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Active, not recruitingNCT03478462CLOVER-2Updated Oct 1, 2026

Dose Escalation Study of CLR 131 in Pediatric Relapsed/Refractory Malignant Tumors Including Neuroblastoma and Sarcomas

A Phase 1 interventional study of CLR 131 in Pediatric Solid Tumor, Pediatric Lymphoma and Pediatric Brain Tumor, sponsored by Cellectar Biosciences, Inc.. Active, not recruiting at 8 sites in 3 countries. Open to participants aged 2 Years to 25 Years. Per ClinicalTrials.gov, last updated 2026-10-01.

Sponsored by Cellectar Biosciences, Inc. · Phase 1, Interventional, and Treatment

Updated Oct 1, 2026Primary completion movedStudy completion movedGo to Updates ↓
Phase
Phase 1
Study type
Interventional
Enrollment
30
Allocation
Not applicable
Ages
2 Years to 25 Years
Sex
All
01

Study summary

The study evaluates CLR 131 in children, adolescents, and young adults with relapsed or refractory malignant solid tumors and lymphoma and recurrent or refractory malignant brain tumors for which there are no standard treatment options with curative potential.

Read the detailed description

Even with standard, highly toxic multimodality therapies and salvage regimen, most pediatric patients with primary metastatic or relapsed solid tumors are confronted with a poor prognosis. For these patients there is currently no accepted successful treatment regimen. There is a need for new drugs, including targeted radiopharmaceuticals, preferably with cancer-specific uptake and broad applicability for these rare pediatric malignancies.

CLR 131 is a radioiodinated therapeutic that exploits the selective uptake and retention of phospholipid ethers (PLEs) by malignant cells. Cellectar Biosciences' novel cancer-targeted small-molecule compound (CLR1404) is radiolabeled with the isotope iodine-131 (I-131). CLR 131 has demonstrated tumor selective uptake across numerous adult and pediatric cancer cell types. Therapeutic efficacy has been demonstrated in various pediatric and adult-type cancer xenograft models, confirming the ability of CLR 131 to target tumors.

Based on the critical unmet medical need for effective agents with novel mechanisms of action in relapsed pediatric cancers and initial preclinical and clinical experience with radioiodinated CLR1404, Cellectar Biosciences has chosen to assess CLR 131 in a phase 1 pediatric trial.

02

Conditions studied

  • Pediatric Solid Tumor
  • Pediatric Lymphoma
  • Pediatric Brain Tumor
  • DIPG
  • Neuroblastoma
  • Ewing Sarcoma
  • Rhabdomyosarcoma
  • Osteosarcoma

Keywords

  • medulloblastoma
  • ependymoma
  • high-grade glioma
  • glioblastoma
  • DIPG
  • diffuse-intrinsic pontine glioma
  • ATRT
  • atypical teratoid rhabdoid tumor
  • PNET
  • primitive neuroectodermal tumor
  • gliosarcoma
  • gliomatosis cerebri
  • neuroblastoma
  • rhabdomyosarcoma
  • Ewing sarcoma
  • osteosarcoma
  • DSRCT
  • desmoplastic small round cell tumor
  • sarcoma
  • malignant germ cell tumor
  • synovial sarcoma
  • rare cancer
  • Wilms tumor
  • lymphoma
  • Hodgkin Lymphoma
  • Non-Hodgkin Lymphoma
03

In context

Neuroblastoma

675 studies on the registry are indexed under Neuroblastoma; 127 are open to participants now.

This study's planned enrollment of 30 is close to the median of 32 across 507 interventional studies indexed under Neuroblastoma.

Browse Neuroblastoma studies →

Lead sponsor

Cellectar Biosciences, Inc. is the lead sponsor of 13 studies on the registry; 2 are open to participants now.

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

04

Who can participate

Ages eligible
2 Years to 25 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

All Patients

  • Previously confirmed (histologically or cytologically) pediatric solid tumor (e.g., neuroblastoma, sarcoma), lymphoma (including Hodgkin's lymphoma), or malignant brain tumors that are clinically or radiographically suspected to be , refractory, or recurrent for which there are no standard treatment options with curative potential. Note: patients with diffuse intrinsic pontine glioma (DIPG) may enroll without histological or cytological confirmation.
  • ≥ 2 years of age and ≤ 25 years of age at time of consent/assent
  • If ≥ age 16 years, performance status of ≥ 60. If \< age 16 years, Lansky performance status ≥ 60
  • ≥ 75,000/µL (last transfusion, if any, must be at least 1 week prior to study registration, and, unless deemed medically necessary, no transfusions are allowed between registration and dosing)
  • ≥ 750/µL
  • ≥ 8 g/dL (last transfusion must be at least 1 week prior to study registration, and, unless deemed medically necessary, no transfusions are allowed between registration and dosing)
  • Using the bedside Schwartz formula, estimated () > 60 ml/min/1.73m2
  • \< 3 ×
  • \< 2 × ULN
  • Patients who have undergone or allogeneic bone marrow transplant must be at least 3 months from transplant.
  • Patients enrolling at total dose levels > 30 millicurie (mCi)/m2 must have availability or ability to collect an autologous hematopoietic stem cell back-up product prior to CLR 131 administration. At minimum, 2 x 10\^6/kg cryopreserved CD34+ cells must be available.
  • Patient or his or her legal representative is judged by the Investigator to have the initiative and means to be compliant with the protocol.

Patients with Pediatric Solid Tumor or Lymphoma

  • At least 1 with longest diameter of at least 10 mm. Patients with a lesion(s) that are determined to be Metaiodobenzylguanidine (MIBG) or positron emission tomography (PET) positive may be enrolled at the investigator's discretion, even if not associated with a measurable lesion of at least 10 mm. Patients with neuroblastoma who have detectable disease may enroll provided they meet the requirements of the International Neuroblastoma Response Criteria.
  • Patients with known must have completed any radiotherapy or systemic treatments for brain metastases prior to enrollment; by investigator assessment be considered stable with no new signs or symptoms for at least 1 month, and on a stable dose of (unchanged for three weeks prior to registration or on a steroid tapering regimen).

Patients with Recurrent or Refractory Brain Tumors

  • At least 1 measurable lesion with longest diameter of at least 10 mm on any imaging sequence.
  • Patients with previously known neurological deficits must be clinically stable at time of enrollment and able to complete all study related procedures. Patients with documented or newly diagnosed neurological deficits will be enrolled at the investigator's discretion.
  • If patient receives steroids for neurological symptom control, the dose must be stable (unchanged for three weeks prior to registration) or on a steroid tapering regimen. Initiation of steroids per routine care immediately prior to CLR 131 dosing is acceptable.

Exclusion criteria

Exclusion Criteria:

  • Patients receiving active treatment for central nervous system or those that are likely to require active treatment during anticipated participation in this trial. Patients with stable treated with may enroll at the investigator's discretion
  • For solid tumor and lymphoma patients only, central nervous system involvement unless previously treated with surgery, systemic therapy, or radiotherapy with the patient neurologically stable. Patients with metastatic brain tumors that have been previously treated are allowed, provided the patient is neurologically stable (determined at the investigator's discretion).
  • Antitumor therapy or therapy, within 2 weeks of dosing. For certain types of radiation (craniospinal, total abdominal, whole lung [spot irradiation to skull-based metastases is not considered craniospinal radiation for the purposes of this study]), at least 3 months must have elapsed. No is required for palliative focal radiation. NOTE: Patients participating in non-interventional clinical trials (i.e., non-drug) are allowed to participate in this trial
  • Patients previously treated with iodine-131 (131I)-MIBG who have already received a cumulative I-131 dose > 54 mCi/kg or who would exceed 54 mCi/kg by participating in this trial, are not eligible.
Terms in these criteria, in plain language(17)

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.

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.

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.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

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.

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.

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.

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.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

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.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

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.

Metastases

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

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Washout period

A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.

05

Study design

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

Study arms

  • Experimental
    CLR 131

    CLR 131 intravenous administration

    Drug: CLR 131

Interventions

  • IV dose of CLR 131, increased/decreased by dose level; single or fractionated dose

    Also known as: I-131-CLR1404

06

What researchers measure

Primary outcomes

  1. Number of participants with dose limiting toxicities (DLT)

    DLT will be assessed by physical examination, vital signs, and laboratory values

    Time frame: up to 64 days

Secondary outcomes

  1. Identification of recommended phase 2 dose of CLR 131 in children, adolescents, and young adults

    Dose and regimen to be used in Phase 2 trials of CLR 131 in children, adolescents, and young adults

    Time frame: until non-tolerated dose is defined; dose escalation decision made upon review of data from a complete cohort (85 days after all subjects in cohort have received infusion)

  2. Determination of preliminary antitumor activity of CLR 131 in children, adolescents, and young adults

    Response assessment per applicable criteria (e.g., Neuroblastoma Response Criteria (modified); RECIST 1.1; positron emission tomography response criteria in solid tumors (PERCIST); RANO)

    Time frame: through Day 85

  3. Determination of therapeutic activity of CLR 131 in children, adolescents, and young adults

    Assessment via 131-I/CLR 131 SPECT/CT scans

    Time frame: up to 22 days post initial infusion

  4. Determination of event free survival following CLR 131 infusion in children, adolescents, and young adults

    Time from first infusion of CLR 131 until progression or recurrence of disease

    Time frame: 1 month to 5 years

  5. Determination of overall survival following CLR 131 infusion in children, adolescents, and young adults

    Time from first infusion of CLR 131 until death due to any reason

    Time frame: 1 month to 5 years

  6. Determine dosimetry of CLR 131 in children, adolescents, and young adults

    Assessment of dosimetry via whole body planar imaging

    Time frame: up to 15 days post initial infusion

07

Study locations

8 sites
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2019 (actual). Primary completion is estimated for Jun 2027, 98 months after the start.

Of 86 phase 1 interventional studies under Neuroblastoma, half reached primary completion within 83 months of starting (the median), counting those still running; a quarter within 60 and three quarters within 114. This study's planned 98 months is above that.

Since we started tracking on Sep 25, 2026, the dates moved once, on Oct 1, 2026: primary completion Aug 2026 → Jun 2027 and completion Feb 2027 → Dec 2027.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Mar 20, 2018
First posted
Mar 27, 2018
StartActual
Apr 30, 2019
Primary completionEst.
Jun 30, 2027was Aug 2026
CompletionEst.
Dec 2027was Feb 2027
Last update
Oct 1, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Primary completion
Aug 25, 2026→Jun 30, 2027
Oct 1, 2026
Study completion
Feb 25, 2027→Dec 2027
Oct 1, 2026
Show all 1 update
  1. Oct 1, 2026
    Primary completion Aug 25, 2026→Jun 30, 2027
    Study completion Feb 25, 2027→Dec 2027
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT03478462
Lead sponsor
Cellectar Biosciences, Inc.
Responsible party
Sponsor
First posted
Mar 27, 2018
Start date
Apr 30, 2019
Primary completion
Jun 30, 2027 (estimated)
Completion
Dec 2027 (estimated)
Last update
Oct 1, 2026

Study contacts

Jarrod Longcor
study director · Cellectar Biosciences

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Studies of the drug tested here: CLR1404

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