Pharmacokinetics of Ch14.18 in Younger Patients With High-Risk Neuroblastoma

PRIMARY OBJECTIVES: I. Describe the pharmacokinetics of ch14.18 (monoclonal antibody Ch14.18) in children with high-risk neuroblastoma. II. Quantify the degree of inter-patient and intra-patient variability in the clearance of ch14.18, and correlate ch14.18 clearance with patient characteristics, the presence of human anti-chimeric antibody (HACA), tumor burden (assessed on scans), and plasma GD2 levels to identify sources of variability in the clearance. III. Develop a pharmacokinetic model to describe the pharmacokinetic profile of ch14.18 and derive pharmacokinetic (PK) parameters. SECONDARY OBJECTIVES: I. Correlate plasma concentrations of ch14.18 with the severity of neuropathic pain, which is being quantified using an observational pain scale, and the total dose of morphine administered to control pain. II. Develop a limited sampling strategy that will accurately quantify the area under the curve (AUC) of ch14.18. III. Simulate alternative dosing strategies with the pharmacokinetic model in order to reduce variability and simplify drug administration. OUTLINE: Patients undergo blood sample collection at baseline and during and after course 1, 3, or 5 of treatment for pharmacokinetic analysis. Some patients undergo blood sample collection at baseline and during and after two treatment courses (1 and 3, 1 and 5, or 3 and 5).