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Cyclophosphamide and Prednisone With or Without Immunoglobulin in Treating Abnormal Muscle Movement in Children With Neuroblastoma - NCT00033293-32207(Clinical Trial 114268)



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City:  Jacksonville
State:  
FL
Zip Code: 32207
Conditions: Neuroblastoma
Purpose: RATIONALE: Drugs used in chemotherapy, work in different ways to stop tumor cells from dividing so they stop growing or die. Steroid therapy decreases inflammation. Combining chemotherapy and steroid therapy with immunoglobulin may be effective in treating abnormal muscle movement associated with neuroblastoma. PURPOSE: This randomized phase II trial is studying cyclophosphamide, prednisone, and immunoglobulin to see how well they work compared to cyclophosphamide and prednisone alone in treating patients with abnormal trunk muscle movements associated with neuroblastoma.
Study summary: OBJECTIVES: - Determine whether cyclophosphamide and prednisone with or without immune globulin is a reasonable baseline standard therapy for pediatric patients with neuroblastoma-associated opsoclonus-myoclonus-ataxia (OMA) syndrome. - Determine whether immunosuppressive therapy with cyclophosphamide and prednisone is an effective backbone therapy for OMA upon which to build additional treatment for these patients. - Determine whether these regimens improve OMA syndrome in these patients. - Determine whether these regimens improve motor coordination in these patients. - Determine whether these regimens improve functional outcome in these patients. - Compare the event-free and overall survival of patients treated with these regimens. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to risk group per protocol COG-ANBL00B1 (low risk vs intermediate risk on COG-A3961 vs high risk on COG-A3973). - Chemotherapy: Patients with intermediate-risk or high-risk neuroblastoma receive chemotherapy (including cyclophosphamide) according to the standard of care for the stage of primary neuroblastoma, beginning on day 0. Patients with low-risk neuroblastoma (and not receiving other chemotherapy) receive cyclophosphamide IV over 1 hour on day 0. Treatment repeats every 4 weeks for 6 courses in the absence of disease progression or unacceptable toxicity. All patients receive oral prednisone twice daily for 3 months and then every other day for 7-15 months. - Immune globulin therapy: Patients are randomized to 1 of 2 treatment arms. - Arm I: Patients receive immune globulin IV on days -2 and -1, at weeks 4, 8, 12, 16, 20, and 24, and then at months 8, 10, and 12 after therapy. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients with no response after 6 months go off treatment. - Arm II: Patients do not receive immune globulin. Patients with unresponsive opsoclonus-myoclonus-ataxia syndrome after 2 months or progression after 6 months may cross over to arm I. Patients are followed during therapy every month for 6 months, at 1 year, and then annually thereafter. PROJECTED ACCRUAL: A total of 18-52 patients (9-26 per treatment arm) will be accrued for this study within 2-5.8 years.
Criteria: DISEASE CHARACTERISTICS: - Newly diagnosed neuroblastoma (NBL) or ganglioneuroblastoma with tumor-associated opsoclonus-myoclonus-ataxia syndrome (OMA) - Patients with NBL diagnosed within 6 months of OMA diagnosis AND patients with OMA diagnosed within 6 months of NBL diagnosis are eligible - Must enroll on study within 4 weeks of diagnosis - Presence of opsoclonus, myoclonus, and/or ataxia associated with neuroblastoma considered eligible - Currently enrolled on COG neuroblastoma protocols: COG-ANBL00B1 or its successor PATIENT CHARACTERISTICS: Age: - 8 and under at the time of diagnosis Performance status: - Not specified Life expectancy: - Not specified Hematopoietic: - Not specified Hepatic: - Not specified Renal: - Creatinine clearance or radioisotope GFR ≥ 70 mL/min OR serum creatinine based on age/gender as follows: - ≤ 0.4 mg/dL (for patients 1 to 5 months of age) - ≤ 0.5 mg/dL (for patients 6 to 11 months of age) - ≤ 0.6 mg/dL (for patients 1 year of age) - ≤ 0.8 mg/dL (for patients 2 to 5 years of age) - ≤ 1.0 mg/dL (for patients 6 to 9 years of age) - ≤ 1.2 mg/dL (for patients 10 to 12 years of age) - ≤ 1.4 mg/dL (for female patients ≥ 13 years of age) - ≤ 1.5 mg/dL (for male patients 13 to 15 years of age) - ≤ 1.6 mg/dL (for male patients ≥ 16 years of age) PRIOR CONCURRENT THERAPY: Biologic therapy: - No prior IV gamma globulin therapy Chemotherapy: - No prior chemotherapy - Concurrent chemotherapy allowed Endocrine therapy: - No prior prednisone or corticotropin - Patients who have received ≤ 14 days of steroids are eligible Radiotherapy: - Not specified Surgery: - Concurrent surgery allowed
Study is available at: Nemours Children's Clinic
Jacksonville, FL 32207
United States

Primary Contact:
Eric S. Sandler
Phone: 904-697-3793
If you are interested in this clinical trial please use the contact information above. If you would like to get additional information about this clinical trial please visit ClinicalTrials.gov.
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Data Source: ClinicalTrials.gov
Date Processed: March 21, 2011
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