Phase 2 Study of Systemic IL-6 Receptor Antagonist ACTEMRA® (Tocilizumab) for the Treatment of Progressive/Recurrent Pediatric Adamantinomatous Craniopharyngioma

Who is this study for? Patients with progressive/recurrent pediatric adamantinomatous craniopharyngioma
What treatments are being studied? Tocilizumab
Status: Recruiting
Location: See all (11) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

ACTEMRA (tocilizumab) is an IL-6 receptor antagonist used for the treatment of adult Rheumatoid Arthritis as well as Polyarticular (PJIA) and Systemic (SJIA) Juvenile Idiopathic Arthritis. In this Phase II, the drug will be used to treat pediatric patients diagnosed with recurrent Adamantinomatous Craniopharyngioma including patients who have undergone surgery and/or radiation therapy.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 1
Maximum Age: 39
Healthy Volunteers: f
View:

• Age: Patients must be ≥ 12 months and ≤ 39 years of age at the time of study enrollment.

• Diagnosis: Patients with histologically-confirmed adamantinomatous craniopharyngioma (ACP) Histologic confirmation of ACP may be made on solid tumor or, if no solid tumor can be safely obtained, cyst fluid with classic ACP characteristics of thick, cholesterol-rich, greenish-brown liquid in the context of imaging features consistent with craniopharyngioma, including lobulated, cystic/solid mass with calcifications that originates in the sellar/suprasellar region.

• Disease Status: Patients must have measurable disease.

‣ Stratum 1: Patients with progressive or recurrent ACP who demonstrate cystic and/or solid recurrence or progression at least 6 months post completion of radiation therapy

⁃ Stratum 2: Patients with measurable ACP who have undergone surgery but have NOT previously undergone irradiation (but may have received prior systemic or intracystic therapy). Progressive disease is allowed but not required.

• Performance Level: Karnofsky ≥ 50% for patients \> 16 years of age and Lansky ≥ 50 for patients ≤ 16 years of age (See Appendix I). Note: Neurologic deficits in patients with CNS tumors must have been stable for at least 7 days prior to study enrollment. Patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score.

• Prior Therapy: Patients must have recovered or stabilized from the acute toxic effects of prior treatments

‣ Biologic (anti-neoplastic agent): At least 7 days must have elapsed after the last (systemic or intracystic) dose of a biologic agent. For agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur. The duration of this interval must be discussed with the study chair

⁃ Immunotherapy: At least 42 days after the completion of any type of systemic immunotherapy, e.g. tumor vaccines.

⁃ Monoclonal antibodies: At least 21 days after the last dose of a monoclonal antibody.

⁃ Radiation therapy: Patients must have had their last (conventional or hypofractionated) fraction of: a) Focal irradiation \> 6 months prior to enrollment and b) No prior craniospinal irradiation is permitted.

⁃ Corticosteroids: Patients receiving dexamethasone must be on a stable or decreasing dose for at least 1 week prior to enrollment

⁃ Myelosuppressive systemic therapy: At least 21 days must have elapsed after the last systemic myelosuppressive therapy.

⁃ Surgery: At least 6 weeks must have elapsed since major or intermediate surgery. Major surgery includes major craniotomy for tumor resection or cyst fenestration, organ resection, exploratory laparotomy. Intermediate procedures include ventriculoperitoneal shunt placement, stereotactic brain biopsy and intraventricular catheter placement. Minor procedures that are not excluded include skin biopsy/incision and drainage, bone marrow aspirate, and central venous catheter placement. Ommaya aspirations and Lumbar Punctures are considered minor procedures..

• Organ Function Requirements

• Adequate Bone Marrow Function Defined as:

⁃ Peripheral absolute neutrophil count (ANC) ≥1000/mm3

⁃ Platelet count ≥100,000/mm3 (transfusion independent, defined as not receiving platelet transfusions for at least 7 days prior to enrollment)

⁃ Hemoglobin \>8 g/dL (may be transfused)

• Adequate Renal Function Defined as:

⁃ Creatinine clearance or radioisotope GFR \> 70ml/min/1.73 m2 or

⁃ A serum creatinine based on (Schwartz et al. J. Peds, 106:522, 1985) age/gender as follows:

‣ 1 to \< 2 years: maximum serum creatinine 0.6 mg/dL for males and females. 2 to \< 6 years: maximum serum creatinine 0.8 mg/dL for males and females. 6 to \< 10 years: maximum serum creatinine 1.0 mg/dL for males and females. 10 to \< 13 years: maximum serum creatinine 1.2 mg/dL for males and females. 13 to \< 16 years: maximum serum creatinine 1.5 mg/dL for males and 1.4 mg/dL for females.

‣ ≥ 16 years: maximum serum creatinine 1.7 mg/dL for males and 1.4 mg/dL for females.

• Adequate Liver Function Defined as:

⁃ Total bilirubin within normal institutional limits

⁃ AST (SGOT) ≤ 2.5 × institutional upper limit of normal

⁃ ALT (SGPT) ≤ 2.5 × institutional upper limit of normal

• Adequate Neurologic Function Defined as:

⁃ Patients with neurological deficits should have deficits that are stable for a minimum of 1 week prior to enrollment.

⁃ Patients with current seizure disorders may be enrolled if seizures are well-controlled on antiepileptic therapies.

• Informed Consent: All patients and/or their parents or legally authorized representatives must sign a written informed consent. Assent, when appropriate, will be obtained according to institutional guidelines.

Locations
United States
Colorado
Children's Hospital Colorado
RECRUITING
Aurora
Washington, D.c.
Children's National Medical Center
RECRUITING
Washington D.c.
Florida
Nicklaus Children's Hospital
RECRUITING
Miami
North Carolina
Duke Children's Hospital
RECRUITING
Durham
Ohio
Cincinnati Children's Hospital Medical Center
RECRUITING
Cincinnati
Nationwide Children's Hospital
RECRUITING
Columbus
Washington
Seattle Children's Hospital
RECRUITING
Seattle
Other Locations
Australia
Perth Children's Hospital
RECRUITING
Perth
Sydney Children's Hospital
RECRUITING
Randwick
Queensland Children's Hospital
RECRUITING
South Brisbane
Canada
McGill University Health Center
RECRUITING
Montreal
Contact Information
Primary
Kelsey H Troyer, PhD
kelsey.troyer@nationwidechildrens.org
16147223284
Time Frame
Start Date: 2022-12-16
Estimated Completion Date: 2027-12
Participants
Target number of participants: 38
Treatments
Experimental: Stratum 1 and Stratum 2
Stratum 1: Patients with progressive or recurrent adamantinomatous craniopharyngiomas following radiation therapy.~Stratum 2: Patients with measurable adamantinomatous craniopharyngioma who have undergone surgery but have not previously received radiation therapy. Progressive disease is allowed but not required
Sponsors
Collaborators: Children's Hospital Colorado
Leads: Nationwide Children's Hospital

This content was sourced from clinicaltrials.gov