Trial Outcomes & Findings for Randomized Efficacy Study of TPI 287 to Treat Primary Refractory or Early Relapsed Neuroblastoma (NCT NCT01505608)

NCT ID: NCT01505608

Last Updated: 2024-08-06

Results Overview

To determine the safety and tolerability of TPI 287 in combination with Irinotecan and Temozolomide (TPI+I+TMZ) in pediatric and young adult patients with primary refractory or recurrent Neuroblastoma. Phase I patients were all enrolled to receive TPI 287. Phase 2 is where randomization began. Patients were different patients than the Phase 1 patients. Below all patients that received TPI 287 are included in the TPI 287 group. This includes Phase I patients and the Phase 2 patients randomized to TPI 287.

Recruitment status

TERMINATED

Study phase

PHASE1/PHASE2

Target enrollment

14 participants

Primary outcome timeframe

6 months

Results posted on

2024-08-06

Participant Flow

Phase 1- All patients assigned to TPI 287 group. Randomization began in Phase 2- Arm A patients were allowed to cross over to Arm B during cycles 1-6 if they experienced progression. 0 (zero) Arm A patients crossed over to Arm B on this study.

Participant milestones

Participant milestones
Measure
Arm A- Temozolomide and Irinotecan
1. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 2. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. During Phase 2- Patients who show progression on the I+TMZ arm may crossover to the I+TMZ+TPI 287 arm at anytime during cycles 1 to 6. If there is evidence of progression after completion of the I+TMZ arm (after completion of cycle 6) then the patient will have been considered to have completed therapy and is not eligible for the crossover. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Arm B- Temozolomide/Irinotecan + TPI 287
Cycle 1 to 6: Irinotecan and Temozolomide in combination with TPI 287 1. Intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. 2. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 3. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. TPI 287: Subjects will receive six cycles of intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Phase I
STARTED
0
8
Phase I
COMPLETED
0
2
Phase I
NOT COMPLETED
0
6
Phase II
STARTED
2
4
Phase II
COMPLETED
0
2
Phase II
NOT COMPLETED
2
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Arm A- Temozolomide and Irinotecan
1. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 2. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. During Phase 2- Patients who show progression on the I+TMZ arm may crossover to the I+TMZ+TPI 287 arm at anytime during cycles 1 to 6. If there is evidence of progression after completion of the I+TMZ arm (after completion of cycle 6) then the patient will have been considered to have completed therapy and is not eligible for the crossover. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Arm B- Temozolomide/Irinotecan + TPI 287
Cycle 1 to 6: Irinotecan and Temozolomide in combination with TPI 287 1. Intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. 2. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 3. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. TPI 287: Subjects will receive six cycles of intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Phase I
Lack of Efficacy
0
4
Phase I
Adverse Event
0
1
Phase I
Withdrawal by Subject
0
1
Phase II
Lack of Efficacy
2
1
Phase II
Protocol Violation
0
1

Baseline Characteristics

Randomized Efficacy Study of TPI 287 to Treat Primary Refractory or Early Relapsed Neuroblastoma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm A- Temozolomide and Irinotecan
n=2 Participants
1. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 2. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. Patients who show progression on the I+TMZ arm may crossover to the I+TMZ+TPI 287 arm at anytime during cycles 1 to 6. If there is evidence of progression after completion of the I+TMZ arm (after completion of cycle 6) then the patient will have been considered to have completed therapy and is not eligible for the crossover. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Arm B- Temozolomide/Irinotecan + TPI 287
n=12 Participants
Cycle 1 to 6: Irinotecan and Temozolomide in combination with TPI 287 1. Intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. 2. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 3. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. TPI 287: Subjects will receive six cycles of intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Total
n=14 Participants
Total of all reporting groups
Age, Categorical
<=18 years
2 Participants
n=99 Participants
11 Participants
n=107 Participants
13 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Sex: Female, Male
Female
2 Participants
n=99 Participants
3 Participants
n=107 Participants
5 Participants
n=206 Participants
Sex: Female, Male
Male
0 Participants
n=99 Participants
9 Participants
n=107 Participants
9 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
1 Participants
n=99 Participants
12 Participants
n=107 Participants
13 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=99 Participants
4 Participants
n=107 Participants
4 Participants
n=206 Participants
Race (NIH/OMB)
White
2 Participants
n=99 Participants
8 Participants
n=107 Participants
10 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants

PRIMARY outcome

Timeframe: 6 months

Population: This group includes the 8 patients enrolled to phase 1 TPI 287 portion of the study plus the 4 additional patients randomized to TPI 287 in the Phase 2 portion = 12 patients total that received TPI 287 on this study.

To determine the safety and tolerability of TPI 287 in combination with Irinotecan and Temozolomide (TPI+I+TMZ) in pediatric and young adult patients with primary refractory or recurrent Neuroblastoma. Phase I patients were all enrolled to receive TPI 287. Phase 2 is where randomization began. Patients were different patients than the Phase 1 patients. Below all patients that received TPI 287 are included in the TPI 287 group. This includes Phase I patients and the Phase 2 patients randomized to TPI 287.

Outcome measures

Outcome measures
Measure
TPI 287
n=12 Participants
Cycle 1 to 6: Irinotecan and Temozolomide in combination with TPI 287 1. Intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. 2. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 3. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. TPI 287: Subjects will receive six cycles of intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Arm A- TMZ + Irinotecan Only
n=2 Participants
Did not receive TPI 287
Number of Participants With Adverse Events as a Measure of Safety and Tolerability
7 participants
0 participants

PRIMARY outcome

Timeframe: 3 years

Population: 8 enrolled to Phase 1: two were non-evaluable =6 move to analysis. Another 4 randomized to Arm B with TPI 287 in Phase 2=10 evaluable in TPI 287 analysis. 2 subjects were enrolled in the Phase 2 randomized portion of the trial to Arm A- without TPI 287. This makes 2 evaluable subjects in this analysis population (did not receive TPI 287).

Phase I portion of trial- All patients enrolled to recieve TPI+I+TMZ. These patients will be added to the Phase II patients that were randomized to Arm B- Arm with TPI 287 (recieved same tx as Phase I participatns). Phase II portion of trial- TPatients enrolled to this portion (different patients than enrolled to Phase 1) were randomized to Arm A: I+TMZ OR Arm B: TPI+I+TMZ Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Outcome measures

Outcome measures
Measure
TPI 287
n=2 Participants
Cycle 1 to 6: Irinotecan and Temozolomide in combination with TPI 287 1. Intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. 2. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 3. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. TPI 287: Subjects will receive six cycles of intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Arm A- TMZ + Irinotecan Only
n=10 Participants
Did not receive TPI 287
Overall Response Rate (ORR) of Participants Using RECIST Criteria
0 participants
2 participants

SECONDARY outcome

Timeframe: 1 year

Population: PK's not run due to early closure of study. Data not collected or analyzed threfore no data exists.

To evaluate the drug levels and pharmacokinetics (PK) of TPI 287 from blood samples at multiple time points within the first 24 hours on study.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 3 years

Population: QOL's not collected due to early closure of study. Data not collected or analyzed threfore no data exists.

Evaluate the impact on QOL of children receiving TPI+I+TMZ

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 3 years

Population: Arm A- 2 subjects randomized to TMZ+I. Arm B- 6 evalubale patients in Phase 1 + 4 evaluable patients in Phase 2- all received TMZ+I+TPI

Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions

Outcome measures

Outcome measures
Measure
TPI 287
n=2 Participants
Cycle 1 to 6: Irinotecan and Temozolomide in combination with TPI 287 1. Intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. 2. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 3. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. TPI 287: Subjects will receive six cycles of intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Arm A- TMZ + Irinotecan Only
n=10 Participants
Did not receive TPI 287
Progression Free Survival (PFS) of Participants Using Days Until Progression
22 Days
125 Days

SECONDARY outcome

Timeframe: 3 years

Population: Not evaluated due to early closure. Study data does not exist.

To determine OS and clinical benefit (CR/PR/SD) in this population

Outcome measures

Outcome data not reported

Adverse Events

TPI 287

Serious events: 3 serious events
Other events: 11 other events
Deaths: 0 deaths

Phase II Arm A- Subjects That Did Not Receive TPI 287

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
TPI 287
n=12 participants at risk
Cycle 1 to 6: Irinotecan and Temozolomide in combination with TPI 287 1. Intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. 2. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 3. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. TPI 287: Subjects will receive six cycles of intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Phase II Arm A- Subjects That Did Not Receive TPI 287
n=2 participants at risk
Cycle 1 to 6: Irinotecan and Temozolomide 1. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 2. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Gastrointestinal disorders
Diarrhea
8.3%
1/12 • Number of events 1 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
General disorders
Progression of Disease resulting in Death
16.7%
2/12 • Number of events 2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.

Other adverse events

Other adverse events
Measure
TPI 287
n=12 participants at risk
Cycle 1 to 6: Irinotecan and Temozolomide in combination with TPI 287 1. Intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. 2. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 3. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle. TPI 287: Subjects will receive six cycles of intravenous (IV) TPI 287 at a dose of 125 mg/m2 on Days 1, 8 and 15 of a 28-day cycle. Temozolomide: Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle Irinotecan: Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Phase II Arm A- Subjects That Did Not Receive TPI 287
n=2 participants at risk
Cycle 1 to 6: Irinotecan and Temozolomide 1. Oral (PO) Temozolomide at a dose of 100mg/m2 on days 1-5 of each 28 day cycle. 2. Intravenous (IV) Irinotecan at a dose of 10mg/m2 on days 1-5 and 8-12 of each 28 day cycle.
Psychiatric disorders
Agitation
8.3%
1/12 • Number of events 1 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
Blood and lymphatic system disorders
Anemia
33.3%
4/12 • Number of events 7 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
Gastrointestinal disorders
Constipation
8.3%
1/12 • Number of events 1 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
Blood and lymphatic system disorders
Neutropenia
50.0%
6/12 • Number of events 18 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
Gastrointestinal disorders
Diarrhea
8.3%
1/12 • Number of events 1 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
Nervous system disorders
peripheral sensory neuropathy
8.3%
1/12 • Number of events 1 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
General disorders
Infusion Related Reaction
33.3%
4/12 • Number of events 16 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
Blood and lymphatic system disorders
lymphocytopenia
16.7%
2/12 • Number of events 21 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
General disorders
Pain
8.3%
1/12 • Number of events 1 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
Blood and lymphatic system disorders
Thrombocytopenia
8.3%
1/12 • Number of events 1 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
Respiratory, thoracic and mediastinal disorders
Pneumonia
8.3%
1/12 • Number of events 1 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
General disorders
Weight loss
8.3%
1/12 • Number of events 1 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
Blood and lymphatic system disorders
leukopenia
25.0%
3/12 • Number of events 11 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.
0.00%
0/2 • New adverse events collected from first dose of study drug to 30 days past last dose of study drug. Related adverse events followed until resolution, approximately 1 year.

Additional Information

Giselle Sholler, MD

NMTRC

Phone: 6162670335

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60