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| ID | Type | Description | Link |
|---|---|---|---|
| P30CA033572 | U.S. NIH Grant/Contract | View source | |
| CHNMC-08047 | |||
| CDR0000631569 | Registry Identifier | NCI PDQ |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Dasatinib and vorinostat may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving dasatinib together with vorinostat may kill more cancer cells.
PURPOSE: This phase I trial is studying the side effects and best dose of dasatinib when given together with vorinostat in treating patients with accelerated phase or blastic phase chronic myelogenous leukemia or acute lymphoblastic leukemia.
OBJECTIVES:
Secondary
OUTLINE: This is a multicenter study.
Patients receive oral dasatinib twice daily on days 1-21 and oral vorinostat twice daily on days 1-14. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Patients undergo bone marrow aspiration and blood sample collection periodically for correlative laboratory studies. Samples are assessed by RT-PCR for DNA damage response and proapoptotic elements (GADD45, FANC, and FOXO3A); cytogenetic analysis; flow cytometry; mutation analysis of bcr-abl; and gene expression array analysis.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| dasatinib | Drug | 50 mg orally 2 times per day or 140 mg orally one time per day | ||
| vorinostat | Drug | 100 mg orally 2 times per day | ||
| cytogenetic analysis | Genetic | Performed at the end of cycle two of treatment and every six cycles for patients with accelerated CML and every 3 cycles for patients with blast crisis or Ph+ ALL | ||
| gene expression analysis | Genetic | Bone marrow aspirate obtained pre-treatment, at first scheduled bone marrow assay and at relapse. Peripheral blood drawn pre-therapy, day +14 of first treatment cycle and at relapse. | ||
| mutation analysis | Genetic | Performed at baseline and at every bone marrow analysis on peripheral blood |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum tolerated dose | 21 days after the beginning of treatment | |
| Toxicity as assessed by NCI CTCAE v3.0 | 21 days from the beginning of the last course of treatment | |
| Response rate | One year after treatment completion | |
| Objective tumor response | One year after treatment completion | |
| Survival | One year after treatment completion | |
| Time to treatment failure | One year after treatment completion | |
| Duration of response | One year after treatment completion |
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DISEASE CHARACTERISTICS:
Diagnosis of 1 of the following hematologic malignancies:
Chronic myelogenous leukemia meeting 1 of the following criteria:
In accelerated phase, defined by the presence of ≥ 1 of the following:
In blastic phase (blast crisis), defined by the presence of ≥ 1 of the following:
Philadelphia chromosome-positive acute lymphoblastic leukemia meeting any of the following criteria:
No active CNS involvement
PATIENT CHARACTERISTICS:
ECOG performance status 0-2
Total bilirubin < 2.0 times upper limit of normal (ULN)
AST and ALT ≤ 2.5 times ULN
Serum sodium, potassium, magnesium, phosphate, and calcium ≥ lower limit of normal
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for ≥ 4 weeks after discontinuation of study drug
Able to take oral medication
No active post-transplantation-related infections (e.g., fungal or viral infection)
No active acute graft-versus-host disease (GVHD) of any grade
No chronic GVHD (other than mild skin, oral, or ocular GVHD not requiring systemic immunosuppression)
No other malignancy that required radiotherapy or systemic treatment within the past 5 years
No concurrent medical condition that may increase the risk of toxicity, including pleural or pericardial effusion of any grade
No cardiac conditions, including any of the following:
No hypokalemia or hypomagnesemia that cannot be corrected prior to dasatinib administration
No history of significant bleeding disorder unrelated to cancer, including any of the following:
No prisoners or individuals who are compulsorily detained (i.e., involuntarily incarcerated) for treatment of either a psychiatric or physical (e.g., infectious) illness
PRIOR CONCURRENT THERAPY:
See Disease Characteristics
Recovered from prior therapy
No prior HDAC inhibitors or compounds with HDAC inhibitor-like activity (e.g., valproic acid) as anti-tumor therapy
Prior allogeneic stem cell transplantation allowed
More than 4 weeks since prior chemotherapy other than TKI (6 weeks for nitrosoureas and mitomycin)
More than 2 weeks since prior radiotherapy
At least 7 days since prior and no concurrent Category I drugs that are generally accepted to have a risk of causing Torsades de pointes, including any of the following:
At least 7 days since prior and no concurrent medications that directly and durably inhibit platelet function, including any of the following:
At least 5 days since prior and no concurrent St. John's wort
No IV bisphosphonates during the first 8 weeks of dasatinib therapy
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| Name | Affiliation | Role |
|---|---|---|
| David Snyder, MD | City of Hope Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| City of Hope Comprehensive Cancer Center | Duarte | California | 91010-3000 | United States | ||
| City of Hope Medical Group |
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| reverse transcriptase-polymerase chain reaction | Genetic | Peripheral blood drawn prior to starting Vorinostat on Day 1 and on Day 14 of treatment |
| flow cytometry | Other | Performed at the end of cycle two of treatment and every six cycles for patients with accelerated CML and every 3 cycles for patients with blast crisis or Ph+ ALL |
| laboratory biomarker analysis | Other | Performed pre-treatment and day +14 of treatment |
| Pasadena |
| California |
| 91105 |
| United States |
| ID | Term |
|---|---|
| D007938 | Leukemia |
| D015465 | Leukemia, Myeloid, Accelerated Phase |
| D001752 | Blast Crisis |
| D054198 | Precursor Cell Lymphoblastic Leukemia-Lymphoma |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D015464 | Leukemia, Myelogenous, Chronic, BCR-ABL Positive |
| D007951 | Leukemia, Myeloid |
| D009196 | Myeloproliferative Disorders |
| D001855 | Bone Marrow Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D002471 | Cell Transformation, Neoplastic |
| D063646 | Carcinogenesis |
| D009385 | Neoplastic Processes |
| D007945 | Leukemia, Lymphoid |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| D000069439 | Dasatinib |
| D000077337 | Vorinostat |
| D020732 | Cytogenetic Analysis |
| D020869 | Gene Expression Profiling |
| D020133 | Reverse Transcriptase Polymerase Chain Reaction |
| D005434 | Flow Cytometry |
| ID | Term |
|---|---|
| D013844 | Thiazoles |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D011743 | Pyrimidines |
| D000813 | Anilides |
| D000577 | Amides |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D006877 | Hydroxamic Acids |
| D006898 | Hydroxylamines |
| D006880 | Hydroxy Acids |
| D002264 | Carboxylic Acids |
| D003584 | Cytological Techniques |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D008919 | Investigative Techniques |
| D005821 | Genetic Techniques |
| D016133 | Polymerase Chain Reaction |
| D021141 | Nucleic Acid Amplification Techniques |
| D002469 | Cell Separation |
| D003592 | Cytophotometry |
| D005470 | Fluorometry |
| D008163 | Luminescent Measurements |
| D010783 | Photometry |
| D002623 | Chemistry Techniques, Analytical |
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