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Study Summary
No. 2007-0881:.......Pediatrics; Sarcoma......Peter M. Anderson......Pediatrics
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Study Summary Title
Study Summary
Number:
2007-0881
Study Title:A Study to Determine the Activity of SCH 717454 in Subjects With Osteosarcoma or Ewing's Sarcoma That Has Relapsed After Standard Systemic Therapy
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Physician New Patient Referral
Name:Peter M. AndersonPatients Call:800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Dept:PediatricsReferring MD
Call:
800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Phone:713-792-6620
Contact us about clinical trials
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General Information
Disease Group:Pediatrics
Sarcoma
Supported By:Schering-Plough Research Institute, a Division of Schering Corporation
Phase of Study:Phase IIReturn
Visit:
Every 2 weeks (+/- 3 days)
Treatment
Agents:
SCH 717454Home Care:Supportive medications may be given at home.
Treatment Loc:Both at MDACC & outside MDACC at one or more Collaborating Sites or Institutions
Estimated
Length of Stay
in Houston:
Hospitalization is required for surgery in the Treatment Phase. Most SCH717454
antibody infusions are expected to be done in the outpatient clinic ( PATC)
Description/
Intervention:
The goal of this clinical research study is to learn if SCH 717454 can help to
control bone sarcoma. The safety of this treatment will also be studied.
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Study Objectives / Outcomes
The subject population for this study will be divided into three groups:

• Group 1: subjects with resectable osteosarcoma whose disease has relapsed after standard therapy (ie, prior exposure to at least one chemotherapy regimen, e.g., platinum and doxorubicin).

• Group 2: subjects with relapsed and unresectable osteosarcoma refractory to standard therapy.

• Group 3: subjects with Ewing's sarcoma refractory to standard therapy.

Primary Objectives:
Group 1: To determine tumor cell proliferation response after dosing with SCH 717454 in subjects with resectable osteosarcoma that has relapsed after standard systemic therapy compared to the subject's historical tumor cell proliferation.

Group 2: To determine the World Health Organization (WHO) and Response Evaluation Criteria in Solid Tumors (RECIST)-defined radiological response rate to SCH 717454 in subjects with unresectable osteosarcoma refractory to standard therapy. Response rate for Group 2 is defined as the proportion of subjects who achieve a complete response (CR), a partial response (PR), or stable disease (SD) for ³ 6 months.

Group 3: To determine the WHO and RECIST-defined radiological response rate to SCH 717454 in subjects with Ewing's sarcoma refractory to standard therapy. Response rate for Group 3 is defined as the proportion of subjects who achieve a CR or a PR.

Secondary Objectives:
Group 1: To determine time to relapse after dosing with SCH 717454 in subjects with resectable osteosarcoma that has relapsed after standard systemic therapy.

Groups 2 and 3: To determine duration of response and time to progression after dosing with SCH
717454 in subjects with either unresectable osteosarcoma or refractory Ewing's sarcoma.

All Groups
• To assess the overall survival of each group.
• To evaluate the safety and tolerability of SCH 717454 administered every 2 weeks in subjects with osteosarcoma and Ewing's sarcoma relapsed after standard systemic therapy. Although the phase I study of SCH717454 had very few serious adverse events at 10 mg/kg and 20 mg/kg doses, additional experience in determining the safety profile bone sarcoma pateints after surgery will be obtained.
• To evaluate peripheral blood levels of:
-Insulin-like Growth Factor I (IGF-I), and IGF-II,
-Insulin-like Growth Factor binding protein 2 (IGFBP-2), and Insulin-like Growth Factor binding protein 3 (IGFBP-3), as well as
-Insulin-like Growth Factor 1 Receptor (IGF-1R) expression on peripheral blood mononuclear cells (PBMC)
by fluorescence activated cell sorting (FACS),
-To determine the incidence of anti-SCH 717454 antibodies.
-To evaluate serum SCH 717454 concentrations.

Exploratory Objectives- All Groups:
• To evaluate the measurement characteristics of health-related quality-of-life in subjects with osteosarcoma and Ewing's sarcoma.
• To explore the change in positron emission tomography/computed tomography (PET/CT) scan after dosing with SCH 717454.
• To examine potential pharmacogenetic markers.
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Study Status Information
Study Activation / Registration Date:02/11/2008
IRB Review and Approval Date:01/24/2008
Study Type:Phase Ii Or Phase I/Ii
Recruitment Status:Closed
Projected Accrual:220
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Enrollment Eligibility
If you do not meet the enrollment eligibility, there may be other treatment options for you. Please Contact the Referral Office for more information.

Inclusion Criteria:1) A subject must be 11 years of age or older and may be of any race, and gender (subjects between 4 and 10 years of age, inclusive, may be considered on a site-by-site basis).

2) A subject must have a diagnosis of histologically confirmed osteosarcoma or Ewing's sarcoma.

3) Group 1: Relapsed and resectable osteosarcoma that: has recurred after prior systemic treatment with active chemotherapy agents (eg, prior exposure to at least one chemotherapy regimen, ie, platinum and doxorubicin); and - must have had the confirmed relapse within 6 months of the immediate prior definitive treatment rendering the study in remission (eg, surgical metastasectomy) of the osteosarcoma (longer intervals require discussion with the sponsor).

4) Group 1 (continued): Must have a surgical or core biopsy tumor specimen (available to determine historical tumor proliferation), and the subject must not have been receiving tumor directed therapy at the time the specimen was obtained, or must have been progressing while on that treatment. The specimen should have been obtained within 8 months of study entry (specimens >8 months before study entry require discussion with the sponsor).

5) Group 2: Relapsed and resectable osteosarcoma that: has recurred after prior systemic treatment with active chemotherapy agents (eg, prior exposure to at least one chemotherapy regimen, ie, platinum and doxorubicin); and - must have had the confirmed relapse within 6 months of the immediate prior treatment of the osteosarcoma (longer intervals require discussion with the sponsor).

6) Group 3: Ewing's sarcoma that is refractory to standard systemic therapies (ie, prior treatment with at least 3 of these agents: ifosfamide, etoposide, cyclophosphamide, doxorubicin, and vincristine). The subject must have measurable disease on a CT or MRI study performed during Screening (within 21 days of Day 1).

7) A subject > 16 years of age must have an Eastern Cooperative Oncology Group (ECOG) performance status of < / = 2; a subject < / = 16 years of age must have a Karnofsky performance status between 50% and 100% or a Lansky play scale between 50% and 100%.

8) A subject must have a minimum life expectancy of > 8 weeks.

9) A subject must have adequate organ function within 3 weeks prior to Day 1 as evidenced by: a. hemoglobin > / = 9 g/dL, (> / = 8 g/dL in subjects with Ewing's sarcoma), b. absolute neutrophil count > / = 1.5 x 109/L, (> / = 1.0 x 109/L in subjects with Ewing's sarcoma), c. platelet count > / = 100 x 109/L, (> / = 50 x 109/L in subjects with Ewing's sarcoma), d. creatinine <1.5 x upper limit of normal (ULN) or creatinine clearance > / = 60 mL/min;

10) # 9, continued: e. total bilirubin <1.5 x ULN, except for subjects with Gilbert's disease, f. aspartate aminotransferase (AST)/serum glutamic-oxalacetic transaminase (SGOT) and alanine aminotransferase (ALT)/serum glutamic-pyruvic transaminase (SGPT) < 3 x ULN, or in the presence of documented liver metastases < / = 5 x ULN. Subjects with evidence of bone marrow involvement or single hematologic abnormalities (eg, ITP) may be permited on study on a case-by-case basis. Out-of-range laboratory values at Screening may be repeated once during the Screening Period.

11) A subject (and/or parent/guardian for subjects under the age of legal consent) must give written informed consent and be able to adhere to dose and visit schedules.

12) A female subject and a male subject's female partner, of childbearing potential, must agree to use a medically accepted method of contraception prior to Screening, while receiving protocol-specified medication, and for 2 months after stopping the medication. Acceptable methods of contraception include abstinence; oral, transdermal, or injectable hormonal contraceptive; and surgical sterilization (eg, hysterectomy or tubal ligation).

13) # 12, continued: Condoms (male or female) with or without a spermicidal agent, diaphragm or cervical cap with spermicide, and medically prescribed intrauterine devices may be acceptable according to local regulations. A woman of child-bearing potential who is not currently sexually active must agree to use a medically accepted method of contraception should she become sexually active while participating in the study. Any other tumor-directed therapy must be discussed with the sponsor on a case-by-case basis.

Exclusion Criteria:1) A subject with a history of another malignancy (with the exception of non-melanoma skin cancer or carcinoma in situ of the cervix treated with curative intent at least 2 years prior to start of treatment, or other adequately treated malignancy for which the subject has been disease free for > / = 5 years).

2) A subject who has known treated or untreated leptomeningeal metastasis, or a metastatic central nervous system lesion.

3) A subject with a history of uncontrolled diabetes mellitus, defined as a hemoglobin A1C of > / = 7.5% in a patient with known diabetes mellitus.

4) A subject with a recent myocardial infarction (within the past year); or a subject who at the time of Screening presents with unstable or uncontrolled angina, New York Heart Association (NYHA) Class III or IV congestive heart failure, uncontrolled hypertension, clinically significant cardiac dysrhythmia or clinically significant electrocardiogram (ECG) abnormality.

5) A subject with an active infection.

6) A subject with clinically significant hepatitis at Screening, or a subject that is hepatitis C antibody positive, hepatitis B surface antigen positive, or human immunodeficiency virus (HIV) seropositive (subjects with risk factors, or clinically suspected infection should be screened for Hepatitis B/C and/or HIV).

7) A subject who has been treated with an anti-IGF-1R targeted drug or antibody.

8) A subject with known hypersensitivity to other antibodies, or any accompanying excipients associated with these medications.

9) A subject with persistent, unresolved common terminology criteria for adverse events (CTCAE) > / = Grade 2 drug-related toxicity associated with previous treatment except for alopecia (inclusion of subjects with persistent neuropathy or hearing loss > / = Grade 2 due to previous treatment require discussion with the sponsor).

10) A subject who has any clinically significant condition or situation, other than the condition being studied that, in the opinion of the investigator, would interfere with the study evaluations or optimal participation in the study.

11) A subject who has received any of these prohibited medications more recently than the indicated washout period prior to Screening or must continue treatment on any of these prohibited medications: 1) Concurrent chemotherapy for the purpose of treating the tumor: 21 days prior to Day 1; 2) Other monoclonal antibodies: Four half lives of the monoclonal antibody prior to Day 1; 3) Immunosuppressive medication (eg, high-dose steroids): Prior to Screening; 4) Investigational drugs: 21 days prior to Day 1. Any other tumor-directed therapy must be discussed with the sponsor on a case-by-case basis.

12) A female subject who is breast-feeding, pregnant, intends to become pregnant, or has a positive pregnancy test at Screening.

13) A subject participating in any other clinical study with a potentially therapeutic agent or who has received another investigational product within 21 days prior to Day 1.

14) A subject unlikely to complete the study and appropriate follow-up visits.

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Links
Registration Number: NCT00617890
Study Information on Clinical Trials Registry (clinicaltrials.gov)

Other Links:
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Results


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