This trial is evaluating the anti-tumor activity and side effects of panobinostat in treating patients with osteosarcoma, malignant rhabdoid tumor/atypical teratoid rhabdoid tumor (MRT/ATRT), and neuroblastoma.
This is an open label, phase II, multi-centre study evaluating the anti-tumor activity of continuous, low dose of panobinostat in patients with recurrent or refractory solid tumors stratified by primary histology into osteosarcoma, malignant rhabdoid tumor/atypical teratoid rhabdoid tumor (MRT/ATRT), and neuroblastoma. Patients will be stratified at study entry by tumor type into three strata: osteosarcoma, MRT/ATRT and neuroblastoma \[osteosarcoma and neuroblastoma arms are closed to enrolment\]. Patients will be enrolled onto the study following completion of their conventional therapy including chemotherapy and/or radiation treatment and completion of a three-week wash out period. Panobinostat will then be administered as a continuous oral dose (starting at a de-escalated dose of 8mg/m2 per day), for up to 12 courses, a total of 48 weeks. The minimum dose is 2mg/m2 per day. Dosing will follow a dose de-escalation or escalation scheme for each stratum which will be determined by biological effect of the drug (measured in patient peripheral blood samples) and levels of toxicity (measured by dose limiting toxicity and adverse events observed). Dose levels for subsequent enrolments in each strata will be based on the de-escalated or escalated dose in each cohort. The final dose per strata will be that which achieves significant biological effect with acceptable toxicity that is maintained for a 4 week period. Patients or their parents/guardians will be required to maintain a drug diary to monitor drug usage throughout the trial. Patients will be followed for up to 2 years from completion of study therapy.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
25
Panobinostat capsules, 10mg, starting at a de-escalated dose of 8mg/m2 per day
The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center
Durham, North Carolina, United States
John Hunter Children's Hospital
New Lambton, New South Wales, Australia
Sydney Children's Hospital
Randwick, New South Wales, Australia
Event free survival
Estimated 2-year Event free survival (EFS). EFS is calculated as the time from study enrolment to first documented disease progression, relapse or second malignancy, or death from any cause.
Time frame: Up to 2 years after study enrolment
Overall Survival
Estimated 2-year Overall Survival (OS). OS is calculated as the time from study enrolment to death from any cause.
Time frame: Up to 2 years after study enrolment
Safety: Adverse events summarised by grade and type
Graded and defined by CTCAE Version 4
Time frame: From 1 week to 12 months after intervention commencement
Efficacy as measured by Clinical Benefit Rate
Clinical benefit rate as the percentage of patients with stable disease or better using MRI/CT imaging). Stable disease is defined as MRT/ATRT/Osteosarcoma with CR/PR/MR/SD/ overall response. Neuroblastoma with CR/PR/SD or Non-CR/Non-PD overall response.
Time frame: At 6 and 12 months after intervention commencement
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The Children's Hospital at Westmead
Westmead, New South Wales, Australia
Women's and Children's Hospital
North Adelaide, South Australia, Australia
Royal Hobart Hospital
Hobart, Tasmania, Australia
Monash Children's Hospital
Clayton, Victoria, Australia
The Royal Children's Hospital
Parkville, Victoria, Australia
Perth Children's Hospital
Nedlands, Western Australia, Australia
Starship Children's Hospital
Grafton, Auckland, New Zealand
...and 1 more locations