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VNP40101M in Treating Young Patients With Recurrent, Progressive, or Refractory Primary Brain Tumors

Phase I Study Of Cloretazine (VNP40101M) In Children With Recurrent, Progressive Or Refractory Primary Brain Tumors

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00098761
Enrollment
42
Registered
2004-12-09
Start date
2005-02-28
Completion date
2008-02-29
Last updated
2011-06-30

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Brain and Central Nervous System Tumors

Keywords

recurrent childhood brain stem glioma, recurrent childhood visual pathway and hypothalamic glioma, recurrent childhood cerebellar astrocytoma, recurrent childhood cerebral astrocytoma, recurrent childhood ependymoma, recurrent childhood medulloblastoma, recurrent childhood supratentorial primitive neuroectodermal tumor, childhood central nervous system germ cell tumor, childhood choroid plexus tumor, childhood craniopharyngioma, childhood infratentorial ependymoma, childhood grade I meningioma, childhood grade II meningioma, childhood grade III meningioma, childhood high-grade cerebral astrocytoma, childhood low-grade cerebral astrocytoma

Brief summary

RATIONALE: Drugs used in chemotherapy, such as VNP40101M, work in different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: This phase I trial is studying the side effects and best dose of VNP40101M in treating young patients with recurrent, progressive, or refractory primary brain tumors.

Detailed description

OBJECTIVES: Primary * Determine the maximum tolerated dose and dose-limiting toxicity of VNP40101M in pediatric patients with recurrent, progressive, or refractory primary brain tumors. Secondary * Determine the pharmacokinetics of this drug and its active metabolite VNP4090CE in these patients. * Determine the efficacy of this drug in these patients. OUTLINE: This is a dose-escalation, multicenter study. Patients are stratified according to receiving ≥ 1 of the following prior therapies: craniospinal irradiation (yes vs no), autologous bone marrow transplant (yes vs no), and \> 2 myelosuppressive chemotherapy or myelosuppressive biologic therapy regimens (yes vs no). Patients receive VNP40101M IV over 30 minutes on days 1-5. Treatment repeats every 42 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 2-6 patients per stratum receive escalating doses of VNP40101M until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose at which 25% of patients experience dose-limiting toxicity. A total of 12 patients are treated at the MTD. Patients are followed for 3 months. PROJECTED ACCRUAL: A total of 4-60 patients (2-30 per stratum) will be accrued for this study within 18 months.

Interventions

This is a dose escalation study. Participants receive 20, 30, 45, 60, 78, 103, 137, 182, or 242 mg/m2/day intravenously over 30 minutes for 5 consecutive days every 6 weeks up to 48 weeks.

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
Pediatric Brain Tumor Consortium
Lead SponsorNETWORK

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
No minimum to 21 Years
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed\* primary brain tumor, including benign brain tumors (e.g., low-grade glioma) * Recurrent or progressive disease OR refractory to standard therapy NOTE: \*Patients with intrinsic brain stem or diffuse optic pathway tumors do not require histological confirmation, but must have clinical and/or radiographic evidence of disease progression * No bone marrow disease PATIENT CHARACTERISTICS: Age * 21 and under Performance status * Karnofsky 50-100% (for patients \> 16 years of age) OR * Lansky 50-100% (for patients ≤ 16 years of age) Life expectancy * Not specified Hematopoietic * Absolute neutrophil count ≥ 1,000/mm\^3\* * Platelet count ≥ 100,000/mm\^3\* * Hemoglobin ≥ 8 g/dL\* NOTE: \*Unsupported Hepatic * Bilirubin ≤ 1.5 times upper limit of normal (ULN) * ALT and AST ≤ 2.5 times ULN * No overt hepatic disease Renal * BUN \< 25 mg/dL * Creatinine ≤ 1.5 times ULN for age OR * Glomerular filtration rate \> 70 mL/min * No overt renal disease Cardiovascular * Shortening fraction ≥ 30% by echocardiogram OR * Ejection fraction ≥ 50% by gated radionucleotide study * No clinically significant cardiac arrhythmia by EKG * No overt cardiac disease Pulmonary * DLCO ≥ 60% of predicted * Chest X-ray normal (defined as absence of pulmonary infiltrates, pneumonitis, pleural effusion, pulmonary hemorrhage, or fibrosis) AND a resting pulse oximetry reading of \> 94% in room air (for patients who cannot perform the DLCO) * No overt pulmonary disease Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * Neurologic deficits allowed provided there has been no deficit progression for ≥ 1 week before study entry * No uncontrolled infection * No known hypersensitivity to polyethylene glycol PRIOR CONCURRENT THERAPY: Biologic therapy * At least 6 months since prior allogeneic bone marrow or stem cell transplantation * At least 3 months since prior autologous bone marrow or stem cell transplantation * More than 1 week since prior colony-stimulating factors (e.g., filgrastim \[G-CSF\], sargramostim \[GM-CSF\], or epoetin alfa) * At least 3 weeks since prior myelosuppressive anticancer biologic therapy * No concurrent routine colony-stimulating factors Chemotherapy * At least 3 weeks since prior myelosuppressive anticancer chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered Endocrine therapy * Concurrent corticosteroids allowed provided dose is stable or decreasing for ≥ 1 week before study entry Radiotherapy * At least 3 months since prior craniospinal irradiation ≥ 18 Gy * At least 2 weeks since prior focal irradiation to the primary tumor and/or symptomatic metastatic sites Surgery * Not specified Other * At least 7 days since prior nonmyelosuppressive anticancer therapy * At least 7 days since prior investigational agents * Concurrent enzyme-inducing anticonvulsant drugs allowed * No other concurrent anticancer or experimental agents or therapies

Design outcomes

Primary

MeasureTime frame
Estimate the maximum tolerated doseFirst 6 weeks of therapy
Number of participants with dose limiting toxicitiesFirst 6 weeks of therapy

Secondary

MeasureTime frameDescription
PharmacokineticsDay 1 of therapyPlasma samples for pharmacokinetic studies will be collected with the first dose of the study drug pre-infusion, and 5, 15, and 30 minutes, 1 hour, 2 hours, and 4 hours after the end of infusion. VNP40101M plasma concentration-time data will be modeled and the individual pharmacokinetic pararmeters volume of the central compartment, elimination rate constant, and half-life will be estimated.
Tumor response to VNP40101MPrior to course 3, 5, and 7 and end of therapyMRI of the brain will be obtained prior to couses 3, 5, and 7 and at the end of therapy

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026