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CompletedNCT00601003Updated Aug 6, 2024Results posted

Study of Nifurtimox to Treat Refractory or Relapsed Neuroblastoma or Medulloblastoma

A Phase 2 interventional study of Nifurtimox and Cyclophosphamide in Neuroblastoma and Medulloblastoma, sponsored by Giselle Sholler. Completed at 15 sites in United States. Open to participants aged Up to 21 Years. Per ClinicalTrials.gov, last updated 2024-08-06.

Sponsored by Giselle Sholler · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
112
Allocation
Not applicable
Ages
Up to 21 Years
Sex
All
01

Study summary

The purpose of this study is to determine whether nifurtimox in combination with cyclophosphamide and topotecan are effective in the treatment of relapsed or refractory neuroblastoma and medulloblastoma.

Read the detailed description

This study is being done to test the effect of a drug, nifurtimox, against neuroblastoma and medulloblastoma in children. Nifurtimox is a drug that has been used in South America for many years to treat a parasitic disease known as Chagas Disease. It is not approved by the Food and Drug Administration for routine use in neuroblastoma or medulloblastoma in the United States, but limited early observations suggest that nifurtimox may have anti tumor activity for neuroblastoma and medulloblastoma.

From the preliminary trials of nifurtimox we have determined a safely tolerated dose of nifurtimox to use in neuroblastoma patients (30mg/kg/day). The dose determined in the Phase I study to be safe, will be the dose used for this study. From clinical experience in South America, we know that children can tolerate nifurtimox when given by mouth, and it appears to have no long-term side effects when used to treat Chagas Disease. Based on our laboratory and animal studies, we believe that drug levels similar to those used to treat Chagas Disease may shrink/kill neuroblastoma cells, especially when combined with other chemotherapy drugs. We do not know whether nifurtimox will shrink/kill tumor cells effectively in children. Therefore, the major goal of the study is to learn if nifurtimox in combination with other chemotherapy drugs is effective in shrinking/killing neuroblastoma and medulloblastoma cells.

02

Conditions studied

  • Neuroblastoma
  • Medulloblastoma
03

In context

Neuroblastoma

625 studies on the registry are indexed under Neuroblastoma; 122 are open to participants now.

This study's enrollment of 112 is above the median of 32 across 475 interventional studies indexed under Neuroblastoma.

Browse Neuroblastoma studies →

Lead sponsor

Giselle Sholler is the lead sponsor of 22 studies on the registry; 6 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Up to 21 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age: 0-21 years at the time of diagnosis.
  • Diagnosis: Histologic verification at either the time of original diagnosis or relapse of neuroblastoma or medulloblastoma.
  • Disease Status: Refractory or first or multiple relapsed neuroblastoma, or medulloblastoma that has relapsed after, or is refractory to, a chemotherapy-containing treatment regimen.
  • Measurable disease, including at least one of the following:

    • Measurable tumor by CT or MRI
    • For neuroblastoma patients only, a positive MIBG (MIBG not required if subject's neuroblastoma is previously determined to not uptake MIBG), abnormal urinary catecholamine levels, or positive bone marrow biopsy/aspirate.
    • For medulloblastoma patients only, positive CSF cytology
  • Current disease state must be one for which there is currently no known curative therapy.
  • A negative urine pregnancy test is required for female participants of child bearing potential (≥13 years of age).
  • Organ Function Requirements Patients without bone marrow metastases must have an ANC > 500/μl and platelet count >50,000/μl.
  • Patients must have adequate liver function as defined by AST or ALT \<10x normal
  • Informed Consent: All patients and/or legal guardians must sign informed written consent. Assent, when appropriate, will be obtained according to institutional guidelines

Exclusion criteria

Exclusion Criteria:

  • Life expectancy \<2 months or Lansky score \<50%
  • Investigational Drugs: Patients who are currently receiving another investigational drug are excluded from participation.
  • Anti-cancer Agents: Patients who are currently receiving other anticancer agents are not eligible. Patients must have fully recovered from the effects of prior chemotherapy, generally at least 3 weeks from the most recent administration (6 weeks for nitrosoureas).
  • Infection: Patients who have an uncontrolled infection are not eligible until the infection is judged to be well controlled.
  • Patients who, in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study, or in whom compliance is likely to be suboptimal, should be excluded.

Compensation for travel related expenses may be available

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
112 participants (actual)

Study arms

  • Experimental
    Nifurtimox

    Drug: Nifurtimox · Drug: Cyclophosphamide · Drug: Topotecan

Interventions

  • DrugNifurtimox

    30mg/kg/day PO divided into TID dosing q day

    Also known as: Lampit

  • DrugCyclophosphamide

    250 mg/m2/dose in normal saline, IV, infused over 30 minutes on days 1-5 of each cycle.

    Also known as: Cytoxan

  • DrugTopotecan

    0.75mg/m2/dose, in normal saline, IV, infused over 30 minutes on days 1-5 of each cycle.

    Also known as: Hycamptin

06

What researchers measure

Primary outcomes

  1. Number of Participants With Related Adverse Events as a Measure of Safety and Tolerability

    Test the safety of nifurtimox in children with relapsed or refractory neuroblastoma or medulloblastoma in combination with cyclophosphamide/topotecan

    Time frame: 2 years

  2. Best Radiological Response in Participants Using the RECIST Criteria

    Test the efficacy of nifurtimox in children with relapsed or refractory neuroblastoma or medulloblastoma in combination with cyclophosphamide/topotecan Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions, Overall Best Response assessed by CT or MRI, MIBG, and Bone Marrow: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions, bone marrow with CR, and MIBG with CR/PR. Overall Response (OR) = CR + PR.

    Time frame: 2 years

07

Results

Posted Dec 29, 2022

Participant flow

Participant flow — Overall Study
MilestoneNifurtimox
Started112
Completed76
Not completed36

Outcome measures

PrimaryNumber of Participants With Related Adverse Events as a Measure of Safety and Tolerability

Test the safety of nifurtimox in children with relapsed or refractory neuroblastoma or medulloblastoma in combination with cyclophosphamide/topotecan

Time frame:
2 years
Reported as:
Count of participants · Participants
Number of Participants With Related Adverse Events as a Measure of Safety and Tolerability
ParticipantsNifurtimox
Number of Participants With Related Adverse Events as a Measure of Safety and Tolerability45
PrimaryBest Radiological Response in Participants Using the RECIST Criteria

Test the efficacy of nifurtimox in children with relapsed or refractory neuroblastoma or medulloblastoma in combination with cyclophosphamide/topotecan Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions, Overall Best Response assessed by CT or MRI, MIBG, and Bone Marrow: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions, bone marrow with CR, and MIBG with CR/PR. Overall Response (OR) = CR + PR.

Time frame:
2 years
Reported as:
Count of participants · Participants
Best Radiological Response in Participants Using the RECIST Criteria
ParticipantsNifurtimox
Complete Response7
Partial Response11
Stable Disease35
Progressive Disease23

Adverse events

Collected over From first dose of Nifurtimox through to 30 days after last dose, an average of 8 months. Additionally all events deemed related to Nifurtimox were followed past the 30 days to resolution or baseline.. Non-serious events are listed at a 2% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Nifurtimox19/110 (17.3%)25/110 (22.7%)45/110 (40.9%)
Most frequent serious events
Showing 10 of 17
Most frequent serious events
EventNifurtimox
Other (Progressive Disease)Neoplasms benign, malignant and unspecified (incl cysts and polyps)17/110
SeizureNervous system disorders3/110
SepsisInfections and infestations2/110
Febrile neutropeniaBlood and lymphatic system disorders2/110
AnorexiaGastrointestinal disorders1/110
Nausea and vomitingGastrointestinal disorders1/110
Bladder ThrombosisRenal and urinary disorders1/110
Tooth PainGeneral disorders1/110
Respiratory DistressRespiratory, thoracic and mediastinal disorders1/110
Aspiration pneumoniaRespiratory, thoracic and mediastinal disorders1/110
Most frequent other events
Showing 10 of 16
Most frequent other events
EventNifurtimox
AtaxiaNervous system disorders10/110
AnemiaBlood and lymphatic system disorders9/110
LeukopeniaBlood and lymphatic system disorders7/110
NeutropeniaBlood and lymphatic system disorders7/110
ThrombocytopeniaBlood and lymphatic system disorders7/110
Motor Neuropathy/WeaknessNervous system disorders7/110
AnorexiaGastrointestinal disorders7/110
ConfusionNervous system disorders6/110
NauseaGastrointestinal disorders6/110
VomitingGastrointestinal disorders6/110

Baseline characteristics

Number of subjects that signed consent and had baseline information collected

Age, Continuous
Age, Continuous(years)Nifurtimox
Mean5.5 (1.1 to 21.5)
Sex: Female, Male
Sex: Female, Male(Participants)Nifurtimox
Female39
Male73
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Nifurtimox
Hispanic or Latino16
Not Hispanic or Latino93
Unknown or Not Reported3
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Nifurtimox
American Indian or Alaska Native1
Asian4
Native Hawaiian or Other Pacific Islander2
Black or African American11
White89
More than one race2
Unknown or Not Reported3
08

Study locations

15 sites
  • Rady Children's Hospital
    San Diego, California 92123, United States
  • Connecticut Children's Hospital
    Hartford, Connecticut 06106, United States
  • Arnold Palmer Hospital for Children- MD Anderson
    Orlando, Florida 32806, United States
  • Kapiolani Medical Center for Women and Children
    Honolulu, Hawaii 96813, United States
  • Tufts Medical Center
    Boston, Massachusetts 02111, United States
  • Helen DeVos Children's Hospital
    Grand Rapids, Michigan 49503, United States
  • Children's Hospital and Clinics on Minnesota
    Minneapolis, Minnesota 55404, United States
  • Children's Mercy Hospitals and Clinics
    Kansas City, Missouri 64108, United States
  • Cardinal Glennon Children's Medical Center
    Saint Louis, Missouri 63104, United States
  • Levine Children's Hospital
    Charlotte, North Carolina 28204, United States
  • Penn State Milton S. Hershey Medical Center and Children's Hospital
    Hershey, Pennsylvania 17033, United States
  • Medical University of South Carolina
    Charleston, South Carolina 29425, United States
  • Children's Medical Center
    Dallas, Texas 75235, United States
  • Texas Children's Cancer and Hematology Centers
    Houston, Texas 77030, United States
  • Primary Children's Hospital
    Salt Lake City, Utah 84113, United States
09

References and documents

Study documents

  • Protocol and statistical analysis plan · Dec 4, 2015
  • Informed consent form · Jan 19, 2016

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 6, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00601003
Lead sponsor
Giselle Sholler
Collaborators
Bayer
Responsible party
Giselle Sholler (Study Chair, Milton S. Hershey Medical Center) — Sponsor-investigator
First posted
Jan 25, 2008
Start date
Jan 14, 2008
Primary completion
Apr 28, 2020
Completion
Oct 28, 2022
Results posted
Dec 29, 2022
Last update
Aug 6, 2024

Study contacts

Giselle Sholler, MD
study chair · Beat Childhood Cancer at Atrium Health

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Aug 2024. You cannot join it, but the record below documents what was studied.

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