Refractory Brain Tumors Clinical Trial
Official title:
A Phase I Study Using Submyeloablative DOsing of Intravenous Busulfan (Busulfex) for Refractory Brain Tumors
This protocol is aimed at establishing a maximum tolerated dose (MTD) for submyeloablative doses of Busulfex ® with the hope that a tolerable, submyeloablative dose can be established to test efficacy as alternative therapy for refractory pediatric brain tumors.
Pediatric brain tumors remain among the most common malignancies in childhood, second only to
leukemia, representing 20% of all childhood cancers in the United States (1). Although
significant strides have been made in therapies for other pediatric malignancies, mortality
for patients with brain tumors remains high. The mainstay of therapy for CNS tumors has been
a combination of surgery, chemotherapy, and radiation. High dose chemotherapy with stem cell
transplant has been proposed as an alternative to radiation, in very young children and for
relapsed patients. Stem cell transplantation however is not without significant side effects
as well as transplant related mortality.
Busulfan is an alkylating agent and is able to exert its cytotoxic effects through hydrolysis
and subsequent production of carbonium ions, directly alkylating DNA, interfering with its
replication, and ultimately leading to cell death (2). Busulfan readily crosses the blood
barrier, allowing for CNS levels nearly equal to those of plasma levels (5,6).
Primary Objectives:
To determine the maximum tolerated dose (MTD) of Busulfex ® in children with recurrent,
progressive, or refractory primary brain tumors.
Secondary Objectives:
To obtain preliminary data regarding progression free survival (PFS) and event free survival
(EFS) when Busulfex ® is used at submyeloablative doses in children with recurrent,
progressive, or refractory primary brain tumors.
To describe the plasma pharmacokinetics of Busulfex ® in children with recurrent,
progressive, or refractory primary brain tumors, using a continuous infusion.
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