Combination Therapy of Antibody Hu3F8 With Granulocyte- Macrophage Colony Stimulating Factor (GM-CSF) in Patients With Relapsed/Refractory High-Risk Neuroblastoma

Prior treatment

• Positive human anti-hu3F8 antibody (HAHA) titer

Other illness

• Active life-threatening infection.
• History of allergy to mouse proteins.

Lab values

• Existing major organ dysfunction \> grade 2, with the exception of hearing loss and hematologic toxicity (defined as suppression of all subtypes of WBCs, RBCs, and platelets).

Other

• Pregnant women or women who are breast-feeding.
• Inability to comply with protocol requirements, including PK studies and genetic studies (phase I only)

• Diagnosis of NB as defined by a) histopathology (confirmed by the MSKCC Department of Pathology), or b) BM metastases or MIBG-avid lesion(s) plus high urine catecholamine levels.
• Patients must have high-risk NB (including MYCNamplified stage 2/3/4/4S of any age and MYCN-nonamplified stage 4 in patients greater than 18 months of age) AND:
• Phase I: Patients must have refractory or relapsed NB, resistant to standard therapy\*.
  • \*For NB, standard therapy includes intensive induction chemotherapy, followed by a variety of consolidation or salvage therapies, depending on response.
• Phase II: Patients must have primary or secondary refractory disease in BM, defined as morphologic evidence of NB in BM and/or abnormal 123I-MIBG uptake in osteomedullary sites, OR patients patients in ≥ 2nd CR patients are in ≥2nd CR
• Patients must be older than 1 year of age.
• Prior treatment with murine and humanized 3F8 is allowed. Patients with prior m3F8, hu3F8, ch14.18 or hu14.18 treatment must have a negative HAHA antibody titer. Human anti-mouse antibody (HAMA) positivity is allowed.
• White blood cell count ≥1000/ul (phase I only)
• Absolute neutrophil count ≥500/ul (phase I only)
• Absolute lymphocyte count ≥500/ul (phase I only)
• Platelet count ≥25,000/ul (phase I only)
• No chemotherapy or immunotherapy for a minimum of three weeks prior to start of hu3F8
• Women of child-bearing potential must be willing to practice an effective method of birth control while on treatment
• Signed informed consent indicating awareness of the investigational nature of this program.