Protocol for the Study and Treatment of Participants With Intraocular Retinoblastoma

Study Summary

The primary objective of this protocol is to evaluate the response rate of bilateral disease participants who have at least one eye with advanced intra-ocular retinoblastoma (stratum B) using upfront therapy with chemotherapy delivered directly to the eye. The main biology objective is to improve our understanding of the biology and tumorigenesis (how tumor develops) of retinoblastoma when biology specimens are available. As clinicians, the primary goal of the investigators for children with retinoblastoma is to provide optimal therapy using multiple treatment approaches \[chemotherapy (into the vein and directly into membrane of eyeball), cryotherapy (freeze and destroy tumor), thermotherapy (laser or heat to destroy tumor), radiation therapy, and surgical removal of eye if needed) in an attempt to preserve the eye and vision whenever possible, while still curing the disease. Therefore, all children with non-metastatic retinoblastoma at St. Jude will be offered enrollment on this study. PRIMARY OBJECTIVE: * To evaluate the response (complete + partial response) rate of bilateral disease participants who have at least one eye with advanced intraocular retinoblastoma (Stratum B) to two upfront courses of therapy consisting of subconjunctival carboplatin and systemic topotecan. SECONDARY OBJECTIVES: * To evaluate the ocular survival of eyes and event-free survival of participants by strata. * To prospectively analyze intraocular disease tissue for participants with at least one eye undergoing enucleation in order to identify the mechanism of RB1 bi-allelic inactivation. Participants may undergo upfront enucleation (due to advanced disease at diagnosis) or may receive enucleation due to progressive disease during protocol therapy.

Primary Outcome

To evaluate the response (CR + PR) rate of bilateral disease patients who have at least one eye with advanced intraocular retinoblastoma (stratum B patients) and subretinal seeding to two upfront courses of therapy consisting of subconjunctival carboplatin and systemic topotecan. Stratum B patients who had no significant subretinal seeding and received vincristine and topotecan are not evaluable for this primary objective. CR: Complete regression, calcification or scarring of all apparent tumor

Conditions Studied

Interventions

• DRUG carboplatin
• DRUG topotecan
• DRUG vincristine
• DRUG filgrastim
• DRUG PEG-filgrastim

Study Locations (1)