 years ]Overall survival from the time of diagnosis will be recorded for every patient in this study. Overall survival will be estimated by Kaplan-Meier methodology.
|Study Start Date:||December 2011|
|Estimated Study Completion Date:||December 2018|
|Estimated Primary Completion Date:||December 2018 (Final data collection date for primary outcome measure)|
Experimental: Radioactive iodine-labeled monoclonal antibody 8H9
This is a therapeutic Phase I study intended to assess the safety of convection-enhanced delivery (CED) of radioimmunotherapy in the treatment of children with diffuse pontine glioma.
Radiation: Radioactive iodine-labeled monoclonal antibody 8H9
Prior to treatment, children will be pre-medicated with super-saturated potassium iodide (SSKI) & liothyronine to prevent thyroid uptake of the therapeutic radioisotopes. The proposed intervention is a surgical procedure using interstitial infusion of the radiolabeled monoclonal antibody 124I-8H9 into the brain stem tumor. This will be performed by stereotactic placement of a small caliber infusion cannula into the tumor followed by a slow infusion (CED) of 124I-8H9. Following treatment, these children will be monitored during inpatient hospitalization with clinical evaluations & PET/CT or PET/MRI scans of the brain & other organs. Clinical observations, intensive care unit monitoring, routine blood & interval imaging studies (MRI & PET/CT or PET/MRI scans) will be performed at predetermined time points. If the PET/CT scan happens to fall on a weekend or holiday, the scan may be done before or after at the discretion of the Study PI. This will not affect dosimetry interpretation.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01502917
|Contact: Mark Souweidane, MD||212-639-2336|
|Contact: Ira Dunkel, MD||212-639-2336|
|United States, New York|
|Weill Medical College of Cornell University||Not yet recruiting|
|New York, New York, United States, 10021|
|Contact: Maria Donzelli, PNP 212-639-2336|
|Memorial Sloan Kettering Cancer Center||Recruiting|
|New York, New York, United States, 10065|
|Contact: Maria Donzelli, PNP 212-639-2336|
|Principal Investigator: Mark Souweidane, MD|
|Principal Investigator:||Mark Souweidane, MD||Memorial Sloan Kettering Cancer Center|