Belinostat and Azacitidine in Treating Patients With Advanced Hematologic Cancers or Other Diseases
Accelerated Phase of Disease, Adult Acute Myeloid Leukemia With Inv(16)(p13.1q22); CBFB-MYH11, Adult Acute Myeloid Leukemia With t(16;16)(p13.1;q22); CBFB-MYH11
About this trial
This is an interventional treatment trial for Accelerated Phase of Disease
Eligibility Criteria
Inclusion Criteria: Histologically confirmed diagnosis of 1 of the following: Relapsed or refractory acute myeloid leukemia (AML) Relapsed or refractory acute promyelocytic leukemia (must have failed both tretinoin and arsenic trioxide) Relapsed or refractory acute lymphoblastic leukemia Secondary AML, including AML arising from antecedent hematologic diseases, such as myelodysplastic syndromes (MDS) or myeloproliferative disorders, OR therapy-related AML Chronic myelogenous leukemia in accelerated or blast phase Advanced phases of Philadelphia chromosome-negative (Ph-) chronic myeloproliferative disorders, as defined by ≥ 1 of the following: Presence of anemia (hemoglobin < 10 g/dL and/or red blood cell transfusion dependent) Presence of palpable splenomegaly MDS, including chronic myelomonocytic leukemia Must have intermediate or high-risk International Prognostic Scoring System (IPSS) scores (≥ 0.5) Low-risk IPSS scores allowed provided ≥ 1 of the following criteria are met: Hemoglobin < 10 g/dL and/or red blood cell transfusion dependent Platelet count < 50,000/mm³ Absolute neutrophil count < 1,000/mm³ Refractory disease OR no standard therapy exists Evidence of AML associated with dysplasia on bone marrow histology for elderly patients (i.e., > 60 years old) who are previously untreated and not candidates for or unwilling to undergoing induction therapy No known active CNS involvement with disease CALGB performance status (PS) 0-2 OR Karnofsky PS 60-100% Bilirubin ≤ 2.0 mg/dL (unless due to Gilbert's syndrome) ALT ≤ 3 times upper limit of normal (unless due to disease) Creatinine ≤ 2 mg/dL Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No history of allergic reactions attributed to compounds of similar chemical or biologic composition to PXD101 or Azacitidine No history of allergic reactions to mannitol No history of dose-limiting toxicity during prior treatment with Azacitidine No concurrent uncontrolled illness including, but not limited to, the following: Ongoing or active infection Symptomatic congestive heart failure Unstable angina pectoris Cardiac arrhythmia Psychiatric illness or social situation that would preclude compliance with study requirements No marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval > 500 msec) No long QT syndrome No uncontrolled cardiovascular disease, including the following: Severe uncontrolled hypertension Uncontrolled congestive heart failure related to primary cardiac disease Uncontrolled cardiac arrhythmia Uncontrolled ischemic or severe valvular heart disease Myocardial infarction within the past 6 months See Disease Characteristics Recovered from prior therapy At least 2 weeks since prior chemotherapy (6 weeks for mitomycin C or nitrosoureas) At least 2 weeks since prior radiotherapy At least 4 weeks since prior investigational agents At least 24 hours since prior hydroxyurea At least 2 weeks since prior valproic acid No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent investigational agents No concurrent medication that may cause torsade de pointes No other concurrent anticancer therapy, including chemotherapy, radiotherapy, or biological agents
Sites / Locations
- University of Chicago Comprehensive Cancer Center
- University of Wisconsin Hospital and Clinics
- University Health Network-Princess Margaret Hospital
- Princess Margaret Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Arm I (chemotherapy)
Arm II (chemotherapy, enzyme inhibitor therapy)
Patients receive azacitidine SC on days 1-5.
Patients receive azacitidine as in arm I and belinostat at the MTD IV over 30 minutes on days 1-5.