This clinical trial studies the side effects and best dose of pembrolizumab and to see how well it works in treating younger patients with high-grade gliomas (brain tumors) or diffuse intrinsic pontine gliomas (brain stem tumors) that have come back, progressed, or have not responded to previous treatment. Monoclonal antibodies, such as pembrolizumab, may block tumor growth in different ways by targeting certain cells.
Primary Objectives:
To establish the safety and describe adverse effects associated with administration of the adult recommended dose of pembrolizumab (MK-3475) in children with recurrent, progressive or refractory non-brainstem high grade glioma (NB-HGG) and diffuse intrinsic pontine glioma (DIPG).
To estimate the sustained objective response rate, (complete response [CR] + partial response [PR], sustained for at least 9 weeks) associated with pembrolizumab (MK-3475) treatment for pediatric patients with recurrent, progressive or refractory NB-HGG or DIPG.
Secondary Objectives:
To assess the relationship between outcome (response and progression-free survival [PFS]) and potential biomarkers, including programmed cell death (PD)-ligand 1 (L1) expression, patient immunophenotype, ribonucleic acid (RNA) signature profile, and tumor gene expression profile.
To estimate the duration of objective response, progression-free/event-free survival and document overall survival for patients with NB-HGG and DIPG treated with pembrolizumab (MK-3475).
To evaluate PD-L1 expression on archival tissue obtained from patients with non-brainstem high-grade glioma.
To examine the ability of quantitative magnetic resonance (MR) spectroscopy and diffusion/weighted imaging/apparent diffusion coefficient (ADC) mapping to provide early assessment of tumor behavior and specifically distinguish pseudoprogression from true progression.
To explore the use of serial MR permeability (dynamic contrast-enhanced [DCE]) and MR perfusion (dynamic susceptibility contrast [DSC]) to determine if elevated relative cerebral blood volume (rCBV) and transfer coefficient (ktrans) can distinguish pseudoprogression from true progression in tumors treated on this protocol.
Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Inclusion Criteria:
Tumor
Exclusion Criteria:
Concurrent illness
Cincinnati Children’s Hospital Medical Center
Division of Hematology/Oncology
3333 Burnet Ave.
Cincinnati, OH 45223-3039
Phone: 513-636-2799
cancer@cchmc.org