Study to Assess Safety and Preliminary Activity of Eribulin Mesylate in Pediatric Participants With Relapsed/Refractory Rhabdomyosarcoma (RMS), Non-rhabdomyosarcoma Soft Tissue Sarcoma (NRSTS) and Ewing Sarcoma (EWS)



Status:Recruiting
Healthy:No
Age Range:Any - 18
Updated:3/17/2019
Start Date:April 17, 2018
End Date:June 30, 2020
Contact:Eisai Medical Information
Email:esi_oncmedinfo@eisai.com
Phone:1-888-274-2378

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A Phase 2, Multicenter, Open-label Study to Assess Safety and Preliminary Activity of Eribulin Mesylate in Pediatric Subjects With Relapsed/Refractory Rhabdomyosarcoma (RMS), Non-rhabdomyosarcoma Soft Tissue Sarcoma (NRSTS) and Ewing Sarcoma (EWS)

This study will be conducted as an assessment of the safety and preliminary activity of
eribulin mesylate in pediatric participants with relapsed/refractory rhabdomyosarcoma (RMS),
non-rhabdomyosarcoma soft tissue sarcoma (NRSTS), or Ewing sarcoma (EWS) to determine whether
each cohort warrants further investigation.


Inclusion Criteria:

- Age: ≥12 months to <18 years old at the time of informed consent

- Diagnosis: Histologically confirmed rhabdomyosarcoma (RMS), non-rhabdomyosarcoma soft
tissue sarcoma (NRSTS) (Grade 2 or 3), or Ewing sarcoma (EWS) which is relapsed or
refractory (failed front line therapy)

- The presence of measurable disease meeting the following criteria:

- At least 1 lesion of ≥1.0 centimeter (cm) in the longest diameter for a non-lymph
node or ≥1.5 cm in the short-axis diameter for a lymph node that is serially
measurable according to Response Evaluation Criteria In Solid Tumors (RECIST) 1.1
using computerized tomography/magnetic resonance imaging (CT/MRI).

- Lesions that have had radiotherapy must show subsequent radiographic evidence of
increase in size by at least 20% to be deemed a target lesion.

- Therapeutic options: Participant's current disease state must be one for which there
is no known curative therapy or therapy proven to prolong survival with an acceptable
quality of life.

- Performance level: Performance score ≥50%. Karnofsky (for participants >16 years of
age) or Lansky (for participants ≤16 years of age). Participants who are unable to
walk because of paralysis and/or previous surgeries, but who are in a wheelchair, will
be considered ambulatory for the purpose of assessing performance score.

- Participants must have fully recovered from the acute toxic effects of all prior
anticancer therapy and must meet the following minimum duration from prior anticancer
directed therapy prior to study drug administration. If, after the required time
frame, the numerical eligibility criteria are met, eg, blood count criteria, the
participant is considered to have recovered adequately:

- Cytotoxic chemotherapy or other chemotherapy known to be myelosuppressive: ≥21
days after the last dose of cytotoxic or myelosuppressive chemotherapy (42 days
if prior nitrosourea).

- Anticancer agents not known to be myelosuppressive (eg, not associated with
reduced platelet or absolute neutrophil count [ANC] counts): ≥7 days after the
last dose of agent.

- Monoclonal antibodies ≥ 3 half-lives must have elapsed from infusion of last dose
of antibody (including checkpoint inhibitors), and toxicity related to prior
antibody therapy must be recovered to Grade ≤1.

- Hematopoietic growth factors: ≥14 days after the last dose of a long-acting
growth factor (eg, Neulasta) or 7 days for a short-acting growth factor. For
agents that have known adverse events (AEs) occurring beyond 7 days after
administration, this period must be extended beyond the time during which AEs are
known to occur. The duration of this interval must be discussed with the sponsor.

- Interleukins, interferons, and cytokines (other than hematopoietic growth
factors): ≥21 days after the completion of interleukins, interferons, or
cytokines (other than hematopoietic growth factors)

- Stem cell infusions (with or without total body irradiation [TBI]): ≥84 days

- Allogeneic (non-autologous) bone marrow or stem cell transplant, or any stem cell
infusion including donor lymphocyte infusion or boost infusion: ≥84 days after
infusion and no evidence of graft versus host disease (GVHD)

- Autologous stem cell infusion including boost infusion: ≥42 days

- Cellular therapy: ≥42 days after the completion of any type of cellular therapy
(eg, modified T-cells, natural killer cells, dendritic cells, etc)

- Radiation therapy (XRT)/External Beam Irradiation including Protons: ≥14 days
after local XRT; ≥150 days after TBI, craniospinal XRT or if radiation to ≥50% of
the pelvis; ≥42 days if other substantial BM radiation

- Radiopharmaceutical therapy (eg, radiolabeled antibody,
131I-metaiodobenzylguanidine): ≥42 days after systemically administered
radiopharmaceutical therapy.

- Adequate bone marrow function, defined as:

- ANC ≥1.0 × 10^9/Liter (L)

- Platelet count ≥100 × 10^9/L (transfusion independent, defined as not receiving
platelet transfusions within a 7-day period prior to study drug administration)

- Hemoglobin at least 8.0 grams per deciliter (g/dL) at Baseline (blood
transfusions are allowed during the screening period to correct hemoglobin values
less than 8.0 g/dL) Note: As blood transfusions are permitted to meet the
hemoglobin criteria, participants requiring transfusion must not be known to be
refractory to red blood cell or platelet transfusions.

- Adequate renal function, defined as:

- A serum creatinine based on age/gender, derived from the Schwartz formula for
estimating glomerular filtration rate (GFR)

- Or creatinine clearance or GFR ≥50 milliliters per minute (mL/min)/1.73 meters
squared (m^2) based on a 12 or 24 hour urine creatinine collection

- Adequate liver function, defined as:

- Bilirubin (sum of conjugated + unconjugated) ≤1.5 × upper limit of normal (ULN)
for age

- Alanine aminotransferase (ALT) ≤110 units per Liter (U/L). For the purpose of
this study, the ULN for ALT is 45 U/L

- Serum albumin ≥2 g/dL

- Informed consent: All participants and/or their parents or legally authorized
representatives must sign a written informed consent. Assent, when appropriate, will
be obtained according to institutional guidelines. Participants must be willing to
comply with all aspects of the protocol.

Exclusion Criteria:

- Pregnancy, breastfeeding, contraception: Females who are breastfeeding or pregnant at
Screening or Baseline (as documented by a positive beta-human chorionic [β-hCG] or
human chorionic gonadotropin [hCG] test with a minimum sensitivity of 25 International
Units per Liter [IU/L] or equivalent units of β-hCG [or hCG]). A separate baseline
assessment is required if a negative screening pregnancy test was obtained more than
72 hours before the first dose of study drug.

- Females of childbearing potential (all post pubertal females will be considered
to be of childbearing potential unless they have early menopause [amenorrheic for
at least 12 consecutive months, in the appropriate age group, and without other
known or suspected cause] or have been sterilized surgically [ie, bilateral tubal
ligation, total hysterectomy, or bilateral oophorectomy, all with surgery at
least 1 month before dosing]) who:

- Do not agree to use a highly effective method of contraception for the entire
study period and for 6 months after study drug discontinuation, ie:

- Total abstinence (if it is their preferred and usual lifestyle);

- An intrauterine device (IUD) or intrauterine system (IUS);

- A contraceptive implant;

- An oral contraceptive (must be on a stable dose of the same oral hormonal
contraceptive product for at least 4 weeks before dosing with study drug and for
the duration of the study and for 6 months after study drug discontinuation); or

- Do not have a vasectomized partner with confirmed azoospermia.

For sites outside of the European Union (EU), it is permissible that if a highly effective
method of contraception is not appropriate or acceptable to the participant, or the
participant has commenced/adjusted/changed oral hormonal contraceptive product/dose within
4 weeks prior to study drug administration, then the participant must agree to use a
medically acceptable method of contraception, ie, double barrier methods of contraception
such as condoms plus diaphragm or cervical/vault cap with spermicide.

- Males who have not had a successful vasectomy (confirmed azoospermia) or if they and
their female partners do not meet the criteria above (ie, not of childbearing
potential or practicing highly effective contraception throughout the study period or
for 3 months after study drug discontinuation). No sperm donation is allowed during
the study period or for 3 months after study drug discontinuation.

- Concomitant medications:

- Corticosteroids: Participants receiving corticosteroids who have not been on a stable
or decreasing dose of corticosteroid for at least 7 days prior to study drug
administration (except when indicated for Central Nervous System [CNS] metastases,
then participants must not have received corticosteroids for at least 28 days)

- Anticancer Agents: participants who are currently receiving other anticancer agents

- Anti-GVHD agents Post-transplant: Participants who are receiving cyclosporine,
tacrolimus or other agents to prevent graft-versus-host disease post bone marrow
transplant

- Strong CYP3A4 inducers/inhibitors

- Received prior therapy with eribulin mesylate

- Any other malignancy that required treatment (except for non-melanoma skin
cancer, or histologically confirmed complete excision of carcinoma in situ),
within 2 years prior to study drug administration

- Has hypersensitivity to eribulin or any of the excipients

- Has a prior history of viral hepatitis (B or C) as demonstrated by positive
serology (presence of antigens) or have an uncontrolled infection requiring
treatment. Participants with a known prior history of hepatitis B or C may be
eligible pending agreement with the sponsor.

- Has > Grade 1 peripheral sensory neuropathy or > Grade 1 peripheral motor
neuropathy graded according to the Modified ("Balis") Pediatric Scale of
Peripheral Neuropathies

- Has cardiac pathology: Participants with known congestive heart failure,
symptomatic or left ventricular (LV) ejection fraction <50% or shortening
fraction <27%

- Participants with congenital long QT syndrome, bradyarrhythmias, or QTc >480 msec
on at least 2 separate electrocardiograms (ECGs).

- Has CNS Disease: Participants with brain or subdural metastases are not eligible
unless the metastases are asymptomatic and do not require treatment or have been
adequately treated by local therapy (eg, surgery or radiotherapy) and have
discontinued the use of corticosteroids for this indication for at least 4 weeks
prior to study drug administration. Confirmation of radiographic stability must
be done by comparing the brain scan (CT or MRI) performed during the Screening
Period, using the same imaging modality, to a brain scan performed earlier (and
following local therapy where applicable). Participants must be clinically
stable. It is not the intention of this protocol to treat participants with
active brain metastases.

Note: CNS imaging is required to confirm eligibility for participants with a known history
of CNS disease.

- Have had or are planning to have the following invasive procedures:

- Major surgical procedure or significant traumatic injury within 28 days prior to
study drug administration

- Laparoscopic procedure or open biopsy within 7 days prior to study drug
administration

- Central line placement or subcutaneous port placement is not considered major
surgery but must be placed at least 2 days prior to study drug administration

- Core biopsy, including bone marrow biopsy, within 2 days prior to study drug
administration

- Fine needle aspirate within 3 days prior to study drug administration

- Has any serious concomitant illness that in the opinion of the investigator(s) could
affect the participant's safety or interfere with the study assessments

- Participants with known human immunodeficiency virus (HIV); due to lack of available
safety data for eribulin therapy in HIV-infected participants
We found this trial at
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New Brunswick, New Jersey 08901
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Ann Arbor, MI 48109Bus: -
Ann Arbor, Michigan 48109
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3400 N Charles St
Baltimore, Maryland 21205
410-516-8000
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1720 2nd Ave S
Birmingham, Alabama 35233
(205) 934-4011 
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3333 Burnet Avenue # Mlc3008
Cincinnati, Ohio 45229
 1-513-636-4200 
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700 Childrens Drive
Columbus, Ohio 43205
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1200 Pleasant Street
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282 Washington St
Hartford, Connecticut 06106
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2500 N State St
Jackson, Mississippi 39216
(601) 984-1000
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807 Childrens Way
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4650 Sunset Blvd
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Minneapolis, Minnesota 55455
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2220 Pierce Ave
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1201 W La Veta Ave
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South 34th Street
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 215-590-1000
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4401 Penn Avenue
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7700 Floyd Curl Dr
San Antonio, Texas 78229
(210) 575-7000
Methodist Children's Hospital of South Texas Methodist Children
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3020 Childrens way
San Diego, California 92123
(858) 576-1700
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1405 Clifton Road NE
Atlanta, Georgia 30322
404-785-6000
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225 E Chicago Ave
Chicago, Illinois 60611
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Dallas, Texas 75235
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100 North Academy Avenue
Danville, Pennsylvania 17822
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801 7th Avenue
Fort Worth, Texas 76104
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30 Prospect Ave
Hackensack, New Jersey 07601
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500 University Drive
Hershey, Pennsylvania 17033
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Kansas City, Missouri 64108
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Loma Linda, California 92354
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Los Angeles, California 90027
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Louisville, Kentucky 40202
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9000 W Wisconsin Ave #270
Milwaukee, Wisconsin 53226
(414) 266-2000
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Minneapolis, Minnesota 55404
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630 W 168th St
New York, New York
212-305-2862
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1919 E Thomas Rd
Phoenix, Arizona 85006
(602) 933-1000
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Seattle, Washington 98115
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101 W 8th Ave
Spokane, Washington 99204
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111 Michigan Ave NW
Washington, District of Columbia
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Wilmington, Delaware 19803
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