Phase I/II Study of Combination of Sorafenib, Vorinostat, and Bortezomib for the Treatment of Acute Myeloid Leukemia With Complex- or Poor-risk (Monosomy 5/7) Cytogenetics or FLT3-ITD Positive Genotype
- A confirmed baseline diagnosis of AML by the revised guidelines of the International
Working Group for AML including newly diagnosed, relapsed or refractory disease.
- Poor-risk or complex cytogenetics profile, or deletion of chromosome 5, or deletion
of chromosome 7, or positive FLT3-ITD mutation.
- The patient must have discontinued all previous therapies for acute leukemia for at
least 14 days and recovered from the acute non-hematologic side effects of the
- Hydroxyurea to control peripheral blood blast count must be discontinued within 24
hours prior to the initiation of treatment.
- Patients must have an ECOG (Zubrod) performance status of 0-2
- Patients must have adequate hepatic and renal function according to the protocol
within one week prior to treatment.
- Female patients must be postmenopausal, surgically sterile or agree to use effective
methods of contraception throughout the study.
- Male patients, even if surgically sterilized, must agree to practice effective
contraception throughout the study.
- Patients must be able to swallow and tolerate oral medications.
- Known central nervous system (CNS) leukemia.
- Diagnosis of acute promyelocytic leukemia (APL).
- Grade >/= 2 peripheral neuropathy.
- Serious illness including, significant ongoing or active infection, New York Heart
Association (NYHA) Grade III or IV congestive heart failure, unstable angina or new
onset angina or myocardial infarction within the past 6 months, cardiac ventricular
arrhythmias requiring anti-arrhythmic therapy, thrombotic or embolic events such as a
cerebrovascular accident including transient ischemic attacks within past 3 months.
Serious medical or psychiatric illness/social situations that in the opinion of the
investigator would limit compliance with study requirements.
- Diagnosed or treated for another malignancy within 3 years of enrollment, with the
exception of complete resection of basal cell carcinoma or squamous cell carcinoma of
the skin, an in situ malignancy, or low-risk prostate cancer after curative therapy.
- Active corneal erosions or history of abnormal corneal sensitivity test.
- Known or suspected history of severe hypersensitivity reaction to tyrosine kinase
inhibitors, histone deacetylase inhibitors, proteosome inhibitors, boron, or
- Female patients who are lactating or have a positive serum pregnancy test within 72
hours of initiation of treatment, or a positive urine pregnancy test on Day 1 before
first dose of study drug.
- Concurrent use of other histone deacetylase inhibitors (e.g. valproic acid) are
prohibited except for HDAC inhibitors or HDAC-inhibitor like agents used for
non-cancer treatment (e.g. epilepsy), where a 14 day washout is allowed.
- Radiation therapy within 3 weeks before randomization.
- Patients with known HIV, or known active hepatitis B or C infections.