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
Urogenital Diseases+68
+ Genital Diseases
+ Adnexal Diseases
Supportive Care Study
Summary
Study start date: November 1, 1998
Actual date on which the first participant was enrolled.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.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.13 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Supportive Care Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.From 1 to 45 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
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
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.2 intervention groups are designated in this study
This study does not include a placebo group
Treatment Groups
Group I
ExperimentalGroup II
ExperimentalStudy Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 1 location
University of Minnesota Cancer Center
Minneapolis, United StatesOpen University of Minnesota Cancer Center in Google Maps