Vorinostat and Decitabine in Treating Patients With Advanced Solid Tumors or Relapsed or Refractory Non-Hodgkin's Lymphoma, Acute Myeloid Leukemia, Acute Lymphocytic Leukemia, or Chronic Myelogenous Leukemia
Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities, Adult Acute Myeloid Leukemia With Inv(16)(p13;q22), Adult Acute Myeloid Leukemia With t(15;17)(q22;q12)
About this trial
This is an interventional treatment trial for Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities
Eligibility Criteria
Inclusion Criteria: Diagnosis of 1 of the following: Confirmed relapsed or refractory acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) or chronic myelogenous leukemia in blast crisis (CML-BC) Patients with acute promyelocytic leukemia who have relapsed while on tretinoin allowed Patients with previously untreated AML who refuse induction chemotherapy allowed Patients who are not candidates for aggressive management (those that have medical conditions that prevent the administration of standard curative chemotherapy or those who require an allogeneic bone marrow transplantation for curative therapy but lack an appropriate donor) are allowed Histologically or cytologically confirmed relapsed or refractory non-Hodgkin's lymphoma (NHL) Histologically confirmed solid tumor that is metastatic or unresectable or for which standard curative or palliative measures do not exist or are no longer effective Clinically or radiologically documented disease Patients whose only evidence of disease is tumor marker elevation are not eligible Patients with AML, ALL, or CML-BC who have cerebral spinal fluid involvement may be included May be treated with intrathecal cytarabine and/or methotrexate prior to and/or during the study No known brain metastases in patients with solid tumors or NHL ECOG performance status 0-2 Karnofsky 60-100% Life expectancy > 12 weeks for patients with solid tumors (including non-Hodgkin's lymphoma) and 6 weeks for patients with hematological malignancies Patients with solid tumors (including NHL) must also have normal marrow function as defined below: Leukocytes ≥ 3,000/mm^3 Absolute neutrophil count ≥ 1,500/mm^3 Platelets ≥ 100,000/mm^3 Creatinine ≤ 150 μmol/L Creatinine clearance ≥ 60 mL/min Bilirubin normal AST/ALT ≤ 2.5 times upper limit of normal (ULN) Women of child-bearing potential and men must agree to use adequate contraception (barrier method of birth control or abstinence) prior to study entry and for the duration of study participation Not pregnant or nursing Negative pregnancy test No history of allergic reactions attributed to compounds of similar chemical or biologic composition to vorinostat or other agents used in study Able to take oral medications Patients who have a clinical or radiological diagnosis of bowel obstruction are ineligible No ongoing or active infection No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia No psychiatric illness/social situations that would limit compliance with study requirements No other uncontrolled intercurrent illness No limitation on the number or types of prior therapy At least 3 weeks since prior radiotherapy, chemotherapy (6 weeks for nitrosoureas or mitomycin C), or molecularly targeted agents Exceptions may be made for low-dose, non-myelosuppressive radiotherapy At least 2 weeks since prior valproic acid or any other histone deacetylase inhibitor Must have recovered from prior therapy Patients with hematological malignancies may receive hydroxyurea until 24 hours prior to starting study medications Previous surgery is permitted provided that wound healing has occurred No prior decitabine No other concurrent investigational agents No other concurrent investigational or commercial agents or therapies administered with the intent to treat the patient's malignancy No HIV-positive patients receiving combination antiretroviral therapy No concurrent prophylactic hematopoietic growth factors (e.g. filgrastim [G-CSF], sargramostim [GM-CSF], thrombopoietin, or epoetin alfa) Hematopoietic growth factors colony stimulating factors for the treatment of cytopenia may be permitted at the discretion of the principal investigator
Sites / Locations
- Chedoke-McMaster Hospitals
- Juravinski Cancer Centre at Hamilton Health Sciences
- Princess Margaret Hospital Phase 2 Consortium
- University Health Network-Princess Margaret Hospital
Arms of the Study
Arm 1
Experimental
Treatment (enzyme inhibitor, chemotherapy)
Regimen 1 (sequential dosing): Patients receive oral vorinostat two or three times daily on days 6-21 or days 6-12 (patients with solid tumors or NHL only) and decitabine IV over 1 hour on days 1-5. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Regimen 2 (concurrent dosing): Patients receive oral vorinostat two or three times daily on days 1-21, days 1-14 (patients with hematological malignancies only), or two times daily on days 1-12 (patients with solid tumors or NHL only) and decitabine IV over 1 hour on days 1-5.