Pembrolizumab, xantoastrocitoma, xanthoastrocytoma

https://braintumorcenter.ucsf.edu/clinical-trial/study-pembrolizumab-mk-3475-pediatric-participants-advanced-solid-tumor-or-lymphoma

• RECRUITING 
 
• PEDIATRICS 
 
• ON HOLD 

A Study of Pembrolizumab (MK-3475) in Pediatric Participants With an Advanced Solid Tumor or Lymphoma (MK-3475-051/KEYNOTE-051)

Conditions

Glioma

 

Astrocytoma

 

Pleomorphic xanthoastrocytoma (grades II-III)

 

Pilocytic astrocytoma (grade I)

 

Brainstem Glioma

Diffuse Midline Glioma

 

Atypical Teratoid / Rhaboid Tumor (AT/RT)

 

Ependymoma

 

Medulloblastoma

Summary

The purpose of this Phase I/II clinical trial is to evaluate the dosage, safety and efficacy of pembrolizumab in treating pediatric participants with any of the following types of cancer:

A Study of Ramucirumab (LY3009806) in Children With Refractory Solid Tumors

Conditions

Glioma

 

Astrocytoma

 

Pleomorphic xanthoastrocytoma (grades II-III)

 

Pilocytic astrocytoma (grade I)

 

Brainstem Glioma

Diffuse Midline Glioma

 

Atypical Teratoid / Rhaboid Tumor (AT/RT)

 

Subependymal giant cell astrocytoma (grade I)

 

Medulloblastoma

Choroid Plexus Tumors

The purpose of this Phase I clinical trial is to evaluate the safety and efficacy of the drug ramucirumab, in treating children with recurrent or refractory solid tumors, including CNS tumors.

Entinostat in Treating Pediatric Patients With Recurrent or Refractory Solid Tumors

Conditions

Glioma

 

Astrocytoma

 

Pleomorphic xanthoastrocytoma (grades II-III)

 

Pilocytic astrocytoma (grade I)

 

Brainstem Glioma

Diffuse Midline Glioma

 

Atypical Teratoid / Rhaboid Tumor (AT/RT)

 

Subependymal giant cell astrocytoma (grade I)

Choroid Plexus Tumors

 

Medulloblastoma

The purpose of this Phase I clinical trial is to study the side effects and best dose of entinostat in treating pediatric patients with recurrent or refractory solid tumors.

Neuropsychological and Behavioral Testing in Younger Patients With Cancer

Conditions

Glioma

 

Astrocytoma

 

Pleomorphic xanthoastrocytoma (grades II-III)

 

Pilocytic astrocytoma (grade I)

 

Brainstem Glioma

Diffuse Midline Glioma

 

Medulloblastoma

 

Choroid Plexus Tumors

 

Atypical Teratoid / Rhaboid Tumor (AT/RT)

The purpose is to evaluate cognitive, social, emotional, and behavioral functioning over time in patients already enrolled in a Children’s Oncology Group Phase III clinical trial.

Pilot Study of Safety and Toxicity of Acquiring Hyperpolarized Carbon-13 Imaging in Children With Brain Tumors

Conditions

Glioma

 

Astrocytoma

 

Pleomorphic xanthoastrocytoma (grades II-III)

 

Pilocytic astrocytoma (grade I)

 

Brainstem Glioma

Diffuse astrocytoma (grade II)

 

Ependymoma

 

Medulloblastoma

 

Pituitary Tumor

This Phase I clinical trial will assess the safety and tolerability of hyperpolarized pyruvate for metabolic imaging in children with brain tumors.

Study of RXDX-101 in Children With Recurrent or Refractory Solid Tumors and Primary CNS Tumors, With or Without TRK, ROS1, or ALK Fusions

Conditions

Glioma

 

Astrocytoma

 

Pleomorphic xanthoastrocytoma (grades II-III)

 

Brainstem Glioma

 

Diffuse astrocytoma (grade II)

Medulloblastoma

 

Atypical Teratoid / Rhaboid Tumor (AT/RT)

The purpose of this Phase I clinical trial is to evaluate the safety, dosage, and efficacy of entrectinib in treating children and young adults with solid tumors, primary CNS tumors, and neuroblastoma.

Vemurafenib in Children With Recurrent/Refractory BRAFV600E-mutant Gliomas

Conditions

Glioma

 

Astrocytoma

 

Pilocytic astrocytoma (grade I)

 

Pleomorphic xanthoastrocytoma (grades II-III)

 

Glioblastoma (grade IV)

This trial is testing the drug vemurafenib (also called PLX4032) in children with pediatric astrocytomas that have the BRAFV600E mutation. Vemurafenib works by blocking the activity of BRAF, a key protein in the RAS/RAF/MAPK pathway that is overactive in these tumors.

WEE1 Inhibitor MK-1775 and Irinotecan Hydrochloride in Treating Younger Patients With Relapsed or Refractory Solid Tumors

Conditions

Medulloblastoma

 

Glioma

 

Astrocytoma

 

Pleomorphic xanthoastrocytoma (grades II-III)

 

Pilocytic astrocytoma (grade I)

Brainstem Glioma

 

Diffuse Midline Glioma

 

Ependymoma

 

Metastatic Brain Tumor

The purpose of this Phase I/II clinical trial is to study the side effects and best dose of irinotecan hydrochloride in combination with MK-1775 to treat pediatric patients with recurrent or refractory solid tumors.

https://www.mayoclinic.org/diseases-conditions/astrocytoma/diagnosis-treatment/clinical-trials/rsc-20320219

Study to Evaluate Eflornithine + Lomustine vs Lomustine in Recurrent Anaplastic Astrocytoma (AA) Patients

1. Rochester, Minn., Jacksonville, Fla.
   The purpose of this study is to compare the efficacy and safety of eflornithine in combination with lomustine, compared to lomustine taken alone, in treating patients whose anaplastic astrocytoma has recurred/progressed after radiation and temozolomide chemotherapy.

2. Pembrolizumab and Standard Therapy in Treating Patients With Glioblastoma

   Rochester, Minn., Scottsdale/Phoenix, Ariz.
   This phase II trial studies the side effects and how well pembrolizumab works in combination with standard therapy in treating patients with glioblastoma. Drugs used in the chemotherapy, such as pembrolizumab and temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Radiation therapy uses high energy beams to kill tumor cells and shrink tumors. Giving pembrolizumab and standard therapy comprising of temozolomide and radiation therapy may kill tumor cells.

La ozonoterapia contra los efectos secundarios de los tratamientos oncológicos

Hace unos años conocí al doctor Bernardino Clavo, especialista del hospital Doctor Negrín en Gran Canaria.
En ese momento estábamos buscando posibles tratamientos para Roberto. Nos atendió con interés y dedicación. Me pareció un profesional inquieto y dispuesto a buscar caminos que mejoraran la vida y las expectativas de pacientes oncológicos.

Hace un año, en junio de 2017, fue premiado por unos estudios clínicos y preclínicos mostrando la utilidad de la ozonoterapia en distintos efectos secundarios de la terapia oncológica, en la quinta reunión científica de la asociación y VI Congreso de la International Medical Ozone Federation.

En este enlace se puede obtener más información:
https://www.eldiario.es/canariasahora/sociedad/Especialistas-Negrin-premiados-estudio-ozonoterapia_0_659684348.html

https://www.laprovincia.es/sociedad/2017/06/29/negrin-aplica-ozonoterapia-paliar-efectos/954572.html

#ozonoterapia
#xantoastrocitoma

Ensayos clínicos actuales Xantoastrocitoma pleomórfico. Clinical trials xanthoastrocytoma

A continuación se detallan los ensayos clínicos actuales en los que participan pacientes con xantoastrocitoma pleomórfico según la clinical trials.gov
https://clinicaltrials.gov/ct2/results?cond=xanthoastrocytoma

Row	Saved	Status	Study Title	Conditions	Interventions	Locations
1		Recruiting	Phase II Pediatric Study With Dabrafenib in Combination With Trametinib in Patients With HGG and LGG	Diffuse Astrocytoma Anaplastic Astrocytoma Astrocytoma (and 19 more...)	Drug: dabrafenib Drug: trametinib Drug: Carboplatin with vincristine	Childrens National Medical Center Washington, District of Columbia, United States Dana Farber Cancer Institute Boston, Massachusetts, United States Novartis Investigative Site Berlin, Germany (and 4 more...)
2		Recruiting	A Phase I Study of Mebendazole for the Treatment of Pediatric Gliomas	Pilomyxoid Astrocytoma Pilocytic Astrocytoma Glioma, Astrocytic (and 9 more...)	Drug: Mebendazole Drug: Vincristine Drug: Carboplatin (and 3 more...)	Cohen Children's Medical Center of New York New Hyde Park, New York, United States
3		Withdrawn	Efficacy of 68Ga-DOTATOC Positron Emission Tomography (PET) CT in Children and Young Adults With Brain Tumors	Acoustic Schwannoma Adult Anaplastic Astrocytoma Adult Anaplastic Ependymoma (and 92 more...)	Radiation: gallium Ga 68-edotreotide Procedure: positron emission tomography Procedure: computed tomography Other: laboratory biomarker analysis	University of Iowa Hospitals and Clinics Iowa City, Iowa, United States
4		Recruiting	SJDAWN: St. Jude Children's Research Hospital Phase 1 Study Evaluating Molecularly-Driven Doublet Therapies for Children and Young Adults With Recurrent Brain Tumors	Anaplastic Astrocytoma Anaplastic Ependymoma Anaplastic Ganglioglioma (and 53 more...)	Drug: Gemcitabine Drug: ribociclib Drug: sonidegib (and 3 more...)	St. Jude Children's Research Hospital Memphis, Tennessee, United States
5		Terminated Has Results	Cyproheptadine in Preventing Weight Loss in Children Receiving Chemotherapy for Cancer	Cancer	Drug: cyproheptadine hydrochloride Other: placebo	Miller Children's Hospital Long Beach, California, United States Connecticut Children's Medical Center Hartford, Connecticut, United States A.I. duPont Hospital for Children Wilmington, Delaware, United States (and 11 more...)
6		Completed	Imetelstat Sodium in Treating Young Patients With Refractory or Recurrent Solid Tumors or Lymphoma	Brain and Central Nervous System Tumors Lymphoma Lymphoproliferative Disorder (and 2 more...)	Drug: imetelstat sodium Other: laboratory biomarker analysis Other: pharmacological study	UAB Comprehensive Cancer Center Birmingham, Alabama, United States Children's Hospital of Orange County Orange, California, United States UCSF Helen Diller Family Comprehensive Cancer Center San Francisco, California, United States (and 20 more...)
7		Active, not recruiting	Crizotinib in Treating Young Patients With Relapsed or Refractory Solid Tumors or Anaplastic Large Cell Lymphoma	Brain and Central Nervous System Tumors Lymphoma Neuroblastoma Unspecified Childhood Solid Tumor, Protocol Specific	Drug: crizotinib Other: pharmacogenomic studies Other: pharmacological study	Children's Hospital of Alabama Birmingham, Alabama, United States University of Alabama at Birmingham Cancer Center Birmingham, Alabama, United States Children's Hospital of Orange County Orange, California, United States (and 23 more...)
8		Unknown †	Photodynamic Therapy With Porfimer Sodium in Treating Patients With Refractory Brain Tumors	Brain and Central Nervous System Tumors Metastatic Cancer	Drug: verteporfin Procedure: conventional surgery	Medical College of Wisconsin Cancer Center Milwaukee, Wisconsin, United States Midwest Children's Cancer Center at Children's Hospital of Wisconsin Milwaukee, Wisconsin, United States

† Study has passed its completion date and status has not been verified in more than two years.

Para encontrar estudios clínicos en España:
https://reec.aemps.es/reec/public/web.html

En este otro enlace hay una línea de comentarios relacionados con el tumor dentro de la página Inspire Brain Tumor (American Brain Tumor Association)
https://www.inspire.com/conditions/pleomorphic-xanthoastrocytoma

Un estudio interesante sobre Pleomorphic Xanthoastrocytoma: Natural History and Long-Term Follow-Up
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400218/

Portal de registro de enfermedades raras en España:
https://registroraras.isciii.es/Comun/Inicio0.aspx

Red de ensayos clínicos pediátricos:
http://www.reclip.org/

Fundación Columbus: Ayuda a que niños con tumores cerebrales puedan acceder a tratamientos con protonterapia en otros países
http://fundacioncolumbus.org/insistimos-en-la-importancia-de-la-protonterapia-en-espana-para-tratar-el-cancer-infantil/

Asociación solidaria La hora violeta trabaja con pacientes con fibromatosis
https://lahoravioleta.org/neurofibromatosis/

Tratamiento positivo xantoastrocitoma / xanthoastrocytoma con inhibidor BRAF (dabrafenib) junto con inhibidor MEK (trametinib)

En este artículo en inglés aparecido en marzo de 2017 en la revista Neurology se expone el caso de una mujer con un xantoastrocitoma, que tras ser tratada únicamente con un inhibidor BRAf (vemurafenib), el tumor se reactivó pero tras volver a ser tratada con otro inhibidor (dabrafenib) más trametinib (MEK) experimenta una notable mejoría después de 11 meses. Tenemos en cuenta que es solo un caso y que está en experimentación y pendiente de sacar conclusiones reales.

BRAF/MEK double blockade in refractory anaplastic pleomorphic xanthoastrocytoma

Denis Migliorini, MD, Diego Aguiar, MD, Maria-Isabel Vargas, MD, Alexander Lobrinus, MD, and Pierre-Yves Dietrich, MD

Author information ► Article notes ► Copyright and License information ►

A 32-year-old woman was diagnosed in February 2012 with a grade II pleomorphic xanthoastrocytoma (PXA) of the right parietal lobe. A complete excision was performed, followed by tumor bed irradiation (66 Gy). A local relapse occurred in September 2013, for which a partial resection was performed, confirming a grade II PXA. Immunohistochemical analysis indicated the presence of a BRAFV600E mutated protein, and combined treatment with vemurafenib and bevacizumab was initiated. A partial response was rapidly obtained, sustained for 12 months. In June 2015, a third surgery was performed for an extended relapse invading the right cerebral hemisphere. Histopathologic examination revealed anaplastic (grade III) PXA and confirmed the presence of the BRAFV600E mutation (figure, A and B). After unsuccessful treatment with bevacizumab and lomustine, tumor treating fields therapy was applied between August and December 2015. Treatment was complicated by severe skin toxicity, with progressive appearance of a 4-cm scalp wound. Concurrently, the patient developed a severe left hemiparesis with ataxia, hemispatial neglect, and central facial palsy. MRI revealed major disease progression. The patient was subsequently referred to our institution.

Figure

Pathologic characterization of anaplastic pleomorphic xanthoastrocytoma (PXA) and radiologic response to BRAF/MEK double blockade therapy

We initiated combination therapy with dabrafenib 300 mg/d (BRAF inhibitor) and trametinib 2 mg/d (MEK inhibitor) in January 2016. Tolerance was poor, with noninfectious fever, grade III neutropenia, and vomiting. Following reduction of the dabrafenib dose to 150 mg/d, all side effects gradually resolved within 3 weeks. An impressive clinical and radiologic response was observed, with improvement in general condition and regaining of autonomy, partial recovery of the motor deficit, and disappearance of headaches. The response and clinical benefit is ongoing at 11 months of treatment. The figure, C, illustrates the major radiologic changes during this treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5373774/

Dabrafenib Promising in BRAF-Mutant Low-Grade Pediatric Glioma (Ensayos clínicos relacionados con el xantoastrocitoma - xanthoastrocytoma)

Publico esta información teniendo muy en cuenta el post anterior y que a veces los tumores reaccionan o aprenden a combatir los nuevos medicamentos, ya que tras una rápida reducción puede aparecer un crecimiento incontrolado. Igualmente el artículo hace referencia a los tumores de bajo grado, como así son considerados los xantoastrocitomas en general, aunque en ocasiones pueden ser diagnosticados de grado 3. (Anaplastic pleomorphic xanthoastrocytoma)
En España no hace falta dirigirse a otros países para acceder a ensayos clínicos relacionados con el dabrafenib y medicamentos parecidos, incluso en ensayos pediátricos. En el hospital Niño Jesús de Madrid,el doctor Lucas Moreno lleva varios años realizándolos.

Dabrafenib Promising in BRAF-Mutant Low-Grade Pediatric Glioma

News | October 12, 2016 | Pediatric Cancers, Brain Tumors, ESMO 2016

By Leah Lawrence

Use of the targeted therapy dabrafenib resulted in a high overall response rate and was well tolerated in a small phase I/II study of pediatric BRAF V600-mutant low-grade glioma, according to results (abstract LBA19_PR) of a study presented at the European Society for Medical Oncology (ESMO) 2016 Congress, held October 7–11 in Copenhagen, Denmark.

“The likelihood of curing a child with a low-grade glioma is very high,” said author Mark Kieran, MD, PhD, of the Dana-Farber Cancer Institute and Boston Children’s Hospital, in a press release. “In fact many children don’t suffer lifelong from the tumor but rather from the cognitive damage and secondary malignancies caused by radiation therapy.”

“The development of drugs that target the specific causative mutation of the tumor and avoid long-term toxicities may revolutionize the treatment of pediatric brain cancer,” Kieran said.

According to the study, about 15% to 20% of patients with pediatric low-grade glioma have BRAF V600 mutations. These patients are known to have poorer survival and lower objective response rates. This was the first study to look at dabrafenib, an inhibitor of V600-mutant form of the BRAF kinase, in pediatric glioma.

The trial included 32 patients aged 2 to 17 with BRAF V600-mutant relapsed or refractory disease. Fifteen participants were in the phase I trial and 17 were in phase II. Four dose levels were tested in phase I up to and including the recommended phase II dose of 4.5 mg/kg/day in patients aged 12 or older, and 5.25 mg/kg/day in patients aged younger than 12, divided into two equal doses per day.

The investigator confirmed overall response rate was 72%, with 1 patient achieving a complete response and 22 achieving a partial response. In 2 patients the tumor disappeared and in 11 patients the tumor shrunk by more than 50%. Eight patients remain on therapy. Additionally, 13 patients had stable disease lasting 6 months of longer; 11 of these patients remain on therapy.

Adverse events with dabrafenib were similar to those in adults, with frequent low-grade pyrexia, vomiting, fatigue, headache, and rash. The most frequent grade 3/4 adverse event was pneumonia.

Studies in adults with BRAF V600E mutations have shown that combining a BRAF inhibitor with a MEK inhibitor reduces toxicity and produces more activity for a longer period of time.

“We want to make the response rate with dabrafenib even higher by combining it with a MEK inhibitor since that works in adults,” Kieran said. “Adding two drugs together normally produces twice as much toxicity. But much of the toxicity from the BRAF drug is inhibited by the MEK drug, so the combination is less toxic than either drug alone, which is unusual.”

Commenting on the findings, Michael Weller, MD, chairman of the department of neurology at the University Hospital Zurich in Switzerland, said: “The encouraging thing about this study is that this targeted treatment seems to work. At the moment in neuro-oncology we know almost everything about the molecular make-up of gliomas in adults and in children but we have not really been able to translate all this knowledge into an effective therapeutic agent.”

“These findings will have implications for clinical practice because many parents are willing to travel all around the world to get access to a promising treatment,” he continued. “We have almost no randomized data for brain tumors in children, at least for gliomas, because the tumors are too rare and the trials are difficult for ethical reasons.”