Official Title: “A Phase I Trial of PXD101 in Combination With 13-Cis-Retinoic Acid in Advanced Solid Tumor Malignancies”

RATIONALE: PXD101 may stop the growth of tumor cells by blocking blood flow to the tumor and by blocking some of the enzymes needed for cell growth. Isotretinoin may cause solid tumor cells to look more like normal cells, and to grow and spread more slowly. Giving PXD101 together with isotretinoin may be an effective treatment for metastatic or unresectable solid tumors.

PURPOSE: This phase I trial is studying the side effects and best dose of PXD101 when given together with isotretinoin in treating patients with metastatic or unresectable solid tumors.

Study Type: Interventional

Study Design: Treatment

Study Primary Completion Date: May 2007

OBJECTIVES:

Primary - Determine the safety and tolerability of PXD101 when administered with isotretinoin in patients with metastatic or unresectable solid tumors. - Determine the maximum tolerated dose of PXD101 when administered with isotretinoin in these patients. - Determine the toxic effects of this regimen in these patients. - Determine the pharmacokinetics of this regimen in these patients.

Secondary - Demonstrate upregulation of retinoic acid receptor-beta and retinoic X-receptor expression in tumor tissue from patients treated with this regimen. - Correlate apoptosis in tumor tissue with tumor response in patients treated with this regimen. - Determine the change in gene expression after exposure to this regimen. - Determine any clinical activity of this regimen in these patients.

OUTLINE: This is a multicenter, dose-escalation study of PXD101.

Patients receive PXD101 IV over 30 minutes on days 1-5 and oral isotretinoin once daily on days 1-14. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of PXD101 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during the first course of therapy.

Once the MTD is determined, an expanded cohort of 10 patients are enrolled and treated at the MTD. These patients also undergo blood collection periodically during treatment for pharmacokinetic studies.

All patients undergo blood collection, buccal scrapings, and tumor biopsies periodically for biomarker, pharmacodynamic, gene expression, and laboratory studies.

After completion of study treatment, patients are followed for ≥ 8 weeks.

PROJECTED ACCRUAL: A total of 34 patients will be accrued for this study.

Intervention(s) in this Clinical Trial

• Drug: belinostat
• Drug: isotretinoin
• Procedure: biopsy
• Procedure: gene expression analysis
• Procedure: gene expression profiling
• Procedure: laboratory biomarker analysis
• Procedure: pharmacological study

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed solid tumor
• Metastatic or unresectable disease
• Refractory to standard curative or palliative treatments or these treatments do not exist
• No known brain metastases

PATIENT CHARACTERISTICS:

• ECOG performance status (PS) 0-2 OR Karnofsky PS 50-100%
• Life expectancy > 3 months
• WBC ≥ 3,000/mm^3
• Absolute neutrophil count ≥ 1,500/mm^3
• Platelet count ≥ 100,000/mm^3
• Bilirubin normal
• AST and ALT ≤ 2.5 times upper limit of normal
• Creatinine normal OR creatinine clearance ≥ 60 mL/min
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception prior to, during, and for 30 days after completion of study treatment
• No history of allergic reactions attributed to compounds of similar chemical or biologic composition to PXD101
• No ongoing or active infection
• No psychiatric illness or social situation that would preclude study compliance
• No other uncontrolled illness
• No marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval > 500 msec)
• No long QT syndrome
• No significant cardiovascular disease, including any of the following:
• Unstable angina pectoris
• Uncontrolled hypertension
• Congestive heart failure related to primary cardiac disease
• Any condition requiring anti-arrhythmic therapy
• Ischemic or severe valvular heart disease
• Myocardial infarction within the past 6 months

PRIOR CONCURRENT THERAPY:

• More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) or radiotherapy and recovered
• At least 2 weeks since prior valproic acid
• No other concurrent investigational agents
• No other concurrent anticancer agents or therapies
• No concurrent medication that may cause torsades de pointes, including any of the following:
• Disopyramide
• Dofetilide
• Ibutilide
• Procainamide
• Quinidine
• Sotalol
• Bepridil
• Amiodarone
• Arsenic trioxide
• Cisapride
• Lidoflazine
• Clarithromycin
• Erythromycin
• Halofantrine
• Pentamidine
• Sparfloxacin
• Domperidone
• Droperidol
• Chlorpromazine
• Haloperidol
• Mesoridazine
• Thioridazine
• Pimozide
• Methadone
• No concurrent combination antiretroviral therapy for HIV-positive patients
• No prophylactic filgrastim (G-CSF) during the first course of study treatment

Gender Eligibility for this Clinical Trial: Both

Minimum Age for this Clinical Trial: 18 Years

Maximum Age for this Clinical Trial: N/A

Are Healthy Volunteers Accepted for this Clinical Trial?: No

Lead Sponsor: California Cancer Consortium

Overall Clinical Trial Officials and Contacts

Thehang H. Luu, MD Study Chair Beckman Research Institute  

Information obtained from ClinicalTrials.gov on October 10, 2008

Link to the current ClinicalTrials.gov record. http://clinicaltrials.gov/show/NCT00334789

Study ID Number: CDR0000479715

ClinicalTrials.gov Identifier: NCT00334789

Health Authority: Unspecified

Clinical trial summary from the National Cancer Institute's PDQ® database