An investigator initiated Phase I trial of alectinib in pediatric patients with refractory malignant solid tumors or malignant lymphoma(NCCH1708) (PANDA trial)
小児悪性固形腫瘍および悪性リンパ腫患者を対象としたアレクチニブの第Ⅰ相試験(NCCH1708)
Phase I trial of alectinib in pediatric patients with malignant solid tumors or malignant lymphoma(NCCH1708)
To assess the safety, efficacy and pharmacokinetics of alectinib and to determine the recommended dose of alectinib in pediatric patients with refractory malignant solid tumors or malignant lymphoma.
To assess the safety of alectinib in pediatric patients with refractory malignant solid tumors or malignant lymphoma,To assess the efficacy of alectinib in pediatric patients with inflammatory myofibroblastic tumor (IMT). To assess the pharmacokinetics of alectinib in pediatric patients with refractory malignant solid tumors or malignant lymphoma.To assess the efficacy of alectinib in pediatric patients with inflammatory myofibroblastic tumor (IMT). To assess the pharmacokinetics of alectinib in pediatric patients with refractory malignant solid tumors or malignant lymphoma.
1)Pediatric patients with refractory malignant solid tumor or malignant lymphoma corresponding to all of the followings
-Progressive, recurrent or metastatic tumor
-No indication of curative surgery
-Standard therapy is ineffective or inappropriate
-No history of allogenic transplant
2)Patients with ALK abnormalities detected with either immunohistochemistry staining, Fluorescence in situ hybridization or gene profiling
3)patients with malignant solid tumor, either or both of the followings are satisfied
-In patients with solid tumor, having one or more lesions confirmed by CT or MRI, regardless of measurable or unmeasurable
-In patients with solid tumor, having tumor infiltration confirmed by bone-marrow examination
-In patients with malignant lymphoma, having one or more lesions confirmed by CT or MRI, regardless of measurable or unmeasurable and not having bone-marrow and/or central nerve system infiltration
4)Aged between 3 and 18
5)Patients who can administer 7mm diameter capsules
6)In patients who are registered to 1st dose in dose determination cohort, body weight with 15 kg or more and less than 35 kg measured within 14 days before registration
7)Performance Status (ECOG) 0, 1, or 2
8)Not having any of the followings: symptomatic brain metastasis, carcinomatous meningitis, or spinal metastasis requiring radiotherapy or surgical intervention
9)Not having any of the followings: pericardial fluid, pleural effusion or ascites requiring treatment
10)Not received anti-cancer drug or other study drug within 28 days before registration
11)No prior treatment with ALK inhibitor (alectinib, crizotinib, ceritinib, brigatinib etc.)
12)Not received operation under general anesthesia within 28 days before registration
13)Leaving the following interval between radiotherapy more than 40 Gy and registration
->=12 weeks: irradiation to any of >=6 spines, whole abdomen, whole lung, whole body, or >= 50% of pelvis
->=6 weeks: irradiation to any of 4 or 5 spines, or >= 25% and < 50% of pelvis
->=14 days: irradiation to any of <= 3 spines, < 25 % of pelvis, or other local sites
14)Correspond to the following values in laboratory tests performed within 14 days before registration without administration of G-CSF and/or blood transfusion within 14 days before the blood collection
-Neutrophil count>=1000 / mm3
-Platelet count>=50000 / mm3
-Total bilirubin<=1.5 mg/dL
-ALT<=100 U/L
-Creatinine<=0.8 mg/dL(2-5 years old), 1.0 mg/dL(6-9 years old), 1.2 mg/dL(10-12 years old), 1.5 mg/dL(13-15 years old), 1.7 mg/dL(16 years old or above)
15) >= 94% of SpO2 under room air conditions within 14 days before registration
16) Consent to contraception and limited breast-feeding
17) Written informed consent
1)Active double cancer (except for completely resected basal cell carcinoma, squamous cell carcinoma, carcinoma in situ, intramucosal cancer, superficial bladder cancer, gastrointestinal cancer resected by ESD or EMR, and other cancer free of relapse for more than 5 years)
2)Infection requiring systemic therapy
3)Active gastrointestinal ulceration
4)Current or previous pneumonitis or pulmonary fibrosis diagnosed based on imaging or clinical findings (except for inactive scar or fibrosis associated with radiotherapy)
5)Current or previous severe hypersensitive reaction to medicines
6)HIV antibody-positive, or HTLV-1 antibody-positive, or HBs antigen-positive, or HCV antibody-positive (except for HCV-RNA-negative even if HCV antibody-positive)
7)Though HBs antigen-negative, HBs antibody-positive and/or HBc antibody-positive, and HBV-DNA quantitative test positive
8)Pregnant or breast-feeding women, or women suspected of being pregnant
9)Psychiatric diseases or psychological symptoms interfering with participation in the trial