Trial Search Results

Study Of Palbociclib Combined With Chemotherapy In Pediatric Patients With Recurrent/Refractory Solid Tumors

This study will evaluate palbociclib in combination with chemotherapy (temozolomide with irinotecan and topotecan with cyclophosphamide) in children, adolescents and young adults with recurrent or refractory solid tumors. The main purpose of this study is to evaluate the safety of palbociclib in combination with chemotherapy in order to estimate the maximum tolerated dose. Pharmacokinetics and efficacy of palbociclib in combination with chemotherapy will be evaluated.

Stanford is currently accepting patients for this trial.

Lead Sponsor:

Pfizer

Stanford Investigator(s):

Intervention(s):

  • Drug: Palbociclib
  • Drug: Temozolomide
  • Drug: Irinotecan
  • Drug: Topotecan
  • Drug: Cyclophosphamide

Phase:

Phase 1

Eligibility


Inclusion:

   1. Histologically confirmed relapsed or refractory solid tumor as follows:

      - For dose escalation and dose determination parts: Histologically confirmed
      relapsed or refractory solid tumor (including CNS tumors but not lymphomas).
      Patients with Diffuse Intrinsic Pontine Glioma do not require histological only
      radiographic confirmed relapse to enroll.

      - For dose expansion and tumor specific cohorts: Histologically confirmed relapsed
      or refractory solid tumor including but not limited to EWS, rhabdoid tumor,
      rhabdomyosarcoma, neuroblastoma, and medulloblastoma. Patients with Diffuse
      Intrinsic Pontine Glioma do not require histological only radiographic confirmed
      relapse to enroll. EWS is not eligible for TOPO and CTX tumor-specific cohorts.

   2. Age ≥2 and <21 years at the time of study entry.

   3. Lansky performance status ≥50% for patients ≤16 years of age, or Eastern Cooperative
   Oncology Group (ECOG) 0, 1 or 2 for patients >16 years of age.

   4. Adequate bone marrow function.

      - Absolute neutrophil count ≥1000/mm3;

      - Platelet count ≥100,000/mm3 (transfusion independent);

      - Hemoglobin ≥8.5 g/dL (transfusion allowed).

   5. Adequate renal function: Serum creatinine level based on age/gender must within
   protocol specified limits.

   6. Adequate liver function, including:

      - Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

      ≤2.5 × upper limit of normal (ULN) or ≤5 × ULN for age, if attributable to
      disease involvement of the liver;

      - Total bilirubin ≤1.5 × ULN for age.

   7. Measurable disease as defined by RECIST version 1.1 or modified RANO criteria for CNS
   disease or INRC for neuroblastoma.

   8. Recovered to CTCAE Grade ≤1, or to baseline, from any non-hematological acute
   toxicities of prior surgery, chemotherapy, immunotherapy, radiotherapy,
   differentiation therapy or biologic therapy, with the exception of alopecia.

   9. Serum/urine pregnancy test (for all girls ≥8 years of age) negative at screening and
   at the baseline visit.

10. Evidence of a personally signed and dated informed consent document indicating that
   the patient or a legally acceptable representative/parent(s)/legal guardian of minors,
   has been informed of all pertinent aspects of the study. Minor study patients also
   must provide age appropriate assent according to the local guidelines, where
   applicable.

11. Willing and able to comply with scheduled visits, treatment plan, laboratory tests,
   and other procedures.

Exclusion:

   1. For palbociclib with IRN and TMZ combination, prior treatment with a CDK4/6 inhibitor
   or progression while on treatment with an IRN-containing regimen that includes TMZ.
   Patients who have received the combination of IRN and TMZ and did not progress while
   on these medications are eligible. For patients enrolling in the palbociclib with TOPO
   and CTX combination, prior treatment with a CDK4/6 inhibitor or progression while on
   treatment with a TOPO-containing regimen that includes CTX. Patients who have received
   the combination of TOPO and CTX and did not progress while on these medications are
   eligible.

   2. Prior intolerability to IRN and/or TMZ, for palbociclib with IRN and TMZ combination
   and prior intolerability to TOPO and/or CTX for palbociclib with TOPO and CTX
   combination.

   3. Use of strong cytochrome P450 (CYP) 3A inhibitors or inducers. Patients who are
   receiving strong uridine diphosphate-glucuronosyl transferase 1A1 (UGT1A1) inhibitors
   within 12 days of Cycle 1 Day 1 (C1D1) are not eligible for the palbociclib with IRN
   and TMZ combination. Patients who are receiving strong UGT1A1 inhibitors within 12
   days of C1D1 are eligible for the palbociclib with TOPO and CTX combination (See
   Section 5.7.1 for list of products.)

   4. Prior growth factors (including filgrastim) within 7 days before study entry or
   PEG-filgrastim within 14 days before study entry.

   5. Radiation therapy within 14 days before study entry.

   6. Systemic anti cancer therapy within 2 weeks prior to study entry and 6 weeks for
   nitrosoureas.

   7. Previous high dose chemotherapy requiring stem cell rescue within 90 days or
   persistent AE >Grade 1.

   8. Prior irradiation to >50% of the bone marrow (see Appendix 9).

   9. Participation in other studies involving investigational drug(s) within 2 weeks or 5
   half lives, whichever is longer, prior to study entry.

10. Major surgery within 4 weeks prior to study entry. Surgical biopsies or central line
   placement are not considered major surgeries.

11. Known or suspected hypersensitivity to palbociclib, IRN and/or TMZ.

12. Patients with known symptomatic brain tumors or brain metastases and require steroids,
   unless they have been on a stable or on a decreasing steroid dose for >14 days.

13. Patients with previously diagnosed brain metastases are eligible if they have
   completed their prior treatment and have recovered from the acute effects of radiation
   therapy or surgery prior to study entry for these metastases for at least 14 days post
   radiation and 4 weeks post-surgery and are neurologically stable.

14. Hereditary bone marrow failure disorder.

15. QTc >470 msec.

16. History of clinically significant or uncontrolled cardiac disease, including:

      - History of or active congestive heart failure; if patient had congestive heart
      failure resolve and >1 year from resolution, patient will be considered eligible;

      - Clinically significant ventricular arrhythmia (such as ventricular tachycardia,
      ventricular fibrillation or Torsades de Pointes);

      - Diagnosed or suspected congenital or acquired prolonged QT syndrome;

      - Need for medications known to prolong the QT interval;

      - Uncorrected hypomagnesemia or hypokalemia because of potential effects on the QT
      interval;

      - Left ventricular ejection fraction <50% or shortening fraction <28%.

17. Recent or ongoing clinically significant gastrointestinal disorder that may interfere
   with absorption of orally administered drugs (eg, gastrectomy).

18. Evidence of serious active or uncontrolled bacterial, fungal or viral infection or
   known history of hepatitis B virus, hepatitis C virus, or human immunodeficiency virus
   infection or acquired immunodeficiency syndrome-related illness.

19. Other severe acute or chronic medical or laboratory test abnormality that may increase
   the risk associated with study participation or investigational product administration
   or may interfere with the interpretation of study results, and in the judgment of the
   Investigator, would make the patient inappropriate for entry into this study.

20. Investigator site staff members directly involved in the conduct of the study and
   their family members, site staff members otherwise supervised by the investigator, or
   patients who are Pfizer employees, including their family members, directly involved
   in the conduct of the study.

21. Fertile male patients and female patients of childbearing potential who are unwilling
   or unable to use a highly effective method of contraception as outlined in this
   protocol for the duration of the study and for at least 90 after the last dose of
   investigational product.

Ages Eligible for Study

2 Years - 20 Years

Genders Eligible for Study

All

Now accepting new patients

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Richard Fu
650-721-4074
Recruiting