Intrathecal Chemotherapy for Central Nervous System Metastasis in Retinoblastoma

Study Purpose

Retinoblastoma is the most common intraocular malignancy in infancy and childhood. The overall survival rate of retinoblastoma was reported to exceed 95% when children were early diagnosed with localized intraocular phase. The advanced retinoblastoma cases with central nervous system metastasis (CNS)is associated with exceedingly poor prognosis. CNS metastasis is the main cause of death in retinoblastoma. Meningeal involvement combined with spinal cord membrane involvement might be due to the meninges invasion and/or the spreading of CSF. As the most sensitive drug to retinoblastoma tumor cells in vitro, melphalan is the most important drug in the local treatment of retinoblastoma, and it is also an irreplaceable drug in the current eye preservation treatment, which greatly improves the success rate of eye preservation for advanced retinoblastoma. According to the research and the practice of vitreous injection (melphalan), the drug concentration in vitreous can effectively kill retinoblastoma tumor cells. It is reasonable to speculate that the tumor cells in CSF can be effectively killed by melphalan. Therefore, based on the above background, this study will explore the effectiveness and feasibility of intrathecal injection of melphalan in patients with CNS metastasis of retinoblastoma through a multicenter prospective study.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages N/A and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - The pathological diagnosis was retinoblastoma.
According to the IRSs (International retinoblastoma staging system) staging system, the stage was IVB.
  • - CSF tumor cells on cytology, or radiographic evidence of NM on MRI scans and histologic diagnosis of systemic malignancy needed.
  • - KPS≥60% - Adequate bone marrow and organ function.
  • - The parents signed the informed consent and were willing to accept the treatment and follow-up.

Exclusion Criteria:

  • - 1.
Eye diseases other than retinoblastoma.
  • - The eyes were infected within 30 days before screening.
  • - There was a history of surgery and / or unhealed wound within 1 month before enrollment .
  • - Those who have allergic reaction or allergic history to chemotherapeutic drugs.
  • - Infectious diseases requiring oral, intramuscular or intravenous administration.
  • - Patients with systemic immune diseases.
  • - Active disseminated intravascular coagulation.
  • - Abnormal coagulation function.
  • - Abnormal bone marrow and organ function.
  • - Uncontrollable clinical problems.
  • - The researchers believe that those who need to be excluded.

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT04903678
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

N/A
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Eye & ENT Hospital of Fudan University
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Jiang Qian, MD
Principal Investigator Affiliation Fudan Eye & ENT Hospital
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other
Overall Status Recruiting
Countries China
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Retinoblastoma, Extraocular
Arms & Interventions

Arms

Experimental: intrathecal chemotherapy in patients with central metastases

Systemic chemotherapy and intrathecal chemotherapy are performed every 3 weeks. After three treatment cycles, the treatment response is comprehensively evaluated including cerebrospinal fluid, intracranial and orbital tumors. If necessary, local radiotherapy and arterial interventional chemotherapy are performed for local solid tumors. Cerebrospinal fluid is detected in each treatment cycle. If RB tumor cells still exist in cerebrospinal fluid, chemotherapy and intrathecal chemotherapy are continued until the end event. If cerebrospinal fluid was negative, intrathecal chemotherapy is supplemented for another 2 cycles with a total of 6 cycles of systemic chemotherapy. The patients are followed up after treatment.

Interventions

Drug: - Melphalan

Melphalan is performed for intrathecal chemotherapy

Contact a Trial Team

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International Sites

Fudan Eye & ENT Hospital, Shanghai, China

Status

Recruiting

Address

Fudan Eye & ENT Hospital

Shanghai, ,

Site Contact

Jiang Qian, MD

[email protected]

+86 (021) 64377134

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