Oxaliplatin in Treating Children With Recurrent or Refractory Medulloblastoma, Supratentorial Primitive Neuroectodermal Tumor, or Atypical Teratoid Rhabdoid Tumor

Overview

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase II trial to study the effectiveness of oxaliplatin in treating children who have recurrent or refractory medulloblastoma, supratentorial primitive neuroectodermal or atypical teratoid rhabdoid tumor.

Full Title of Study: “A Phase II Study of Oxaliplatin in Children With Recurrent or Refractory Medulloblastoma, Supratentorial Primitive Neuroectodermal Tumors and Atypical Teratoid Rhabdoid Tumors”

Study Type

  • Study Type: Interventional
  • Study Design
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: August 2004

Detailed Description

OBJECTIVES: – Estimate the objective response rate to oxaliplatin in pediatric patients with recurrent or refractory medulloblastoma at first progression. – Estimate the objective response rate to oxaliplatin in pediatric patients with recurrent or refractory medulloblastoma at second or later relapse. – Estimate the objective response rate to oxaliplatin in pediatric patients with recurrent or refractory supratentorial primitive neuroectodermal tumor, or atypical teratoid rhabdoid tumor. – Describe the pharmacokinetics of this drug in these patients. OUTLINE: This is a multicenter study. Patients are stratified according to tumor type (medulloblastoma [measurable disease at first relapse vs positive cerebrospinal fluid or linear leptomeningeal disease vs measurable disease at second or later progression] vs supratentorial primitive neuroectodermal tumor vs atypical teratoid rhabdoid tumor). Patients receive oxaliplatin IV over 2 hours on day 1. Treatment repeats every 21 days for up to 17 courses (1 year) in the absence of disease progression or unacceptable toxicity. PROJECTED ACCRUAL: A total of 65 patients will be accrued for this study within 1.5-2.8 years.

Interventions

  • Drug: Oxaliplatin

Clinical Trial Outcome Measures

Primary Measures

  • Objective response rate to oxaliplatin in recurrent or progressive medulloblastoma at first progression
  • Objective response rate to oxaliplatin in recurrent or refractory medulloblastoma at second or later relapse

Secondary Measures

  • Objective response rate to oxaliplatin in recurrent or progressive supratentorial PNETs or atypical teratoid rhabdoid tumor (ATRT)
  • Pharmacokinetics of oxaliplatin in the serum and CSF

Participating in This Clinical Trial

DISEASE CHARACTERISTICS:

  • Histologically confirmed medulloblastoma, supratentorial primitive neuroectodermal tumor (including pineoblastomas and ependymoblastomas), or atypical teratoid rhabdoid tumor – Recurrent or refractory disease – Measurable disease by radiography – Patients with positive cerebrospinal fluid cytology or linear leptomeningeal disease are eligible PATIENT CHARACTERISTICS: Age – 21 and under Performance status – Karnofsky 50-100% OR – Lansky 50-100% Life expectancy – Not specified Hematopoietic – Absolute neutrophil count at least 1,000/mm^3 – Platelet count at least 100,000/mm^3 (transfusion independent) – Hemoglobin at least 8.0 g/dL (RBC transfusions allowed) Hepatic – Bilirubin no greater than 1.5 times normal – ALT less than 2.5 times normal Renal – Creatinine no greater than 1.5 times normal OR – Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min Cardiovascular – Shortening fraction at least 27% by echocardiogram OR – Ejection fraction at least 50% by MUGA Pulmonary – No dyspnea at rest – No exercise intolerance – Pulse oximetry greater than 94% Other – No uncontrolled infection – No active graft-versus-host disease – No uncontrolled seizure disorders – Seizure disorders well controlled with anticonvulsants allowed – Not pregnant or nursing – Negative pregnancy test – Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy – At least 2 weeks since prior growth factors – At least 6 months since prior allogeneic stem cell transplantation – No concurrent colony-stimulating factors during the first course of study – No concurrent immunomodulating agents Chemotherapy – At least 3 weeks since prior myelosuppressive therapy (6 weeks for nitrosoureas) and recovered – No other concurrent anticancer chemotherapy Endocrine therapy – If concurrent corticosteroids necessary for intracranial pressure, must be on stable or decreasing dose for at least 1 week prior to study – No other concurrent corticosteroids Radiotherapy – At least 2 weeks since prior local palliative radiotherapy (small port) to symptomatic metastatic sites – At least 3 months since prior craniospinal radiotherapy – No concurrent palliative radiotherapy – Recovered from prior radiotherapy Surgery – Not specified Other – No other concurrent anticancer or experimental drugs

Gender Eligibility: All

Minimum Age: N/A

Maximum Age: 21 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Pediatric Brain Tumor Consortium
  • Collaborator
    • National Cancer Institute (NCI)
  • Provider of Information About this Clinical Study
    • James M. Boyett/PBTC Operations and Biostatistics Center Executive Director, Pediatric Brain Tumor Consortium
  • Overall Official(s)
    • Maryam Fouladi, MD, Study Chair, Children’s Hospital Medical Center, Cincinnati

Citations Reporting on Results

Fouladi M, Blaney SM, Poussaint TY, Freeman BB 3rd, McLendon R, Fuller C, Adesina AM, Hancock ML, Danks MK, Stewart C, Boyett JM, Gajjar A. Phase II study of oxaliplatin in children with recurrent or refractory medulloblastoma, supratentorial primitive neuroectodermal tumors, and atypical teratoid rhabdoid tumors: a pediatric brain tumor consortium study. Cancer. 2006 Nov 1;107(9):2291-7.

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