NCT00309907

Brief Summary

This phase II trial is studying how well etanercept works in treating young patients with idiopathic pneumonia syndrome after undergoing a donor stem cell transplant. Etanercept may be effective in treating patients with idiopathic pneumonia syndrome after undergoing a donor stem cell transplant.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
39

participants targeted

Target at P25-P50 for phase_2

Timeline
Completed

Started Apr 2006

Longer than P75 for phase_2

Geographic Reach
1 country

26 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 29, 2006

Completed
3 days until next milestone

Study Start

First participant enrolled

April 1, 2006

Completed
2 days until next milestone

First Posted

Study publicly available on registry

April 3, 2006

Completed
5.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2011

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2011

Completed
2.5 years until next milestone

Results Posted

Study results publicly available

February 14, 2014

Completed
Last Updated

September 29, 2017

Status Verified

February 1, 2017

Enrollment Period

5.4 years

First QC Date

March 29, 2006

Results QC Date

January 6, 2014

Last Update Submit

September 1, 2017

Conditions

Outcome Measures

Primary Outcomes (1)

  • Response of IPS (Idiopathic Pneumonia Syndrome) to Etanercept Plus Corticosteroid Therapy by Day 28.

    Response to therapy is defined as survival to Day 28 of study, PLUS complete discontinuation all supplemental oxygen support by Day 28 of study. Subjects must be able to remain off all supplemental oxygen support for \> 72 consecutive hours. Subjects who discontinue supplemental oxygen within the last 72 hours of the observation period will be followed until they have completed 72 consecutive hours off oxygen or failed prior to assessing response.

    At day 28

Secondary Outcomes (5)

  • Survival Rate

    Up to day 56

  • Estimate Percentage Pulmonary Response in Patients With IPS Treated With Etanercept + Corticosteroid Therapy

    up to day 56

  • Toxicity of Etanercept Plus Corticosteroid Therapy Using the Common Terminology Criteria Version 4.0

    Up to 56 days

  • Plasma Cytokine IL6 Level

    From baseline to days 7 and 28

  • C-reactive Protein Levels

    From baseline to days 7, 14, 21, and 28

Study Arms (1)

Etanercept and corticosteroid therapy

EXPERIMENTAL

Patients receive etanercept IV (dose 0.4 mg/kg- max 25 mg) over 30 minutes on day 0 and subcutaneously (dose 0.4 mg/kg- max 25 mg) on days 3, 7, 10, 14, 17, 21, and 24. Treatment continues in the absence of an infectious pathogen, disease progression, or unacceptable toxicity. Patients also receive methylprednisolone (or corticosteroid equivalent) IV (dose 2.0 mg/kg/day) on days 0-2 and then orally with a taper beginning day 7. Dose on days 7-20 (1.0 mg/kg/day), days 21-34 (0.5 mg/kg/day), days 35-48 (0.25 mg/kg/day) and days 49-56 (0.25 mg/kg/every other day) discontinuing on day 56.

Biological: etanerceptDrug: methylprednisolone

Interventions

etanerceptBIOLOGICAL

Given IV and subcutaneously

Also known as: Enbrel, ETN, TNFR:Fc, Tumor Necrosis Factor Receptor IgG Chimera
Etanercept and corticosteroid therapy

Given IV and orally

Also known as: Depo-Medrol, Medrol, MePRDL, Solu-Medrol, Wyacort
Etanercept and corticosteroid therapy

Eligibility Criteria

Age1 Year - 17 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • Diagnosis of acute, noninfectious idiopathic pulmonary dysfunction (IPS) as defined by the following:
  • Evidence of diffuse lung injury occurring within the first several months after hematopoietic stem cell transplantation for which an infectious etiology is not identified. To meet the criteria for IPS there must be:
  • Evidence of widespread alveolar injury
  • Diffuse multi-lobar infiltrates on chest x-ray or CT scan
  • Evidence for abnormal respiratory physiology based upon 1 of the following:
  • Room air oxygen saturation \< 93%
  • Supplemental oxygen required to maintain an oxygen saturation ≥ 93%
  • Absence of active lower respiratory tract infection, defined as Bronchoalveolar lavage (BAL)-negative for infection based on one of the following:
  • Gram stain, fungal stain, acid-fast bacilli stain
  • Bacterial culture (a quantitative culture ≥ 10\^4 colony-forming units/mL is considered positive)
  • Fungal culture
  • Mycobacterial culture
  • Viral culture (respiratory syncytial virus \[RSV\], parainfluenza, adenovirus, influenza A and B, and cytomegalovirus \[CMV\])
  • If direct fluorescent antibody (DFA) screening is performed on BAL, it must be negative for all viruses listed above
  • Pneumocystis carinii pneumonia by polymerase chain reaction (PCR), DFA stain, or cytology
  • +26 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (26)

University of Alabama at Birmingham

Birmingham, Alabama, 35294, United States

Location

Children's Oncology Group

Arcadia, California, 91006-3776, United States

Location

Loma Linda University Medical Center

Loma Linda, California, 92354, United States

Location

Children's Hospital Colorado

Aurora, Colorado, 80045, United States

Location

Children's National Medical Center

Washington D.C., District of Columbia, 20010, United States

Location

All Children's Hospital

St. Petersburg, Florida, 33701, United States

Location

Children's Healthcare of Atlanta - Egleston

Atlanta, Georgia, 30322, United States

Location

Childrens Memorial Hospital

Chicago, Illinois, 60614, United States

Location

Indiana University Cancer Center

Indianapolis, Indiana, 46202, United States

Location

Indiana University Medical Center

Indianapolis, Indiana, 46202, United States

Location

Children's Hospital-Main Campus

New Orleans, Louisiana, 70118, United States

Location

Johns Hopkins University

Baltimore, Maryland, 21287-8936, United States

Location

C S Mott Children's Hospital

Ann Arbor, Michigan, 48109, United States

Location

University of Nebraska Medical Center

Omaha, Nebraska, 68198, United States

Location

Hackensack University Medical Center

Hackensack, New Jersey, 07601, United States

Location

Columbia University Medical Center

New York, New York, 10032, United States

Location

New York Medical College

Valhalla, New York, 10595, United States

Location

Oregon Health and Science University

Portland, Oregon, 97239, United States

Location

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, 19104, United States

Location

Children's Hospital of Pittsburgh of UPMC

Pittsburgh, Pennsylvania, 15224, United States

Location

Medical University of South Carolina

Charleston, South Carolina, 29425, United States

Location

University of Texas Southwestern Medical Center

Dallas, Texas, 75390, United States

Location

Cook Children's Medical Center

Fort Worth, Texas, 76104, United States

Location

Methodist Children's Hospital of South Texas

San Antonio, Texas, 78229, United States

Location

Seattle Children's Hospital

Seattle, Washington, 98105, United States

Location

Midwest Children's Cancer Center

Milwaukee, Wisconsin, 53226, United States

Location

MeSH Terms

Conditions

Leukemia, Myeloid, Accelerated PhaseBlast CrisisLeukemia, Myeloid, Chronic-PhaseLeukemia, Myelomonocytic, JuvenilePrecursor Cell Lymphoblastic Leukemia-LymphomaDendritic Cell Sarcoma, InterdigitatingBurkitt LymphomaNeuroblastomaWilms TumorRecurrence

Interventions

EtanerceptMethylprednisoloneMethylprednisolone AcetateMethylprednisolone Hemisuccinate

Condition Hierarchy (Ancestors)

Leukemia, Myelogenous, Chronic, BCR-ABL PositiveLeukemia, MyeloidLeukemiaNeoplasms by Histologic TypeNeoplasmsMyeloproliferative DisordersBone Marrow DiseasesHematologic DiseasesHemic and Lymphatic DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and SymptomsCell Transformation, NeoplasticCarcinogenesisNeoplastic ProcessesMyelodysplastic-Myeloproliferative DiseasesLeukemia, LymphoidLymphoproliferative DisordersLymphatic DiseasesImmunoproliferative DisordersImmune System DiseasesHistiocytic Disorders, MalignantHistiocytosisEpstein-Barr Virus InfectionsHerpesviridae InfectionsDNA Virus InfectionsVirus DiseasesInfectionsTumor Virus InfectionsLymphoma, B-CellLymphoma, Non-HodgkinLymphomaNeuroectodermal Tumors, Primitive, PeripheralNeuroectodermal Tumors, PrimitiveNeoplasms, NeuroepithelialNeuroectodermal TumorsNeoplasms, Germ Cell and EmbryonalNeoplasms, Glandular and EpithelialNeoplasms, Nerve TissueNeoplasms, Complex and MixedKidney NeoplasmsUrologic NeoplasmsUrogenital NeoplasmsNeoplasms by SiteNeoplastic Syndromes, HereditaryFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesKidney DiseasesUrologic DiseasesMale Urogenital DiseasesGenetic Diseases, InbornCongenital, Hereditary, and Neonatal Diseases and Abnormalities

Intervention Hierarchy (Ancestors)

Immunoglobulin Fc FragmentsImmunoglobulin FragmentsPeptide FragmentsPeptidesAmino Acids, Peptides, and ProteinsImmunoglobulin Constant RegionsImmunoglobulinsImmunoproteinsBlood ProteinsProteinsSerum GlobulinsGlobulinsReceptors, Tumor Necrosis FactorReceptors, CytokineReceptors, ImmunologicReceptors, Cell SurfaceMembrane ProteinsPrednisolonePregnadienetriolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic Compounds

Results Point of Contact

Title
Results Reporting Coordinator
Organization
Children's Oncology Group

Study Officials

  • Gregory Yanik, MD

    Children's Oncology Group

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 2
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
NETWORK
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 29, 2006

First Posted

April 3, 2006

Study Start

April 1, 2006

Primary Completion

September 1, 2011

Study Completion

September 1, 2011

Last Updated

September 29, 2017

Results First Posted

February 14, 2014

Record last verified: 2017-02

Locations