ClinicalTrials.gg
TerminatedNCT03420963Updated Mar 20, 2026

Donor Natural Killer Cells, Cyclophosphamide, and Etoposide in Treating Children and Young Adults With Relapsed or Refractory Solid Tumors

A Phase 1 interventional study of Cord Blood-derived Expanded Allogeneic Natural Killer Cells and Cyclophosphamide in Recurrent Cutaneous Melanoma, Recurrent Lip and Oral Cavity Carcinoma and Recurrent Malignant Endocrine Neoplasm, sponsored by M.D. Anderson Cancer Center. Terminated at 1 site in United States. Open to participants aged 12 Months to 40 Years. Per ClinicalTrials.gov, last updated 2026-03-20.

Sponsored by M.D. Anderson Cancer Center · Phase 1, Interventional, and Treatment

Why this study was terminated
\<75% participation
Phase
Phase 1
Study type
Interventional
Enrollment
12
Allocation
Not applicable
Ages
12 Months to 40 Years
Sex
All
01

Study summary

This phase I trial studies the side effects and best dose of cord blood-derived expanded allogeneic natural killer cells (donor natural killer [NK] cells) and how well they work when given together with cyclophosphamide and etoposide in treating children and young adults with solid tumors that have come back (relapsed) or that do not respond to treatment (refractory). NK cells, white blood cells important to the immune system, are donated/collected from cord blood collected at birth from healthy babies and grown in the lab. Drugs used in chemotherapy, such as cyclophosphamide and etoposide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving NK cells together with cyclophosphamide and etoposide may work better in treating children and young adults with solid tumors.

Read the detailed description

PRIMARY OBJECTIVE:

I. Determine the safety, maximum tolerated dose and/or recommended phase II dose of cord blood-derived expanded allogeneic natural killer cells (expanded allogeneic cord donor natural killer [NK] cells) following chemotherapy.

SECONDARY OBJECTIVES:

I. Determine the persistence of adoptively-transferred cord NK cells after solid tumor directed chemotherapy.

II. Preliminarily define the antitumor activity to adoptively transferred NK cells following the study preparative regimen in the confines of a phase I study.

III. Determine the immunophenotype and function of the infused NK cell product. IV. Preliminarily evaluate for any correlate of phenotype, killer cell immunoglobulin-like receptor (kir) haplotype, and function with overall response.

OUTLINE: This is a dose escalation study of cord blood derived allogeneic NK cells.

Patients receive cyclophosphamide intravenously (IV) once daily (QD) over 30 minutes and etoposide IV QD over 60 minutes on days 1-5 in the absence of unacceptable toxicity. Patients then receive cord blood derived allogeneic NK cells IV on day 8.

After completion of study treatment, patients are followed up at 3-4 days, and then every week for 30 days.

02

Conditions studied

  • Recurrent Cutaneous Melanoma
  • Recurrent Lip and Oral Cavity Carcinoma
  • Recurrent Malignant Endocrine Neoplasm
  • Recurrent Malignant Female Reproductive System Neoplasm
  • Recurrent Malignant Male Reproductive System Neoplasm
  • Recurrent Malignant Mesothelioma
  • Recurrent Malignant Neoplasm of Multiple Primary Sites
  • Recurrent Malignant Oral Neoplasm
  • Recurrent Malignant Pharyngeal Neoplasm
  • Recurrent Malignant Skin Neoplasm
  • Recurrent Malignant Soft Tissue Neoplasm
  • Recurrent Malignant Solid Neoplasm
  • Recurrent Malignant Thyroid Gland Neoplasm
  • Recurrent Malignant Urinary System Neoplasm
  • Refractory Cutaneous Melanoma
  • Refractory Malignant Bone Neoplasm
  • Refractory Malignant Endocrine Neoplasm
  • Refractory Malignant Female Reproductive System Neoplasm
  • Refractory Malignant Male Reproductive System Neoplasm
  • Refractory Malignant Mesothelioma
  • Refractory Malignant Neoplasm of Multiple Primary Sites
  • Refractory Malignant Oral Neoplasm
  • Refractory Malignant Pharyngeal Neoplasm
  • Refractory Malignant Skin Neoplasm
  • Refractory Malignant Soft Tissue Neoplasm
  • Refractory Malignant Solid Neoplasm
  • Refractory Malignant Thyroid Gland Neoplasm
  • Refractory Malignant Urinary System Neoplasm
03

In context

Melanoma

3,370 studies on the registry are indexed under Melanoma; 578 are open to participants now.

This study's enrollment of 12 is below the median of 40 across 2,649 interventional studies indexed under Melanoma.

Browse Melanoma studies →

Lead sponsor

M.D. Anderson Cancer Center is the lead sponsor of 3,047 studies on the registry; 578 are open to participants now.

Of its 612 completed or terminated interventional studies of FDA-regulated products, 409 (67%) have results posted.

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

04

Who can participate

Ages eligible
12 Months to 40 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • SCREENING: Patients with solid tumors and without known curative therapy or therapy proven to proven to prolong survival with acceptable quality of life.
  • SCREENING: Patients older than 21 years must have a solid tumor considered by study doctor to be of the childhood cancer type.
  • SCREENING: Performance level as measured by >= 60% for patients > 16 years of age or Lansky >= 60% for patients =\< 16 years of age.
  • SCREENING: Documentation of measurable or evaluable non-.
  • SCREENING: At least one documented histological verification of solid tumor diagnosis. Can be from original diagnosis or more recent.
  • ENROLLMENT: Patient must have fully recovered (i.e. returned to baseline) from the acute treatment-related toxicities of all prior treatments prior to beginning treatment on this protocol with exceptions of cytopenias resulting from persistent disease, hearing loss and alopecia.
  • ENROLLMENT: Performance level as measured by Karnofsky >= 60% for patients > 16 years of age or Lansky >= 60% for patients =\< 16 years of age.
  • ENROLLMENT: >= 60 mL/min/1.73m\^2 (calculated by 24 hour [h] urine collection or nuclear [GFR] scan if 24 h collection is not possible) or a serum creatinine based on age and gender as follows:

    • Age, maximum serum creatinine (mg/dL):

      • 1 month to \< 6 months, male 0.4, female 0.4;
      • 6 months to \< 1 year, male 0.5, female 0.5;
      • 1 to \< 2 years, male 0.6, female 0.6;
      • 2 to \< 6 years, male 0.8, female 0.8;
      • 6 to \< 10 years, male 1, female 1;
      • 10 to \< 13 years, male 1.2, female 1.2;
      • 13 to \< 16 years, male 1.5, female 1.4;
      • >= 16 years, male 1.7, female 1.4.
  • ENROLLMENT: Adequate liver function, defined as: total =\< 2 mg/dl
  • ENROLLMENT: Adequate liver function, as defined as serum glutamate pyruvate transaminase () (alanine aminotransferase [ALT]) =\< 2.5 x (ULN) for age (unless Gilbert's disease or abnormal liver function due to primary disease).
  • ENROLLMENT: Evidence of adequate bone marrow function (defined by >= 750), unless patient has documented tumor to the bone marrow or other condition that results in cytopenia without abnormal marrow function.
  • ENROLLMENT: Evidence of adequate bone marrow function (defined by >= 50,000), unless patient has documented tumor metastasis to the bone marrow or other condition that results in cytopenia without abnormal marrow function.
  • ENROLLMENT: Pulmonary symptoms controlled by medication and pulse oximetry >= 92% on room air.
  • ENROLLMENT: Sexually active males and females of must agree to use a form of considered effective and medically acceptable by the investigator. (Non-childbearing potential defined as pre-menarche, greater than one year or surgically sterilized).
  • ENROLLMENT: Confirmation that a cord blood donor which is matched with the recipient at a 4, 5, or 6/6 human leukocyte antigen (HLA) class I (serological) and HLA class II (molecular) antigens.
  • ENROLLMENT: Signed and if applicable pediatric assent.

Exclusion criteria

Exclusion Criteria:

  • SCREENING: Primary tumors of the central nervous system.
  • SCREENING: Chronic dependence that is unable to be weaned to discontinue.
  • SCREENING: Determined by study doctor that patient is unlikely to meet inclusion criteria after screening.
  • ENROLLMENT: Uncontrolled arrhythmias or uncontrolled symptoms of cardiac disease noted by screening history and physical. Patients with known cardiac dysfunction should have an (EF) > 40% documented by echocardiogram (ECHO).
  • ENROLLMENT: Patients where the burden of pulmonary , location, or bulkiness of disease may cause high morbidity if localized swelling such as causing uncontrolled symptoms, oxygen dependence, or location near a major bronchi as determined by investigator.
  • ENROLLMENT: Pregnant females.
  • ENROLLMENT: Any uncontrolled systemic infection.
Terms in these criteria, in plain language(18)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
12 participants (actual)

Study arms

  • Experimental
    Treatment (cyclophosphamide, etoposide, NK cells)

    Patients receive cyclophosphamide IV QD over 30 minutes and etoposide IV QD over 60 minutes on days 1-5 in the absence of unacceptable toxicity. Patients then receive cord blood derived allogeneic NK cells IV on day 8.

    Biological: Cord Blood-derived Expanded Allogeneic Natural Killer Cells · Drug: Cyclophosphamide · Drug: Etoposide

Interventions

  • BiologicalCord Blood-derived Expanded Allogeneic Natural Killer Cells

    Given IV

    Also known as: Allogeneic CB-derived Ex vivo-expanded NK Cells, CB-derived Expanded Allogeneic NK Cells, UCB-derived Expanded Allogeneic NK Cells, Umbilical Cord Blood-derived Expanded Allogeneic Natural Killer Cells

  • 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, Cyclophosphamide Monohydrate, Cyclophosphamidum, Cyclophosphan, Cyclophosphane, Cyclophosphanum, Cyclostin, Cyclostine, Cytophosphan, Cytophosphane, Cytoxan, Fosfaseron, Genoxal, Genuxal, Ledoxina, Mitoxan, Neosar, Revimmune, Syklofosfamid, WR- 138719

  • Given IV

    Also known as: Demethyl Epipodophyllotoxin Ethylidine Glucoside, EPEG, Lastet, Toposar, Vepesid, VP 16, VP 16-213, VP-16, VP-16-213, VP16

06

What researchers measure

Primary outcomes

  1. Incidence of adverse events

    Since toxicity is the primary outcome, patients with non-measurable disease (who are still evaluable) will be included in the analysis and in these cases standard methods for categorizing response of non-measurable disease will be used. Toxicity rate will be estimated separately by dose and cohort along with a 95% confidence interval. Adverse events will be tabulated for all the patients separately by dose levels.

    Time frame: Up to 30 days after the NK cell infusion

  2. Maximum tolerated dose and/or recommended phase 2 dose of cord blood-derived expanded allogeneic natural killer (NK) cells following chemotherapy

    Primary analyses in this phase I trial are descriptive and exploratory. Toxicity rate will be estimated separately by dose and cohort along with a 95% confidence interval. Adverse events will be tabulated for all the patients separately by dose levels.

    Time frame: Up to 30 days after the NK cell infusion

Secondary outcomes

  1. Response rate per immune-related therapy trials Response Evaluation Criteria in Solid Tumors (irRECIST)

    Complete response and partial response will be estimated separately by dose and cohort along with a 95% confidence interval. Correlation of NK cell persistence, phenotype, and function with overall response will be estimated using two-sample t-test/Wilcoxon sum-rank test and analysis of variance (ANOVA)/Kruskal-Wallis test as appropriate.

    Time frame: Up to 30 days after the NK cell infusion

  2. NK cell persistence, phenotype, and function

    Correlation of NK cell persistence, phenotype, and function with overall response will be estimated using two-sample t-test/Wilcoxon sum-rank test and ANOVA/Kruskal-Wallis test as appropriate.

    Time frame: Up to 30 days after the NK cell infusion

  3. Overall survival (OS)

    The Kaplan-Meier method will be used to estimate the distribution of OS. The description statistics of rate of OS may be analyzed separately by different tumor types and response/stable patients. Cox proportional hazards regression analysis may also be conducted to model the association between OS and factors of interest.

    Time frame: Up to 30 days after the NK cell infusion

  4. Time to progression (TTP)

    The Kaplan-Meier method will be used to estimate the distribution of TTP. The description statistics of rate of TTP may be analyzed separately by different tumor types and response/stable patients. Cox proportional hazards regression analysis may also be conducted to model the association between TTP and factors of interest.

    Time frame: Up to 30 days after the NK cell infusion

07

Study locations

1 site
  • M D Anderson Cancer Center
    Houston, Texas 77030, United States
08

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 20, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03420963
Responsible party
Sponsor
First posted
Feb 5, 2018
Start date
Aug 31, 2018
Primary completion
Feb 26, 2026
Completion
Feb 26, 2026
Last update
Mar 20, 2026

Study contacts

Demetrios Petropoulos
principal investigator · M.D. Anderson Cancer Center

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Cyclophosphamide · Etoposide

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