A Phase I Study of the Chemoprotectant Amifostine With Autologous Stem Cell Transplantation for High Risk or Relapsed Pediatric Solid Tumors and Brain Tumors
amifostine trihydrate
+ busulfan
+ filgrastim
Enfermedades Urogenitales+54
+ Enfermedades Genitales
+ Enfermedades Anexiales
Estudio de Cuidados de Apoyo
Resumen
Fecha de inicio: 1 de noviembre de 1998
Fecha en la que se inscribió al primer participante.OBJECTIVES: Determine the dose-limiting toxicity of amifostine chemoprotection with peripheral blood stem cell transplantation plus chemotherapy in patients with high-risk or relapsed solid tumors or brain tumors. Determine response or time to disease progression in patients treated with this regimen. OUTLINE: This is a dose-escalation study of amifostine. Patients are stratified according to age (1 to 18 vs 19 to 45 years). All patients receive filgrastim (G-CSF) IV for 1 week. On day 6 of G-CSF administration, patients undergo peripheral blood stem cell (PBSC) harvest followed by chemotherapy. Patients receive oral busulfan every 6 hours on days -8 to -6 followed by melphalan IV over 30 minutes on days -5 and -4 and thiotepa IV over 2 hours on days -3 and -2. Patients receive amifostine IV over 5 minutes beginning 30 minutes prior to melphalan and thiotepa administration on days -5 to -1. PBSC are reinfused on day 0. Cohorts of 3-6 patients receive escalating doses of amifostine until the maximum tolerated dose is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Patients are followed on day 50; at 3, 6, and 9 months; and at 1, 2, and 3 years post PBSC transplantation. PROJECTED ACCRUAL: A maximum of 60 patients (30 per stratum) will be accrued for this study within 3 years.
Protocolo
Esta sección proporciona detalles del plan del estudio, incluyendo cómo está diseñado y qué se está evaluando.Se reclutarán 13 pacientes
Número total de participantes que el ensayo clínico espera reclutar.Estudio de Cuidados de Apoyo
Elegibilidad
Los investigadores buscan pacientes que cumplan ciertos criterios, conocidos como criterios de elegibilidad: estado general de salud o tratamientos previos.Cualquier sexo
Sexo biológico de los participantes elegibles para inscribirse.De 1 a 45 años
Rango de edades de los participantes que pueden unirse al estudio.Voluntarios sanos no permitidos
Indica si personas sanas, sin la condición que se estudia, pueden participar.Condiciones
Patología
Criterios
Inclusion Criteria: Histologically confirmed high-risk or relapsed solid tumors or brain tumors, including: Metastatic or relapsed Ewing's sarcoma Metastatic or relapsed rhabdomyosarcoma Refractory Wilms' tumor Diffuse anaplastic Wilms' tumor Stage III or IV neuroblastoma Recurrent retinoblastoma Metastatic or relapsed germ cell tumors Metastatic or relapsed other soft tissue sarcomas Small cell ovarian sarcoma Metastatic or relapsed primitive neuroectodermal tumors of the bone Recurrent brain tumors Desmoplastic small round cell tumors Recurrent or metastatic chordomas Metastatic or relapsed hepatoblastoma Patients receive peripheral blood stem cell transplantation only if in complete remission or in very good partial remission with no disease progression Must have radiologic, nuclear image, or histologic verification of relapse Age 1 to 45 Performance status:Karnofsky 70-100% Absolute neutrophil count greater than 1,000/mm^3 Platelet count greater than 100,000/mm^3 Hemoglobin count at least 10 g/dL Bilirubin less than 2 times upper limit of normal (ULN) SGOT or SGPT less than 2.5 times ULN Creatinine less than 2 times ULN Creatinine clearance greater than 70 mL/min Cardiac shortening fraction greater than 30% Cardiac ejection fraction greater than 45% At least 1 week since prior hematopoietic growth factor and recovered At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas) and recovered Recovered from any prior therapy Exclusion Criteria: Osteogenic sarcoma Less than 4 months Uncontrolled bleeding Congestive heart failure Uncontrolled hypertension Asthma Pregnant or nursing Uncontrolled metabolic disease Active severe infection Allergy to aminothiol compounds Prior bone marrow transplantation Other concurrent investigational agents
Plan de Estudio
Conoce todos los tratamientos administrados en este estudio, su descripción detallada y en qué consisten.2 grupos de intervención están designados en este estudio
0% de probabilidad de ser asignado al grupo placebo
Grupos de Tratamiento
Grupo I
ExperimentalGrupo II
ExperimentalCentros del Estudio
Estos son los hospitales, clínicas o centros de investigación donde se lleva a cabo el estudio. Puedes encontrar la ubicación más cercana a ti y su estado de reclutamiento.Este estudio tiene una ubicación
University of Minnesota Cancer Center
Minneapolis, United StatesAbrir University of Minnesota Cancer Center en Google Maps