MLN8237 in Treating Young Patients With Recurrent or Refractory Solid Tumors or Leukemia
Status: Recruiting
Phase: Phase 2
Diagnosis: Pediatric Oncology
NCT ID: NCT01154816
(View complete trial on ClinicalTrials.gov)
DFCI Protocol ID: 11-102
RATIONALE: Alisertib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. PURPOSE: This phase II trial is studying the side effects of and how well alisertib works in treating young patients with relapsed or refractory solid tumors or leukemia.
Conducting Institutions:
Dana-Farber Cancer Institute, Children's Hospital Boston
Overall PI:
Suzanne Shusterman, MD,
Dana-Farber Cancer Institute
Site-responsible Investigators:
Contacts:
Dana-Farber Cancer Institute:
Childrens Hospital Pediatric Clinical Translation Investigation Program CTIP,
ctip@partners.org
Eligibility Criteria
DISEASE CHARACTERISTICS:
- Diagnosis of 1 of the following:
- Histologically confirmed malignant solid tumor at original diagnosis or relapse
- Neuroblastoma
- Rhabdomyosarcoma (RMS)
- Osteosarcoma
- Ewing sarcoma/peripheral primitive neuroectodermal tumor
- Non-RMS soft tissue sarcoma
- Hepatoblastoma
- Malignant germ cell tumor
- Wilms tumor
- Histologically confirmed leukemia recurrent or refractory to ≥ 2 prior induction
or treatment regimens (must not be known to be refractory to red blood cell or
platelet transfusions)
- Acute lymphoblastic leukemia
- > 25% blasts in the bone marrow (M3 bone marrow), excluding known CNS
disease
- Acute myeloid leukemia
- ≥ 5 % blasts in the bone marrow (M2/M3 bone marrow), excluding known
CNS disease
- Radiographically measurable disease for solid tumors
- Patients with neuroblastoma who do not have measurable disease but have
iodine-123 metaiodobenzylguanidine (¹²³ I-MIBG)-positive lesions allowed
- None of the following qualify as measurable disease:
- Malignant fluid collections (e.g., ascites, pleural effusions)
- Bone marrow infiltration
- Lesions detected by nuclear medicine studies (e.g., bone, gallium, or PET
scans)
- Elevated tumor markers in plasma or cerebrospinal fluid
- Previously irradiated lesions that have not demonstrated clear progression
after radiotherapy
- No CNS disease (leukemia patients)
PATIENT CHARACTERISTICS:
- ECOG performance score (PS) 0-2
- Karnofsky PS 50-100% (for patients > 16 years of age)
- Lansky PS 50-100% (for patients ≤ 16 years of age)
- ANC ≥ 1,000/mm³
- ANC ≥ 750/mm³ (solid tumor and known bone marrow metastatic disease)
- Transfusion allowed
- Hemoglobin ≥ 8.0 g/dL (RBC transfusion allowed)
- Platelet count ≥ 100,000/mm³ (transfusion independent, > 7 days since platelet
transfusion )
- Platelet count ≥ 50,000/mm³ (solid tumor and known bone marrow metastatic
disease)
- Transfusion allowed
- Not refractory to RBC or platelet transfusions
- Creatinine clearance or radioisotope GFR ≥ 70 mL/min OR a serum creatinine based on
age and/or gender as follows:
- 0.6 mg/dL (1 to < 2 years of age)
- 0.8 mg/dL (2 to < 6 years of age)
- 1.0 mg/dL (6 to < 10 years of age)
- 1.2 mg/dL (10 to < 13 years of age)
- 1.5 mg/dL (male) and 1.4 mg/dL (female) (13 to < 16 years of age)
- 1.7 mg/dL (male) and 1.4 mg/dL (female) (≥ 16 years of age)
- Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
- ALT ≤ 5.0 times ULN
- Serum albumin ≥ 2 g/dL
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for ≥ 3 months after
completion of study therapy
- Not unable to swallow capsules
- No uncontrolled infection
- No patient who, in the opinion of the investigator, may not be able to comply with
the safety monitoring requirements of the study
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Fully recovered from all prior chemotherapy, immunotherapy, or radiotherapy
- More than 3 weeks since prior myelosuppressive chemotherapy (6 weeks for nitrosourea)
(solid tumor patients)
- At least 14 days since prior cytotoxic therapy (leukemia patients)
- Patients who relapse during standard maintenance therapy are not required to
wait 14 days
- At least 24 hours since prior cytoreduction with hydroxyurea
- More than 7 days since prior growth factors (14 days for pegfilgrastim [Neulasta])
- At least 7 days since prior biologic agent (antineoplastic agent)
- At least 3 half-lives since prior monoclonal antibody therapy
- At least 2 weeks since prior local palliative radiotherapy (small port)
- At least 6 weeks since prior therapeutic doses of ¹²³ I-MIBG or other
substantial bone marrow irradiation
- At least 6 months since prior craniospinal radiotherapy, radiotherapy to ≥ 50%
of the pelvis, or total-body irradiation
- At least 3 months since stem cell transplantation with no evidence of active
graft-vs-host disease
- Concurrent corticosteroids allowed provided patient is on a stable or decreasing dose
for ≥ 7 days before study enrollment
- No other concurrent investigational drugs
- No other concurrent anticancer agents, including chemotherapy, radiotherapy, or
immunomodulating agents
- No concurrent daily benzodiazepine therapy
- No concurrent P-glycoprotein substrates (e.g., digoxin, cyclosporine, tacrolimus, or
sirolimus)