DFMO as Maintenance Therapy for Molecular High/Very High Risk and Relapsed Medulloblastoma

NCT ID: NCT04696029

Last Updated: 2025-05-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

118 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-03-29

Study Completion Date

2029-03-31

Brief Summary

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Difluoromethylornithine (DFMO) will be used in an open label, multicenter, study as Maintenance Therapy for Molecular High Risk/Very High Risk and Relapsed/Refractory Medulloblastoma.

Detailed Description

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In this study subjects will receive 730 Days of oral difluoromethylornithine (DFMO) at a dose of 2500 mg/m2 BID on each day of study.

Subjects will be evaluated in 3 Cohorts:

Cohort 1: Molecular High Risk Medulloblastoma Cohort 2: Molecular Very High Risk Medulloblastoma Cohort 3: Relapsed/Refractory Medulloblastoma

A total of 118 subjects across all cohorts will be enrolled to ensure that there will be 107 evaluable subjects (32-39 per cohort)

Conditions

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Medulloblastoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Difluoromethylornithine (DFMO)

study subjects will receive 730 Days of oral difluoromethylornithine (DFMO) at a dose of 2500 mg/m2 BID on each day of study.

Group Type EXPERIMENTAL

Difluoromethylornithine

Intervention Type DRUG

DFMO (difluoromethylornithine is an inhibitor of ornithine decarboxylase (ODC) designated chemically as 2-(difluoromethyl)-DL-ornithine monohydrochloride monohydrate.

The dosage form to be used in this study is provided as a convex tablet containing 192 mg eflornithine (equivalent to 250 mg of eflornithine HCl, monohydrate). The tablets are packaged and sealed in opaque white HDPE bottles, and each bottle contains 100 tablets. The DMFO tablets are supplied by USWorldMeds (USWM).

The tablets are to be stored at room temperature (20-250C).

Interventions

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Difluoromethylornithine

DFMO (difluoromethylornithine is an inhibitor of ornithine decarboxylase (ODC) designated chemically as 2-(difluoromethyl)-DL-ornithine monohydrochloride monohydrate.

The dosage form to be used in this study is provided as a convex tablet containing 192 mg eflornithine (equivalent to 250 mg of eflornithine HCl, monohydrate). The tablets are packaged and sealed in opaque white HDPE bottles, and each bottle contains 100 tablets. The DMFO tablets are supplied by USWorldMeds (USWM).

The tablets are to be stored at room temperature (20-250C).

Intervention Type DRUG

Other Intervention Names

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Eflornithine DFMO

Eligibility Criteria

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Inclusion Criteria

1. Age: 0-21 years of age at diagnosis
2. Pathology All patients must either have a pathologically confirmed diagnosis of medulloblastoma with molecular grouping identified by either Nanostring or methylation profiling.

Cohort 1- Molecular High Risk:
* Metastatic non-MYC amplified Group 3
* Metastatic Group 4
* Metastatic non-WNT/non-SHH (Must be non-MYC amplified)

Cohort 2- Molecular Very High Risk
* Metastatic OR MYCN amplified OR TP53 mutant non-infant (\>3 yrs) SHH
* MYC amplified Group 3
* Non-WNT, non-SHH infant (\< 3 yrs)

Cohort 3: Relapsed/Refractory Medulloblastoma
3. Pre-enrollment tumor survey:

Prior to enrollment on this study, a determination of mandatory disease staging must be performed:
* Tumor imaging studies including: Brain and spine MRI
* Lumbar Puncture only if previously positive
* Bone Marrow aspiration/biopsy only if previously positive
* This disease assessment is required for eligibility and preferably should be done within 2 weeks prior to first dose of study drug, but must be done within a maximum of 4 weeks before first dose of study drug.
4. Disease Status: Subjects must have no evidence of disease, or stable\* residual nonbulky\*\* disease.

\*Stable residual disease defined as non-progression over 2 separate imaging studies at least 6 weeks apart

\*\*Non-bulky disease defined as maximal cross-sectional area \< 3cm\^2 at enrollment. Patients with leptomeningeal disease are allowed to participate on study.
5. Timing from prior therapy:

Enrollment (first dose of DFMO) no later than 60 days after last dose of conventional chemotherapy. Patients who have undergone high dose chemotherapy (HDCT) with autologous stem cell transplantation (SCT) are eligible if more than 45 days have elapsed since date of last SCT.
6. Patients must have a Lansky or Karnofsky Performance Scale score of ≥ 50% (see Appendix II) and patients must have a life expectancy of ≥ 2 months.
7. All clinical and laboratory studies for organ functions to determine eligibility must be performed within 7 days prior to first dose of study drug unless otherwise indicated below.
8. Patients must have adequate organ functions at the time of registration:

* Hematological: Hematological recovery as defined by ANC ≥750/μL, platelets ≥30 (non-transfused x 7 days)
* Liver: Adequate liver function as defined by AST and ALT \<10x upper limit of normal
* Renal: Adequate renal function defined as (perform one of the following): Creatinine clearance or radioisotope GFR ≥ 70 mL/min/1.73 m2 or a serum creatinine based on age/gender
9. Females of childbearing potential must have a negative pregnancy test. Patients of childbearing potential must agree to use an effective birth control method. Female patients who are lactating must agree to stop breast-feeding.
10. Written informed consent in accordance with institutional and FDA guidelines must be obtained from all subjects (or patients' legal representative).

Exclusion Criteria

1. BSA of \<0.25 m2
2. Metastatic disease outside of CNS
3. Relapsed/refractory patients who are radiation-naïve and age 5 years or older at time of enrollment
4. Investigational Drugs: Subjects who are currently receiving another investigational drug are excluded from participation.
5. Anti-cancer Agents: Subjects who are currently receiving other anticancer agents are not eligible. Subjects must have fully recovered from the hematological and bone marrow suppression effects of prior chemotherapy.
6. Infection: Subjects who have an uncontrolled infection are not eligible until the infection is judged to be well controlled in the opinion of the investigator.
7. Subjects who, in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study, or in whom compliance is likely to be suboptimal, should be excluded.
Maximum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Giselle Sholler

OTHER

Sponsor Role lead

Responsible Party

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Giselle Sholler

Beat Childhood Cancer Chair

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Michael A Huang, MD

Role: STUDY_CHAIR

Beat Childhood Cancer at Atrium Health

Locations

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Arkansas Children's Hospital

Little Rock, Arkansas, United States

Site Status RECRUITING

UCSF Benioff Children's Hospital Oakland-

Oakland, California, United States

Site Status RECRUITING

Rady Children's Hospital

San Diego, California, United States

Site Status RECRUITING

Connecticut Children's Hospital

Hartford, Connecticut, United States

Site Status NOT_YET_RECRUITING

Arnold Palmer Hospital for Children

Orlando, Florida, United States

Site Status RECRUITING

St. Joseph's Children's Hospital

Tampa, Florida, United States

Site Status RECRUITING

Kentucky Children's Hospital

Lexington, Kentucky, United States

Site Status RECRUITING

University of Louisville/Norton's Children's

Louisville, Kentucky, United States

Site Status RECRUITING

Children's Mercy Hospitals and Clinics

Kansas City, Missouri, United States

Site Status RECRUITING

Cardinal Glennon Children's Medical Center

St Louis, Missouri, United States

Site Status NOT_YET_RECRUITING

Hackensack University Medical Center

Hackensack, New Jersey, United States

Site Status RECRUITING

Levine Children's Hospital

Charlotte, North Carolina, United States

Site Status RECRUITING

Penn State Milton S. Hershey Medical Center and Children's Hospital

Hershey, Pennsylvania, United States

Site Status RECRUITING

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status RECRUITING

Dell Children's Blood and Cancer Center

Austin, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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BCC Enroll

Role: CONTACT

7175310003

Facility Contacts

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Susan Hall

Role: primary

501-364-2760

Group Contact

Role: primary

Franchesca Ramirez

Role: primary

858-966-8155

Nicole McCracken

Role: primary

860-545-9337

Marie Frankos

Role: primary

321-841-8588

Jennifer Manns

Role: primary

Brittany Fuller

Role: primary

Jennifer Miller

Role: primary

Michael A Huang, MD

Role: backup

502.852.8450

Nicole Harvey

Role: primary

816-302-6893

Gina Martin, RN

Role: primary

314-268-4000

Sherri Mayans

Role: primary

Jontyce Green

Role: primary

980-442-2356

Suzanne Treadway

Role: primary

Shanta Salzar, MD

Role: primary

843-792-2957

Rhea Robinson, RN

Role: primary

512-628-1902

Related Links

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http://www.beatcc.org

Beat Childhood Cancer Consortium website

Other Identifiers

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BCC016

Identifier Type: -

Identifier Source: org_study_id

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