oxaliplatin in treating children with recurrent or refractory medulloblastoma, supratentorial primitive neuroectodermal tumor, or atypical teratoid rhabdoid tumor

Conditions: Brain and Central Nervous System Tumors

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. purpose: phase ii trial to study the effectiveness of oxaliplatin in treating children who have recurrent or refractory medulloblastoma, supratentorial primitive neuroectodermal or atypical teratoid rhabdoid tumor.

objectives: * estimate the objective response rate to oxaliplatin in pediatric patients with recurrent or refractory medulloblastoma at first progression. * estimate the objective response rate to oxaliplatin in pediatric patients with recurrent or refractory medulloblastoma at second or later relapse. * estimate the objective response rate to oxaliplatin in pediatric patients with recurrent or refractory supratentorial primitive neuroectodermal tumor, or atypical teratoid rhabdoid tumor. * describe the pharmacokinetics of this drug in these patients. outline: this is a multicenter study. patients are stratified according to tumor type (medulloblastoma \[measurable disease at first relapse vs positive cerebrospinal fluid or linear leptomeningeal disease vs measurable disease at second or later progression\] vs supratentorial primitive neuroectodermal tumor vs atypical teratoid rhabdoid tumor). patients receive oxaliplatin iv over 2 hours on day 1. treatment repeats every 21 days for up to 17 courses (1 year) in the absence of disease progression or unacceptable toxicity. projected accrual: a total of 65 patients will be accrued for this study within 1.5-2.8 years.

Eligibility criteria:
disease characteristics: * histologically confirmed medulloblastoma, supratentorial primitive neuroectodermal tumor (including pineoblastomas and ependymoblastomas), or atypical teratoid rhabdoid tumor * recurrent or refractory disease * measurable disease by radiography * patients with positive cerebrospinal fluid cytology or linear leptomeningeal disease are eligible patient characteristics: age * 21 and under performance status * karnofsky 50-100% or * lansky 50-100% life expectancy * not specified hematopoietic * absolute neutrophil count at least 1,000/mm\^3 * platelet count at least 100,000/mm\^3 (transfusion independent) * hemoglobin at least 8.0 g/dl (rbc transfusions allowed) hepatic * bilirubin no greater than 1.5 times normal * alt less than 2.5 times normal renal * creatinine no greater than 1.5 times normal or * creatinine clearance or radioisotope glomerular filtration rate at least 70 ml/min cardiovascular * shortening fraction at least 27% by echocardiogram or * ejection fraction at least 50% by muga pulmonary * no dyspnea at rest * no exercise intolerance * pulse oximetry greater than 94% other * no uncontrolled infection * no active graft-versus-host disease * no uncontrolled seizure disorders * seizure disorders well controlled with anticonvulsants allowed * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception prior concurrent therapy: biologic therapy * at least 2 weeks since prior growth factors * at least 6 months since prior allogeneic stem cell transplantation * no concurrent colony-stimulating factors during the first course of study * no concurrent immunomodulating agents chemotherapy * at least 3 weeks since prior myelosuppressive therapy (6 weeks for nitrosoureas) and recovered * no other concurrent anticancer chemotherapy endocrine therapy * if concurrent corticosteroids necessary for intracranial pressure, must be on stable or decreasing dose for at least 1 week prior to study * no other concurrent corticosteroids radiotherapy * at least 2 weeks since prior local palliative radiotherapy (small port) to symptomatic metastatic sites * at least 3 months since prior craniospinal radiotherapy * no concurrent palliative radiotherapy * recovered from prior radiotherapy surgery * not specified other * no other concurrent anticancer or experimental drugs

Keywords: recurrent childhood medulloblastoma recurrent childhood supratentorial primitive neuroectodermal tumor recurrent childhood ependymoma childhood atypical teratoid/rhabdoid tumor