Pleuropulmonary Blastoma, Recurrent Malignant Peripheral Nerve Sheath Tumor, Recurrent Neuroblastoma, Recurrent Rhabdomyosarcoma, Recurrent Synovial Sarcoma, Wilms Tumor
Conditions
Brief summary
This phase II trial studies how well lorvotuzumab mertansine works in treating younger patients with Wilms tumor, rhabdomyosarcoma, neuroblastoma, pleuropulmonary blastoma, malignant peripheral nerve sheath tumor (MPNST), or synovial sarcoma that has returned or that does not respond to treatment. Antibody-drug conjugates, such as lorvotuzumab mertansine, are created by attaching an antibody (protein used by the body?s immune system to fight foreign or diseased cells) to an anti-cancer drug. The antibody is used to recognize tumor cells so the anti-cancer drug can kill them.
Detailed description
PRIMARY OBJECTIVES: I. To assess the efficacy of IMGN901 (lorvotuzumab mertansine) in Wilms tumor, rhabdomyosarcoma, neuroblastoma and other cluster of differentiation (CD)56-expressing tumors such as pleuropulmonary blastoma, malignant peripheral nerve sheath tumor (MPNST) and synovial sarcoma. II. To determine the tolerability of the adult recommended phase 2 dose (RP2D) of IMGN901 administered as an intravenous infusion, administered on days 1 and 8 of a 21-day cycle, to children with refractory Wilms tumor, rhabdomyosarcoma, neuroblastoma, pleuropulmonary blastoma, MPNST, or synovial sarcoma. III. To define and describe the toxicities of IMGN901 administered on this schedule. EXPLORATORY OBJECTIVES: I. To correlate tumor response with tumor CD56+ expression. II. To characterize the pharmacokinetics of IMGN901 in children with refractory cancer, including an assessment of impact on circulating CD56+ peripheral blood cells. OUTLINE: Patients receive lorvotuzumab mertansine intravenously (IV) over 1-1.5 hours on days 1 and 8. Treatment repeats every 21 days for up to 17 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for 5 years.
Interventions
OTHERLaboratory Biomarker Analysis
Correlative studies
BIOLOGICALLorvotuzumab Mertansine
Given IV
OTHERPharmacological Study
Correlative studies
Sponsors
National Cancer Institute (NCI)
Children's Oncology Group
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Months to 30 Years
Healthy volunteers
No
Inclusion criteria
* Patients must have had histologic verification of one of the malignancies listed below at original diagnosis or at relapse * Primary strata * Wilms tumor * Rhabdomyosarcoma * Neuroblastoma * Secondary strata: miscellaneous CD56-expressing tumors: * Pleuropulmonary blastoma * Malignant peripheral nerve sheath tumor (MPNST) * Synovial sarcoma * Patients must have radiographically measurable disease (with the exception of those with neuroblastoma) * Measurable disease is defined as the presence of at least one lesion on magnetic resonance imaging (MRI) or computed tomography (CT) scan that can be accurately measured with the longest diameter a minimum of 10 mm in at least one dimension (CT scan slice thickness no greater than 5 mm) * Note: the following do not qualify as measurable disease: * Malignant fluid collections (e.g., ascites, pleural effusions) * Bone marrow infiltration except that detected by metaiodobenzylguanidine (MIBG) scan for neuroblastoma * Lesions only detected by nuclear medicine studies (e.g., bone, gallium or positron emission tomography \[PET\] scans) except as noted in patients with neuroblastoma who do not have measurable disease but have MIBG-avid evaluable disease * Elevated tumor markers in plasma or cerebrospinal fluid (CSF) * Previously radiated lesions that have not demonstrated clear progression post radiation * Leptomeningeal lesions that do not meet the measurements noted above * Patients with neuroblastoma who do not have measurable disease but have MIBG-avid evaluable disease are eligible * Patients must have a Lansky or Karnofsky performance status score of \>= 50, corresponding to Eastern Cooperative Oncology Group (ECOG) categories 0, 1 or 2; use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age; patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score * Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study * Patients must have received standard treatment appropriate for their tumor type * Myelosuppressive chemotherapy: patients with solid tumors must not have received myelosuppressive chemotherapy within 3 weeks of enrollment onto this study (6 weeks if prior nitrosourea) * Hematopoietic growth factors: at least 14 days must have elapsed after receiving pegfilgrastim and least 7 days must have elapsed since the completion of therapy with a non-pegylated growth factor * Biologic (anti-neoplastic agent): at least 7 days must have elapsed since completion of therapy with a biologic agent; for agents that have known adverse events occurring beyond 7 days after administration, this period prior to enrollment must be extended beyond the time during which adverse events are known to occur * Monoclonal antibodies: at least 3 half-lives must have elapsed since prior therapy that included a monoclonal antibody * Radiotherapy: \>= 2 weeks must have elapsed since local palliative external beam radiation therapy (XRT) (small port); \>= 6 weeks must have elapsed since treatment with therapeutic doses of MIBG; \>= 3 months must have elapsed if prior craniospinal XRT was received, if \>= 50% of the pelvis was irradiated, or if total body irradiation (TBI) was received; \>= 6 weeks must have elapsed if other substantial bone marrow irradiation was given * Stem cell transplant or rescue without TBI: no evidence of active graft vs. host disease and \>= 2 months must have elapsed since transplant * For patients with solid tumors without bone marrow involvement: peripheral absolute neutrophil count (ANC) \>= 1000/uL * For patients with solid tumors without bone marrow involvement: platelet count \>= 100,000/uL (transfusion independent, defined as not receiving platelet transfusions within a 7 day period prior to enrollment) * For patients with solid tumors and known bone marrow metastatic disease: peripheral absolute neutrophil count (ANC) \>= 750/uL * For patients with solid tumors and known bone marrow metastatic disease: platelet count \>= 75,000/uL (transfusion independent, defined as not receiving platelet transfusions for at least 7 days prior to enrollment) * Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 mL/min/1.73 m\^2 or a serum creatinine based on age/gender as follows: * Age 1 to \< 2 years: maximum serum creatinine: 0.6 mg/dL in males and females * Age 2 to \< 6 years: maximum serum creatinine: 0.8 mg/dL in males and females * Age 6 to \< 10 years: maximum serum creatinine: 1 mg/dL in males and females * Age 10 to \< 13 years: maximum serum creatinine: 1.2 mg/dL in males and females * Age 13 to \< 16 years: maximum serum creatinine: 1.5 mg/dL in males and 1.4 mg/dL in females * Age \>= 16 years: maximum serum creatinine: 1.7 mg/dL in males and 1.4 mg/dL in females * Total bilirubin =\< 1.5 x upper limit of normal (ULN) for age * Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\]) =\< 110 U/L (for the purpose of this study, the ULN for SGPT is 45 U/L) * Serum albumin \>= 2 g/dL * Shortening fraction of \>= 27% by echocardiogram, or ejection fraction of \>= 50% by gated radionuclide study * Patients with seizure disorder may be enrolled if on anticonvulsants and well controlled * All patients and/or their parents or legal guardians must sign a written informed consent * All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met
Exclusion criteria
* Patients who are pregnant or breast-feeding are not eligible for this study; negative pregnancy tests must be obtained in girls who are post-menarchal; males or females of reproductive potential may not participate unless they have agreed to use an effective contraceptive method for the duration of study therapy and for 4 weeks after the last dose of study therapy; breastfeeding women are excluded * Concomitant medications * Corticosteroids: patients requiring corticosteroids who have not been on a stable or decreasing dose of corticosteroid for the 7 days prior to enrollment are not eligible * Patients who have received previous treatment with IMGN901 are not eligible * Investigational drugs: patients who are currently receiving another investigational drug are not eligible * Anti-cancer agents: patients who are currently receiving other anti-cancer agents are not eligible * Anti-graft-versus-host disease (GVHD) or agents to prevent organ rejection post-transplant: patients who are receiving cyclosporine, tacrolimus or other agents to prevent either graft-versus-host disease post bone marrow transplant or organ rejection post-transplant are not eligible for this trial * Patients who have a CNS toxicity \> grade 2 are not eligible * Patients must not have known active central nervous system (CNS) metastases; patients with known central nervous system metastases are excluded unless treated surgically or with radiotherapy, and stable with no recurrent lesions for at least 6 months * Patients who have baseline peripheral neuropathy \>= grade 2 are not eligible * Patients who have an uncontrolled infection are not eligible * Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study are not eligible
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Objective Response by Response Evaluation Criteria in Solid Tumors Version 1.1 | Up to 18 weeks (6 courses) | The best response of disease will be examined separately in each stratum. A responder is defined as a patient who achieves a best response of partial response or complete response on the study. Response rates will be calculated as the percent of evaluable patients who are responders, and Clopper-Pearson confidence intervals will be constructed. |
| Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Up to 12 months (17 courses) | Toxicity tables will be constructed to summarize the observed incidence by type of toxicity and grade for toxicities with Possible, Probable, or Definite attribution to the study drug. Tables will summarize incidence by cycle. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Pharmacokinetic (PK) Parameters of Lorvotuzumab Mertansine | Pre-treatment, end of infusion, and 2, 6, 24, 48, and 96 hours after end of infusion on day 1 of course 1, and pre-treatment, end of infusion, and 2 and 6 hours after end of infusion on day 8 of course 1 | A descriptive analysis of PK parameters of lorvotuzumab mertansine will be performed to define systemic exposure, drug clearance, and other pharmacokinetic parameters. The PK parameters will be summarized with simple summary statistics, including means, medians, ranges, and standard deviations (if numbers and distribution permit). Analyses will be descriptive and exploratory and hypotheses generating in nature. |
| CD56 Expression | Day 1 and 8 of course 1 prior to lorvotuzumab mertansine | The association between CD56+ expression and response will be evaluated using the exact conditional test of proportions (Fisher?s Exact test). Analyses will be descriptive and exploratory and hypotheses generating in nature. |
Countries
United States
Participant flow
Recruitment details
Each of 6 disease strata enrolled up to 16 patients who were evaluable for the primary response criteria.
Participants by arm
| Arm | Count |
|---|---|
| Stratum 1: Wims Tumor ADVL1522 Dose Level 1: IMGN901 110 mg/m2/IV over 1-1.5 hours on Days 1 and 8 every 21 days, repeatable up to 17 cycles | 17 |
| Stratum 2: Rhabdomyosarcoma ADVL1522 Dose Level 1: IMGN901 110 mg/m2/IV over 1-1.5 hours on Days 1 and 8 every 21 days, repeatable up to 17 cycles | 17 |
| Stratum 3: Neuroblastoma ADVL1522 Dose Level 1: IMGN901 110 mg/m2/IV over 1-1.5 hours on Days 1 and 8 every 21 days, repeatable up to 17 cycles | 12 |
| Stratum 4: Pleuropulmonary Blastoma ADVL1522 Dose Level 1: IMGN901 110 mg/m2/IV over 1-1.5 hours on Days 1 and 8 every 21 days, repeatable up to 17 cycles | 1 |
| Stratum 5: Malignant Peripheral Nerve Sheath Tumor ADVL1522 Dose Level 1: IMGN901 110 mg/m2/IV over 1-1.5 hours on Days 1 and 8 every 21 days, repeatable up to 17 cycles | 5 |
| Stratum 6: Synovial Sarcoma ADVL1522 Dose Level 1: IMGN901 110 mg/m2/IV over 1-1.5 hours on Days 1 and 8 every 21 days, repeatable up to 17 cycles | 10 |
| Total | 62 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 | FG005 |
|---|---|---|---|---|---|---|---|
| Overall Study | Death | 2 | 1 | 0 | 0 | 0 | 0 |
| Overall Study | Ineligible | 0 | 1 | 0 | 0 | 0 | 0 |
| Overall Study | Lack of Efficacy | 13 | 14 | 9 | 1 | 5 | 8 |
| Overall Study | Never Received Treatment | 1 | 0 | 0 | 0 | 0 | 0 |
| Overall Study | Physician Decision | 0 | 1 | 0 | 0 | 0 | 0 |
| Overall Study | Withdrawal by Subject | 1 | 0 | 2 | 0 | 0 | 1 |
Baseline characteristics
| Characteristic | Stratum 2: Rhabdomyosarcoma | Stratum 3: Neuroblastoma | Stratum 4: Pleuropulmonary Blastoma | Stratum 5: Malignant Peripheral Nerve Sheath Tumor | Stratum 6: Synovial Sarcoma | Stratum 1: Wims Tumor | Total |
|---|---|---|---|---|---|---|---|
| Age, Categorical <=18 years | 7 Participants | 12 Participants | 1 Participants | 5 Participants | 6 Participants | 13 Participants | 44 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 10 Participants | 0 Participants | 0 Participants | 0 Participants | 4 Participants | 4 Participants | 18 Participants |
| Age, Continuous | 18.43 Years STANDARD_DEVIATION 5.28 | 7.78 Years STANDARD_DEVIATION 1.94 | 3.69 Years | 12.96 Years STANDARD_DEVIATION 4.29 | 17.37 Years STANDARD_DEVIATION 4.59 | 12.61 Years STANDARD_DEVIATION 6.48 | 13.2 Years STANDARD_DEVIATION 6.37 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 3 Participants | 1 Participants | 0 Participants | 1 Participants | 1 Participants | 2 Participants | 8 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 14 Participants | 10 Participants | 1 Participants | 4 Participants | 9 Participants | 13 Participants | 51 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 2 Participants | 3 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants | 1 Participants | 2 Participants |
| Race (NIH/OMB) Black or African American | 3 Participants | 1 Participants | 0 Participants | 1 Participants | 2 Participants | 2 Participants | 9 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 3 Participants | 4 Participants | 8 Participants |
| Race (NIH/OMB) White | 14 Participants | 10 Participants | 1 Participants | 3 Participants | 5 Participants | 10 Participants | 43 Participants |
| Sex: Female, Male Female | 8 Participants | 3 Participants | 1 Participants | 4 Participants | 6 Participants | 5 Participants | 27 Participants |
| Sex: Female, Male Male | 9 Participants | 9 Participants | 0 Participants | 1 Participants | 4 Participants | 12 Participants | 35 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk |
|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 10 / 17 | 11 / 16 | 4 / 12 | 1 / 1 | 1 / 5 | 2 / 10 |
| other Total, other adverse events | 5 / 16 | 4 / 16 | 4 / 12 | 1 / 1 | 1 / 5 | 4 / 10 |
| serious Total, serious adverse events | 7 / 16 | 8 / 16 | 1 / 12 | 0 / 1 | 0 / 5 | 3 / 10 |
Outcome results
Primary
Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0
Toxicity tables will be constructed to summarize the observed incidence by type of toxicity and grade for toxicities with Possible, Probable, or Definite attribution to the study drug. Tables will summarize incidence by cycle.
Time frame: Up to 12 months (17 courses)
Population: 203 treatment-cycles were reported for the analysis. 2 participants were excluded from analysis;1 participant never received treatment and 1 participant was ineligible, also never receiving treatment.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Anemia: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Anemia: Grade 3 | 2 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Anemia: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Anemia: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Colonic fistula: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Colonic fistula: Grade 3 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Colonic fistula: Grade 4 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Colonic fistula: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Colonic perforation: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Colonic perforation: Grade 3 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Colonic perforation: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Colonic perforation: Grade 5 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Dental caries: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Dental caries: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Dental caries: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Dental caries: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Nausea: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Nausea: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Nausea: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Nausea: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Vomiting: Grade 2 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Vomiting: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Vomiting: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Vomiting: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Tooth infection: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Tooth infection: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Tooth infection: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Tooth infection: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Alanine aminotransferase increased: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Alanine aminotransferase increased: Grade 3 | 3 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Alanine aminotransferase increased: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Alanine aminotransferase increased: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Aspartate aminotransferase increased: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Aspartate aminotransferase increased: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Aspartate aminotransferase increased: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Aspartate aminotransferase increased: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Lymphocyte count decreased: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Lymphocyte count decreased: Grade 3 | 2 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Lymphocyte count decreased: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Lymphocyte count decreased: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hyperglycemia: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hyperglycemia: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hyperglycemia: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hyperglycemia: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hyperuricemia: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hyperuricemia: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hyperuricemia: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hyperuricemia: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hypokalemia: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hypokalemia: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hypokalemia: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hypokalemia: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hypophosphatemia: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hypophosphatemia: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hypophosphatemia: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Hypophosphatemia: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Headache: Grade 2 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Headache: Grade 3 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Headache: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Headache: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Peripheral motor neuropathy: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Peripheral motor neuropathy: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Peripheral motor neuropathy: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Peripheral motor neuropathy: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Peripheral sensory neuropathy: Grade 2 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Peripheral sensory neuropathy: Grade 3 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Peripheral sensory neuropathy: Grade 4 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | Peripheral sensory neuropathy: Grade 5 | 0 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | All Reportable AEs: Grade 2 | 2 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | All Reportable AEs: Grade 3 | 18 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | All Reportable AEs: Grade 4 | 1 Treatment cycles |
| Stratum 1: Wims Tumor | Incidence of Toxicities of Lorvotuzumab Mertansine, Using the NCI Common Terminology Criteria for Adverse Events Version 4.0 | All Reportable AEs: Grade 5 | 1 Treatment cycles |
Primary
Objective Response by Response Evaluation Criteria in Solid Tumors Version 1.1
The best response of disease will be examined separately in each stratum. A responder is defined as a patient who achieves a best response of partial response or complete response on the study. Response rates will be calculated as the percent of evaluable patients who are responders, and Clopper-Pearson confidence intervals will be constructed.
Time frame: Up to 18 weeks (6 courses)
Population: 2 participants were excluded from analysis; 1 participant never received treatment and 1 participant was ineligible, also never receiving treatment.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Stratum 1: Wims Tumor | Objective Response by Response Evaluation Criteria in Solid Tumors Version 1.1 | 0.00 Percent of participants |
| Stratum 2: Rhabdomyosarcoma | Objective Response by Response Evaluation Criteria in Solid Tumors Version 1.1 | 6.25 Percent of participants |
| Stratum 3: Neuroblastoma | Objective Response by Response Evaluation Criteria in Solid Tumors Version 1.1 | 0.00 Percent of participants |
| Stratum 4: Pleuropulmonary Blastoma | Objective Response by Response Evaluation Criteria in Solid Tumors Version 1.1 | 0.00 Percent of participants |
| Stratum 5: Malignant Peripheral Nerve Sheath Tumor | Objective Response by Response Evaluation Criteria in Solid Tumors Version 1.1 | 0.00 Percent of participants |
| Stratum 6: Synovial Sarcoma | Objective Response by Response Evaluation Criteria in Solid Tumors Version 1.1 | 0.00 Percent of participants |
Other Pre-specified
CD56 Expression
The association between CD56+ expression and response will be evaluated using the exact conditional test of proportions (Fisher?s Exact test). Analyses will be descriptive and exploratory and hypotheses generating in nature.
Time frame: Day 1 and 8 of course 1 prior to lorvotuzumab mertansine
Other Pre-specified
Pharmacokinetic (PK) Parameters of Lorvotuzumab Mertansine
A descriptive analysis of PK parameters of lorvotuzumab mertansine will be performed to define systemic exposure, drug clearance, and other pharmacokinetic parameters. The PK parameters will be summarized with simple summary statistics, including means, medians, ranges, and standard deviations (if numbers and distribution permit). Analyses will be descriptive and exploratory and hypotheses generating in nature.
Time frame: Pre-treatment, end of infusion, and 2, 6, 24, 48, and 96 hours after end of infusion on day 1 of course 1, and pre-treatment, end of infusion, and 2 and 6 hours after end of infusion on day 8 of course 1