N2007-01: Ultratrace™ Iobenguane I 131 in Patients With Relapsed/Refractory High-Risk Neuroblastoma

Sponsor
Molecular Insight Pharmaceuticals, Inc. (Industry)
Overall Status
Completed
CT.gov ID
NCT00659984
Collaborator
(none)
15
8
1
29
1.9
0.1

Study Details

Study Description

Brief Summary

RATIONALE: Radioactive drugs, such as iodine I 131 metaiodobenzylguanidine (MIBG), may carry radiation directly to tumor cells and not harm normal cells. A bone marrow or peripheral stem cell transplant using stem cells from the patient may be able to replace blood-forming cells that were destroyed by I 131 MIBG.

PURPOSE: This phase II trial is studying the side effects and best dose of iodine I 131 MIBG followed by a stem cell transplant in treating young patients with relapsed or refractory high-risk neuroblastoma.

Condition or Disease Intervention/Treatment Phase
  • Drug: UltratraceTM Iobenguane I 131 Imaging
  • Drug: UltratraceTM Iobenguane I 131 Therapy
Phase 2

Detailed Description

OBJECTIVES:

Primary

  • To establish the maximum tolerated dose of iodine I 131 metaiodobenzylguanidine (^131I-MIBG) in patients with relapsed/refractory high-risk neuroblastoma.

Secondary

  • To describe toxicity following treatment with ^131I-MIBG in patients with relapsed/refractory high-risk neuroblastoma.

  • To estimate radiation absorbed doses to measurable lesions and to a standard set of normal organs following a 0.1 mCi/kg [3.7 MBq/kg] (minimum dose of 1.0 mCi [37 MBq] but not to exceed 5.0 mCi [185 MBq]) intravenous administration of ^131I-MIBG in patients with relapsed/refractory high-risk neuroblastoma.

  • To describe, within the confines of a phase IIa trial, objective tumor response following treatment with ^131I-MIBG in patients with relapsed/refractory high-risk neuroblastoma.

  • To explore dose-response following treatment with ^131I-MIBG in patients with relapsed/refractory high-risk neuroblastoma.

  • To explore quality of life assessment following treatment with ^131I-MIBG in patients with relapsed/refractory high-risk neuroblastoma.

OUTLINE:
  • Dosimetry: Patients receive a dosimetric dose of iodine I 131 metaiodobenzylguanidine (^131I-MIBG) IV over 1-3 minutes. Patients then undergo 2 or 3 MIBG scans within 5 days of the dosimetry dose to assess biodistribution and tumor uptake. Patients with normal tumor uptake and biodistribution proceed to treatment.

  • Treatment: Within 1-4 weeks of the dosimetric dose, patients with normal tumor uptake and biodistribution receive a therapeutic dose of ^131I-MIBG IV over 1 hour on day 0 and undergo MIBG scan on day 7. Patients then proceed to autologous stem cell infusion.

  • Autologous stem cell infusion: Patients receive an infusion of autologous stem cells from peripheral blood or bone marrow on day 14. Patients with an ANC of < 500/µl at any point after autologous stem cell infusion receive filgrastim (G-CSF) IV or subcutaneously once daily until ANC is > 2,000/µl.

Patients complete a quality of life questionnaire at baseline and then at day 60.

After completion of study treatment, patients are followed at day 60 and periodically thereafter.

Study Design

Study Type:
Interventional
Actual Enrollment :
15 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Intervention Model Description:
Ultratrace™ Iobenguane I 131Ultratrace™ Iobenguane I 131
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase 2a Study of Ultratrace™ Iobenguane I 131 in Patients With Relapsed/Refractory High-Risk Neuroblastoma
Study Start Date :
Jun 1, 2008
Actual Primary Completion Date :
Aug 1, 2010
Actual Study Completion Date :
Nov 1, 2010

Arms and Interventions

Arm Intervention/Treatment
Experimental: Ultratrace™ Iobenguane I 131

Eligible patients received a diagnostic imaging dose of Ultratrace™ Iobenguane I 131 (1-5 mCi) within 7 days of study enrollment, followed by three dosimetry scans over 3-6 days. If the imaging dose demonstrated normal biodistribution and tumor uptake, then the patient received a therapeutic dose within 7-28 days of the diagnostic imaging dose, followed by a single imaging scan on Day 7 post therapy. As per protocol, therapeutic dosing was to begin at 12.0 mCi/kg and escalate to 15.0, 18.0, and 21.0 mCi/kg until the MTD was established or the 21.0 mCi/kg dose level was reached. Actual doses administered ranged from 8.8 to 18.6 mCi/kg. Based on actual doses administered, patients were grouped into 3 mean dose groups: 11.2, 15.5, and 18.2 mCi/kg. The dosimetry dose was administered over a period of 1-3 minutes by injection; the therapeutic dose was diluted in up to 25 mL normal saline and infused intravenously over 30 to 60 minutes.

Drug: UltratraceTM Iobenguane I 131 Imaging
0.1 mCi/kg [3.7 MBq/kg] (minimum dose 1mCi [37MBq] but not to exceed 5 mCi [185 MBq]) of UltratraceTM Iobenguane I 131 given 7 -28 days before therapeutic dose administration on day 0. Thyroid protection will be administered per institutional protocol for I-131-MIBG however, thyroid blocking must be started prior to the Ultratrace imaging dose. Anterior and posterior whole body images will be taken to assess organ distribution, tumor uptake and dosimetry calculations.
Other Names:
  • Azedra
  • Drug: UltratraceTM Iobenguane I 131 Therapy
    Therapeutic dose will be given on Day 0 if dosimetry scans showed that the prescribed or adjusted dose will not exceed > 23 Gy to the kidneys, > 30 Gy to the liver, or > 15 Gy to the lungs. and tumor uptake confirmed with UltratraceTM imaging dose. Only one treatment course of therapeutic UltratraceTM will be given in this study.
    Other Names:
  • Azedra
  • Outcome Measures

    Primary Outcome Measures

    1. Maximum Tolerated Dose [Day 60 +/-10 or Engraftment, whichever comes first]

      The maximum tolerated dose (MTD) was defined as the dose immediately below the level at which dose escalation would be stopped due to dose limiting toxicities (DLTs). Once the MTD was reached, an additional 3 patients were to be treated at that dose level, for a total of 6 patients at that planned dose level. DLTs were defined as any of the events that are possibly, probably or definitely attributable to UltratraceTM iobenguane I 131. The MTD was supposed to be the highest dose tested at which fewer than 1/3 of pts experience a DLT when 6 patients have been treated at the MTD but the dosimetry results indicated that the maximal dosage allowed to normal organs would be exceeded if the highest planned dose (21.0 mCi/kg) was administered, so the highest dose administered in the study was 18.6 mCi/kg .

    Secondary Outcome Measures

    1. Dose Limiting Toxicities [From the time of signed informed consent until Day 60 or until the end of therapy evaluation is completed (whichever comes first).]

      Dose limiting toxicities include treatment emergent adverse events (TEAEs) that were possibly, probably, or definitely related to Ultratrace™ Iobenguane I 131.

    2. Dosimetric Estimation of Radiation Absorbed Doses to Measurable Lesions [Day 5 post Dosimetric Dose]

      The dosimetric endpoint was to estimate radiation absorbed doses to measurable lesions and to a standard set of normal organs following an imaging dose of 0.1 mCi/kg Ultratrace™ Iobenguane I 131. Biodistribution was assessed by determination of total body residence (TBR) time and by visual examination of whole body camera images. 3 timepoints were used, the 1st image was taken within 1hr after the imaging dose, the 2nd image was taken at ~24hr after imaging dose, the 3rd image was taken 2-5d after imaging dose. Whole body radiation absorbed dose estimates & kidney, liver, and lung were calculated using the Medical Internal Radiation Dose (MIRD) schema.TBR time is derived from time integration of curve-fitted injected activity across all 3 timepoints when the isotope is emitting radiation.Three points are sampled to estimate a singular value for each organ and tissue according to the commonly used methods of the Society of Nuclear Medicine and Molecular Imaging Committee on MIRD.

    3. Overall Objective Tumor Response Post Therapeutic Treatment [Day 60 +/- 10 days post Therapeutic Dose]

      The International Neuroblastoma Response Criteria (INRC) were utilized as a basis for the overall response criteria, which incorporated responses in MIBG positive lesions,bone marrow disease, and CT/MRI lesions that met NANT-modified RECIST criteria. Efficacy success was defined as the proportion of pts who were successful overall [i.e., achieving a Complete Response (CR), Very Good Partial Response (VGPR), or Partial Response (PR)] determined by independent reviewers. CR = Disappearance of all target lesions, homovanillic acid/ vanillylmandelic acid (HVA/VMA) normal (NL); VGPR = > 90% decr of disease for CT/MRI target lesions, all pre-existing bone lesions with CR by MIBG; MIBG scan can be SD/CR in soft tissue lesions. CR in bone marrow, no new tumor sites, and NL HVA/VMA.; PR = At least 30% decr in disease measurement for CT/MRI target lesions. Bone marrow with CR, MIBG with either PR/CR in bone lesions, MIBG may be SD /CR in soft tissue lesions, and HVA/VMA may still be elevated.

    4. Tumor Response in CT/MRI Lesions Post Therapeutic Treatment [Day 60 +/- 10 days post Therapeutic Dose]

      Measurable disease was defined for a conventional CT scan by the presence of at least one lesion that could be accurately measured in at least one dimension with the longest diameter at least 20 mm by Independent Review. Efficacy success was defined as a patient achieving a Complete Response (CR)=disappearance of all target and non-target CT/MRI lesions; or, Very Good Partial Response (VGPR)=greater than 90% decrease of the disease measurement for CT/MRI lesions, taking as reference the disease measurement done to confirm measurement disease at study entry. Non-target CT/MRI lesions stable to smaller in size; or, Partial Response (PR)=at least 30% decrease in the disease measurement for CT/MRI lesions, taking as reference the disease measurement done to confirm measurable disease at study entry. Non-target CT/MRI lesions stable to smaller in size.

    5. Quality of Life [Day 60 +/- 10 days post Therapeutic Dose]

      Patients (aged 5-18) and parents (of patients aged 2-18) were asked to complete the 23-item Pediatric Quality of Life InventoryTM (PedsQLTM). PedsQLTM consists of 4 scales (physical, emotional, social, school functioning) which are then averaged into an overall summary score (scale: 0-100 with 0 representing the worst possible Quality of Life overall summary score and 100 representing the best possible Quality of Life overall summary score). The mean difference between the post treatment overall summary score and the baseline overall summary score is reported.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    1 Year to 30 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Patients must be at least one year and no more than 30 years of age when registered on this study.

    • Patients must have high risk neuroblastoma and either have tumor left after treatment started at diagnosis or have had the tumor grow back (relapsed) after getting some treatment

    • Patients must an MIBG scan done and it must be positive for neuroblastoma.

    • Patients must have a PBSC or bone marrow stem cell product available that meets study criteria. If they don't already have stem cells frozen away then they must be able to have a stem cell pheresis done to collect the necessary amount of stem cells for study entry and these stem cells must meet study criteria.

    • Patients must have adequate heart, lung, liver, kidney and bone marrow function.

    Exclusion Criteria:
    • They have had a stem cell transplant using another person as the stem cell donor. (You can still be in the study if a previous transplant used your own stem cells)

    • They have other medical problems that could get much worse if they had this treatment.

    • They are on dialysis for badly working kidneys or have other kidney problems.

    • They are pregnant or breast feeding.

    • They have tumor in the brain or spinal cord that is seen on a CT or MRI scan one month before starting treatment

    • They had total body radiation or radiation to the entire belly.

    • They have a known allergy to MIBG, iodine or SSKI.

    • They can't cooperate with the special precautions that are needed during UltratraceTM MIBG treatment or with other safety monitoring requirements of the study..

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Childrens Hospital Los Angeles Los Angeles California United States 90027-0700
    2 Lucile Packard Children's Hospital at Stanford University Medical Center Palo Alto California United States 94304
    3 UCSF Helen Diller Family Comprehensive Cancer Center San Francisco California United States 94115
    4 University of Chicago Comer Children's Hospital Chicago Illinois United States 60637
    5 C.S. Mott Children's Hospital at University of Michigan Medical Center Ann Arbor Michigan United States 48109-0286
    6 Cincinnati Children's Hospital Medical Center Cincinnati Ohio United States 45229-3039
    7 Children's Hospital of Philadelphia Philadelphia Pennsylvania United States 19104-4318
    8 Texas Children's Hospital Houston Texas United States 77030

    Sponsors and Collaborators

    • Molecular Insight Pharmaceuticals, Inc.

    Investigators

    • Principal Investigator: Katherine K. Matthay, MD, University of California, San Francisco

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Molecular Insight Pharmaceuticals, Inc.
    ClinicalTrials.gov Identifier:
    NCT00659984
    Other Study ID Numbers:
    • CDR0000593357
    • NANT-2007-01
    First Posted:
    Apr 17, 2008
    Last Update Posted:
    Oct 4, 2017
    Last Verified:
    Sep 1, 2017
    Keywords provided by Molecular Insight Pharmaceuticals, Inc.
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title Ultratrace™ Iobenguane I 131
    Arm/Group Description Eligible patients received a diagnostic imaging dose of Ultratrace™ Iobenguane I 131 within 7 days (d) of enrollment, followed by 3 dosimetry scans over 3-6 days. For the imaging dose, 0.1 mCi/kg (3.7 MBq/kg), at a min dose of 1 mCi (37 MBq) but not to exceed 5 mCi (185 MBq) of Ultratrace™ Iobenguane I 131 was administered 7-28 d prior to the therapeutic dose on Day 0. If the imaging dose demonstrated NL biodistribution/tumor uptake, pts received a therapeutic dose within 7-28 d of the imaging dose followed by a single imaging scan on Day 7 post therapy. Therapeutic dosing was to begin at 12.0 mCi/kg and escalate to 15.0, 18.0, and 21.0 mCi/kg until the MTD was established or the 21.0 mCi/kg dose level was reached. Based on actual doses administered, pts were grouped into 3 mean dose groups: 11.2, 15.5, and 18.2 mCi/kg. The dosimetry dose was administered over 1-3 mins by injection; the therapeutic dose was diluted in up to 25 mL normal saline and infused over 30 to 60 mins.
    Period Title: Overall Study
    STARTED 15
    COMPLETED 14
    NOT COMPLETED 1

    Baseline Characteristics

    Arm/Group Title Ultratrace™ Iobenguane I 131
    Arm/Group Description Eligible patients received a diagnostic imaging dose of Ultratrace™ Iobenguane I 131 (1-5 mCi) within 7 days of study enrollment, followed by three dosimetry scans over 3-6 days. If the imaging dose demonstrated normal biodistribution and tumor uptake, then the patient received a therapeutic dose within 7-28 days of the diagnostic imaging dose, followed by a single imaging scan on Day 7 post therapy. Therapeutic dosing began at 12.0 mCi/kg and escalated to 15.0, 18.0, and 21.0 mCi/kg until the MTD was established or the 21.0 mCi/kg dose level was reached. The dosimetry dose was administered over a period of 1-3 minutes by injection; the therapeutic dose was diluted in up to 25 mL normal saline and infused intravenously over 30 to 60 minutes.
    Overall Participants 15
    Age (years) [Median (Full Range) ]
    Median (Full Range) [years]
    8
    Sex: Female, Male (Count of Participants)
    Female
    6
    40%
    Male
    9
    60%
    Region of Enrollment (participants) [Number]
    United States
    15
    100%

    Outcome Measures

    1. Primary Outcome
    Title Maximum Tolerated Dose
    Description The maximum tolerated dose (MTD) was defined as the dose immediately below the level at which dose escalation would be stopped due to dose limiting toxicities (DLTs). Once the MTD was reached, an additional 3 patients were to be treated at that dose level, for a total of 6 patients at that planned dose level. DLTs were defined as any of the events that are possibly, probably or definitely attributable to UltratraceTM iobenguane I 131. The MTD was supposed to be the highest dose tested at which fewer than 1/3 of pts experience a DLT when 6 patients have been treated at the MTD but the dosimetry results indicated that the maximal dosage allowed to normal organs would be exceeded if the highest planned dose (21.0 mCi/kg) was administered, so the highest dose administered in the study was 18.6 mCi/kg .
    Time Frame Day 60 +/-10 or Engraftment, whichever comes first

    Outcome Measure Data

    Analysis Population Description
    A total of 15 patients underwent dosimetry (received a single imaging dose of Ultratrace™ Iobenguane I 131 injection) and all 15 patients later received a single therapeutic dose of Ultratrace™ Iobenguane I 131.
    Arm/Group Title Ultratrace™ Iobenguane I 131
    Arm/Group Description Following therapeutic dosing at the 12.0, 15.0, and 18.0 mCi/kg cohorts, 4 patients who were to receive the 21.0 mCi/kg therapeutic dose were required to have their planned dose reduced below the dose that was calculated based on the patient's dosimetry results, in order to meet the protocol guidelines for maximal dosage allowed to normal organs described above. Because of the differences between the planned and actual therapeutic doses that were administered to several patients, patients were grouped and the study data were presented and analyzed by actual doses rather than by the planned dose cohorts of 12.0, 15.0, 18.0, and 21.0 mCi/kg. Based on the actual doses administered, patients were grouped into 3 dose groups of 6, 3, and 6 patients, according to the mean doses of the groups, which were 11.2, 15.5, and 18.2 mCi/kg, respectively.
    Measure Participants 15
    Number [mCi/kg]
    18.6
    2. Secondary Outcome
    Title Dose Limiting Toxicities
    Description Dose limiting toxicities include treatment emergent adverse events (TEAEs) that were possibly, probably, or definitely related to Ultratrace™ Iobenguane I 131.
    Time Frame From the time of signed informed consent until Day 60 or until the end of therapy evaluation is completed (whichever comes first).

    Outcome Measure Data

    Analysis Population Description
    A total of 15 patients underwent dosimetry (received a single imaging dose of Ultratrace™ Iobenguane I 131 injection) and all 15 patients later received a single therapeutic dose of Ultratrace™ Iobenguane I 131.
    Arm/Group Title 11.2 mCi Group 15.5 mCi Group 18.2 mCi Group
    Arm/Group Description 11.2 mCi/kg Ultratrace™ Iobenguane I 131 represents the mean dose administered to this group of subjects. 15.5 mCi/kg Ultratrace™ Iobenguane I 131 represents the mean dose administered to this group of subjects. 18.2 mCi/kg Ultratrace™ Iobenguane I 131 represents the mean dose administered to this group of subjects.
    Measure Participants 6 3 6
    Number [number of DLTs]
    0
    0
    0
    3. Secondary Outcome
    Title Dosimetric Estimation of Radiation Absorbed Doses to Measurable Lesions
    Description The dosimetric endpoint was to estimate radiation absorbed doses to measurable lesions and to a standard set of normal organs following an imaging dose of 0.1 mCi/kg Ultratrace™ Iobenguane I 131. Biodistribution was assessed by determination of total body residence (TBR) time and by visual examination of whole body camera images. 3 timepoints were used, the 1st image was taken within 1hr after the imaging dose, the 2nd image was taken at ~24hr after imaging dose, the 3rd image was taken 2-5d after imaging dose. Whole body radiation absorbed dose estimates & kidney, liver, and lung were calculated using the Medical Internal Radiation Dose (MIRD) schema.TBR time is derived from time integration of curve-fitted injected activity across all 3 timepoints when the isotope is emitting radiation.Three points are sampled to estimate a singular value for each organ and tissue according to the commonly used methods of the Society of Nuclear Medicine and Molecular Imaging Committee on MIRD.
    Time Frame Day 5 post Dosimetric Dose

    Outcome Measure Data

    Analysis Population Description
    A total of 15 patients underwent dosimetry (received a single imaging dose of Ultratrace™ Iobenguane I 131 injection).
    Arm/Group Title Ultratrace™ Iobenguane I 131
    Arm/Group Description Following therapeutic dosing at the 12.0, 15.0, and 18.0 mCi/kg cohorts, 4 patients who were to receive the 21.0 mCi/kg therapeutic dose were required to have their planned dose reduced below the dose that was calculated based on the patient's dosimetry results, in order to meet the protocol guidelines for maximal dosage allowed to normal organs described above. Because of the differences between the planned and actual therapeutic doses that were administered to several patients, patients were grouped and the study data were presented and analyzed by actual doses rather than by the planned dose cohorts of 12.0, 15.0, 18.0, and 21.0 mCi/kg. Based on the actual doses administered, patients were grouped into 3 dose groups of 6, 3, and 6 patients, according to the mean doses of the groups, which were 11.2, 15.5, and 18.2 mCi/kg, respectively.
    Measure Participants 15
    Kidney
    16.7
    (5.2)
    Liver
    12.7
    (4.1)
    Lungs
    11.1
    (2.8)
    4. Secondary Outcome
    Title Overall Objective Tumor Response Post Therapeutic Treatment
    Description The International Neuroblastoma Response Criteria (INRC) were utilized as a basis for the overall response criteria, which incorporated responses in MIBG positive lesions,bone marrow disease, and CT/MRI lesions that met NANT-modified RECIST criteria. Efficacy success was defined as the proportion of pts who were successful overall [i.e., achieving a Complete Response (CR), Very Good Partial Response (VGPR), or Partial Response (PR)] determined by independent reviewers. CR = Disappearance of all target lesions, homovanillic acid/ vanillylmandelic acid (HVA/VMA) normal (NL); VGPR = > 90% decr of disease for CT/MRI target lesions, all pre-existing bone lesions with CR by MIBG; MIBG scan can be SD/CR in soft tissue lesions. CR in bone marrow, no new tumor sites, and NL HVA/VMA.; PR = At least 30% decr in disease measurement for CT/MRI target lesions. Bone marrow with CR, MIBG with either PR/CR in bone lesions, MIBG may be SD /CR in soft tissue lesions, and HVA/VMA may still be elevated.
    Time Frame Day 60 +/- 10 days post Therapeutic Dose

    Outcome Measure Data

    Analysis Population Description
    The evaluable population (which excludes non-evaluable responses) contains one patient less than the full ITT population.
    Arm/Group Title Ultratrace™ Iobenguane I 131
    Arm/Group Description The proportion of patients who were considered successful defined as a patient achieving a Complete Response, Very Good Partial Response or Partial Response as determined by the Independent Reviewers.
    Measure Participants 14
    Number (95% Confidence Interval) [proportion of evaluable population]
    0.29
    5. Secondary Outcome
    Title Tumor Response in CT/MRI Lesions Post Therapeutic Treatment
    Description Measurable disease was defined for a conventional CT scan by the presence of at least one lesion that could be accurately measured in at least one dimension with the longest diameter at least 20 mm by Independent Review. Efficacy success was defined as a patient achieving a Complete Response (CR)=disappearance of all target and non-target CT/MRI lesions; or, Very Good Partial Response (VGPR)=greater than 90% decrease of the disease measurement for CT/MRI lesions, taking as reference the disease measurement done to confirm measurement disease at study entry. Non-target CT/MRI lesions stable to smaller in size; or, Partial Response (PR)=at least 30% decrease in the disease measurement for CT/MRI lesions, taking as reference the disease measurement done to confirm measurable disease at study entry. Non-target CT/MRI lesions stable to smaller in size.
    Time Frame Day 60 +/- 10 days post Therapeutic Dose

    Outcome Measure Data

    Analysis Population Description
    The evaluable population (which excludes non-evaluable responses) contains one patient less than the full ITT population.
    Arm/Group Title Over Tumor Response
    Arm/Group Description The proportion of patients who were considered successful defined as a patient achieving a Complete Response, Very Good Partial Response or Partial Response as determined by the Independent Reviewers.
    Measure Participants 14
    Number (95% Confidence Interval) [percentage of evaluable population]
    21
    6. Secondary Outcome
    Title Quality of Life
    Description Patients (aged 5-18) and parents (of patients aged 2-18) were asked to complete the 23-item Pediatric Quality of Life InventoryTM (PedsQLTM). PedsQLTM consists of 4 scales (physical, emotional, social, school functioning) which are then averaged into an overall summary score (scale: 0-100 with 0 representing the worst possible Quality of Life overall summary score and 100 representing the best possible Quality of Life overall summary score). The mean difference between the post treatment overall summary score and the baseline overall summary score is reported.
    Time Frame Day 60 +/- 10 days post Therapeutic Dose

    Outcome Measure Data

    Analysis Population Description
    Self reported PedsQL™ scores were obtained for 9 patients in the ITT population (n=15) at baseline (prior to the start of the Ultratrace™ Iobenguane I 131 imaging studies) and at the end of therapy (60 ±10 days post treatment).
    Arm/Group Title Ultratrace™ Iobenguane I 131
    Arm/Group Description Based on the actual doses administered, patients were grouped into 3 dose groups of 6, 3, and 6 patients, according to the mean doses of the groups, which were 11.2, 15.5, and 18.2 mCi/kg, respectively.
    Measure Participants 9
    Mean (Standard Deviation) [units on a scale]
    5.2
    (11.27)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Ultratrace™ Iobenguane I 131
    Comments
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value 0.363
    Comments
    Method Cochran Armitage Trend Test
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 5.2
    Confidence Interval (2-Sided) 95%
    -3.4 to 13.9
    Parameter Dispersion Type:
    Value:
    Estimation Comments

    Adverse Events

    Time Frame From the time of signed informed consent until Day or until the end of therapy evaluation was completed (whichever occurred first).
    Adverse Event Reporting Description Serious adverse events (SAEs) that were ongoing at study completion (Day 60 ±10 days) were followed for 60 days or until resolution, whichever occurred first.
    Arm/Group Title Ultratrace™ Iobenguane I 131
    Arm/Group Description Eligible patients received a diagnostic imaging dose of Ultratrace™ Iobenguane I 131 (1-5 mCi) within 7 days of study enrollment, followed by three dosimetry scans over 3-6 days. If the imaging dose demonstrated normal biodistribution and tumor uptake, then the patient received a therapeutic dose within 7-28 days of the diagnostic imaging dose, followed by a single imaging scan on Day 7 post therapy. Mean therapeutic dosing groups were 11.2 mCi/kg, 15.5 nCi/kg and 18.2 mCi/kg. The dosimetry dose was administered over a period of 1-3 minutes by injection; the therapeutic dose was diluted in up to 25 mL normal saline and infused intravenously over 30 to 60 minutes.
    All Cause Mortality
    Ultratrace™ Iobenguane I 131
    Affected / at Risk (%) # Events
    Total / (NaN)
    Serious Adverse Events
    Ultratrace™ Iobenguane I 131
    Affected / at Risk (%) # Events
    Total 5/15 (33.3%)
    Blood and lymphatic system disorders
    Febrile neutropenia 2/15 (13.3%) 2
    General disorders
    Disease progression 1/15 (6.7%) 1
    Infections and infestations
    Upper respiratory tract infection 1/15 (6.7%) 1
    Infection 1/15 (6.7%) 1
    Bacteremia 1/15 (6.7%) 1
    Neutropenia infection 1/15 (6.7%) 1
    Other (Not Including Serious) Adverse Events
    Ultratrace™ Iobenguane I 131
    Affected / at Risk (%) # Events
    Total 15/15 (100%)
    Blood and lymphatic system disorders
    Leukopenia 15/15 (100%)
    Thrombocytopenia 15/15 (100%)
    Neutropenia 14/15 (93.3%)
    Lymphopenia 8/15 (53.3%)
    Febrile Neutropenia 2/15 (13.3%)
    Gastrointestinal disorders
    Nausea 9/15 (60%)
    Vomiting 6/15 (40%)
    Diarrhoea 4/15 (26.7%)
    Salivary gland pain 4/15 (26.7%)
    Salivary gland enlargement 3/15 (20%)
    Abdominal pain 2/15 (13.3%)
    Constipation 2/15 (13.3%)
    Dry mouth 2/15 (13.3%)
    General disorders
    Pyrexia 5/15 (33.3%)
    Fatigue 3/15 (20%)
    Oedema peripheral 2/15 (13.3%)
    Infections and infestations
    Candidiasis 2/15 (13.3%)
    Investigations
    Aspartate aminotransferase increased 12/15 (80%)
    Hemoglobin decreased 11/15 (73.3%)
    Alanine aminotransferase increased 9/15 (60%)
    Activated partial thromboplastin time prolonged 3/15 (20%)
    Blood bilirubin increased 3/15 (20%)
    Weight decreased 3/15 (20%)
    Metabolism and nutrition disorders
    Anorexia 4/15 (26.7%)
    Hypokalaemia 3/15 (20%)
    Hyponatraemia 3/15 (20%)
    Hyperglycaemia 2/15 (13.3%)
    Hypocalcaemia 2/15 (13.3%)
    Hypoglycaemia 2/15 (13.3%)
    Hypophosphataemia 2/15 (13.3%)
    Musculoskeletal and connective tissue disorders
    Arthralgia 2/15 (13.3%)
    Neck pain 2/15 (13.3%)
    Pain in jaw 2/15 (13.3%)
    Nervous system disorders
    Headache 4/15 (26.7%)
    Dysgeusia 2/15 (13.3%)
    Renal and urinary disorders
    Bladder spasm 2/15 (13.3%)
    Respiratory, thoracic and mediastinal disorders
    Nasal congestion 2/15 (13.3%)
    Skin and subcutaneous tissue disorders
    Alopecia 2/15 (13.3%)
    Vascular disorders
    Hypertension 2/15 (13.3%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days. The sponsor cannot require changes to the communication and cannot extend the embargo.

    Results Point of Contact

    Name/Title NANT Operations Center
    Organization NANT Consortium
    Phone 323-361-5687
    Email nantops@chla.usc.edu
    Responsible Party:
    Molecular Insight Pharmaceuticals, Inc.
    ClinicalTrials.gov Identifier:
    NCT00659984
    Other Study ID Numbers:
    • CDR0000593357
    • NANT-2007-01
    First Posted:
    Apr 17, 2008
    Last Update Posted:
    Oct 4, 2017
    Last Verified:
    Sep 1, 2017