Panobinostat (LBH589) and Imatinib Mesylate in Treating Patients With Previously Treated Chronic Phase Chronic Myelogenous Leukemia
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Purpose
RATIONALE: Panobinostat and imatinib mesylate may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.
PURPOSE: This phase I trial is studying the side effects and best dose of panobinostat when given together with imatinib in treating patients with previously treated chronic phase chronic myelogenous leukemia.
| Condition | Intervention | Phase |
|---|---|---|
|
Leukemia |
Drug: imatinib mesylate Drug: panobinostat Genetic: polymerase chain reaction Genetic: protein expression analysis Genetic: western blotting Other: flow cytometry Other: laboratory biomarker analysis Other: pharmacological study |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase I Dose Escalation Study of LBH589 in Combination With Imatinib Mesylate for Patients With Chronic Myeloid Leukemia in Cytogenetic Remission With Residual Disease Detectable by Q-PCR |
- Maximum tolerated dose of histone deacetylase inhibitor LBH589 in combination with imatinib mesylate [ Time Frame: 1 month ] [ Designated as safety issue: Yes ]
- Safety and tolerability of histone deacetylase inhibitor LBH589 in combination with imatinib mesylate [ Time Frame: 4 months ] [ Designated as safety issue: Yes ]
- Effect of treatment with histone deacetylase inhibitor LBH589 in combination with imatinib mesylate on cytogenetic response status and BCR-Abl levels [ Time Frame: 4 months ] [ Designated as safety issue: No ]
- Effect of treatment with histone deacetylase inhibitor LBH589 in combination with imatinib mesylate on residual BCR-Abl positive primitive progenitors [ Time Frame: 4 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 23 |
| Study Start Date: | May 2008 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Treatment (panobinostat, imatinib mesylate)
Patients receive oral panobinostat once daily on days 1, 3 and 5; 8, 10, and 12; 15, 17, and 19; and 22, 24, and 26. Patients also receive oral imatinib mesylate once daily on days 1-28. Treatment repeats every 21 or 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity.
|
Drug: imatinib mesylate
Given orally
Other Names:
Drug: panobinostat
Given orally
Other Names:
Genetic: polymerase chain reaction
Testing
Genetic: protein expression analysis
Testing
Genetic: western blotting
Testing
Other: flow cytometry
Testing
Other: laboratory biomarker analysis
Testing
Other: pharmacological study
Testing
|
Detailed Description:
OBJECTIVES:
Primary
- To determine the safety and tolerability of LBH589 given in combination with imatinib mesylate in CML patients who are in Major Cytogenetic Remission (MCR) with residual BCR-ABL positive cells after at least 1 year of daily imatinib mesylate treatment.
- To determine the maximum tolerated dose (MTD) and dose-limiting toxicity of LBH589 given in combination with imatinib mesylate in CML patients.
Secondary
- To study the effect of LBH589 given in combination with imatinib mesylate on cytogenetic response status and BCR-ABL levels in CML patients in major cytogenetic remission on imatinib mesylate treatment.
Tertiary
- To study the effect of LBH589 given in combination with imatinib mesylate on residual BCR-ABL positive primitive progenitors in CML patients in major cytogenetic remission on imatinib mesylate treatment.
OUTLINE: This is dose-escalation study of panobinostat.
Patients receive oral panobinostat once daily on days 1, 3 and 5; 8, 10, and 12; 15, 17, and 19; and 22, 24, and 26. Patients also receive oral imatinib mesylate once daily on days 1-28. Treatment repeats every 21 or 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up at 1 month and then every 3 months for up to 1 year.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Ability to provide written informed consent obtained prior to participation in the study and any related procedures being performed
- CML CP patients who have been treated with and tolerated Imatinib for 1 year or more, have achieved at least major cytogenetic response and continue to be BCR-ABL positive (Patients should be receiving Imatinib at a dose of 400 daily at the time of entry into the study)
- ANC and PLT need to be in the normal range
- Serum albumin >= 3g/dL
- AST/SGOT and ALT/SGPT =< 2.5 x upper limit of normal (ULN)
- Serum bilirubin =< 1.5 x ULN
- Serum creatinine =< 1.5 x ULN or 24-hour creatinine clearance >= 50 ml/min
- Serum potassium >= lower limit of normal (LLN)
- Serum phosphorus >= LLN
- Serum total calcium (corrected for serum albumin) or serum ionized calcium >= LLN
- Serum magnesium >= LLN
- ECOG performance status of =< 2
Exclusion Criteria:
- Prior treatment with an HDAC inhibitor
- Patient who have been treated with Imatinib < 1 year or patients are currently being treated with Imatinib at a dose > 400 mg daily
- Impaired cardiac function including any one of the following: Screening ECG with a QTc > 450 msec; Patients with congenital long QT syndrome; History or presence of sustained ventricular tachycardia; Any history of ventricular fibrillation or torsades de pointes; Bradycardia defined as heart rate < 50 beats per minute (patients with a pacemaker and heart rate >= 50 beats per minute are eligible); Patients with a myocardial infarction or unstable angina within 6 months of study entry; Congestive heart failure (NY Heart Association class III or IV); Right bundle branch block and left anterior hemiblock (bifascicular block)
- Uncontrolled hypertension
- Concomitant use of drugs with a risk of prolonging the QT interval or inducing torsades de pointes
- Concomitant use of CYP3A4 inhibitors
- Patients with unresolved diarrhea > CTCAE grade 1
- Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral LBH589
- Other concurrent severe and/or uncontrolled medical conditions
- Patients who have received chemotherapy, any investigational drug or undergone major surgery < 4 weeks prior to starting study drug or who have not recovered from side effects of such therapy
- Concomitant use of any other anti-cancer therapy or radiation therapy
- Patients being treated with Coumadin (unless patients who require anticoagulation can be switched to a low-molecular weight or standard heparin)
- Female patients who are pregnant or breast feeding or patients of reproductive potential not willing to use a double method of contraception including a barrier method (i.e. condom) during the study and 3 months after the end of treatment (Women of childbearing potential [WOCBP] must have a negative serum pregnancy test within 7 days of the first administration of oral LBH589)
- Male patients whose sexual partners are WOCBP not willing to use a double method of contraception including condom during the study and 3 months after the end of treatment
- Patients with a history of another primary malignancy within 5 years other than curatively treated CIS of the cervix, or basal or squamous cell carcinoma of the skin
- Patients with known positivity for human immunodeficiency virus (HIV) or hepatitis C; baseline testing for HIV and hepatitis C is not required
- Patients with any significant history of non-compliance to medical regimens or with inability to grant a reliable informed consent
Contacts and Locations| United States, California | |
| City of Hope Medical Center | Recruiting |
| Duarte, California, United States, 91010-3000 | |
| Contact: Jennifer Arceo 800-826-4673 | |
| Principal Investigator: Ravi Bhatia, MD | |
| South Pasadena Cancer Center | Terminated |
| South Pasadena, California, United States, 91030 | |
| United States, Oregon | |
| Knight Cancer Institute at Orgegon Health & Science University | Withdrawn |
| Portland, Oregon, United States, 97239-3098 | |
| United States, Washington | |
| Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium | Recruiting |
| Seattle, Washington, United States, 98109 | |
| Contact: Vivian Oehler, MD 206-667-1340 voehler@u.washington.edu | |
| Principal Investigator: Vivian Oehler, MD | |
| Principal Investigator: | Ravi Bhatia, MD | City of Hope Medical Center |
More Information
No publications provided
| Responsible Party: | City of Hope Medical Center |
| ClinicalTrials.gov Identifier: | NCT00686218 History of Changes |
| Other Study ID Numbers: | 07203, P30CA033572, NOVARTIS-CSTI571AUS275T, CDR0000596065, NCI-2010-00528 |
| Study First Received: | May 28, 2008 |
| Last Updated: | November 6, 2012 |
| Health Authority: | United States: Food and Drug Administration United States: Institutional Review Board |
Keywords provided by City of Hope Medical Center:
|
chronic phase chronic myelogenous leukemia |
Additional relevant MeSH terms:
|
Leukemia Leukemia, Myeloid Leukemia, Myelogenous, Chronic, BCR-ABL Positive Leukemia, Myeloid, Chronic-Phase Neoplasms by Histologic Type Neoplasms Myeloproliferative Disorders Bone Marrow Diseases Hematologic Diseases |
Imatinib Histone Deacetylase Inhibitors Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Protein Kinase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 19, 2013