PEACH TRIAL- Precision mEdicine and Adoptive Cellular tHerapy for the Treatment of Recurrent Neuroblastoma and Newly Diagnosed Diffuse Intrinsic Pontine Glioma (DIPG)

Who is this study for? Patients with Malignant Glioma, Neuroblastoma
What treatments are being studied? Tumor-Specific Ex Vivo Expanded Autologous Lymphocyte Transfer (TTRNA-xALT)
Status: Recruiting
Location: See all (3) locations...
Intervention Type: Biological
Study Type: Interventional
Study Phase: Phase 1
SUMMARY

A Phase I open-label, multicenter study, to evaluate the safety, feasibility, and maximum tolerated dose (MTD) of treating children with newly diagnosed DIPG or recurrent neuroblastoma with molecular targeted therapy in combination with adoptive cell therapy (Total tumor mRNA-pulsed autologous Dendritic Cells (DCs) (TTRNA-DCs), Tumor-specific ex vivo expanded autologous lymphocyte transfer (TTRNA-xALT) and Autologous G-CSF mobilized Hematopoietic Stem Cells (HSCs)).

Eligibility
Participation Requirements
Sex: All
Minimum Age: 1
Maximum Age: 30
Healthy Volunteers: f
View:

• Subjects must have proven pediatric cancer with confirmation at diagnosis or at the time of recurrence/progression and clinical determination of disease for which there is no known effective curative therapy or disease that is refractory to established proven therapies fitting into one of the following categories:

• Disease Status:

‣ High Risk Neuroblastoma-

⁃ Patients that have relapsed following standard of care therapy or having progressed during standard of care therapy and non-responsive/progressive to accepted curative chemotherapy.

⁃ Neuroblastoma must be age \>12 months at enrollment

‣ Diffuse Intrinsic Pontine (or other brain stem) Glioma

⁃ Newly-diagnosed patients willing to undergo biopsy

⁃ Must be within 2 months of diagnosis and prior to starting radiation

⁃ DIPG must be ≥ 3 years of age at enrollment

∙ All subjects must be age ≤ 30 years at enrollment

‣ Patient and/or parents/guardian willing to consent to biopsy for obtaining tumor material for confirmatory diagnosis and/or tumor RNA extraction and amplification.

‣ Subjects must have measurable disease as defined Per section 8 at the time of biopsy and tumor must be accessible for biopsy. Tumor samples submitted for analysis must contain \>30% viable tumor tissue to qualify. In addition, subjects with NB disease confined to the bone marrow are eligible to enroll if the degree of marrow involvement is expected to be \>30%.

‣ Current disease state must be one for which there is currently no known effective therapy

‣ Specimens will be obtained only in a non-significant risk manner and not solely for the purpose of investigational testing.

‣ Lansky or Karnofsky Score must be ≥ 60

‣ Bone Marrow:

⁃ ANC (Absolute neutrophil count) ≥ 1000/µl (unsupported)

• Platelets ≥ 100,000/µl (can be transfused)

• Hemoglobin \> 8 g/dL (can be transfused)

‣ Renal: Serum creatinine ≤ upper limit of institutional normal.

‣ Adequate liver function must be demonstrated, defined as:

⁃ Total bilirubin ≤ 1.5 x upper limit of normal (ULN) for age AND

• ALT (SGPT) ≤ 3 times upper limit of normal (ULN) for age

• AST (SGOT) ≤ 3 times upper limit of normal (ULN) for age.

‣ Subjects with CNS disease currently taking steroids must have been on a stable dose of steroids for at least one week prior to their biopsy and must not have progressive hydrocephalus at enrollment.

‣ A negative serum pregnancy test is required for female participants of childbearing potential (≥13 years of age or after onset of menses)

‣ Both male and female post-pubertal study subjects need to agree to use one of the more effective birth control methods during treatment and for six months after treatment is stopped. These methods include total abstinence (no sex), oral contraceptives (the pill), an intrauterine device (IUD), levonorgestrel implants (Norplant), or medroxyprogesterone acetate injections (Depo-provera shots). If one of these cannot be used, contraceptive foam with a condom is recommended.

‣ Informed Consent: All subjects and/or legal guardians must sign informed written consent. Assent, when appropriate, will be obtained according to institutional guidelines

‣ Post-Biopsy: Patients with post-biopsy neurological deficits should have deficits that are stable for a minimum of 1 week prior to registration.

Locations
United States
Florida
University of Florida
RECRUITING
Gainesville
North Carolina
Levine Children's Hospital
ACTIVE_NOT_RECRUITING
Charlotte
Pennsylvania
Penn State Milton S. Hershey Medical Center and Children's Hospital
RECRUITING
Hershey
Contact Information
Primary
G Bergendahl, MSN
genevieve.bergendahl@atriumhealth.org
(704) 355-1220
Time Frame
Start Date: 2021-09-20
Estimated Completion Date: 2032-09
Participants
Target number of participants: 24
Treatments
Experimental: Arm 1: Subjects with Diffuse Intrinsic Pontine Glioma (DIPG).
This Phase I study is will utilize a standard 3+3 dose escalation design to establish the MTD and will evaluate the following three pre-specified dose levels of xALT:~Dose Level 1: 3 x10\^7 cells/kg Dose Level +1: 3 x10\^8 cells/kg Dose Level -1: 3 x10\^6 cells/kg~The dose escalation scheme will be evaluated for Arm 1 and Arm 2 separately. For each Study Arm, a minimum of 4 DLT evaluable subjects and a maximum of 12 DLT evaluable subjects will be enrolled (a total of 8 to 24 DLT evaluable subjects).
Experimental: Arm 2: Relapsed/Refractory Neuroblastoma (NB)
This Phase I study is will utilize a standard 3+3 dose escalation design to establish the MTD and will evaluate the following three pre-specified dose levels of xALT:~Dose Level 1: 3 x10\^7 cells/kg Dose Level +1: 3 x10\^8 cells/kg Dose Level -1: 3 x10\^6 cells/kg~The dose escalation scheme will be evaluated for Arm 1 and Arm 2 separately. For each Study Arm, a minimum of 4 DLT evaluable subjects and a maximum of 12 DLT evaluable subjects will be enrolled (a total of 8 to 24 DLT evaluable subjects).
Sponsors
Collaborators: Beat Childhood Cancer Research Consortium
Leads: University of Florida

This content was sourced from clinicaltrials.gov

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