NCI-COG Pediatric MATCH (Molecular Analysis for Therapy Choice) - Phase 2 Subprotocol of Selumetinib (AZD6244 Hydrogen Sulfate) in Patients With Tumors Harboring Activating MAPK Pathway Mutations

Who is this study for? Patients with Neoplasm, Refractory Non-Hodgkin Lymphoma
What treatments are being studied? Laboratory Biomarker Analysis+Selumetinib+Selumetinib Sulfate
Status: Completed
Location: See all (110) locations...
Intervention Type: Drug, Other
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

This phase II Pediatric MATCH trial studies how well selumetinib sulfate works in treating patients with solid tumors, non-Hodgkin lymphoma, or histiocytic disorders with MAPK pathway activation mutations that have spread to other places in the body and have come back or do not respond to treatment. Selumetinib sulfate may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 1
Maximum Age: 21
Healthy Volunteers: f
View:

• Patient must have enrolled onto APEC1621SC and must have been given a treatment assignment to molecular analysis for therapy choice (MATCH) to APEC1621E based on the presence of an actionable mutation

‣ Note: patients with BRAF V600 actionable mutations of interest (aMOIs) will be preferentially assigned to APEC1621G (vemurafenib) if that study is open and they are otherwise eligible for it

• Patients must have a body surface area \>= 0.5 m\^2 at enrollment

• Patients must have radiographically measurable disease at the time of study enrollment; patients with neuroblastoma who do not have measurable disease but have iobenguane (MIBG) positive (+) evaluable disease are eligible; measurable disease in patients with CNS involvement is defined as tumor that is measurable in two perpendicular diameters on magnetic resonance imaging (MRI) and visible on more than one slice

‣ Note: the following do not qualify as measurable disease:

• Malignant fluid collections (e.g., ascites, pleural effusions)

∙ Bone marrow infiltration except that detected by MIBG scan for neuroblastoma

∙ Lesions only detected by nuclear medicine studies (e.g., bone, gallium or positron emission tomography \[PET\] scans) except as noted for neuroblastoma

∙ Elevated tumor markers in plasma or cerebrospinal fluid (CSF)

∙ Previously radiated lesions that have not demonstrated clear progression post radiation

∙ Leptomeningeal lesions that do not meet the measurement requirements for Response Evaluation Criteria in Solid Tumors (RECIST) 1.1

• Karnofsky \>= 50% for patients \> 16 years of age and Lansky \>= 50 for patients =\< 16 years of age; 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

• Patients must have fully recovered from the acute toxic effects of all prior anti-cancer therapy and must meet the following minimum duration from prior anti-cancer directed therapy prior to enrollment; if after the required timeframe, the numerical eligibility criteria are met, e.g. blood count criteria, the patient is considered to have recovered adequately

‣ Cytotoxic chemotherapy or other anti-cancer agents known to be myelosuppressive: \>= 21 days after the last dose of cytotoxic or myelosuppressive chemotherapy (42 days if prior nitrosourea)

⁃ Anti-cancer agents not known to be myelosuppressive (e.g. not associated with reduced platelet or absolute neutrophil count \[ANC\] counts): \>= 7 days after the last dose of agent

⁃ Antibodies: \>= 21 days must have elapsed from infusion of last dose of antibody, and toxicity related to prior antibody therapy must be recovered to grade =\< 1

⁃ Corticosteroids: if used to modify immune adverse events related to prior therapy, \>= 14 days must have elapsed since last dose of corticosteroid

⁃ Hematopoietic growth factors: \>= 14 days after the last dose of a long-acting growth factor (e.g. pegfilgrastim) or 7 days for short-acting growth factor; for growth factors 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 and the study-assigned research coordinator

⁃ Interleukins, interferons and cytokines (other than hematopoietic growth factors): \>= 21 days after the completion of interleukins, interferon or cytokines (other than hematopoietic growth factors)

⁃ Stem cell Infusions (with or without total body irradiation \[TBI\]):

• Allogeneic (non-autologous) bone marrow or stem cell transplant, or any stem cell infusion including donor lymphocyte infusion (DLI) or boost infusion: \>= 84 days after infusion and no evidence of graft versus host disease (GVHD)

∙ Autologous stem cell infusion including boost infusion: \>= 42 days

⁃ Cellular therapy: \>= 42 days after the completion of any type of cellular therapy (e.g. modified T cells, natural killer \[NK\] cells, dendritic cells, etc.)

⁃ X-ray therapy (XRT)/external beam irradiation including protons: \>= 14 days after local XRT; \>= 150 days after TBI, craniospinal XRT or if radiation to \>= 50% of the pelvis; \>= 42 days if other substantial bone marrow (BM) radiation

• Note: radiation may not be delivered to measurable disease tumor site(s) being used to follow response to subprotocol treatment

⁃ Radiopharmaceutical therapy (e.g., radiolabeled antibody, iodine I 131 metaiodobenzylguanidine \[131I-MIBG\]): \>= 42 days after systemically administered radiopharmaceutical therapy

⁃ Patients must not have received prior exposure to selumetinib (AZD6244 hydrogen sulfate)

• For patients with solid tumors without known bone marrow involvement:

‣ Peripheral absolute neutrophil count (ANC) \>= 1000/mm\^3 within 7 days prior to enrollment

⁃ Platelet count \>= 100,000/mm\^3 (transfusion independent, defined as not receiving platelet transfusions for at least 7 days prior to enrollment)

• Patients with known bone marrow metastatic disease will be eligible for study provided they meet the blood counts (may receive transfusions provided they are not known to be refractory to red cell or platelet transfusions); these patients will not be evaluable for hematologic toxicity

• Creatinine clearance or radioisotope glomerular filtration rate (GFR) within 7 days prior to enrollment \>= 70 ml/min/1.73 m\^2 or a serum creatinine based on age/gender as follows:

‣ Age: 1 to \< 2 years; maximum serum creatinine (mg/dL): male 0.6; female 0.6

⁃ Age: \>= 16 years; maximum serum creatinine (mg/dL): male 1.7; female 1.4

• Bilirubin (sum of conjugated + unconjugated) =\< 1.5 x upper limit of normal (ULN) for age within 7 days prior to enrollment

• Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\]) =\< 135 U/L; (for the purpose of this study, the ULN for SGPT is 45 U/L) within 7 days prior to enrollment

• Serum albumin \>= 2 g/dL within 7 days prior to enrollment

• Shortening fraction of \>= 27% by echocardiogram, or ejection fraction of \>= 50% by gated radionuclide study within 7 days prior to enrollment

• A blood pressure (BP) =\< the 95th percentile for age, height, and gender measured within 7 days prior to enrollment; please note that 3 serial blood pressures should be obtained and averaged to determine baseline BP; patients with hypertension controlled on antihypertensive medications will be allowed if otherwise eligible

• Serum triglyceride level =\< 300 mg/dL within 7 days prior to enrollment

• Serum total cholesterol level =\< 300 mg/dL within 7 days prior to enrollment

• Patients must be able to swallow intact capsules whole

• 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
Alabama
Children's Hospital of Alabama
Birmingham
Arkansas
Arkansas Children's Hospital
Little Rock
Arizona
Banner Children's at Desert
Mesa
Phoenix Childrens Hospital
Phoenix
California
Kaiser Permanente Downey Medical Center
Downey
Loma Linda University Medical Center
Loma Linda
Miller Children's and Women's Hospital Long Beach
Long Beach
Children's Hospital Los Angeles
Los Angeles
Mattel Children's Hospital UCLA
Los Angeles
Valley Children's Hospital
Madera
Kaiser Permanente-Oakland
Oakland
UCSF Benioff Children's Hospital Oakland
Oakland
Lucile Packard Children's Hospital Stanford University
Palo Alto
UCSF Medical Center-Mission Bay
San Francisco
Colorado
Children's Hospital Colorado
Aurora
Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
Denver
Connecticut
Yale University
New Haven
Washington, D.c.
Children's National Medical Center
Washington D.c.
Delaware
Alfred I duPont Hospital for Children
Wilmington
Florida
University of Florida Health Science Center - Gainesville
Gainesville
Nemours Children's Clinic-Jacksonville
Jacksonville
Nicklaus Children's Hospital
Miami
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami
Arnold Palmer Hospital for Children
Orlando
Nemours Children's Hospital
Orlando
Nemours Children's Clinic - Pensacola
Pensacola
Johns Hopkins All Children's Hospital
St. Petersburg
Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa
Saint Mary's Medical Center
West Palm Beach
Georgia
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta
Memorial Health University Medical Center
Savannah
Hawaii
Kapiolani Medical Center for Women and Children
Honolulu
Iowa
Blank Children's Hospital
Des Moines
University of Iowa/Holden Comprehensive Cancer Center
Iowa City
Idaho
Saint Luke's Cancer Institute - Boise
Boise
Illinois
Lurie Children's Hospital-Chicago
Chicago
University of Chicago Comprehensive Cancer Center
Chicago
Saint Jude Midwest Affiliate
Peoria
Indiana
Riley Hospital for Children
Indianapolis
Kentucky
Norton Children's Hospital
Louisville
Louisiana
Children's Hospital New Orleans
New Orleans
Ochsner Medical Center Jefferson
New Orleans
Maryland
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore
Sinai Hospital of Baltimore
Baltimore
Maine
Eastern Maine Medical Center
Bangor
Michigan
C S Mott Children's Hospital
Ann Arbor
Minnesota
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis
University of Minnesota/Masonic Cancer Center
Minneapolis
Missouri
Children's Mercy Hospitals and Clinics
Kansas City
Cardinal Glennon Children's Medical Center
St Louis
Mercy Hospital Saint Louis
St Louis
Washington University School of Medicine
St Louis
Mississippi
University of Mississippi Medical Center
Jackson
North Carolina
Mission Hospital
Asheville
Carolinas Medical Center/Levine Cancer Institute
Charlotte
Novant Health Presbyterian Medical Center
Charlotte
Duke University Medical Center
Durham
Nebraska
Children's Hospital and Medical Center of Omaha
Omaha
University of Nebraska Medical Center
Omaha
New Jersey
Hackensack University Medical Center
Hackensack
Morristown Medical Center
Morristown
Saint Peter's University Hospital
New Brunswick
Nevada
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas
Summerlin Hospital Medical Center
Las Vegas
University Medical Center of Southern Nevada
Las Vegas
New York
Roswell Park Cancer Institute
Buffalo
The Steven and Alexandra Cohen Children's Medical Center of New York
New Hyde Park
Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York
NYP/Weill Cornell Medical Center
New York
University of Rochester
Rochester
State University of New York Upstate Medical University
Syracuse
Ohio
Children's Hospital Medical Center of Akron
Akron
Cincinnati Children's Hospital Medical Center
Cincinnati
Cleveland Clinic Foundation
Cleveland
Nationwide Children's Hospital
Columbus
Dayton Children's Hospital
Dayton
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo
Oklahoma
University of Oklahoma Health Sciences Center
Oklahoma City
Oregon
Legacy Emanuel Children's Hospital
Portland
Oregon Health and Science University
Portland
Pennsylvania
Geisinger Medical Center
Danville
Children's Hospital of Philadelphia
Philadelphia
Children's Hospital of Pittsburgh of UPMC
Pittsburgh
South Carolina
BI-LO Charities Children's Cancer Center
Greenville
South Dakota
Sanford USD Medical Center - Sioux Falls
Sioux Falls
Tennessee
East Tennessee Childrens Hospital
Knoxville
Saint Jude Children's Research Hospital
Memphis
Vanderbilt University/Ingram Cancer Center
Nashville
Texas
Dell Children's Medical Center of Central Texas
Austin
Medical City Dallas Hospital
Dallas
UT Southwestern/Simmons Cancer Center-Dallas
Dallas
Cook Children's Medical Center
Fort Worth
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston
M D Anderson Cancer Center
Houston
Children's Hospital of San Antonio
San Antonio
Methodist Children's Hospital of South Texas
San Antonio
University of Texas Health Science Center at San Antonio
San Antonio
Utah
Primary Children's Hospital
Salt Lake City
Virginia
Children's Hospital of The King's Daughters
Norfolk
Virginia Commonwealth University/Massey Cancer Center
Richmond
Vermont
University of Vermont and State Agricultural College
Burlington
Washington
Seattle Children's Hospital
Seattle
Providence Sacred Heart Medical Center and Children's Hospital
Spokane
Madigan Army Medical Center
Tacoma
Wisconsin
University of Wisconsin Carbone Cancer Center - University Hospital
Madison
Children's Hospital of Wisconsin
Milwaukee
West Virginia
West Virginia University Healthcare
Morgantown
Other Locations
Puerto Rico
San Jorge Children's Hospital
San Juan
University Pediatric Hospital
San Juan
Time Frame
Start Date: 2017-10-30
Completion Date: 2024-12-31
Participants
Target number of participants: 21
Treatments
Experimental: Treatment (selumetinib)
Patients receive selumetinib sulfate PO BID on days 1-28. Cycles repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity.
Authors
Laura A. Campbell, Angela R. Girvin, Kenneth J. Cohen, Kelly L. Vallance, Erin H. Breese, Alberto S. Pappo, David O. Walterhouse, Alexander Aledo, Douglas S. Hawkins, Vinod K. Gidvani-Diaz, Julio C. Barredo, Gita V. Massey, Luis A. Clavell, Rene Y. McNall-Knapp, Eric J. Lowe, William A. May, Kevin F. Ginn, Nadine P. SantaCruz, Mariko Sato, Ashok B. Raj, John J. Gregory, Jodi Muscal, Jessica Boklan, Stacie L. Stapleton, Stanton C. Goldman, Kayelyn J. Wagner, Joel A. Kaplan, Phillip E. Barnette, Hardeo K. Panchoosingh, Timothy C. Griffin, Robin D. Hanson, Vincent F. Giusti, Jaszianne A. Tolbert, Carl Allen, Scott C. Borinstein, Don E. Eslin, William B. Slayton, Lolie C. Yu, Mark J. Mogul, Kamnesh R. Pradhan, Aron Flagg, Mark A. Ranalli, Leo Mascarenhas, Ray C. Pais, Jamie L. Dargart, Nibal A. Zaghloul, Sheri L. Spunt, Andrew L. Pendleton, Rajen Mody, Margaret E. Macy, Clare J. Twist, Craig Lotterman, Erlyn C. Smith, Sandeep Batra, Suman Malempati, Emily G. Greengard, Jacqueline N. Casillas, Robert M. Cooper, Christopher J. Forlenza, Carla B. Golden, Elizabeth D. Alva, Douglas J. Scothorn, William T. Cash, Judy L. Felgenhauer, Minnie Abromowitch, Fariba Navid, Wade T. Kyono, William S. Ferguson, Shannon M. Cohn, Scott M. Bradfield, Robert E. Goldsby, Nichole L. Bryant, Santosh S. Hanmod, Wendy L. Woods-Swafford, Susan G. Kreissman, Steven K. Bergstrom, Jeffrey R. Andolina, Jagadeesh Ramdas, Philip M. Monteleone, Robert J. Hayashi, Elizabeth Fox, Katharine Offer, Alan K. Ikeda, Samantha L. Mallory, Enrique A. Escalon, Janice F. Olson, Michael K. Richards, Steven J. Kuerbitz, James I. Geller, Sharon L. Gardner, Jessica A. Bell, Jessica L. Heath, Jeffrey S. Dome, Melissa A. Forouhar, Arun A. Rangaswami, Lars M. Wagner, David L. Becton, Paul D. Harker-Murray, Eugenia Chang, Albert Kheradpour, Bethany G. Sleckman, Jean M. Tersak, Jason M. Fixler, Linda C. Stork, Julie I. Krystal, Vonda L. Crouse, Narayana Gowda
Sponsors
Leads: National Cancer Institute (NCI)

This content was sourced from clinicaltrials.gov

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