The Cure Our Children Foundation
New and Emerging Treatments for Ewing's Sarcoma Weblog (Blog)
Lainie, Alon, Lilah and Barry Sugarman Alon Sugarman During Chemotherapy

 

View Article  New Federal Health Initiative to Improve Cancer Therapy Patients will Benefit from Rapid Development and Delivery of New Cancer Treatments

http://www.fda.gov/bbs/topics/news/2006/NEW01316.html

Press Release

FOR IMMEDIATE RELEASE
Tuesday, February 14, 2006

FDA Press Office
301-827-6242
NCI Press Office
(301) 496-6641
CMS Press Office
(202) 690-6145

New Federal Health Initiative to Improve Cancer Therapy
Patients will Benefit from Rapid Development and Delivery of New Cancer Treatments

The Food and Drug Administration (FDA), the National Cancer Institute (NCI), part of the National Institutes of Health, and the Centers for Medicare & Medicaid Services (CMS) today announced the Oncology Biomarker Qualification Initiative (OBQI) -- an agreement to collaborate on improving the development of cancer therapies and the outcomes for cancer patients through biomarker development and evaluation.

Biomarkers are biologic indicators of disease or therapeutic effects, which can be measured through dynamic imaging tests, as well as tests on blood, tissue and other biologic samples. This initiative is the first time these three Department of Health and Human Services (HHS) agencies have focused together on biomarkers as a way of speeding the development and evaluation of cancer therapies.

"We are excited about this effort to speed the development and delivery of new cancer treatments for patients," said Secretary of Health and Human Services Mike Leavitt. "By bringing together the scientific, regulatory and delivery expertise of these three agencies, we can bring targeted, more personalized cancer diagnostics, treatments and preventions to patients more rapidly."

The collaboration will develop scientific understanding of how biomarkers can be used to assess the impact of therapies and better match therapies to patients. For instance, OBQI will address questions such as how particular biomarkers can be used to:

  • Assess after one or two treatments if a patient';s tumor is responding to treatment
  • Determine more definitively if a tumor is dying, even if it is not shrinking
  • Identify which cancer patients are at high risk of their tumor coming back after therapy
  • Determine if a patient';s tumor is likely to respond at all to a specific treatment
  • Efficiently evaluate whether an investigational therapy is effective for tumor treatment.

The goal of OBQI is to validate particular biomarkers so that they can be used to evaluate new, promising technologies in a manner that will shorten clinical trials, reduce the time and resources spent during the drug development process, improve the linkage between drug approval and drug coverage, and increase the safety and appropriateness of drug choices for cancer patients.

"Almost four years ago, NIH set out to create a "roadmap" for 21st century medical research. Programs like OBQI will be central to that vision, not only because they will lead to vital discoveries about the biology of disease, but because they will be models for scientific collaboration," said NIH Director Elias A. Zerhouni, M.D.

"An enhanced understanding of clinical biomarkers will help make the development of diagnostics and treatments more targeted, one of our most pressing goals under the Critical Path Initiative, FDA';s program to modernize the medical product development process," said FDA Acting Commissioner of Food and Drugs Andrew C. von Eschenbach, M.D. "We believe partnerships that help us standardize the use of new technologies are essential to refining the drug development process, so we can bring personalized medicines to patients more quickly and ultimately improve outcomes."

Under the OBQI, biomarker research will be focused in four key areas: standardizing and evaluating imaging technologies to see in more detail how treatments are working, developing scientific bases for diagnostic assays to enable personalized treatments, instituting new trial designs to utilize biomarkers, and pooling data to ensure that key lessons are shared from one trial to another. By working with academic and industry scientists, as well as professional organizations, the OBQI teams can foster the development of key information on biomarkers through clinical trials.

"By identifying biomarkers for specific cancers and clinically evaluating them, researchers will have an evidence base for their use in targeted drug development and to determine which therapies are likely to work for patients before treatment selection," said NCI Deputy Director Anna D. Barker, Ph.D. "Rather than waiting weeks to months to determine if a specific drug works for a patient, biomarkers could be used to monitor real-time treatment responses."

The first OBQI project to be implemented will serve to validate and standardize the use of Fluorodeoxyglucose - Positron Emission Tomography (FDG-PET) scanning. PET scans are used to characterize biochemical changes in a cancer. Under the collaboration, researchers will use FDG-PET imaging technology in trials of patients being treated for non-Hodgkin';s lymphoma, to determine if FDG-PET is a predictor of tumor response. Data resulting from this type of evidence-based study will help both FDA and CMS work with drug developers based on a common understanding of the roles of these types of assessments.

"There are many steps between a novel scientific idea with tremendous promise and a new drug reliably benefiting patients," said CMS Administrator Mark B. McClellan, M.D., Ph.D. "This collaboration will produce evidence that will help people with Medicare and Medicaid get better care more quickly, as a result of better-targeted treatment decisions for cancer patients."

Over the next several months, the OBQI team will design a number of initiatives to identify and clinically qualify other cancer biomarkers. The new initiatives will bring together scientists from many sources and address agency priorities identified through FDA';s Critical Path and NIH';s Roadmap Initiatives. The OBQI also represents the work of the NCI-FDA Interagency Oncology Task Force (IOTF). The IOTF is a collaboration between NCI and FDA to enhance the efficiency of clinical research and the scientific evaluation of new cancer treatments. The two agencies, along with CMS, share knowledge and resources to facilitate the development of new cancer drugs and diagnostics and speed their delivery to patients as safely and as cost-effectively as possible.

FDA Critical Path

Critical Path is the FDA';s premier initiative to identify and prioritize the most pressing medical product development problems and the greatest opportunities for rapid improvement in public health benefits. Its primary purpose is to ensure that basic scientific discoveries translate more rapidly into new and better medical treatments by creating new tools to find answers about how the safety and effectiveness of new medical products can be demonstrated in faster timeframes with more certainty and at lower costs.

The NIH Roadmap

The NIH Roadmap is a series of new initiatives designed to pursue major opportunities and gaps in biomedical research that no single NIH institute could tackle alone, but which the agency as a whole can address to make the biggest impact possible on the progress of medical research, and to catalyze changes that will serve to transform new scientific knowledge into tangible benefits for public health. Additional information about the NIH Roadmap can be found at its Web site, www.nihroadmap.nih.gov.

For information about the Food and Drug Administration, please visit http://www.fda.gov.
For additional information about the National Cancer Institute, please visit http://www.cancer.gov.
For information about the Centers for Medicare & Medicaid Services, please visit http://cms.hhs.gov.

FDA/NCI/CMS Memorandum of Understanding

###


View Article  Clinical Trial: Summary: Study of Gamma Knife Radio Surgery and Temozolomide for Patients with 1- 4 Unresected Brain Metastases

Clinical Trial: Summary: Study of Gamma Knife Radio Surgery and Temozolomide for Patients with 1- 4 Unresected Brain Metastases


http://www.centerwatch.com/patient/studies/stu87321.html

Summary: Study of Gamma Knife Radio Surgery and Temozolomide for Patients with 1- 4 Unresected Brain Metastases
The purpose of this study is to determine if Gamma Knife radiosurgery with Temodar improves the overall survival time of patients with one to four brain metastases (cancer to the brain). All patients will receive stereotactic radiosurgery (Gamma Knife), done on a single day, outpatient procedure and chemotherapy with temodar may be given up to 24 months, depending on your tumor response.

Patient Inclusion Criteria

Confirmed diagnosis of cancer with 1-4 brain metastases.
No previous cranial radiation.
No chemotherapy within one month prior to treatment.
No prior surgery for brain metastases.
No allergy to MRI contrast dye.
Age > 18.
Patient Exclusion Criteria

Diagnosis of lymphoma, small cell lung cancer and germ cell tumor.
Systemic therapy within 1 month prior to treatment.
Major medical illnesses or psychiatric impairments, which in the investigator's opinion will prevent administration of completion of the protocol therapy and/or interfere with follow-up.
All patients who have undergone a complete resection of all known brain metastases.

Contact:

Laszlo Mechtler, MD
Roswell Park Cancer Institute
Elm & Carlton Streets
Buffalo, NY 14263
Telephone: 716-845-3154
Email: Laszlo.mechtler@roswellpark.org 

This site is run by CenterWatch, a publishing company that focuses on the clinical trials industry. The information provided in this service is designed to help patients find clinical trials that may be of interest to them, and to help patients contact the centers conducting the research. CenterWatch is neither promoting this research nor involved in conducting any of these trials.

Trial listings updated: February 17, 2006 at 3:52:01 PM


View Article  Radiolabeled Monoclonal Antibody Therapy in Treating Patients With Refractory, Recurrent, or Advanced CNS or Leptomeningeal Cancer

Radiolabeled Monoclonal Antibody Therapy in Treating Patients With Refractory, Recurrent, or Advanced CNS or Leptomeningeal Cancer

http://www.clinicaltrials.gov/ct/show/NCT00089245?order=100

This study is currently recruiting patients.
Verified by National Cancer Institute (NCI) August 2004
Sponsors and Collaborators: Memorial Sloan-Kettering Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00089245

Purpose

RATIONALE: Radiolabeled monoclonal antibodies can locate tumor cells and deliver tumor-killing substances, such as radioactive iodine, to them without harming normal cells.

PURPOSE: This phase I trial is studying the side effects and best dose of radiolabeled monoclonal antibody therapy in treating patients with refractory, recurrent, or advanced CNS or leptomeningeal cancer.

Condition
                                                                            Intervention                                                    Phase
Adult Brain Tumor                                                                 Drug: iodine I 131 monoclonal antibody 8H9     Phase I
Adult Medulloblastoma                                                          Procedure: antibody therapy
Adult Rhabdomyosarcoma                                                     Procedure: biological response modifier therapy
Adult Soft Tissue Sarcoma                                                     Procedure: isotope therapy
Childhood Medulloblastoma                                                   Procedure: monoclonal antibody therapy
Childhood Rhabdoid Tumor of the Central Nervous System    Procedure: radiation therapy
Childhood Rhabdomyosarcoma                                              Procedure: radioimmunotherapy
Childhood Soft Tissue Sarcoma
Desmoplastic Small Round-Cell Tumor
Disseminated Neuroblastoma
Leptomeningeal Metastases
Metastatic Childhood Soft Tissue Sarcoma
Metastatic Osteosarcoma
Metastatic Tumors of the Ewing's Family
Neuroblastoma
Osteosarcoma
Previously Treated Childhood Rhabdomyosarcoma
Tumors of the Ewing's Family

MedlinePlus related topics: Bone Cancer; Brain Cancer; Cancer; Cancer Alternative Therapies; Neuroblastoma;   Neurologic Diseases; Soft Tissue Sarcoma
Genetics Home Reference related topics: Cancer; Neurologic Diseases

Study Type: Interventional
Study Design: Treatment

Official Title: Phase I Study of Intrathecal Iodine I 131 Monoclonal Antibody 8H9 in Patients With Refractory, Recurrent, or Advanced CNS or Leptomeningeal Cancer

Further study details as provided by National Cancer Institute (NCI):

OBJECTIVES:

   * Determine the maximum tolerated dose of intrathecal iodine I 131 monoclonal antibody 8H9 in patients with refractory,
        recurrent, or advanced CNS or leptomeningeal cancer.
   * Determine the clinical toxic effects of this drug in these patients.
   * Determine the pharmacokinetics and dosimetry of this drug in these patients.
   * Correlate tumor response by MRI with CSF reverse-transcription polymerase chain reaction in patients treated with
        this drug.

OUTLINE: This is a dose-escalation study.

Patients receive iodine I 131 monoclonal antibody 8H9 (^131I MOAB 8H9) intrathecally on day 1. Treatment repeats every 4 weeks for up to 2 courses (total of 2 injections) in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of ^131I MOAB 8H9 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

PROJECTED ACCRUAL: A total of 3-30 patients will be accrued for this study within 2-3 years.

Eligibility
Genders Eligible for Study: Both
Criteria

DISEASE CHARACTERISTICS:

   * Histologically confirmed CNS or leptomeningeal cancer, meeting 1 of the following criteria:
   * Refractory to conventional therapy OR for which no conventional therapy exists
   * Less than 10% chance of cure with conventional therapy
   * Recurrent brain tumor or other solid tumor with a predilection for leptomeningeal dissemination, including, but not
        limited to, the following:
   * Medulloblastoma
   * Ewing's sarcoma/primitive neuroectodermal tumor
   * Rhabdoid tumor
   * Neuroblastoma
   * Osteosarcoma
   * Desmoplastic small rounded-cell tumor
   * Rhabdomyosarcoma
   * 8H9 reactivity confirmed by immunohistochemical staining
   * No rapidly progressing or deteriorating neurologic examination
   * Stable neurological deficits as a result of brain tumor allowed
   * No obstructive or symptomatic communicating hydrocephalus

PATIENT CHARACTERISTICS:

Age
    * Any age

Performance status
    * Not specified

Life expectancy
    * Not specified

Hematopoietic
    * Absolute neutrophil count > 1,000/mm^3
    * Platelet count > 50,000/mm^3

Hepatic
    * No hepatic toxicity ≥ grade 2

Renal
    * No renal toxicity ≥ grade 2

Cardiovascular
    * No cardiac toxicity ≥ grade 2

Pulmonary
    * No pulmonary toxicity ≥ grade 2

Other
    * Not pregnant or nursing
    * Negative pregnancy test
    * Concurrent active malignancy outside the CNS allowed
    * No uncontrolled life-threatening infection
    * No gastrointestinal system toxicity ≥ grade 2
    * No other severe major organ toxicity
    * Hearing loss ≤ grade 3

PRIOR CONCURRENT THERAPY:

Biologic therapy
    * Not specified

Chemotherapy
    * At least 3 weeks since prior systemic chemotherapy

Endocrine therapy
    * Prior corticosteroids allowed

Radiotherapy
    * At least 3 weeks since prior cranial or spinal radiotherapy

Surgery
    * Not specified

Location and Contact Information
Please refer to this study by ClinicalTrials.gov identifier  NCT00089245

New York
      Memorial Sloan-Kettering Cancer Center, New York,  New York,  10021,  United States; Recruiting
      Clinical Trials Office for Memorial Sloan-Kettering Cancer Cen  646-227-2149

Study chairs or principal investigators
      Kim Kramer, MD,  Study Chair,  Memorial Sloan-Kettering Cancer Center  

More Information

Clinical trial summary from the National Cancer Institute's PDQ® database
Study ID Numbers:  CDR0000378183; MSKCC-03133
Last Updated:  February 7, 2006
Record first received:  August 4, 2004
ClinicalTrials.gov Identifier:  NCT00089245
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2006-02-21
View Article  A new therapeutic approach in patients with advanced sarcoma.

Int J Clin Oncol. 2005 Dec;10(6):438-40.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16369750&dopt=Abstract

A new therapeutic approach in patients with advanced sarcoma.

Kasper B, Ho AD, Egerer G.

University of Heidelberg, Department of Internal Medicine V, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany. Bernd.Kasper@med.uni-heidelberg.de

Sarcomas represent a rare and heterogeneous disease and the prognosis of patients remains poor, with a disease-free survival at 5 years of less than 10%. Only a few chemotherapeutic agents, such as doxorubicin and ifosfamide, have been identified to be active with response rates above 20%. The concept of angiostatic therapy in combination with proapoptotic biomodulators and chemotherapeutics has not been evaluated in these patients. Therefore, the efficacy of low-dose trofosfamide in combination with the peroxisome proliferator-activated receptor-gamma-agonist, pioglitazone, and the selective cyclooxygenase-2 inhibitor, rofecoxib, was evaluated in a pilot study. Six patients with advanced sarcoma received a combination of oral pioglitazone plus rofecoxib and, after 14 days, oral trofosfamide. The therapy was administered continuously daily. Four patients received the triple combination as maintenance therapy; three of them achieved stabilization of disease. Two patients received the combination as relapse therapy; however, it failed to stop disease progression. Side effects were generally mild and hospitalization was not necessary. This new triple combination of low-dose trofosfamide, pioglitazone, and rofecoxib may represent a feasible new alternative in the palliative treatment of sarcoma patients.

PMID: 16369750 [PubMed - in process]
View Article  The role of high-dose therapy and autologous stem cell transplantation for pediatric bone and soft tissue sarcomas.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16445375&dopt=Abstract

Expert Rev Anticancer Ther. 2006 Feb;6(2):225-37. 

 
The role of high-dose therapy and autologous stem cell transplantation for pediatric bone and soft tissue sarcomas.

Ek ET, Choong PF.

Department of Orthopedics, St. Vincent's Hospital, Melbourne, Australia. eugene_ek@msn.com

The prognosis for children with bone and soft tissue sarcomas has significantly improved since the advent of effective multiagent chemotherapy, aggressive surgery for local disease and more precise delivery of radiotherapy doses. However, in a small proportion of patients that present with high-risk disease, long-term outcome has not substantially increased, with disease-free survival rates still in the order of 20-30%. It is therefore clear that novel therapies are needed for children with these tumors. Based on the highly chemosensitive nature of the majority of pediatric sarcomas, several small studies have been conducted to investigate the potential role of high-dose chemotherapy followed by hematopoietic stem cell reconstitution. This review will provide an overview of the current literature concerning the use of high-dose therapy with stem cell transplantation for the three main pediatric sarcomas--Ewing sarcoma, rhabdomyosarcoma and osteosarcoma.

PMID: 16445375 [PubMed - in process]