Convection-Enhanced Delivery of 124I-Omburtamab for Patients With Non-Progressive Diffuse Pontine Gliomas Previously Treated With External Beam Radiation Therapy
Condition: Brain Cancer; Brain Stem Glioma
MeSH terms: Glioma; Brain Neoplasms
Study type: Interventional
Phase: Phase 1

Summary: 
      The purpose of this study is to test the safety of a new method to treat Diffuse Intrinsic
      Pontine Glioma (DIPG). The researchers will use "convection-enhanced delivery" (CED) to
      deliver an agent called 124I-omburtamab. CED is performed during surgery. The study agent is
      infused through a small tube placed into the tumor in the brain. Many studies have shown this
      can safely be done in animals but this study is the first time 124I-omburtamab will be given
      by CED in humans. This will be one of the first times that CED has been performed in the
      brain stem.

      Omburtamab is something called an antibody. Antibodies are made by the body to fight
      infections and sometimes cancer. The antibody omburtamab is produced by mice and can attack
      many kinds of tumors. A radioactive substance, 124I-omburtamab, is attached to omburtamab.
      124I-omburtamab sticks to parts of tumor cells and can cause the tumor cells to die from
      radiation. Studies have also been done on humans using 124I-omburtamab to treat other kinds
      of cancer. Our studies of some DPG and related tumors suggest that omburtamab will bind to
      the tumor, but the investigators don't know that for sure.

      In this study, the researchers want to find out how safe 124I-omburtamab given by CED is at
      different dose levels. They will look to see what effects (both good and bad) it has on the
      patient. The dose of 124I-omburtamab will increase for each new group of patients. The
      procedure has already been safely performed with lower doses and infusion volumes in a number
      of patients here at MSKCC. The amount they get will depend on when they enter the study. If
      too many serious side effects are seen with a certain dose, no one will be treated with a
      higher dose, and some more patients may be treated with a lower dose to make sure that dose
      is safe.
    


Intervention name(s): Radioactive iodine-labeled monoclonal antibody omburtamab; External Beam Radiotherapy
Intervention type(s): Drug; Radiation
Intervention description(s): Prior to treatment children will be pre-medicated with super-saturated potassium iodide & liothyronine to prevent thyroid uptake of the therapeutic radioisotopes. The proposed intervention is a surgical procedure using interstitial infusion of the radiolabeled monoclonal antibody 124I-omburtamab into the brain stem tumor. This will be performed by stereotactic placement of a small caliber infusion cannula into the tumor followed by a slow infusion (CED) of 124I-omburtamab. Following treatment, these children will be monitored during inpatient hospitalization with clinical evaluations & PET/CT or PET/MRI scans of the brain & other organs. Clinical observations, intensive care unit monitoring, routine blood & interval imaging studies (MRI & PET/CT or PET/MRI scans) will be performed at predetermined time points. If the PET/CT scan happens to fall on a weekend or holiday, the scan may be done before or after at the discretion of the Study PI. This will not affect dosimetry interpretation.; Standard radiation therapy is given 4-6 weeks prior to study entry.
Intervention MeSH terms: Antibodies; Antibodies, Monoclonal
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Brain stem glioma; CNS; MAB 124I-omburtamab; infusion cannula; DIPG; Diffuse Intrinsic Pontine Glioma; 11-011