About this trial
This is a phase II single center study to administer two courses of myeloablative consolidation chemotherapy each followed by an autologous peripheral blood stem cell (PBSC) rescue in patients with high-risk neuroblastoma who have completed induction chemotherapy (independent of this study). Ideally, patients should begin consolidation chemotherapy no later than 8 weeks after the start of Induction Cycle #5; however it is strongly recommended to begin consolidation within 4-6 weeks after the start of Induction Cycle #5.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Less than 30 years of age at diagnosis of neuroblastoma
End of Induction disease evaluation demonstrating CR, PR, MR or SD
Hematopoietic Recovery from last induction course of chemotherapy
No uncontrolled infection
Disqualifiers
None
Trial design
Single group
Treatments tested in this trial
Thiotepa
DrugThiotepa by IV once daily for 3 doses on Days -7, -6 and -5. Given as part of Consolidation Course #1 along with Cyclophosphamide.
Cyclophosphamide
DrugCyclophosphamide by IV once daily for 4 doses on Days -5, -4, -3 and -2. Given as part of Consolidation Course #1 along with Thiotepa.
Melphalan
DrugMelphalan by IV once daily for 3 doses on Days -8, -7, and -6. Given as part of Consolidation Course #2 along with Etoposide and Carboplatin.
Etoposide
DrugEtoposide by IV once daily for 4 doses on Days -8, -7, -6 and -5. Given as part of Consolidation Course #2 along with Melphalan and Carboplatin.
Carboplatin
DrugCarboplatin by IV once daily for 4 doses on Days -8, -7, -6 and -5. Given as part of Consolidation Course #2 along with Etoposide and Melphalan.
Autologous Stem Cell Infusion
Biological/VaccineOn Day 0 the stem cells will be infused immediately after thawing over 15-60 minutes per institutional guidelines.
Granulocyte colony stimulating factor
Biological/VaccineBeginning on day 0 after infusion of the PBSC, patients will receive G-CSF SQ or IV (SQ preferred) 5 micrograms/kg once daily and continuing once daily until post-nadir ANC \> 2000/μL for 3 consecutive days.
Treatment groups
Trial outcomes
Primary outcomes
Progression Free Survival
Percentage of patients with progression free survial. Kaplan-Meier curves and 95% confidence intervals will be used to estimate.
Secondary outcomes
Time to Engraftment
Defined as an absolute neutrophil count (ANC) greater than or equal to 0.5 x 109/L for three consecutive days by day 42 after first transplant.
Relapse
Percentage of patients with relapse. Relapse will be defined as any new lesion; increase of any measurable lesion by \>25%; previous negative bone is positive.
Overall Survival
Kaplan-Meier curves and 95% confidence intervals will be used to estimate overall survival.
Sponsors and contacts
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