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CompletedNCT01606878Updated Jan 5, 2024Results posted

Crizotinib and Combination Chemotherapy in Treating Younger Patients With Relapsed or Refractory Solid Tumors or Anaplastic Large Cell Lymphoma

A Phase 1 interventional study of Crizotinib and Cyclophosphamide in Childhood Solid Neoplasm, Recurrent Childhood Anaplastic Large Cell Lymphoma and Recurrent Neuroblastoma, sponsored by Children's Oncology Group. Completed at 23 sites in 2 countries. Open to participants aged 13 Months to 21 Years. Per ClinicalTrials.gov, last updated 2024-01-05.

Sponsored by Children's Oncology Group · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
46
Allocation
Non-randomized
Ages
13 Months to 21 Years
Sex
All
01

Study summary

This phase I trial studies the side effects and the best dose of crizotinib when given together with combination chemotherapy in treating younger patients with solid tumors or anaplastic large cell lymphoma that has returned or does not respond to treatment. Crizotinib may stop the growth of tumor or cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cyclophosphamide, topotecan hydrochloride, dexrazoxane hydrochloride, doxorubicin hydrochloride, and vincristine sulfate, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving crizotinib together with combination chemotherapy may be a better treatment for patients with solid tumors or anaplastic large cell lymphoma.

Read the detailed description

PRIMARY OBJECTIVES:

I. To estimate the recommended phase 2 dose (RP2D) or maximum tolerated dose (MTD) of crizotinib administered orally twice daily in combination with topotecan (topotecan hydrochloride) and cyclophosphamide in children with refractory/relapsed solid tumors or anaplastic large cell lymphoma (ALCL).

II. To define and describe the toxicities of crizotinib in combination with topotecan and cyclophosphamide administered on this schedule.

III. To estimate the recommended phase 2 dose (RP2D) or maximum tolerated dose (MTD) of crizotinib administered orally twice daily in combination with vincristine (vincristine sulfate) and doxorubicin (doxorubicin hydrochloride)/dexrazoxane (dexrazoxane hydrochloride) in children with refractory/relapsed solid tumors or ALCL.

IV. To define and describe the toxicities of crizotinib in combination with vincristine and doxorubicin/dexrazoxane administered on this schedule.

V. To characterize the pharmacokinetics of crizotinib in children with relapsed/refractory cancer when combined with either topotecan and cyclophosphamide or vincristine and doxorubicin/dexrazoxane.

SECONDARY OBJECTIVES:

I. To preliminarily define the antitumor activity of crizotinib in combination with either topotecan and cyclophosphamide or vincristine and doxorubicin/dexrazoxane within the confines of a Phase 1 study.

II. To preliminarily examine the relationship between anaplastic lymphoma kinase (ALK) status in patients with neuroblastoma or ALCL and response to crizotinib in combination with either topotecan and cyclophosphamide or vincristine and doxorubicin/dexrazoxane.

III. To preliminarily examine the relationship between minimal residual disease (MRD) status and clinical response to crizotinib in combination with either topotecan and cyclophosphamide or vincristine and doxorubicin/dexrazoxane in patients with ALCL.

IV. To use a questionnaire to gather preliminary information on the palatability of the oral solution formulation of crizotinib.

V. To examine ALK and MET proto-oncogene (c-Met) expression, copy number and mutations status in archival tumor tissue from solid tumor and ALCL patients.

VI. To use a questionnaire to gather information on the acceptability of the crizotinib capsule formulation.

OUTLINE: This is a dose-escalation study of crizotinib. Patients are assigned to Part A or Part B based on the treating physician's choice and availability of a reservation. After closure of Part A and Part B, patients are assigned to Part C.

PART A (CLOSED TO ACCRUAL 10/3/14): Patients receive crizotinib (oral solution) orally (PO) twice daily (BID) on days 1-21, cyclophosphamide intravenously (IV) once daily (QD) on days 1-5, and topotecan hydrochloride IV QD on days 1-5. Treatment repeats every 21 days for up to 35 courses in the absence of disease progression or unacceptable toxicity.

PART B (CLOSED TO ACCRUAL 10/3/14): Patients receive crizotinib (oral solution) PO BID as in Part A. Patients also receive vincristine sulfate IV on day 1, dexrazoxane hydrochloride IV on day 1, and doxorubicin hydrochloride IV over 15 minutes on day 1. Treatment repeats every 21 days for up to 35 courses in the absence of disease progression or unacceptable toxicity.

PART C: Patients receive crizotinib (capsule formulation) PO BID, cyclophosphamide IV QD, and topotecan hydrochloride IV QD as in Part A. Treatment repeats every 21 days for up to 35 courses in the absence of disease progression or unacceptable toxicity.

PART D: Patients receive crizotinib (microsphere formulation) PO BID, cyclophosphamide IV QD, and topotecan hydrochloride IV QD as in Part A. Treatment repeats every 21 days for up to 35 courses in the absence of disease progression or unacceptable toxicity.

02

Conditions studied

  • Childhood Solid Neoplasm
  • Recurrent Childhood Anaplastic Large Cell Lymphoma
  • Recurrent Neuroblastoma

Keywords

  • Crizotinib
  • Chemotherapy
  • Solid Tumors
  • Anaplastic Large Cell Lymphoma
03

In context

Lymphoma

5,578 studies on the registry are indexed under Lymphoma; 825 are open to participants now.

This study's enrollment of 46 is above the median of 40 across 4,508 interventional studies indexed under Lymphoma.

Browse Lymphoma studies →

Lead sponsor

Children's Oncology Group is the lead sponsor of 436 studies on the registry; 34 are open to participants now.

Of its 12 completed or terminated interventional studies of FDA-regulated products, 11 (92%) have results posted.

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

04

Who can participate

Ages eligible
13 Months to 21 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients must have had histologic verification of malignancy at original diagnosis or relapse; all patients with relapsed or refractory solid tumors or anaplastic large cell lymphoma (ALCL) are eligible except for patients with primary or metastatic central nervous system (CNS) tumors or patients with primary cutaneous ALCL
  • Patients must have either measurable or evaluable disease
  • Patients current disease state must be one for which there is no known curative therapy or therapy proven to prolong survival with an acceptable quality of life
  • Karnofsky >= 60% for patients > 16 years of age and Lansky >= 50 for patients =\< 16 years of age; Note: patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score
  • Patients must have fully recovered from the acute toxic effects of all prior anti-cancer chemotherapy

    • Myelosuppressive chemotherapy:

      • Solid tumors: at least 21 days after the last dose of myelosuppressive chemotherapy (42 days if prior nitrosourea)
      • ALCL:

        • Patients with ALCL who relapse while receiving standard maintenance chemotherapy will not be required to have a waiting period before enrollment onto this study
        • Patients who relapse while they are not receiving standard maintenance therapy, must have fully recovered from all acute toxic effects of prior therapy; at least 14 days must have elapsed after the completion of cytotoxic therapy
    • Hematopoietic growth factors: at least 14 days after the last dose of a long-acting growth factor (e.g. Neulasta) or 7 days for short-acting growth factor; for agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur; the duration of this interval must be discussed with the study chair
    • Biologic (anti-neoplastic agent): at least 7 days after the last dose of a biologic agent; for agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur; the duration of this interval must be discussed with the study chair
    • Immunotherapy: at least 42 days after the completion of any type of immunotherapy, e.g. tumor vaccines
    • Monoclonal antibodies: at least 3 half-lives of the antibody after the last dose of a monoclonal antibody
    • Radiation therapy (XRT):

      • Solid tumors: at least 14 days after local palliative XRT (small port); >= 6 weeks must have elapsed since treatment with therapeutic doses of metaiodobenzylguanidine (MIBG); at least 150 days must have elapsed if prior total body irradiation (TBI), craniospinal XRT or if >= 50% radiation of pelvis; at least 42 days must have elapsed if other substantial bone marrow (BM) radiation
      • ALCL: at least 14 days after local palliative XRT (small port); at least 84 days must have elapsed if prior TBI, craniospinal XRT or if >= 50% radiation of pelvis; at least 42 days must have elapsed if other substantial BM radiation
    • Stem cell infusion without TBI: no evidence of active graft vs. host disease and at least 84 days must have elapsed after transplant and >= 42 days for autologous stem cell infusion after iodine (I)131-MIBG therapy
    • Patients must not have received prior therapy with crizotinib
    • Prior anthracycline dose: patients with a total lifetime cumulative anthracycline dose of > 650 mg/m\^2 at the time of enrollment are not eligible for Part B of the study
  • For patients with solid tumors or ALCL without known bone marrow involvement:

    • Peripheral absolute neutrophil count (ANC) >= 1000/mm\^3
    • Platelet count >= 100,000/mm\^3 (transfusion independent, defined as not receiving platelet transfusions for at least 7 days prior to enrollment)
  • Patients with known bone marrow metastatic disease will be eligible for study provided they meet the blood counts (may receive transfusions provided they are not known to be refractory to red cell or platelet transfusions); these patients will not be evaluable for hematologic toxicity; if dose-limiting hematologic toxicity is observed, all subsequent patients enrolled must be evaluable for hematologic toxicity
  • Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 ml/min/1.73 m\^2 or a serum creatinine based on age/gender as follows:

    • Age 1 to \< 2 years: 0.6 mg/dL
    • Age 2 to \< 6 years: 0.8 mg/dL
    • Age 6 to \< 10 years: 1 mg/dL
    • Age 10 to \< 13 years: 1.2 mg/dL
    • Age 13 to \< 16 years: 1.5 mg/dL (males) and 1.4 mg/dL (females)
    • Age >= 16 years: 1.7 mg/dL (males) and 1.4 mg/dL (females)
  • Bilirubin (sum of conjugated + unconjugated) =\< 1.5 x upper limit of normal (ULN) for age
  • Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =\< 110 U/L; for the purpose of this study, the ULN for SGPT is 45 U/L
  • Serum albumin >= 2 g/dL
  • Corrected QT interval (QTc) =\< 480 msec
  • For patients on Part B: shortening fraction of >= 27% by echocardiogram or ejection fraction of >= 50% by gated radionuclide study
  • All patients and/or their parents or legally authorized representatives must sign a written informed consent; assent, when appropriate, will be obtained according to institutional guidelines
  • Part C: Patients must have a body surface area (BSA) >= 1.07 m\^2 at the time of study enrollment
  • Part D: Patients must have a body surface area (BSA) >= 0.43 m\^2 at the time of study enrollment
  • Tumor tissue must be sent; if tumor tissue is unavailable, the study chair must be notified prior to enrollment

Exclusion criteria

Exclusion Criteria:

  • Pregnant or breast-feeding women will not be entered on this study; pregnancy tests must be obtained in girls who are post-menarchal; males or females of reproductive potential may not participate unless they have agreed to use an effective contraceptive method during treatment and for 3 months after stopping treatment
  • Patients receiving corticosteroids who have not been on a stable or decreasing dose of corticosteroid for at least 7 days prior to enrollment are not eligible
  • Patients who are currently receiving another investigational drug are not eligible
  • Patients who are currently receiving other anti-cancer agents are not eligible
  • Patients who are receiving cyclosporine, tacrolimus or other agents to prevent graft-versus-host disease post bone marrow transplant are not eligible for this trial
  • Patients chronically receiving medications known to be metabolized by cytochrome P 450, family 3, subfamily A, polypeptide 4 (CYP3A4) and with narrow therapeutic indices including pimozide, aripiprazole, triazolam, ergotamine and halofantrine are not eligible; the topical use of these medications (if applicable) is allowed
  • Patients chronically receiving drugs that are known potent CYP3A4 inhibitors within 7 days prior to study enrollment, including but not limited to ketoconazole, itraconazole, miconazole, clarithromycin, erythromycin, ritonavir, indinavir, nelfinavir, saquinavir, amprenavir, delavirdine, nefazodone, diltiazem, verapamil, and grapefruit juice are not eligible; the topical use of these medications (if applicable), e.g. 2% ketoconazole cream, is allowed
  • Patients chronically receiving drugs that are known potent CYP3A4 inducers within 12 days prior to study enrollment, including but not limited to carbamazepine, phenobarbital, phenytoin, rifabutin, rifampin, tipranavir, ritonavir, and St. John?s wort are not eligible; the topical use of these medications (if applicable) is allowed
  • Patients receiving PPIs and H2 blockers are not eligible for Part D
  • Patients who have an uncontrolled infection are not eligible
  • Patients who have received a prior solid organ transplantation are not eligible
  • Patients who have a primary or metastatic CNS tumor at the time of study enrollment are not eligible; a prior history of metastatic CNS tumor is allowed as long as there is no evidence of CNS disease at study enrollment
  • Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study are not eligible
  • Parts A and B: Patients who are able to swallow liquid or use a nasogastric or gastrostomy (G) tube are eligible
  • Part C: Patients must be able to swallow intact capsules
  • Part D: Patients must be able to swallow liquid
05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
46 participants (actual)

Study arms

  • Experimental
    Part A (crizotinib, cyclophosphamide, topotecan hydrochloride)

    Patients receive crizotinib (oral solution) PO BID on days 1-21, cyclophosphamide IV QD on days 1-5, and topotecan hydrochloride IV QD on days 1-5. Treatment repeats every 21 days for up to 35 courses in the absence of disease progression or unacceptable toxicity. (closed to accrual 10/3/14)

    Drug: Crizotinib · Drug: Cyclophosphamide · Other: Laboratory Biomarker Analysis · Other: Pharmacological Study · Other: Questionnaire Administration · Drug: Topotecan Hydrochloride

  • Experimental
    Part B (crizotinib, vincristine, dexrazoxane, doxorubicin)

    Patients receive crizotinib (oral solution) PO BID as in Part A. Patients also receive vincristine sulfate IV on day 1, dexrazoxane hydrochloride IV on day 1, and doxorubicin hydrochloride IV over 15 minutes on day 1. Treatment repeats every 21 days for up to 35 courses in the absence of disease progression or unacceptable toxicity. (closed to accrual 10/3/14)

    Drug: Crizotinib · Drug: Dexrazoxane Hydrochloride · Drug: Doxorubicin Hydrochloride · Other: Laboratory Biomarker Analysis · Other: Pharmacological Study · Other: Questionnaire Administration · Drug: Vincristine Sulfate

  • Experimental
    Part C (crizotinib, cyclophosphamide, topotecan hydrochloride)

    Patients receive crizotinib (capsule formulation) PO BID, cyclophosphamide IV QD, and topotecan hydrochloride IV QD as in Part A. Treatment repeats every 21 days for up to 35 courses in the absence of disease progression or unacceptable toxicity.

    Drug: Crizotinib · Drug: Cyclophosphamide · Other: Laboratory Biomarker Analysis · Other: Pharmacological Study · Other: Questionnaire Administration · Drug: Topotecan Hydrochloride

  • Experimental
    Part D (crizotinib, cyclophosphamide, topotecan hydrochloride)

    Patients receive crizotinib (microsphere formulation) PO BID, cyclophosphamide IV QD, and topotecan hydrochloride IV QD as in Part A. Treatment repeats every 21 days for up to 35 courses in the absence of disease progression or unacceptable toxicity.

    Drug: Crizotinib · Drug: Cyclophosphamide · Other: Laboratory Biomarker Analysis · Other: Pharmacological Study · Other: Questionnaire Administration · Drug: Topotecan Hydrochloride

Interventions

  • DrugCrizotinib

    Given PO

    Also known as: MET Tyrosine Kinase Inhibitor PF-02341066, PF-02341066, PF-2341066, Xalkori

  • DrugCyclophosphamide

    Given IV

    Also known as: (-)-Cyclophosphamide, 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate, Carloxan, Ciclofosfamida, Ciclofosfamide, Cicloxal, Clafen, Claphene, CP monohydrate, CTX, CYCLO-cell, Cycloblastin, Cycloblastine, Cyclophospham, Cyclophosphamid monohydrate, Cyclophosphamidum, Cyclophosphan, Cyclophosphane, Cyclophosphanum, Cyclostin, Cyclostine, Cytophosphan, Cytophosphane, Cytoxan, Fosfaseron, Genoxal, Genuxal, Ledoxina, Mitoxan, Neosar, Revimmune, Syklofosfamid, WR- 138719

  • DrugDexrazoxane Hydrochloride

    Given IV

    Also known as: Cardioxane, Totect, Zinecard

  • DrugDoxorubicin Hydrochloride

    Given IV

    Also known as: 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI), ADM, Adriacin, Adriamycin, Adriamycin Hydrochloride, Adriamycin PFS, Adriamycin RDF, ADRIAMYCIN, HYDROCHLORIDE, Adriamycine, Adriblastina, Adriblastine, Adrimedac, Chloridrato de Doxorrubicina, DOX, DOXO-CELL, Doxolem, Doxorubicin.HCl, Doxorubin, Farmiblastina, FI 106, FI-106, hydroxydaunorubicin, Rubex

  • OtherLaboratory Biomarker Analysis

    Correlative studies

  • OtherPharmacological Study

    Correlative studies

  • OtherQuestionnaire Administration

    Ancillary studies

  • DrugTopotecan Hydrochloride

    Given IV

    Also known as: Hycamptamine, Hycamtin, SKF S-104864-A, Topotecan HCl, topotecan hydrochloride (oral)

  • DrugVincristine Sulfate

    Given IV

    Also known as: Kyocristine, Leurocristine sulfate, Leurocristine, sulfate, Oncovin, Vincasar, Vincosid, Vincrex, Vincristine, sulfate

06

What researchers measure

Primary outcomes

  1. Maximum Tolerated Dose (MTD) of Crizotinib

    The MTD of crizotinib administered with combination chemotherapy based on the incidence of dose-limiting toxicity (DLT) at which fewer than one-third of patients experience DLT, as assessed by NCI CTCAE version 4.0.

    Time frame: Up to 21 days

  2. Number of Patients With Dose Limiting Toxicity (DLT)

    Number of patients of all DLT reported as assessed by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. stratified by dose level and study part.

    Time frame: Up to 21 days

  3. Area Under the Concentration

    Median (min, max) of the area under the concentration time curve for crizotinib assessed in course 1 at 1, 2, 4, 6-8 hours, and 15-21 days post-administration stratified by dose level and study part.

    Time frame: Up to 21 days

Secondary outcomes

  1. Response Rate

    Number of patients of response-evaluable participants with response (CR/PR) assessed according to Response Evaluation Criteria in Solid Tumors version 1.1 including CR: disappearance of all target and non-target lesions; PR: at least 30% decrease in the sum of the diameters of target lesions

    Time frame: Up to 2 years

  2. ALK Status and Response to Crizotinib

    Number of patients who respond (CR/PR) to crizotinib in combination with either topotecan and cyclophosphamide or vincristine and doxorubicin/dexraroxane stratified by ALK positive or negative status

    Time frame: up to 2 years

  3. MRD Status and Response to Crizotinib

    Frequency (%) of patients who respond (CR/PR) to crizotinib in combination with either topotecan and cyclophosphamide or vincristine and doxorubicin/dexraroxane stratified by MRD status

    Time frame: Up to 2 years

  4. ALK Expression for Crizotinib

    Median (p25, p75) ALK expression stratified by dose level and study part

    Time frame: Up to 7 days

  5. Acceptability of Crizotinib Capsule Formulation Palatability

    Number of patients who at least accept palatability of capsule formulation in the first week

    Time frame: Up to 1 week

  6. Acceptability of Crizotinib Microsphere Formulation Palatability

    Number of patients who at least accept palatability of microsphere formation in the first week

    Time frame: Up to 1 week

07

Results

Posted Jan 5, 2024

Participant flow

This is a dose-escalation study of crizotinib. Patients are assigned to Part A or Part B based on the treating physician's choice and availability of a reservation. After closure of Part A and Part B, patients are assigned to Part C and Part D.

Participant flow — Overall Study
MilestonePart A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2
Started64533463633
Completed00000000000
Not completed64533463633
Withdrew: Adverse event11000010130
Withdrew: Lack of efficacy11121212201
Withdrew: Physician decision10211120100
Withdrew: Withdrawal by subject32201121202

Outcome measures

PrimaryMaximum Tolerated Dose (MTD) of Crizotinib

The MTD of crizotinib administered with combination chemotherapy based on the incidence of dose-limiting toxicity (DLT) at which fewer than one-third of patients experience DLT, as assessed by NCI CTCAE version 4.0.

Time frame:
Up to 21 days
Reported as:
Number · mg/m^2
Maximum Tolerated Dose (MTD) of Crizotinib
mg/m^2Part C (Crizotinib, Cyclophosphamide, Topotecan Hydrochloride)
Maximum Tolerated Dose (MTD) of Crizotinib215
PrimaryNumber of Patients With Dose Limiting Toxicity (DLT)

Number of patients of all DLT reported as assessed by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. stratified by dose level and study part.

Time frame:
Up to 21 days
Reported as:
Count of participants · Participants
Number of Patients With Dose Limiting Toxicity (DLT)
ParticipantsPart A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2
Number of Patients With Dose Limiting Toxicity (DLT)22002012331
PrimaryArea Under the Concentration

Median (min, max) of the area under the concentration time curve for crizotinib assessed in course 1 at 1, 2, 4, 6-8 hours, and 15-21 days post-administration stratified by dose level and study part.

Time frame:
Up to 21 days
Reported as:
Median · hr*ug/mL
Area Under the Concentration
hr*ug/mLPart A Dose Level 1Part B Dose Level 1Part B Dose Level 2Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 2Part PK Dose Level 2
Area Under the Concentration3792.5 (1808.8 to 5520.3)1549.3 (811.4 to 2544.3)4070.5 (3588.0 to 10145.9)1612 (1612.0 to 1612.0)3796.6 (2976.0 to 7299.3)7462.8 (7462.8 to 7462.8)3248 (3109.9 to 3386.1)8881.3 (5701.6 to 12061.0)
SecondaryResponse Rate

Number of patients of response-evaluable participants with response (CR/PR) assessed according to Response Evaluation Criteria in Solid Tumors version 1.1 including CR: disappearance of all target and non-target lesions; PR: at least 30% decrease in the sum of the diameters of target lesions

Time frame:
Up to 2 years
Reported as:
Count of participants · Participants
Response Rate
ParticipantsPart A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2
Response Rate20110111000
SecondaryALK Status and Response to Crizotinib

Number of patients who respond (CR/PR) to crizotinib in combination with either topotecan and cyclophosphamide or vincristine and doxorubicin/dexraroxane stratified by ALK positive or negative status

Time frame:
up to 2 years
Reported as:
Count of participants · Participants
ALK Status and Response to Crizotinib
ParticipantsPart A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2
ALK Positive00000000000
ALK Negative11100000000
SecondaryMRD Status and Response to Crizotinib

Frequency (%) of patients who respond (CR/PR) to crizotinib in combination with either topotecan and cyclophosphamide or vincristine and doxorubicin/dexraroxane stratified by MRD status

Time frame:
Up to 2 years

No measurements were reported for this outcome.

SecondaryALK Expression for Crizotinib

Median (p25, p75) ALK expression stratified by dose level and study part

Time frame:
Up to 7 days

No measurements were reported for this outcome.

SecondaryAcceptability of Crizotinib Capsule Formulation Palatability

Number of patients who at least accept palatability of capsule formulation in the first week

Time frame:
Up to 1 week
Reported as:
Count of participants · Participants
Acceptability of Crizotinib Capsule Formulation Palatability
ParticipantsPart A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2
Acceptability of Crizotinib Capsule Formulation Palatability00000353003
SecondaryAcceptability of Crizotinib Microsphere Formulation Palatability

Number of patients who at least accept palatability of microsphere formation in the first week

Time frame:
Up to 1 week
Reported as:
Count of participants · Participants
Acceptability of Crizotinib Microsphere Formulation Palatability
ParticipantsPart A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2
Acceptability of Crizotinib Microsphere Formulation Palatability00000000420

Adverse events

Collected over Up to 2 years. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Part A Dose Level 10/6 (0%)3/6 (50%)6/6 (100%)
Part A Dose Level 20/4 (0%)3/4 (75%)4/4 (100%)
Part B Dose Level 11/5 (20%)1/5 (20%)5/5 (100%)
Part B Dose Level 20/3 (0%)1/3 (33.3%)3/3 (100%)
Part B Dose Level 30/3 (0%)2/3 (66.7%)3/3 (100%)
Part C Dose Level 11/4 (25%)3/4 (75%)4/4 (100%)
Part C Dose Level 20/6 (0%)3/6 (50%)6/6 (100%)
Part C Dose Level 30/3 (0%)1/3 (33.3%)3/3 (100%)
Part D Dose Level 10/6 (0%)3/6 (50%)6/6 (100%)
Part D Dose Level 20/3 (0%)3/3 (100%)3/3 (100%)
Part PK Dose Level 20/3 (0%)2/3 (66.7%)3/3 (100%)
Most frequent serious events
Showing 10 of 39
Most frequent serious events
EventPart A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2
HypotensionVascular disorders0/60/40/50/30/30/41/61/30/62/30/3
HypoxiaRespiratory, thoracic and mediastinal disorders1/61/40/50/30/31/40/60/30/62/30/3
DehydrationMetabolism and nutrition disorders0/62/40/50/31/30/40/60/31/60/30/3
Back painMusculoskeletal and connective tissue disorders0/60/40/50/31/30/40/60/30/60/30/3
DysphagiaGastrointestinal disorders0/60/40/50/30/30/40/60/30/60/31/3
DyspneaRespiratory, thoracic and mediastinal disorders0/60/40/50/31/31/40/60/30/60/30/3
EsophagitisGastrointestinal disorders0/60/40/50/30/30/40/60/30/60/31/3
Febrile neutropeniaBlood and lymphatic system disorders0/60/40/51/30/30/40/60/30/60/30/3
FeverGeneral disorders1/61/40/50/31/30/40/60/30/60/30/3
HyperuricemiaMetabolism and nutrition disorders0/60/40/50/31/30/40/60/30/60/30/3
Most frequent other events
Showing 10 of 336
Most frequent other events
EventPart A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2
Alanine aminotransferase increasedInvestigations3/63/44/53/33/31/45/62/36/62/32/3
AlopeciaSkin and subcutaneous tissue disorders3/63/43/53/30/34/46/60/33/62/30/3
AnemiaBlood and lymphatic system disorders6/64/45/53/33/34/46/63/36/63/32/3
AnorexiaMetabolism and nutrition disorders3/62/45/52/33/31/44/63/34/62/31/3
Aspartate aminotransferase increasedInvestigations4/63/42/52/33/31/45/62/34/62/31/3
Blurred visionEye disorders1/62/42/51/30/32/42/62/31/61/33/3
DiarrheaGastrointestinal disorders5/64/43/52/32/32/44/62/33/62/32/3
DizzinessNervous system disorders2/60/41/50/31/32/41/62/31/63/32/3
FatigueGeneral disorders4/63/43/52/32/34/46/63/35/63/31/3
HeadacheNervous system disorders4/62/41/51/30/31/44/62/32/63/32/3

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Part A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2Total
<=18 years4422325363135
Between 18 and 65 years2031021000211
>=65 years000000000000
Age, Continuous
Age, Continuous(years)Part A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2Total
Median16 (4.0 to 21.0)12.5 (7.0 to 17.0)19 (7.0 to 21.0)6 (6.0 to 19.0)11 (10.0 to 17.0)17.5 (15.0 to 20.0)15 (9.0 to 20.0)17 (13.0 to 17.0)13.5 (1.0 to 17.0)17 (10.0 to 18.0)20 (11.0 to 21.0)15 (1.0 to 21.0)
Sex: Female, Male
Sex: Female, Male(Participants)Part A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2Total
Female2321223131222
Male4132123232124
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Part A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2Total
Hispanic or Latino001110201017
Not Hispanic or Latino6442244353239
Unknown or Not Reported000000000000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Part A Dose Level 1Part A Dose Level 2Part B Dose Level 1Part B Dose Level 2Part B Dose Level 3Part C Dose Level 1Part C Dose Level 2Part C Dose Level 3Part D Dose Level 1Part D Dose Level 2Part PK Dose Level 2Total
American Indian or Alaska Native100000000001
Asian000000000000
Native Hawaiian or Other Pacific Islander000000000000
Black or African American211011111009
White3343235243335
More than one race000000000000
Unknown or Not Reported000000001001
08

Study locations

23 sites
  • Children's Hospital of Alabama
    Birmingham, Alabama 35233, United States
  • Children's Hospital Los Angeles
    Los Angeles, California 90027, United States
  • Children's Hospital of Orange County
    Orange, California 92868, United States
  • UCSF Medical Center-Parnassus
    San Francisco, California 94143, United States
  • UCSF Medical Center-Mission Bay
    San Francisco, California 94158, United States
  • Children's Hospital Colorado
    Aurora, Colorado 80045, United States
  • Children's National Medical Center
    Washington, District of Columbia 20010, United States
  • Children's Healthcare of Atlanta - Egleston
    Atlanta, Georgia 30322, United States
  • Lurie Children's Hospital-Chicago
    Chicago, Illinois 60611, United States
  • Riley Hospital for Children
    Indianapolis, Indiana 46202, United States
  • C S Mott Children's Hospital
    Ann Arbor, Michigan 48109, United States
  • University of Minnesota/Masonic Cancer Center
    Minneapolis, Minnesota 55455, United States
  • Washington University School of Medicine
    Saint Louis, Missouri 63110, United States
  • Columbia University/Herbert Irving Cancer Center
    New York, New York 10032, United States
  • Cincinnati Children's Hospital Medical Center
    Cincinnati, Ohio 45229, United States
  • Oregon Health and Science University
    Portland, Oregon 97239, United States
  • Children's Hospital of Philadelphia
    Philadelphia, Pennsylvania 19104, United States
  • Children's Hospital of Pittsburgh of UPMC
    Pittsburgh, Pennsylvania 15224, United States
  • St. Jude Children's Research Hospital
    Memphis, Tennessee 38105, United States
  • Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
    Houston, Texas 77030, United States
  • Seattle Children's Hospital
    Seattle, Washington 98105, United States
  • Children's Hospital of Wisconsin
    Milwaukee, Wisconsin 53226, United States
  • Hospital for Sick Children
    Toronto, Ontario M5G 1X8, Canada
09

References and documents

Publications

  • Greengard E, Mosse YP, Liu X, Minard CG, Reid JM, Voss S, Wilner K, Fox E, Balis F, Blaney SM, Adamson PC, Weigel BJ. Safety, tolerability and pharmacokinetics of crizotinib in combination with cytotoxic chemotherapy for pediatric patients with refractory solid tumors or anaplastic large cell lymphoma (ALCL): a Children's Oncology Group phase 1 consortium study (ADVL1212). Cancer Chemother Pharmacol. 2020 Dec;86(6):829-840. doi: 10.1007/s00280-020-04171-4. Epub 2020 Oct 23. PubMed 33095287 ↗

Study documents

  • Protocol and statistical analysis plan · Nov 21, 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 Jan 5, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01606878
Lead sponsor
Children's Oncology Group
Collaborators
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
May 28, 2012
Start date
Apr 29, 2013
Primary completion
Dec 31, 2018
Completion
Dec 31, 2018
Results posted
Jan 5, 2024
Last update
Jan 5, 2024

Study contacts

Emily Greengard
principal investigator · COG Phase I Consortium

Oversight

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

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This study is completed, as verified in Dec 2023. You cannot join it, but the record below documents what was studied.

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