Study of Chemoimmunotherapy for High-Risk Neuroblastoma

Memorial Sloan Kettering Cancer Center (MSK)

Status and phase: Active, not recruiting; Early Phase 1

Conditions: Neuroblastoma (NB)

Treatments: Drug: GM-CSF; Biological: Hu3F8; Drug: Irinotecan; Drug: temozolomide

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT03189706

17-251

Details and patient eligibility

About

The purpose of this study is to find out whether an experimental drug called Hu3F8 can be given with the chemotherapy drugs irinotecan and temozolomide and another drug called GM-CSF. The investigators want to find out if this combination is safe and what effect it has on the participant and the disease.

Enrollment: 48 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosis of NB as defined by international criteria,.e., histopathology (confirmed by the MSK Department of Pathology) or bone marrow metastases plus high urine catecholamine levels

• High-risk NB as defined as any of the following:

  • Stage 4 with MYCN amplification (any age)
  • Stage 4 without MYCN amplification (>1.5 years of age)
  • Stage 3 with MYCN amplification (unresectable; any age)
  • Stage 4S with MYCN amplification (any age)

• Patients fulfill one of the following criteria:

  1. Have evidence of soft tissue disease OR

  2. If they only have osteomedullary disease at protocol enrollment, they should have:

     • Had previously received Hu3F8+GMCSF therapy AND have had less than a complete response to it OR
     • Had progressed progressive disease after their most recent anti-neuroblastoma therapeutic regimen

• Patients must have evaluable (microscopic marrow metastasis, elevated tumor markers, positive MIBG or PET scans) or measurable (CT, MRI) disease documented after completion of prior systemic therapy.

• Prior treatment with murine and hu3F8 is allowed.

• Prior treatment with irinotecan or temozolomide is permitted.

• Patients with prior m3F8, hu3F8, ch14.18 or hu14.18 treatment must have a negative HAHA antibody titer. Human anti-mouse antibody positivity is allowed.

• Signed informed consent indicating awareness of the investigational nature of this program.

Exclusion criteria

• Patients with CR/VGPR disease
• Existing severe major organ dysfunction, i.e., renal, cardiac, hepatic, neurologic, pulmonary, or gastrointestinal toxicity ≥ grade 3 except for hearing loss, alopecia, anorexia, nausea, and hypomagnesemia from TPN, which may be grade 3
• ANC < 500/uL
• Platelet count <30K/uL
• History of allergy to mouse proteins
• Active life-threatening infection
• Inability to comply with protocol requirements
• Women who are pregnant or breast-feeding

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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48 participants in 1 patient group

Hu3F8, Irinotecan/Temozolomide and Sargramostim (HITS)

Experimental group

Description:

Each cycle consists of four doses of hu3F8, five doses each of irinotecan and temozolomide and five doses of GM-CSF.

Treatment:

Drug: temozolomide

Drug: Irinotecan

Biological: Hu3F8

Drug: GM-CSF