Phase II Trial of Deflexifol for Refractory or Recurrent Paediatric Central Nervous System (CNS) Tumours

Inclusion Criteria18

• Written informed consent.
• Patients must be greater than 12 months and less than or equal to 21 years of age at the time of study enrolment.
• Patient must have ependymoma that is recurrent or refractory, previously treated with irradiation therapy, with no known curative therapies or therapy proven to prolong survival with an acceptable quality of life.
• Only patients with measurable disease as per RAPNO are eligible.
• Karnofsky performance status greater than or equal to 50 for patients above 16 years old; or Lansky performance status greater than or equal to 50 for patients less than or equal to 16 years old. Patients who are not able to walk due to paralysis, but who are sitting up in a wheelchair, are considered ambulatory for the purpose of performance score assessment.
• Life expectancy of greater than 6 weeks.
• Patients receiving corticosteroids will need to be on a stable, or reducing, dose of steroids for at least one week before enrolment.
• Fully recovered from acute toxic effects of all prior anti-cancer therapy.
• a. Must not have received myelosuppressive chemotherapy within 21 days of start of study treatment (42 days if prior nitrosourea or mitomycin-C).
• b. At least 7 days after the last dose of anti-cancer agents not known to be myelosuppressive. For agents that have known adverse events occurring beyond 7 days after last administration, this period must be extended beyond the time during which adverse events are known to occur. The duration of this interval must be discussed with the study chair.
• c. At least 42 days after the completion of any type of immunotherapy, e.g. tumour vaccines.
• d. At least 21 days after the last dose of a monoclonal antibody, and toxicities related to prior antibody therapy have recovered to less than or equal to grade 1.
• e. At least 6 weeks after the completion of radiation therapy (including cranio-spinal irradiation). If palliative radiotherapy has been administered, then 2 weeks must have lapsed before the patient can commence on this trial, and this lesion cannot be used as the target lesion for assessment of treatment response.
• f. 14 days or more from last long-acting haematopoietic growth factors (e.g. pegfilgrastim) or 7 days for short acting growth factor.
• Adequate function in bone marrow, renal and liver. Blood pressure within normal range for age.
• Patient must be or have been previously enrolled in the ZERO Childhood Cancer (ZERO) precision medicine trial or program.
• Female patient of childbearing potential must have a negative serum or urine pregnancy test at screening and prior to the beginning of each cycle. They must agree to use an effective method of contraception during the study period and for six months after treatment discontinuation.
• Fertile male patients must use an effective method of contraception during the study period and for six months after treatment discontinuation.