Clinical Trials for Pediatrics | Re-MATCH: Recurrent Medulloblastoma and Primitive Neuroectodermal Tumor Adoptive T Cell Therapy during Recovery from Myeloablative Chemotherapy and Hematopoietic Stem Cell Transplantation
To evaluate the safety and effectiveness of an anti-tumor vaccine combined with activated tumor-specific white blood cells following high dose chemotherapy and stem cell transplant in pediatric patients with recurrent medulloblastoma and primitive neuroectodermal tumor (reMB/PNETs).
- Age 21 years old or younger
- Histopathologic diagnosis of local recurrent or progressive medulloblastoma/cerebral PNET
- Able to undergo surgical debulking of recurrent disease
- Failed standard radiotherapy (craniospinal + focal boost)
- Suitable candidate for high dose chemotherapy with autologous peripheral blood stem cells rescue
The treatment includes 4 parts: Surgery, Induction, Consolidation (high-dose chemotherapy) and Post-transplant Immunotherapy. During surgery, a portion of the tumor will be used to make the vaccine. During Induction, stem cells are collected from the patient through a procedure called leukapheresis. After the collection, a portion of the cells are frozen and stored to be used for regrowing the bone marrow during the Consolidation part of treatment. The remaining PBSCs are used to create the two parts of the vaccine: the activated white blood cells and multiple doses of dendritic cell vaccine, both of which are frozen and stored for future use during the Post-transplant Immunotherapy.
During Consolidation, extremely high doses of chemotherapy are given to help kill any remaining cancer cells. Some of the stem cells that were stored are given back to the patient after the high dose chemotherapy. This is called an autologous stem cell transplant.
The fourth and final part of this research study, Post-transplant Immunotherapy, begins the day following autologous stem cell transplant. The patient will receive an infusion of his/her activated tumor-specific white blood cells through a central line and a shot of the dendritic cells under the skin. The shot of dendritic cells will be given monthly and may last up to one year if the subject shows no signs of progression and vaccine is available.