Clinical trial · Interventional
Donor Stem Cell Transplant After Chemotherapy for the Treatment of Recurrent or Refractory High-Risk Solid Tumors in Pediatric and Adolescent-Young Adults
A Pilot Study of Allogeneic Hematopoietic Stem Cell Transplantation for Pediatric and Adolescent-Young Adults Patients With High Risk Solid Tumors
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Why stopped (as posted): PI Request
Summary
Brief summary (as posted)
This phase II trial investigates side effects and how well donor stem cell transplant after chemotherapy works in treating pediatric and adolescent-young adults with high-risk solid tumor that has come back (recurrent) or does not respond to treatment (refractory). Chemotherapy drugs, such as fludarabine, thiotepa, etoposide, melphalan, and rabbit anti-thymocyte globulin 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 chemotherapy before a donor stem cell transplant helps kill cancer cells in the body and helps make room in the patient's bone marrow for new blood-forming cells (stem cells) to grow. When the healthy stem cells from a donor are infused into a patient, they may help the patient's bone marrow make more healthy cells and platelets and may help destroy any remaining cancer cells.
Conditions
Conditions (12)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Desmoplastic Small Round Cell Tumor | Desmoplastic Small Round Cell Tumor | ONTOLOGY_EXACT | 0.90 |
| Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor | Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor | ONTOLOGY_EXACT | 0.98 |
| Recurrent Desmoplastic Small Round Cell Tumor | Desmoplastic Small Round Cell Tumor | CURATED_BROADER | 0.78 |
| Recurrent Malignant Peripheral Nerve Sheath Tumor | Malignant Peripheral Nerve Sheath Tumor | CURATED_BROADER | 0.78 |
| Recurrent Malignant Solid Neoplasm | Malignant Solid Neoplasm | CURATED_BROADER | 0.78 |
| Recurrent Neuroblastoma | Neuroblastoma | CURATED_BROADER | 0.78 |
Interventions
Interventions (9)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Allogeneic Hematopoietic Stem Cell Transplantation | Procedure | — | UNRESOLVED |
| Cyclosporine | Drug | — | UNRESOLVED |
| Etoposide | Drug | Etoposide | ALIAS |
| Fludarabine Phosphate | Drug | Fludarabine | ALIAS |
| Lapine T-Lymphocyte Immune Globulin | Biological | — | UNRESOLVED |
| Melphalan | Drug | Melphalan | ALIAS |
| Mycophenolate Mofetil | Drug | — | UNRESOLVED |
| Tacrolimus | Drug | — | UNRESOLVED |
Design
Arms and outcomes
Arms (1)
- type
- EXPERIMENTAL
- label
- Treatment (conditioning regimen, HSCT)
- description
- CONDITIONING REGIMEN: Patients receive thiotepa IV over 2-4 hours, etoposide IV over 60 minutes on days -8 to -6, melphalan IV over 20 minutes on days -5 and -4, and fludarabine phosphate IV over 1 hour on days -5 to -3 in the absence of disease progression or unacceptable toxicity. Patients receiving umbilical cord transplant also receive rabbit anti-thymocyte globulin IV on days -3 and -4. TRANSPLANT: Patients undergo HSCT on day 0. GVHD PROPHYLAXIS: Beginning day -2, patients receive tacrolimus or cyclosporine IV continuously until able to receive PO. Patients continue tacrolimus or cyclosporine PO to day 60 and tapered to day 100. Patients also receive mycophenolate mofetil PO or IV every 8 hours until day 40 and tapered to day 90.
- interventionNames
- Procedure: Allogeneic Hematopoietic Stem Cell Transplantation
- Drug: Cyclosporine
- Drug: Etoposide
- Drug: Fludarabine Phosphate
- Biological: Lapine T-Lymphocyte Immune Globulin
- Drug: Melphalan
- Drug: Mycophenolate Mofetil
- Drug: Tacrolimus
- Drug: Thiotepa
Primary outcomes (2)
- measure
Eligibility
Eligibility (as posted)
- Sex
- All
- Maximum age
- 25 Years
Show eligibility criteria text
Inclusion Criteria: * Pathological criteria, including malignant recurrent/refractory solid tumors. This would include: * Ewing's/peripheral primitive neuroectodermal tumor (PNET) * Malignant peripheral nerve sheath tumor, neurofibrosarcoma * Rhabdomyosarcoma * Neuroblastoma (patients who are ineligible for tandem autologous transplant or who are at least 3 months post autologous HCT) * Desmoplastic small round cell tumor (DSRCT)- both new diagnoses as well as recurrent/refractory disease * Patients must have chemo-responsive disease, defined as; 30% or greater decrease in the tumor target lesions when compared to its pre-treatment evaluation. Patients with complete response will be eligible to participate * Available suitable HCT donor * Creatinine clearance or glomerular filtration rate (GFR) \>= 50 ml/min/1.73m\^2, and not requiring dialysis * Diffusing capacity of lung for carbon monoxide (DLCO) (corrected for hemoglobin) \>= 50% predicted. If unable to perform pulmonary function tests, then oxygen (O2) saturation \>= 92% in room air * Bilirubin =\< 3 x upper limit of normal (ULN) and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =\< 5 x for age (with the exception of isolated hyperbilirubinemia due to Gilbert's syndrome) * DONOR: Matched related donor bone marrow (10 of 10 HLA alleles \[HLA-A, B, C, DR, and DQ\]. Matched related donor peripheral blood stem cell (PBSC) is allowed only if collection of bone marrow (BM) is not available or refused by parents/donor * DONOR: Matched allogeneic umbilical cord blood (UCB): related * High-resolution matching at A,B, DRB1 (minimum 4/6) * KIR major histocompatibility complex (MHC) class 1 preferential mismatch (minimum 4/6) * DONOR: Matched allogeneic umbilical cord blood: unrelated * High-resolution matching at A,B, DRB1 (minimum 4/6) •\*KIR MHC class 1 preferential mismatch (minimum 4/6) Exclusion Criteria: * Lack of histocompatible suitable related donor/ graft source * End-organ failure that precludes the ability to tolerate the transplant procedure, including conditioning regimen * Renal failure requiring dialysis * Congenital heart disease resulting in congestive heart failure * Ventilatory failure: requires invasive mechanical ventilation * Human immunodeficiency virus (HIV) infection * Uncontrolled bacterial, viral, or fungal infections (currently taking medication yet clinical symptoms progress); stable, controlled disease with treatment is not an exclusion criteria * A female of reproductive potential who is pregnant, planning to become pregnant during the study, or is nursing a child * Any patient who does not fulfill the inclusion criteria listed above
References
Publications (0)
Data not yet available