Phase 1 Study of Tarceva and Rapamycin For Recurrent Low-Grad Gliomas in Children With or Without Neurofibromatosis Type 1 (NF1)
- children less than 21 years of age, with or without neurofibromatosis, with recurrent
- patients with or without NF1 must have failed some form of conventional therapy,
radiotherapy, or chemotherapy (carboplatin/vincristine) to be eligible, including
those treated wtih initial surgery. Patients do not have to have received
radiotherapy to be eligible.
- children with all types of histologically proven low-grade gliomas will be eligible;
re-operation at the time of recurrence is not mandatory for entry on study.
- patients with intrinsic brain lesions, believed neuroradiographically consistent with
a low-grade glial tumor, with neurofibromatosis type 1 can be treated without
- patients without neurofibromatosis type 1 must have histological confirmation of a
low-grade glial tumor prior to entry on study.
- patients must have a Karnofsky score of greater than or equal to 50% for children
greater than 10 years of age, or a Lansky score of greater than or equal to 50% for
patients less than 10 years of age.
- patients who are unable to walk because of paralysis, but who are able to use a
wheelchair, will be considered ambulatory for purposes of assessing performance
- patients must have a life expectancy of at least 12 weeks.
- patients must be able to swallow medication in tablet form.
- patients must have adequate organ function, including: peripheral ANC of greater than
1,000/microliters; a platelet count of greater than 100,000/microliters; hemoglobin
of greater than 8 gms,dl (pRBC transfusions of allowed to maintain hemoglobin > 8
- patients must have adequate renal function, which is defined as a normal serum
creatinine for age
- patients must have adequate liver function, as defined as a total bilirubin or less
than 1.5 times the upper limit of normal for age, and an SGPT (ALT) of less than 2.5
times the upper limit of normal for age
- patients must have had a MR scan within 3 weeks of starting treatment
- all patients, and/or their parents or legal guardian, must sign a recent informed
- all institutional, FDA, and NCI requirements for human study must be met.
- patients must not have any other active tumors.
- pregnancy or breast feeding is an exclusion criteria, as the potential mutagenicity
and cytotoxicity of these drugs in developing fetuses are unknown. A pregnancy test
must be obtained in females who are postmenarchal. Males or females of reproductive
potential may not participate unless they have agreed to use an effective
- patients with uncontrolled infection are excluded.
- patients who have previously received Tarceva or Rapamycin are excluded.
- patients on antiepileptics and/or corticosteroids are allowed on study as long as
they have been on a stable or weaning dose for 7 days prior to study initiation
(defined as first day of treatment).