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| ID | Type | Description | Link |
|---|---|---|---|
| P30CA033572 | U.S. NIH Grant/Contract | View source | |
| CHNMC-08099 | Registry Identifier | PDQ | |
| NOVARTIS-CHNMC-08099 | |||
| CDR0000652208 | Registry Identifier | PDQ | |
| NCI-2010-00259 | Registry Identifier | NCI CTRP |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Panobinostat and everolimus may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the cancer. Giving panobinostat together with everolimus may kill more cancer cells.
PURPOSE: This phase I trial is studying the side effects and best dose of panobinostat when given together with everolimus in treating patients with relapsed or refractory lymphoma or multiple myeloma.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a dose-escalation study of panobinostat.
Patients receive oral panobinostat 3 days a week and oral everolimus once every other day for 4 weeks Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.
Blood and bone marrow samples may be collected for pharmacokinetic and correlative laboratory studies.
After completion of study treatment, patients are followed up for ≥ 4 weeks.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| everolimus | Drug | Beginning with 5 mg every other day Monday, Wednesday or Friday for a 28 day cycle. Dose escalation will be determined by the toxicities associated with treatment. | ||
| panobinostat | Drug | 10 mg every Monday and Thursday of a 28 day cycle. Dose escalation will be determined by the toxicities associated with treatment. | ||
| laboratory biomarker analysis | Other | Pre-study, day 1 and day 26 samples to evaluation how the study drugs work in vitro (in a test tube). | ||
| pharmacological study | Other | Pre-study, day 1 and day 26 |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum tolerated dose | 90 days post treatment start | |
| Toxicity | 90 days post treatment start |
| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetic and correlative studies | Day 1 and Day 26 of the first cycle of treament |
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DISEASE CHARACTERISTICS:
Histologically confirmed diagnosis of one of the following:
Hodgkin or non-Hodgkin lymphoma (including small lymphocytic lymphoma [SLL])
Multiple myeloma (MM)
Relapsed or refractory disease
Patients with lymphoma must have relapsed after or be refractory to an upfront regimen (e.g., CHOP or ABVD) and a salvage regimen (e.g., ICE or ESHAP)
Patients with MM must have progressed within 100 days after receiving a regimen containing bortezomib and either thalidomide or lenalidomide AND have a 25% increase in serum paraproteins, urinary light chains, or plasma cell number in the bone marrow
No active CNS disease
PATIENT CHARACTERISTICS:
ECOG performance status 0-2
ANC ≥ 1,500/mm³
Platelet count ≥ 75,000/mm³ (transfusion allowed in patients with biopsy-proven bone marrow involvement)
AST and ALT ≤ 2.5 times upper limit of normal (ULN) (≤ 5.0 times ULN if elevation due to leukemic involvement)
Serum bilirubin ≤ 1.5 times ULN
Serum creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 50 mL/min
Serum potassium normal
Serum phosphorous normal
Serum total calcium (corrected for serum albumin) or serum ionized calcium normal
Serum magnesium normal
TSH and free T4 normal (thyroid hormone replacement allowed)
Fasting serum cholesterol ≤ 300 mg/dL (or ≤ 7.75 mmol/L) AND fasting triglycerides ≤ 2.5 times ULN (elevated levels allowed provided an appropriate lipid-lowering medication has been initiated)
LVEF normal by MUGA or ECHO
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective double-method (including barrier method) contraception during and for 3 months after completion of study treatment
No impaired cardiac function, including any of the following:
No uncontrolled hypertension
No unresolved diarrhea > CTCAE grade 1
No impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral agents (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection)
No other concurrent severe or uncontrolled medical condition
No other primary malignancy within the past 5 years other than curatively treated carcinoma in situ of the cervix or basal cell or squamous cell carcinoma of the skin
No known HIV or hepatitis C positivity
No significant history of non-compliance to medical regimens
No known hypersensitivity to everolimus, other rapamycins (e.g., sirolimus or temsirolimus), or their excipients
PRIOR CONCURRENT THERAPY:
See Disease Characteristics
Prior autologous or allogeneic stem cell transplantation allowed
More than 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) or radiotherapy and recovered
More than 1 week since prior and no concurrent immunization with live attenuated vaccines
More than 4 weeks since prior valproic acid
No other prior histone deacetylase inhibitors
No concurrent chronic systemic corticosteroids or another immunosuppressive agent, other than for control of itching (as in cutaneous T-cell lymphoma)
No concurrent drugs that may induce torsades de pointes
No concurrent CYP3A4 inhibitors
No concurrent radiotherapy or other anticancer therapy
No concurrent grapefruit, grapefruit juice, or seville (sour) oranges
No concurrent medications that may cause QTc prolongation
No other concurrent investigational therapy
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| Name | Affiliation | Role |
|---|---|---|
| Leslie Popplewell, MD | City of Hope Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| City of Hope Medical Center | Duarte | California | 91010-3000 | United States | ||
| City of Hope Medical Group |
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| Pasadena |
| California |
| 91105 |
| United States |
| ID | Term |
|---|---|
| D008223 | Lymphoma |
| D009101 | Multiple Myeloma |
| D054219 | Neoplasms, Plasma Cell |
| D054218 | Precursor T-Cell Lymphoblastic Leukemia-Lymphoma |
| D054391 | Lymphoma, Extranodal NK-T-Cell |
| D017728 | Lymphoma, Large-Cell, Anaplastic |
| D007119 | Immunoblastic Lymphadenopathy |
| D018442 | Lymphoma, B-Cell, Marginal Zone |
| D006689 | Hodgkin Disease |
| D002051 | Burkitt Lymphoma |
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| D008228 | Lymphoma, Non-Hodgkin |
| D016400 | Lymphoma, Large-Cell, Immunoblastic |
| D054198 | Precursor Cell Lymphoblastic Leukemia-Lymphoma |
| D016410 | Lymphoma, T-Cell, Cutaneous |
| D009182 | Mycosis Fungoides |
| D012751 | Sezary Syndrome |
| D008224 | Lymphoma, Follicular |
| D020522 | Lymphoma, Mantle-Cell |
| D015451 | Leukemia, Lymphocytic, Chronic, B-Cell |
| D008258 | Waldenstrom Macroglobulinemia |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D020141 | Hemostatic Disorders |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010265 | Paraproteinemias |
| D001796 | Blood Protein Disorders |
| D006402 | Hematologic Diseases |
| D006474 | Hemorrhagic Disorders |
| D007945 | Leukemia, Lymphoid |
| D007938 | Leukemia |
| D016399 | Lymphoma, T-Cell |
| D000072281 | Lymphadenopathy |
| D016393 | Lymphoma, B-Cell |
| D020031 | Epstein-Barr Virus Infections |
| D006566 | Herpesviridae Infections |
| D004266 | DNA Virus Infections |
| D014777 | Virus Diseases |
| D007239 | Infections |
| D014412 | Tumor Virus Infections |
| D015448 | Leukemia, B-Cell |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000068338 | Everolimus |
| D000077767 | Panobinostat |
| ID | Term |
|---|---|
| D020123 | Sirolimus |
| D018942 | Macrolides |
| D007783 | Lactones |
| D009930 | Organic Chemicals |
| D006877 | Hydroxamic Acids |
| D006898 | Hydroxylamines |
| D000588 | Amines |
| D006880 | Hydroxy Acids |
| D002264 | Carboxylic Acids |
| D007211 | Indoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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