Neuroblastoma Clinical Trial
Official title:
PILOT STUDY OF BUTHIONINE SULFOXIMINE (BSO) IN COMBINATION WITH MELPHALAN FOR HIGH RISK NEUROBLASTOMA PATIENTS
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Some tumors become resistant to chemotherapy drugs. Combining
buthionine sulfoximine with chemotherapy may reduce resistance to the drug and allow more
tumor cells to be killed.
PURPOSE: Phase I trial to study the effectiveness of melphalan, buthionine sulfoximine, and
G-CSF in treating children with progressive neuroblastoma that has not responded to previous
therapy.
OBJECTIVES: I. Describe the toxic effects of combined chemotherapy with buthionine
sulfoximine (BSO) and melphalan (L-PAM) in pediatric patients with progressive
neuroblastoma. II. Determine the pharmacokinetics of BSO/L-PAM in pediatric patients. III.
Assess the ability of BSO to deplete glutathione by at least 90% in tumor metastatic to bone
marrow, in normal marrow, and in peripheral blood lymphocytes. IV. Estimate the response
rate in these patients treated with BSO/L-PAM within the confines of a pilot study.
OUTLINE: The following acronyms are used: BSO Buthionine sulfoximine, NSC-326231 L-PAM
Melphalan, NSC-8806 G-CSF Granulocyte Colony-Stimulating Factor, NSC-614629 Single-Agent
Chemotherapy with Drug Resistance Inhibition. L-PAM/BSO.
PROJECTED ACCRUAL: At least 18 patients will be entered to provide an adequate number of
patients with marrow involvement; if the BSO dose is increased to achieve adequate GSH
depletion in the marrow, an additional 12 patients will be entered. If less than 50% of
patients have tumor metastatic to marrow at entry, there will be a proportional increase in
the total number of patients required.
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