PXD101 and Bortezomib in Treating Patients With Advanced Solid Tumors or Lymphomas
PXD101 and Bortezomib in Treating Patients With Advanced Solid Tumors or Lymphomas
This phase I trial is studying the side effects and best dose of PXD101 and bortezomib in
 treating patients with advanced solid tumors or lymphomas. PXD101 and bortezomib may stop the
 growth of cancer cells by blocking some of the enzymes needed for cell growth. PXD101 may
 also cause cancer cells to look more like normal cells, and to grow and spread more slowly.
 Giving PXD101 together with bortezomib may kill more cancer cells.
OBJECTIVES:

 I. Evaluate the safety profile and determine the maximum tolerated dose of PXD101 in
 combination with bortezomib in patients with advanced solid tumors or lymphomas.

 II. Determine the pharmacokinetics of the combination of PXD101 and bortezomib in these
 patients.

 III. Evaluate selected biomarkers of drug effect in these patients. IV. Evaluate the activity
 of this regimen, in terms of objective response rate, in these patients.

 OUTLINE: This is a dose-escalation study.

 Patients receive PXD101 IV over 30 minutes on days 1-5 and bortezomib IV on days 1, 4, 8, and
 11 (2, 5, 8, and 11 during course 1). Treatment repeats every 21 days in the absence of
 disease progression or unacceptable toxicity.

 Cohorts of 3-9 patients receive escalating doses of bortezomib and PXD101 until the maximum
 tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2
 of 6 patients experience dose-limiting toxicity. Blood is collected at baseline and
 periodically during course 1 of study treatment for pharmacokinetic studies.

 After completion of study treatment, patients are followed periodically for 4 weeks.
Inclusion Criteria:

 -  Histologically or cytologically confirmed solid tumor or lymphoma that is refractory
 to standard therapy or for which no standard therapy exists

 -  No active, untreated, or symptomatic brain metastases

 -  Patients with treated brain metastases are eligible provided metastasis are
 stable and the patient is off all steroids and anticonvulsants

 -  ECOG performance status 0-2

 -  Life expectancy ≥ 12 weeks

 -  WBC ≥ 3,000/mm^3

 -  Absolute neutrophil count ≥ 1,500/mm^3

 -  Platelet count ≥ 100,000/mm^3

 -  Bilirubin ≤ 1.5 mg/dL

 -  AST and ALT ≤ 2.5 times upper limit of normal (ULN) (5 times ULN in the presence of
 liver metastases)

 -  Creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 60 mL/min

 -  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, bortezomib, boron, or mannitol

 -  No peripheral neuropathy > grade 1

 -  No uncontrolled intercurrent illness, including, but not limited to, any of the
 following:

 -  Ongoing or active infection

 -  Symptomatic congestive heart failure

 -  Psychiatric illness or social situation that would preclude study requirements

 -  No significant cardiovascular disease, including any of the following:

 -  Myocardial infarction within the past 6 months

 -  New York Heart Association class III-IV heart failure

 -  Unstable angina pectoris

 -  Uncontrolled hypertension

 -  Condition requiring antiarrhythmic therapy

 -  Ischemic or severe valvular heart disease

 -  Acute ischemia or active conduction system abnormalities by ECG

 -  No marked baseline prolongation of QT/QTc interval (repeated demonstration of a QTc
 interval > 500 msec), long QT syndrome, or required use of concurrent medication
 during PXD101 administration that may cause torsade de pointes

 -  No severe medical or psychiatric problems of that would preclude study compliance

 -  At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas, carmustine, or
 mitomycin C)

 -  At least 4 weeks since prior radiotherapy and recovered

 -  At least 2 weeks since prior palliative radiotherapy to sites involving < 35% of bone
 marrow reserve

 -  At least 4 weeks since prior investigational agents

 -  At least 2 weeks since prior valproic acid or any other histone deacetylase inhibitor

 -  No prior stem cell or bone marrow transplantation

 -  No concurrent radiotherapy or immunotherapy

 -  No concurrent hormonal therapy

 -  Luteinizing hormone-releasing hormone agonists, selective estrogen receptor
 modulators, or aromatase inhibitors as chronic maintenance therapy allowed

 -  No concurrent combination antiretroviral therapy for HIV-positive patients

 -  No other concurrent investigational agents

 -  No other concurrent anticancer agents or therapies