A Phase II Study Of hu14.18-IL2 In Children With Recurrent Or Refractory Neuroblastoma

Date de début de l'étude : 1 août 2005

DISEASE CHARACTERISTICS: * Histologically confirmed neuroblastoma * Relapsed or refractory to conventional therapy * Measurable or evaluable disease documented by 1 of the following criteria: * Clinical * Radiographic * Histologic * MIBG (meta-iodobenzylguanidine) scanning * Immunocytochemistry * No symptomatic pleural effusions or ascites requiring constant or intermittent drainage * No clinical or radiological evidence of central nervous system (CNS) disease PATIENT CHARACTERISTICS: Age * 21 and under Performance status * Karnofsky 50-100% (\> 16 years of age) * Lansky 50-100% (≤ 16 years of age) Life expectancy * At least 8 weeks Hematopoietic * Absolute neutrophil count \> 1,000/mm\^3 * Platelet count ≥ 75,000/mm\^3\* * Must not be refractory to platelet transfusions * Hemoglobin ≥ 9.0 g/dL\* NOTE: \*Transfusion allowed if patient is known to have a history of bone marrow involvement with tumor Hepatic * Alanine transaminase (ALT) \< 2.5 times upper limit of normal (ULN) * Bilirubin ≤ 1.5 times ULN * Hepatitis B surface antigen negative Renal * Creatinine adjusted according to age as follows: * No greater than 0.4 mg/dL (≤ 5 months) * No greater than 0.5 mg/dL (6 months -11 months) * No greater than 0.6 mg/dL (1 year-23 months) * No greater than 0.8 mg/dL (2 years-5 years) * No greater than 1.0 mg/dL (6 years-9 years) * No greater than 1.2 mg/dL (10 years-12 years) * No greater than 1.4 mg/dL (13 years and over \[female\]) * No greater than 1.5 mg/dL (13 years to 15 years \[male\]) * No greater than 1.7 mg/dL (16 years and over \[male\]) OR * Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min Cardiovascular * Shortening fraction ≥ 27% by echocardiogram OR * Ejection fraction ≥ 50% by Multi Gated Acquisition Scan (MUGA) * No symptomatic congestive heart failure * No uncontrolled cardiac rhythm disturbance Pulmonary * Pulse oximetry \> 94% on room air * Forced vital capacity (FVC) \> 80% * Forced expiratory volume (FEV_1) \> 80% * No abnormal respiratory function * No dyspnea at rest * No exercise intolerance * No prior history of ventilator support related to lung injury (e.g., pneumonia, hemorrhagic pneumonitis, or capillary leakage) Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * HIV negative * No active uncontrolled infection * No active uncontrolled peptic ulcer * No objective peripheral neuropathy ≥ grade 2 * No significant psychiatric disabilities * No seizure disorders requiring antiseizure medications * No other concurrent significant illness PRIOR CONCURRENT THERAPY: Biologic therapy * Recovered from prior immunotherapy * Prior in vivo monoclonal antibodies for biologic therapy or tumor imaging allowed provided there is documented absence of detectable antibody to hu14.18 by serology * More than 28 days since prior autologous stem cell transplantation * Prior autologous marrow or stem cell infusion using monoclonal antibody-purged specimens allowed * More than 1 week since prior growth factors * At least 7 days since prior nonmyelosuppressive biologic agents * No prior allogeneic bone marrow or stem cell transplantation * No concurrent immunomodulating agents * No concurrent growth factors Chemotherapy * More than 3 weeks since prior myelosuppressive chemotherapy (4 weeks for nitrosoureas) and recovered * No concurrent anticancer chemotherapy Endocrine therapy * No concurrent corticosteroids except 100 mg or less of hydrocortisone (or equivalent) as premedication for blood transfusion or treatment for transfusion reaction * No other use of systemic steroids Radiotherapy * Recovered from prior radiotherapy * At least 2 weeks since prior local palliative radiotherapy (small port) * At least 6 months since prior craniospinal radiotherapy * At least 6 months since prior total body irradiation * At least 6 months since prior radiotherapy to ≥ 50% of the pelvis * At least 6 weeks since other prior substantial bone marrow radiotherapy * Concurrent radiotherapy to localized painful lesions allowed provided at least 1 measurable or evaluable lesion is not irradiated Surgery * More than 2 weeks since prior major surgery (e.g., laparotomy or thoracotomy) * No prior organ allografts Other * No concurrent immunosuppressive drugs * No other concurrent myelosuppressive antineoplastic drugs