Phase I Clinical Trial of Rapamycin and Irinotecan in Pediatric Patients With Refractory Solid Tumors
Inclusion Criteria:
- Age >= 1 year old and =< 21 years old;
- Refractory solid tumors, histologically proven at diagnosis (no additional biopsy
needs to be performed for the purpose of the study);
- Relapsed or refractory solid tumors after standard treatment or phase II, III-IV
clinical trials treatment have failed;
- Karnofsky or Lansky status >= 70%;
- Life expectancy >= 8 weeks;
- No chemotherapy / radiotherapy within 4 weeks before entry into the study;
- Adequate biological parameters :
- Absolute neutrophil count >= 1.0 x 109/L;
- Platelet count >= 100 x 109/L;
- Hemoglobin >= 8 mg/dL;
- Total bilirubine =< 1.5 ULN;
- Transaminases =< 2.5 ULN (=< 5 ULN in case of liver metastases);
- Creatinine clearance (Cockroft) >= 70 mL/min/1.73 m2;
- Normal coagulation profile with prothrombin >= 70%, TCA =< 35 and fibrinogen >=
2 g/L;
- Patients with 1 to 3 previous therapeutic lines are eligible;
- No current grade >= 2 organ toxicity based on NCI-CTCAE version 3.0;
- All patients with reproductive potential must have an effective method of birth
control while on study;
- Negative pregnancy test in females when indicated;
- Informed written consent signed by patients or their parents or legal guardians;
- Patient who was informed of the results of prior medical consultation;
- Patient having a social insurance.
Exclusion Criteria:
- Patient with a constitutional anomaly of coagulation and/or of hemostasis (type
hemophilia, von Willebrand disease, congenital clotting factor deficit, platelet
disorder), exposing them to increased risk of bleeding;
- Pre-treatment with a mTOR inhibitor;
- Other simultaneous malignancy;
- Concurrent administration of any other anti-tumour therapy;
- Known hypersensitivity or contraindication to study drugs or ingredients;
- Severe concomitant disease (e.g. infection disease);
- Patient unable for medical follow-up;
- Pregnancy and/or lactation;
- Patient included in another clinical drug trial;
- Patient taking drugs interfering with pharmacology of rapamycin and/or irinotecan
(e.g. drugs interfering with CYP3A4);
- Patient under judicial protection.