Pediatric Brain Tumor Trials

Lead Physician: David Sandberg, MD 

A new brain tumor trial is now open to qualified participants. The research study is being conducted by David Sandberg, MD, pediatric neurosurgeon affiliated with Children’s Memorial Hermann Hospital in Houston.

The study is called “Fourth Ventricular Administration of Immune Checkpoint Inhibitor (Nivolumab) and Methotrexate or 5-Azacytidine for Recurrent Medulloblastoma, Ependymoma,

and other CNS Malignancies.” It is open to patients ages 2 to 80 years old with recurrent medulloblastoma, ependymoma, and certain other tumors that start or recur in the posterior fossa (back of the brain).

The study employs a novel means of treating these tumors: infusion of two agents directly into

the fourth ventricle or tumor resection cavity rather than through systemic intravenous delivery. All enrolled patients will receive infusions of Nivolumab, an immune checkpoint inhibitor. Patients with ependymoma will additionally receive infusions of 5-azacytidine, and patients with medulloblastoma and other tumors will additionally receive infusions of methotrexate. There will be no simultaneous systemic chemotherapy.

The study is listed at ClinicalTrials.gov under NCT06466798,

(https://clinicaltrials.gov/study/NCT06466798).

Lead Physician: David Sandberg, MD 

A new brain tumor trial is now open to qualified participants. The research study is being conducted by David Sandberg, MD, pediatric neurosurgeon affiliated with Children’s Memorial Hermann Hospital.

The study is called “Combination Intraventricular Chemotherapy Pilot Study: 5-Azacytidine (5-AZA) and Trastuzumab Infusions Into the Fourth Ventricle or Resection Cavity in Children and Adults With Recurrent or Residual Posterior Fossa Ependymoma.” It is open to patients ages 1 to 80 years old with recurrent ependymoma.

The study employs a novel means of treating recurrent Ependymoma: infusion of two chemotherapy agents (5-Azacytidine and Trastuzumab) directly into the fourth ventricle or tumor resection cavity rather than through systemic intravenous delivery. 5-Azacytidine (5-AZA) is a DNA methylation inhibitor that has been safely infused into the fourth ventricle in our previous clinical trial (NCT02940483). Trastuzumab is a targeted antibody therapy that is of interest for the treatment of ependymoma and has been safely infused intrathecally in children. There will be no simultaneous systemic chemotherapy.

This study is listed at ClinicalTrials.gov under NCT04958486.

Lead Physician: David Sandberg, MD 

This pilot study seeks to enroll qualified participants with recurrent medulloblastoma. This novel trial places MTX110, a new formulation of panobinostat, directly into the fourth ventricle of the brain. The research study is led by David Sandberg, MD, pediatric neurosurgeon affiliated with Children’s Memorial Hermann Hospital in Houston.

MTX110 is a chemotherapy drug that has shown promise in laboratory models of medulloblastoma, the most common malignant brain tumor in children. Treatments that are currently available for recurrent medulloblastoma are often associated with considerable toxicity, and when tumors recur despite these treatments, survival rates are low. Dr. Sandberg’s novel trial places the chemotherapy directly into the fourth ventricle, in an effort to deliver the treatment only to the affected area while avoiding the surrounding healthy tissue.

The pilot study, which has been approved by the Food and Drug Administration, will enroll five (5) patients with recurrent medulloblastoma at Children’s Memorial Hermann Hospital. MTX110 is a new formulation of panobinostat from Midatech Pharma PLC.

This study is listed at ClinicalTrials.gov under NCT04315064.

Lead Physician: David Sandberg, MD 

This study, called “Infusion of 5-Azacytidine (5-AZA) into the Fourth Ventricle or Resection Cavity in Children with Recurrent Posterior Fossa Ependymoma: A Pilot Study,” is open to patients ages 1 to 21 years old with recurrent ependymoma that originated in the posterior fossa of the brain. The research study is being conducted by David Sandberg, MD, pediatric neurosurgeon affiliated with Children’s Memorial Hermann Hospital in Houston.

The study employs a novel means of treating ependymoma brain tumors that originate from the fourth ventricle: infusion of a chemotherapy agent directly into the fourth ventricle rather than systemic intravenous delivery. The agent being infused, 5-AZA, has never been infused into the brain in humans but has been shown to effectively kill ependymoma cells in the laboratory. There will be no simultaneous systemic chemotherapy.

This study is listed at ClinicalTrials.gov, NCT # 02940483, under “Brain Tumor Recurrent.”

Methotrexate and Etoposide Infusions into the Fourth Ventricle or Resection Cavity in Children with Recurrent Posterior Fossa Brain Tumors

Lead Physician: David Sandberg, MD 

This pilot study is called “Combination Intraventricular Chemotherapy Pilot Study: Methotrexate and Etoposide Infusions into the Fourth Ventricle or Resection Cavity in Children with Recurrent Posterior Fossa Brain Tumors.” It is open to patients ages 1 to 80 years old with recurrent medulloblastoma (PNET), recurrent ependymoma, and recurrent atypical teratoid/rhabdoid tumors involving the brain and/or spine. The study is being conducted by David Sandberg, MD, pediatric neurosurgeon affiliated with Children’s Memorial Hermann Hospital in Houston. The study is called “Combination Intraventricular Chemotherapy Pilot Study: Methotrexate and Etoposide Infusions into the Fourth Ventricle or Resection Cavity in Children with Recurrent Posterior Fossa Brain Tumors.” It is open to patients who are age 1 to 21 years old with recurrent medulloblastoma (PNET), recurrent ependymoma, and recurrent atypical teratoid/rhabdoid tumors involving the brain and/or spine.

The study employs a novel means of treating malignant tumors that originate from the fourth ventricle: infusion of two chemotherapy agents directly into the fourth ventricle rather than through systemic intravenous delivery. There will be no simultaneous systemic chemotherapy.

This study is listed at ClinicalTrials.gov, NCT # 02905110, under “Brain Tumor Recurrent.”

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