A trial looking at a new drug called pegylated recombinant human arginase for children and young adults with cancer (PARC)

Cancer type:

Acute leukaemia
Acute lymphoblastic leukaemia (ALL)
Acute myeloid leukaemia (AML)
Brain (and spinal cord) tumours
Children's cancers
Leukaemia
Neuroblastoma
Sarcoma
Secondary cancers

Status:

Open

Phase:

Phase 1/2

This trial is for children and young adults with cancer that has come back or continued to grow despite treatment.

It is for children and young adults with one of the following cancers:

  • a type of leukaemia called acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia (AML)
  • neuroblastoma
  • sarcoma
  • a type of brain tumour called glioma that usually grows quickly and is likely to spread (high grade glioma)

Everyone taking part needs to be older than 12 months but less than 25 years old. We use the term ‘you’ in this summary, but if you are a parent, we are referring to your child.

Cancer Research UK supports this trial.

More about this trial

Chemotherapy is a common treatment for children and young adults with cancer. It uses anti cancer (cytotoxic) drugs to destroy cancer cells. But chemotherapy doesn’t always work. So doctors are looking for new ways to help children and young adults with a cancer that continues to grow or comes back after treatment. This is called refractory Open a glossary item or relapsed Open a glossary itemcancer.

A protein (an amino acid Open a glossary item) called arginine is important for cells to grow and survive. Normal, healthy cells can make arginine using a protein (an enzyme Open a glossary item) that is often missing in cancer cells. If the amount of arginine available is reduced, it starves the cancer cells and stops them from growing.

Healthy cells are able to survive much better than cancer cells when there is less arginine available. This is partly because they can make it. So, by reducing the amount of arginine available the cancer might stop growing.

In this trial, doctors are looking at a drug called pegylated recombinant human arginase (BCT-100), which reduces the amount of arginine available.

This trial is in 2 parts. In the 1st part, doctors want to find the highest dose of BCT-100 that you can safely have. Once doctors find the best dose, part 2 will open. In the 2nd part of this trial, everyone has the best dose of BCT-100 found during part 1.

Please note – doctors are currently looking for people to join the 2nd part of this trial.

The main aims of this trial are:

  • learn about the side effects of BCT-100
  • find out the highest safest dose of BCT-100
  • find out how well BCT-100 works as a treatment for children and young adults with cancer

Who can enter

The following bullet points list the entry conditions for this trial. Talk to your doctor or the trial team if you are unsure about any of these. They will be able to advise you.

Who can take part

You may be able to join this trial if you have 1 of the following cancers:

As well as one of the above, all of the following must apply:

  • you are at least 12 months old and less than 25 years old  
  • your cancer has come back or continued to grow despite treatment
  • your cancer can be measured using a scan or a bone marrow test
  • you have satisfactory blood tests results  
  • if there is any possibility that you or your partner could become pregnant you are willing to use reliable contraception during treatment and for a year afterwards

Who can’t take part

You cannot join this trial if any of these apply. You:

  • have had treatment with a drug that decreases the amount of arginine or any other similar drug 
  • have severe side effects from previous anti cancer treatments 
  • have an infection that isn’t controlled 
  • are pregnant or breastfeeding

Trial design

This is an international phase 1/2 trial. Doctors hope that up to 64 children and young adults will take.

This trial is in 2 parts. Doctors are currently looking for people to join part 2.

Part 1

The first few people taking part have a low dose of pegylated recombinant human arginase (BCT-100). If they don’t have any serious side effects, the next few people have a higher dose of BCT-100. And so on, until doctors find the highest dose of BCT-100 that you can safely have.

Once doctors find the best dose of BCT-100, part 2 opens.

Part 2

Everyone has the highest safest dose of BCT-100 found during part 1. Doctors want to find out whether BCT-100 helps children and young adults with refractory or relapsed cancer.

How do I have BCT-100?

Everyone has BCT-100 as a drip into a vein (intravenously) every week. It takes about an hour each time you have it.   

You can have up to 24 treatments with BCT-100, taking around 6 months in total. After 6 months, you might be able to continue to have BCT-100 for as long as it is helping you and the side effects aren’t too bad. Your doctor can tell you more about this.

Blood tests and tissue samples
You have extra blood tests as part of this trial. Doctors want to:

  • find out what happens to BCT-100 in your body
  • look at the levels of arginine in your body

You have the extra blood tests before the start of treatment and at set times during the trial.

Doctors might ask you to give extra tissue samples if you are having tests such as lumbar puncture that are part of your normal care. They may also ask for a sample of tissue from a biopsy Open a glossary item that you had in the past.

Hospital visits

You see a doctor and have some tests before taking part in this trial. The tests may include:

During treatment, you see the trial doctor every week. You have blood tests and a physical examination each time you see them.

You have a test to find out how well the treatment is working every 8 weeks. It can be:

  • a bone marrow test
  • lumbar puncture
  • a scan such as CT scan, MRI scan or MIBG scan

Your doctor can tell you which test you will have. It depends on your cancer type.

You have treatment for up to 24 weeks (about 6 months). After 24 weeks, you may be able to continue to have BCT-100. Your doctor can tell you more about this.

When you finish treatment, you see the trial team and have more tests such as blood tests and scans. You then continue to see your doctor as part of your normal care.  

Side effects

Pegylated recombinant human arginase (BCT-100) is a new treatment and there might be side effects we don’t know about yet. The trial team will monitor you during the time you have treatment. You have a phone number to call them if you are worried about anything.

Adults with liver cancer have already had BCT-100. But this is the first time that children have had BCT-100.

The most common side effects of BCT-100 reported so far are:

  • diarrhoea
  • changes in the way your liver works
  • shortness of breath
  • tummy (abdominal) pain

Location

Birmingham
Bristol
Cambridge
Camden
Leeds
Manchester
Sutton

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Francis Mussai

Supported by

Cancer Research UK

University of Birmingham

Innovative Therapies for Children with Cancer in Europe (ITCC)

European Cancer Organisation Methods in Clinical Research workshop

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

14953

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Charlie took part in a trial to try new treatments

A picture of Charlie

“I think it’s really important that people keep signing up to these type of trials to push research forward.”

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