Temozolomide, Vincristine, and Irinotecan in Treating Young Patients With Refractory Solid Tumors

Not Recruiting

Trial ID: NCT00138216


RATIONALE: Drugs used in chemotherapy, such as temozolomide, vincristine, and irinotecan, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. PURPOSE: This phase I trial is studying the side effects and best dose of irinotecan when given together with temozolomide and vincristine in treating young patients with refractory solid tumors.

Official Title

A Phase I Study of Temozolomide, Oral Irinotecan, and Vincristine for Children With Refractory Solid Tumors

Stanford Investigator(s)



   - Histologically confirmed* malignant solid tumor, including brain tumor, at original
   diagnosis or relapse

      - Refractory disease NOTE: *Histologic confirmation not required for intrinsic
      brain stem tumors

   - Measurable or evaluable disease

   - No known curative therapy OR therapy proven to prolong survival with an acceptable
   quality of life exists

   - No known bone marrow metastases



   - 1 to 21

Performance status

   - Lansky 50-100% (for patients ≤ 10 years of age)

   - Karnofsky 50-100% (for patients > 10 years of age)

Life expectancy

   - Not specified


   - Absolute neutrophil count ≥ 1,000/mm^3

   - Platelet count ≥ 100,000/mm^3 (transfusion independent)

   - Hemoglobin ≥ 8.0 g/dL (RBC transfusions allowed)


   - ALT ≤ 110 U/L (upper limit of normal [ULN] for ALT is 45 U/L)

   - Bilirubin ≤ 1.5 times ULN

   - Albumin ≥ 2 g/dL


   - Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min OR

   - Creatinine based on age as follows:

      - No greater than 0.8 mg/dL (for patients ≤ 5 years of age)

      - No greater than 1.0 mg/dL (for patients 6 to 10 years of age)

      - No greater than 1.2 mg/dL (for patients 11 to 15 years of age)

      - No greater than 1.5 mg/dL (for patients > 15 years of age)


   - Not pregnant or nursing

   - Negative pregnancy test

   - Fertile patients must use effective contraception

   - Neurologic deficits in patients with CNS tumors must be stable for ≥ 1 week prior to
   study entry

   - No uncontrolled infection

   - No documented allergy to cephalosporins or dacarbazine


Biologic therapy

   - Recovered from prior immunotherapy

   - At least 3 months since prior stem cell transplantation or rescue without total-body

      - No evidence of active graft-versus-host disease

   - At least 7 days since prior antineoplastic biologic agents

   - At least 7 days since prior hematopoietic growth factors

   - No concurrent biologic therapy or immunotherapy

   - No concurrent prophylactic filgrastim (G-CSF) during the first course of study


   - Recovered from prior chemotherapy

   - Prior temozolomide, vincristine, irinotecan, or topotecan allowed

      - No prior coadministration of temozolomide and irinotecan

      - No disease progression during treatment with either irinotecan or temozolomide

   - More than 3 weeks since prior myelosuppressive chemotherapy (6 weeks for nitrosoureas)

   - No other concurrent chemotherapy

Endocrine therapy

   - Patients with CNS tumors must be on a stable or decreasing dose of dexamethasone for ≥
   7 days prior to study entry


   - Recovered from prior radiotherapy

   - At least 6 months since prior total-body irradiation, craniospinal radiotherapy, or
   radiotherapy to ≥ 50% of the pelvis

   - At least 6 weeks since other prior substantial bone marrow radiotherapy

   - At least 2 weeks since prior local palliative radiotherapy (small port)

   - No concurrent radiotherapy


   - Not specified


   - No other concurrent investigational drugs

   - No other concurrent anticancer therapy

   - No concurrent enzyme-inducing anticonvulsants, including any of the following:

      - Phenobarbital

      - Phenytoin

      - Carbamazepine

      - Oxcarbazepine

   - No concurrent administration of any of the following:

      - Rifampin

      - Voriconazole

      - Itraconazole

      - Ketoconazole

      - Aprepitant

      - Hypericum perforatum (St. John's wort)

   - No concurrent treatment for clostridium difficile infection


drug: irinotecan hydrochloride

drug: temozolomide

drug: vincristine sulfate

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Nadeem Mukhtar

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