The purpose of this study is to evaluate the efficacy and safety of 131I-MIBG in combination with Vorinostat in patients with Recurrent or Progressive neuroblastoma
OPTIMUM (MIBG 2014-01) is a Phase II, Two arm, non-randomized, open-label study of therapeutic 131I-iobenguane (131I-MIBG) as single agent or in combination with Vorinostat for the treatment of neuroblastoma. The study will be conducted in male and female subjects, greater than 1 year of age, with iobenguane avid, who have recurrent or progressive disease, regardless of overall response to frontline therapy, where frontline therapy includes a minimum of 4 cycles of induction therapy at any time prior to enrollment, high-risk neuroblastoma. Subjects who are eligible for combination treatment will receive vorinostat 180 mg/m2/dose (maximum dose 400 mg) once daily for 14 days (Day -1 to Day 12) continuously. Subjects will receive 18 mCi/kg of 131I-MIBG intravenously on Day 1. If the subject qualifies, the subject will receive the second treatment course of 131I-MIBG in combination with vorinostat or 131I-MIBG alone (no sooner than 6 weeks following first treatment course). Subject must have an overall response of stable disease or better, as assessed by the Investigator, and meet certain predefined criteria to receive the second course of treatment. Following a screening period of up to 4 weeks, the duration in the study treatment phase for an individual subject, who receives two treatments, is up to 26 weeks. For an individual subject, who receives one treatment only, the duration of the treatment phase is 16 weeks. In addition, there is a 2-year follow-up after the treatment phase, during which assessments will be performed to assess disease progression, as well as record adverse events.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Subjects will receive 18 mCi/kg of 131I-MIBG administered over 1.5 to 2 hours on Day 1 either a central line or a peripheral intravenous catheter. The maximum absolute dose of 131I-MIBG is determined by institution therapeutic limits and will not exceed 1,000 mCi. Subjects with an overall response of stable disease or better as assessed by the Investigator, and who meet certain protocol predefined criteria, may receive a second 18 mCi/kg 131I-MIBG treatment no sooner than 6 weeks following the first treatment.
Subjects will receive vorinostat 180 mg/m2/dose (maximum dose 400 mg) once daily by mouth, NG, or G-tube on days -1 to +12 (14 total doses) for 14 days continuously. The 131I-MIBG treatment will be administered on day 1 via either a central line or a peripheral intravenous catheter over 1.5 to 2 hours. On day 1 of therapy, vorinostat should be taken 1 hour prior to the start of the 131I-MIBG infusion. Subjects with an overall response of stable disease or better, as assessed by the Investigator and who meet certain predefined criteria, may receive a second course of 18 mCi/kg 131I-MIBG combined with vorinostat (180 mg/m2) no sooner than 6 weeks following the first therapeutic 131I-MIBG treatment.
Stanford University
Overall Response
Overall response (Yes/No) is based on the International Neuroblastoma Response Criteria (INRC, published 2017). The INRC will be calculated based on 123I-iobenguane scans, CT/MRI, and bone marrow biopsies and aspirates. A "Yes" is defined as complete response, partial response or minor response. A "No" response is defined as stable disease or progressive disease.
Time frame: 6 weeks after the last 131I-MIBG treatment which will either be the first or the second treatment course (131I-MIBG + vorinostat) and a confirmatory assessment at least 6 weeks thereafter (at least 12 weeks from the end of treatment)
Overall Response at 6 weeks after 131I-MIBG treatment
The Revised INRC overall response (yes/no) defined as complete response, partial response, or minor response 6 weeks after the last131I-MIBG treatment which will either be the first treatment or the second treatment.
Time frame: 6 weeks after the last 131I-MIBG treatment (first or second treatment of 131I-MIBG + vorinostat).
Durability of Effect of Overall Response (Yes/No)
Durability of effect with the INRC will be assessed as INRC for all tumor assessment data available including any data collected beyond 12 weeks after the last 131I-MIBG treatment which will either be the first treatment or the second treatment.
Time frame: For all tumour assessment data collected throughout the study (up to the end of the 2-year follow-up)(131I-MIBG + vorinostat).
Relative Curie Extension Score
Relative Curie Extension Score 6 weeks after the last MIBG 131I treatment, which will either be the first treatment or the second treatment.
Time frame: 6 weeks after the last 131I-MIBG treatment which will either be the first or the second treatment course (131I-MIBG + vorinostat)
Durability of Effect of Relative Curie Extension Score
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Palo Alto, California, United States
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San Francisco, California, United States
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Aurora, Colorado, United States
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RECRUITINGUniversity of Minnesota
Minneapolis, Minnesota, United States
RECRUITINGWashington University Medical Center in St. Louis
St Louis, Missouri, United States
RECRUITINGNorthwell Health /Cohen Children's Medical Center
New Hyde Park, New York, United States
RECRUITING...and 11 more locations
Durability of effect with the Relative Curie Extension Score will be assessed as the score for all tumor assessment data available including any data collected beyond 12 weeks after the last MIBG 131I treatment, which will either be the first treatment or the second treatment. The Relative Curie Extension Score will be calculated using the Baseline (Visit 2) Absolute Curie Extension Score. The Curie Extension Scores will be calculated from the results of the (123I) iobenguane scans.
Time frame: For all tumour assessment data collected throughout the study for both arms (up to the end of the 2-year follow-up).