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Dose Escalation Study of CLR 131 in Children, Adolescents, and Young Adults With Relapsed or Refractory Malignant Tumors Including But Not Limited to Neuroblastoma, Rhabdomyosarcoma, Ewings Sarcoma, and Osteosarcoma

Study Purpose

The study evaluates CLR 131 in children, adolescents, and young adults with relapsed or refractory malignant solid tumors and lymphoma and recurrent or refractory malignant brain tumors for which there are no standard treatment options with curative potential.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 2 Years - 25 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

All Patients.
  • - Previously confirmed (histologically or cytologically) pediatric solid tumor (e.g., neuroblastoma, sarcoma), lymphoma (including Hodgkin's lymphoma), or malignant brain tumors that are clinically or radiographically suspected to be relapsed, refractory, or recurrent for which there are no standard treatment options with curative potential.
Note: patients with diffuse intrinsic pontine glioma (DIPG) may enroll without histological or cytological confirmation.
  • - ≥ 2 years of age and ≤ 25 years of age at time of consent/assent.
  • - If ≥ age 16 years, Karnofsky performance status of ≥ 60.
If < age 16 years, Lansky performance status ≥ 60.
  • - Platelets ≥ 75,000/µL (last transfusion, if any, must be at least 1 week prior to study registration, and, unless deemed medically necessary, no transfusions are allowed between registration and dosing) - Absolute neutrophil count ≥ 750/µL.
  • - Hemoglobin ≥ 8 g/dL (last transfusion must be at least 1 week prior to study registration, and, unless deemed medically necessary, no transfusions are allowed between registration and dosing) - Using the bedside Schwartz formula, estimated GFR (creatinine clearance) > 60 ml/min/1.73m2.
  • - Alanine aminotransferase < 3 × ULN.
  • - Bilirubin < 2 × ULN.
  • - Patients who have undergone autologous or allogeneic bone marrow transplant must be at least 3 months from transplant.
  • - Patients enrolling at total dose levels > 30 millicurie (mCi)/m2 must have availability or ability to collect an autologous hematopoietic stem cell back-up product prior to CLR 131 administration.
At minimum, 2 x 10^6/kg cryopreserved CD34+ cells must be available.
  • - Patient or his or her legal representative is judged by the Investigator to have the initiative and means to be compliant with the protocol.
Patients with Pediatric Solid Tumor or Lymphoma.
  • - At least 1 measurable lesion with longest diameter of at least 10 mm.
Patients with a lesion(s) that are determined to be Metaiodobenzylguanidine (MIBG) or positron emission tomography (PET) positive may be enrolled at the investigator's discretion, even if not associated with a measurable lesion of at least 10 mm. Patients with neuroblastoma who have detectable disease may enroll provided they meet the requirements of the International Neuroblastoma Response Criteria.
  • - Patients with known brain metastases must have completed any radiotherapy or systemic treatments for brain metastases prior to enrollment; by investigator assessment be considered stable with no new signs or symptoms for at least 1 month, and on a stable dose of steroids (unchanged for three weeks prior to registration or on a steroid tapering regimen).
Patients with Recurrent or Refractory Brain Tumors.
  • - At least 1 measurable lesion with longest diameter of at least 10 mm on any imaging sequence.
  • - Patients with previously known neurological deficits must be clinically stable at time of enrollment and able to complete all study related procedures.
Patients with documented or newly diagnosed neurological deficits will be enrolled at the investigator's discretion.
  • - If patient receives steroids for neurological symptom control, the dose must be stable (unchanged for three weeks prior to registration) or on a steroid tapering regimen.
Initiation of steroids per routine care immediately prior to CLR 131 dosing is acceptable.

Exclusion Criteria:

  • - Patients receiving active treatment for central nervous system metastases or those that are likely to require active treatment during anticipated participation in this trial.
Patients with stable brain metastases treated with steroids may enroll at the investigator's discretion.
  • - For solid tumor and lymphoma patients only, central nervous system involvement unless previously treated with surgery, systemic therapy, or radiotherapy with the patient neurologically stable.
Patients with metastatic brain tumors that have been previously treated are allowed, provided the patient is neurologically stable (determined at the investigator's discretion).
  • - Antitumor therapy or investigational therapy, within 2 weeks of dosing.
For certain types of radiation (craniospinal, total abdominal, whole lung [spot irradiation to skull-based metastases is not considered craniospinal radiation for the purposes of this study]), at least 3 months must have elapsed. No washout is required for palliative focal radiation. NOTE: Patients participating in non-interventional clinical trials (i.e., non-drug) are allowed to participate in this trial.
  • - Patients previously treated with iodine-131 (131I)-MIBG who have already received a cumulative I-131 dose > 54 mCi/kg or who would exceed 54 mCi/kg by participating in this trial, are not eligible.

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT03478462
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 1
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Cellectar Biosciences, Inc.
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Jarrod Longcor
Principal Investigator Affiliation Cellectar Biosciences
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Industry
Overall Status Unknown status
Countries Australia, Canada, United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Pediatric Solid Tumor, Pediatric Lymphoma, Pediatric Brain Tumor, DIPG, Neuroblastoma, Ewing Sarcoma, Rhabdomyosarcoma, Osteosarcoma
Additional Details

Even with standard, highly toxic multimodality therapies and salvage regimen, most pediatric patients with primary metastatic or relapsed solid tumors are confronted with a poor prognosis. For these patients there is currently no accepted successful treatment regimen. There is a need for new drugs, including targeted radiopharmaceuticals, preferably with cancer-specific uptake and broad applicability for these rare pediatric malignancies. CLR 131 is a radioiodinated therapeutic that exploits the selective uptake and retention of phospholipid ethers (PLEs) by malignant cells. Cellectar Biosciences' novel cancer-targeted small-molecule compound (CLR1404) is radiolabeled with the isotope iodine-131 (I-131). CLR 131 has demonstrated tumor selective uptake across numerous adult and pediatric cancer cell types. Therapeutic efficacy has been demonstrated in various pediatric and adult-type cancer xenograft models, confirming the ability of CLR 131 to target tumors. Based on the critical unmet medical need for effective agents with novel mechanisms of action in relapsed pediatric cancers and initial preclinical and clinical experience with radioiodinated CLR1404, Cellectar Biosciences has chosen to assess CLR 131 in a phase 1 pediatric trial.

Arms & Interventions

Arms

Experimental: CLR 131

CLR 131 intravenous administration

Interventions

Drug: - CLR 131

IV dose of CLR 131, increased/decreased by dose level; single or fractionated dose

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Lucile Packard Children's Hospital, Palo Alto, California

Status

Address

Lucile Packard Children's Hospital

Palo Alto, California, 94304

Memorial Sloan Kettering Cancer Center, New York, New York

Status

Address

Memorial Sloan Kettering Cancer Center

New York, New York, 10065

Duke University, Chapel Hill, North Carolina

Status

Address

Duke University

Chapel Hill, North Carolina, 27708

Cincinnati, Ohio

Status

Address

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, 45229

Texas Children's Hospital, Houston, Texas

Status

Address

Texas Children's Hospital

Houston, Texas, 77030

Madison, Wisconsin

Status

Address

University of Wisconsin Hospital and Clinics

Madison, Wisconsin, 53792

International Sites

Children's Hospital at Westmead, Westmead, New South Wales, Australia

Status

Address

Children's Hospital at Westmead

Westmead, New South Wales, 2145

Hospital for Sick Children, Toronto, Ontario, Canada

Status

Address

Hospital for Sick Children

Toronto, Ontario, M5G1X8