Clinical Trial: Use of Rituximab in Opsoclonus-Myoclonus in Children With Neuroblastoma
Study Status: Completed
Recruit Status: Unknown status
Study Type: Interventional
Official Title: Use of Rituximab in Opsoclonus-Myoclonus in Children With Neuroblastoma
Brief Summary: The purpose of this study is to evaluate the feasibility of giving four weekly doses of Rituximab (anti-CD20 antibody) in the treatment of children with refractory neuroblastoma associated opsoclonus-myoclonus. Patients must have continued symptoms of opsoclonus, myoclonus and or ataxia despite surgical resection and a minimum of one month of steroid therapy. Evaluations include clinical symptoms of opsoclonus-myoclonus and ataxia as well as detailed evaluation of learning and development.
Detailed Summary:
Opsoclonus-myoclonus ataxia syndrome (OMS) is a rare immune mediated paraneoplastic syndrome that occurs in approximately 2 to 3% of children with neuroblastoma. Children with neuroblastoma associated opsoclonus-myoclonus tend to have a favorable prognosis from the standpoint of the cure of their cancer. Unfortunately,approximately two-thirds of this subgroup of patients are left with long term sequellae of the syndrome, including residual symptoms of opsoclonus, myoclonus, ataxia, learning difficulties and disturbance of sleep and mood.
Multiple lines of evidence indicate an immune mechanism to this rare disorder. This includes occurence of OMS in the post-infectious state, aggressive lymphocytic infiltration of the tumor in children with OMS, and documented responses to therapries that act through suppression of the immune system.
The current study utilizes four weekly doses of anti-CD 20 antibody (rituximab) to treat children with refractory OMS. Refractory disease is defined as continued symptoms of OMS despite surgical resection of the tumor and a minimum of one month of steroid therapy.
All patients have baseline OMS evaluation and detailed neurocognitive testing with all studies being repeated at the completion of the four weekly infusions. OMS testing is repeated at Month 3. OMS testing and detailed neurocognitive testing is conducted at 6 months intervals until 2 years from the initial infusion.
The goal of the study is to utilize this novel therapy to improve long term neurologic and neurodevelopmental outcome in children with refratory neuroblastoma associated opsoclonus-myoclonus.
Sponsor: Tersak, Jean M., M.D.
Current Primary Outcome:
- Feasibility and toxicity
- Response
Original Primary Outcome: Same as current
Current Secondary Outcome: Pharmacokinetic data and HACA development in the pediatric population
Original Secondary Outcome: Same as current
Information By: Tersak, Jean M., M.D.
Dates:
Date Received: September 12, 2005
Date Started: July 2005
Date Completion: July 2008
Last Updated: September 19, 2006
Last Verified: September 2006
