Tegavivint for Recurrent or Refractory Solid Tumors in Children and Young Adults
This study is testing tegavivint, a drug given through an IV, for children and young adults (ages 12 months to 30 years) with solid tumors that have returned (recurrent) or haven't responded to other treatments (refractory). This includes certain lymphomas and desmoid tumors. Tegavivint works by blocking signals inside tumor cells that tell them to grow. Researchers want to find the safest and most effective dose of tegavivint, understand its side effects, and see if it can shrink tumors. The study is currently unclear on its recruitment status and plans to enroll 147 participants.
- Study design
- This is an interventional study, meaning participants will receive a specific treatment. It aims to enroll 147 participants, including children and young adults.
- What's involved
- You would undergo blood sample collection, DEXA scans (to measure bone density), and X-ray imaging. Tegavivint is given intravenously once weekly for 3 weeks, followed by a 1-week rest, in a 28-day cycle.
- Compensation
- Not stated in the trial record.
- Follow-up
- Researchers will track adverse events (side effects) for up to 60 months.
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NCT04851119
Tegavivint for the Treatment of Recurrent or Refractory Solid Tumors, Including Lymphomas and Desmoid Tumors
Recruiting
PHASE1Ages 12–30InterventionalTreatmentChildren's Oncology GroupGovernment-funded
~147 participants
Updated 2026-08-25 on ClinicalTrials.gov
What's tested:Biospecimen CollectionDual X-ray AbsorptiometryTegavivintX-Ray Imaging
At a glance
Recruiting sites
19 of 21 listed sites are recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Frequency of dose limiting toxicities of tegavivint
Measured over Up to 28 days
+2 more outcomes measured
Conditions
Where it's being run
21 sites across 17 statesCalifornia4
Pennsylvania2
Alabama1
Colorado1
District of Columbia1
Georgia1
Illinois1
Indiana1
Study leadership
- Sarah B Whittle · PRINCIPAL_INVESTIGATOR · Pediatric Early Phase Clinical Trial Network
Who to contact
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Do you actually qualify for this trial?
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Eligibility criteria
Inclusion
PART A: Patients must be \>= 12 months and =\< 21 years of age at the time of study enrollment
PART B: Patients must be \>= 12 months and =\< 30 years of age at the time of study enrollment
Patients with recurrent or refractory solid tumors including non-Hodgkin lymphoma and desmoid tumors are eligible. Patients must have had histologic verification of malignancy at original diagnosis or relapse
PART A: Patients with relapsed or refractory solid tumors, including patients with non-Hodgkin lymphoma and desmoid tumors
PART B: Patients with recurrent or refractory Ewing sarcoma, desmoid tumors, osteosarcoma, liver tumors (HCC and hepatoblastoma), Wilms tumor, and tumors with Wnt pathway aberrations. For the Wnt pathway aberrations cohort we will include the most common CTNNB1 mutations (S37F, S45F, T41A, S45P, S33C, S37C, D32Y, S33F, T41I, G34R, G34V, D32N, S33P, G34E, D32G) as well as any loss of function mutations in the APC, Axin2FBXW7, TCF7L2, and RNF43 genes or any gain-of-function mutations in the GSK3B, LRP6, and LGR5 genes. For patients without prior sequencing, immunohistochemistry (IHC), is required. IHC showing strong nuclear beta-catenin staining will be accepted for the following tumor types: colorectal carcinoma, melanoma, endometrial cancer, ovarian cancer, neuroblastoma, non-Hodgkin lymphoma, pancreatic ductal adenocarcinoma, and solid pseudopapillary tumor of the pancreas
PART A: Patients must have either measurable or evaluable disease. For desmoid tumors, the patient must have disease that the investigator deems unresectable or sufficiently morbid or potentially life-threatening that there is favorable risk/benefit to the patient to participate in the trial
PART B: Patients must have measurable disease. For desmoid tumors, the patient must have measurable disease that the investigator deems unresectable or sufficiently morbid or potentially life-threatening that there is favorable risk/benefit to the patient to participate in the trial
Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1 or 2. Use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age
Patients must have fully recovered from the acute toxic effects of all prior anti-cancer therapy and must meet the following minimum duration from prior anti-cancer directed therapy prior to enrollment. If after the required timeframe, the numerical eligibility criteria are met, e.g., blood count criteria, the patient is considered to have recovered adequately.
Cytotoxic chemotherapy or other anti-cancer agents known to be myelosuppressive
Solid tumor patients: \>= 21 days after the last dose of myelosuppressive chemotherapy (42 days if prior nitrosourea)
Non-Hodgkin lymphoma patients
A waiting period prior to enrollment is not required for patients receiving standard maintenance chemotherapy (i.e., corticosteroid, vincristine, thioguanine \[6MP\], and/or methotrexate)
\>= 14 days must have elapsed after the completion of other cytotoxic therapy, with the exception of hydroxyurea, for patients not receiving standard maintenance therapy
NOTE: Cytoreduction with hydroxyurea must be discontinued \>= 24 hours prior to the start of protocol therapy
Anti-cancer agents not known to be myelosuppressive (e.g., not associated with reduced platelet or absolute neutrophil counts \[ANC\]): \>= 7 days after the last dose of agent
Antibodies: \>= 21 days must have elapsed from infusion of last dose of antibody, and toxicity related to prior antibody therapy must be recovered to grade =\< 1
Corticosteroids: If used to modify immune adverse events related to prior therapy, \>= 14 days must have elapsed since last dose of corticosteroid
Hematopoietic growth factors: \>= 14 days after the last dose of a long-acting growth factor (e.g., pegfilgrastim) or 7 days for short acting growth factor. For agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur
Interleukins, interferons and cytokines (other than hematopoietic growth factors): \>= 21 days after the completion of interleukins, interferon or cytokines (other than hematopoietic growth factors)
Stem cell Infusions (with or without total-body irradiation \[TBI\]):
Allogeneic (non-autologous) bone marrow or stem cell transplant, or any stem cell infusion including donor lymphocyte infusion (DLI) or boost infusion: \>= 84 days after infusion and no evidence of graft versus host disease (GVHD)
Autologous stem cell infusion including boost infusion: \>= 42 days.
Cellular therapy: \>= 42 days after the completion of any type of cellular therapy (e.g., modified T cells, natural killer \[NK\] cells, dendritic cells, etc.).
External beam radiation therapy (XRT)/external beam irradiation including protons: \>= 14 days after local XRT; \>= 150 days after TBI, craniospinal XRT or if radiation to \>= 50% of the pelvis; \>= 42 days if other substantial bone marrow (BM) radiation
Radiopharmaceutical therapy (e.g., radiolabeled antibody, iobenguane I-131 \[131I MIBG\]): \>= 42 days after systemically administered radiopharmaceutical therapy
Patients must not have received prior exposure to tegavivint
PATIENTS WITH SOLID TUMORS WITHOUT KNOWN BONE MARROW INVOLVEMENT: Peripheral absolute neutrophil count (ANC) \>= 1000/uL (within 7 days prior to enrollment)
PATIENTS WITH SOLID TUMORS WITHOUT KNOWN BONE MARROW INVOLVEMENT: Platelet count \>= 100,000/uL (transfusion independent, defined as not receiving platelet transfusions for at least 7 days prior to enrollment) (within 7 days prior to enrollment)
PATIENTS WITH SOLID TUMORS WITHOUT KNOWN BONE MARROW INVOLVEMENT: Hemoglobin \>= 8.0 g/dL at baseline (may receive red blood cell \[RBC\] transfusions) (within 7 days prior to enrollment)
Patients with known bone marrow metastatic disease will be eligible for study provided they meet blood counts (may receive transfusions provided they are not known to be refractory to red cell or platelet transfusions). These patients will not be evaluable for hematologic toxicity. At least 5 of every cohort of 6 patients must be evaluable for hematologic toxicity for the dose-escalation part of the study. If dose-limiting hematologic toxicity is observed, all subsequent patients enrolled on Part A must be evaluable for hematologic toxicity
Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 mL/min/1.73 m\^2 or a creatinine based on age/gender as follows (within 7 days prior to enrollment):
Age; maximum serum creatinine
Age 1 to \< 2 years; 0.6 mg/dL (male); 0.6 mg/dL (female)
Age 2 to \< 6 years; 0.8 mg/dL (male); 0.8 mg/dL (female)
Age 6 to \< 10 years; 1 mg/dL (male); 1 mg/dL (female)
Age 10 to \< 13 years; 1.2 mg/dL (male); 1.2 mg/dL (female)
Age 13 to \< 16 years; 1.5 mg/dL (male); 1.4 mg/dL (female)
Age \>= 16 years; 1.7 mg/dL (male); 1.4 mg/dL (female)
PATIENTS WITH SOLID TUMORS: Bilirubin (sum of conjugated + unconjugated or total) =\< 1.5 x upper limit of normal (ULN) for age (within 7 days prior to enrollment)
PATIENTS WITH SOLID TUMORS: Serum glutamic pyruvic transaminase (SGPT) (alanine aminotransferase \[ALT\]) =\< 135 U/L. For the purpose of this study, the ULN for SGPT is 45 U/L (within 7 days prior to enrollment)
PATIENTS WITH SOLID TUMORS: Albumin \>= 2 g/dL (within 7 days prior to enrollment)
Exclusion
Pregnant or breast-feeding women will not be entered on this study because there is yet no available information regarding human fetal or teratogenic toxicities. Pregnancy tests must be obtained in girls who are post-menarchal. Males or females of reproductive potential may not participate unless they have agreed to use two effective methods of birth control, including a medically accepted barrier or contraceptive method (e.g., male or female condom) for the duration of the study. Abstinence is an acceptable method of birth control
Patients receiving corticosteroids who have not been on a stable or decreasing dose of corticosteroid for at least 7 days prior to enrollment are not eligible. If used to modify immune adverse events related to prior therapy, \>= 14 days must have elapsed since last dose of corticosteroid
Patients who are currently receiving another investigational drug are not eligible
Patients who are currently receiving other anti-cancer agents are not eligible
Patients who are receiving cyclosporine, tacrolimus or other agents to prevent graft-versus-host disease post bone marrow transplant are not eligible for this trial
Patients who are currently receiving drugs that are strong inducers or inhibitors of CYP3A4 are not eligible. Strong inducers or inhibitors of CYP3A4 should be avoided from 14 days prior to the 1st dose of tegavivint to the end of the study
Patients who have received bisphosphonates within 4 weeks prior to study enrollment will be excluded
Patients who have received denosumab within 180 days prior to study enrollment will be excluded
Patients with primary brain tumors are ineligible
Patients with known central nervous system (CNS) metastasis, except for craniopharyngeal tumors, will be excluded
Patients with a known metabolic bone disease (ex: hyperparathyroidism, Paget's disease, osteomalacia) are not eligible
Patients with a disorder associated with abnormal bone metabolism will be excluded
Patients with grade \>= 2 hypocalcemia that is not corrected with oral calcium supplementation will be excluded
Patients with vitamin D \< 20 ng/mL will require supplementation, or will otherwise be excluded. Patients must agree to take vitamin D +/- calcium supplements (if necessary) according to institutional or published guidelines. Additional calcium supplementation is not required if adequate dietary intake can be ascertained
Patients with pre-existing grade 3 osteoporosis are excluded
Patients who have an uncontrolled infection are not eligible
Patients who have received a prior solid organ transplantation are not eligible
Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study are not eligible
What this trial measures
- Frequency of dose limiting toxicities of tegavivintUp to 28 days
The number of patients experiencing a cycle 1 dose limiting toxicity at least possibly attributable to tegavivint by study part and dose level.
- Frequency of adverse events attributable to tegavivintUp to 60 months
The number of patients experiencing adverse events that are at least possibly attributable to tegavivint by study part and dose level.
- Area under the drug concentration curve of tegavivintUp to 2 days
The median (minimum \[min\], maximum \[max\]) of the area under the drug concentration curve for tegavivint by study part and dose level.