Dinutuximab, Sargramostim, and Combination Chemotherapy in Treating Patients With Newly Diagnosed High-Risk Neuroblastoma

Completed · Phase 2

Conditions studied: Ganglioneuroblastoma, High Risk Neuroblastoma

In brief

This phase II pilot trial studies the side effects and how well dinutuximab and sargramostim work when combined with chemotherapy in patients with high-risk neuroblastoma. Immunotherapy with monoclonal antibodies, such as dinutuximab, may induce changes in the body's immune system and may interfere with the ability of tumor cells to grow and spread. Sargramostim helps the body produce normal infection-fighting white blood cells. These cells also help the dinutuximab work better. Giving chemotherapy before a stem cell transplant, with drugs such as cisplatin, etoposide, vincristine, doxorubicin, cyclophosphamide, thiotepa, melphalan, etoposide, carboplatin, topotecan, and isotretinoin, helps kill cancer cells that are in the body and helps make room in a patient's bone marrow for new blood-forming cells (stem cells). Giving dinutuximab and sargramostim with combination chemotherapy may work better than combination chemotherapy alone in treating patients with high-risk neuroblastoma.

Key facts

Study ID: NCT03786783
Run by: National Cancer Institute (NCI)
People needed: 42
Starts: 2019-03-04
Expected to finish: 2026-03-31
Last updated by the study team: 2026-06-02

Who can join

Age: any, up to 30. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Patients must be enrolled on ANBL00B1 or APEC14B1 prior to enrollment on ANBL17P1.
Patients must have a diagnosis of neuroblastoma or ganglioneuroblastoma (nodular) verified by tumor pathology analysis or demonstration of clumps of tumor cells in bone marrow with elevated urinary catecholamine metabolites. The following disease groups are eligible:
Patients with International Neuroblastoma Risk Group (INRG) stage M disease are eligible if found to have either of the following features:
MYCN amplification (> 4-fold increase in MYCN signals as compared to reference signals), regardless of age or additional biologic features; OR
Age > 547 days regardless of biologic features;
Patients with INRG stage MS disease with MYCN amplification
Patients with INRG stage L2 disease with MYCN amplification
Patients > 547 days of age initially diagnosed with INRG stage L1, L2 or MS disease who progress to stage M without prior chemotherapy may enroll within 4 weeks of progression to stage M.
Patients >= 365 days of age initially diagnosed with MYCN amplified INRG stage L1 disease who progress to stage M without systemic therapy may enroll within 4 weeks of progression to stage M.
Patients initially recognized to have high-risk disease must have had no prior systemic therapy (other than topotecan/cyclophosphamide initiated on an emergent basis and within allowed timing as described).
Patients observed or treated with a single cycle of chemotherapy per a low or intermediate risk neuroblastoma regimen (e.g., as per ANBL0531, ANBL1232 or similar) for what initially appeared to be non-high risk disease but subsequently found to meet the criteria will also be eligible.
Patients who receive localized emergency radiation to sites of life-threatening or function-threatening disease prior to or immediately after establishment of the definitive diagnosis will be eligible.
Creatinine clearance (CrCl) or radioisotope glomerular filtration rate (GFR) >= 70 mL/min/1.73 m\^2 or a serum creatinine based on age/sex as follows:
Age 1 month to < 6 months (male 0.4 mg/dL, female 0.4 mg/dL)
Age 6 months to < 1 year (male 0.5 mg/dL, female 0.5 mg/dL)
Age 1 to < 2 years (male 0.6 mg/dL, female 0.6 mg/dL)
Age 2 to < 6 years (male 0.8 mg/dL, female 0.8 mg/dL)
Age 6 to < 10 years (male 1 mg/dL, female 1 mg/dL)
Age 10 to < 13 years (male 1.2 mg/dL, female 1.2 mg/dL)
Age 13 to < 16 years (male 1.5 mg/dL, female 1.4 mg/dL)
Age >= 16 years (male 1.7 mg/dL, female 1.4 mg/dL) (within 7 days prior to enrollment).
Total bilirubin =< 1.5 x upper limit of normal (ULN) for age (within 7 days prior to enrollment).
Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) < 10 x ULN. For the purposes of this study, ULN for ALT is 45 IU/L (within 7 days prior to enrollment).
Shortening fraction of >= 27% by echocardiogram (within 7 days prior to enrollment).
Ejection fraction of >= 50% by echocardiogram or radionuclide angiogram (within 7 days prior to enrollment).

You may not qualify if…

Patients >18 months of age with INRG stage L2, MYCN non-amplified, regardless of additional biologic features.
Patients with bone marrow failure syndromes.
Patients that are >= 12 and =< 18 months of age with INRG stage M and all 3 favorable biologic features (i.e., non-amplified MYCN, favorable pathology, and deoxyribonucleic acid [DNA] index > 1) are not eligible.
Patients on immunosuppressive medications (e.g. tacrolimus, cyclosporine, corticosteroids for reasons other than prevention/treatment of allergic reactions, adrenal replacement therapy, etc.) are not eligible.
Female patients who are pregnant are ineligible since fetal toxicities and teratogenic effects have been noted for several of the study drugs. A pregnancy test is required for female patients of childbearing potential.
Lactating females who plan to breastfeed their infants.
Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method during study therapy and for two months after the last dose of ch14.18 (dinutuximab) are not eligible.

Where it is running

Saint Jude Children's Research Hospital — Memphis, Tennessee, United States
Primary Children's Hospital — Salt Lake City, Utah, United States
The Children's Hospital at Westmead — Westmead, New South Wales, Australia
Royal Children's Hospital — Parkville, Victoria, Australia
Starship Children's Hospital — Grafton, Auckland, New Zealand
Children's Hospital Los Angeles — Los Angeles, California, United States
Children's National Medical Center — Washington D.C., District of Columbia, United States
Dana-Farber Cancer Institute — Boston, Massachusetts, United States
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center — New York, New York, United States
Children's Hospital of Pittsburgh of UPMC — Pittsburgh, Pennsylvania, United States

Full record on ClinicalTrials.gov

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