A Phase II Pilot Study of Kinase Inhibition in Relapsed/Refractory Acute Leukemias: Using a Comprehensive in Vitro Kinase Inhibitor Panel to Select Individualized, Targeted Therapies.
Inclusion Criteria:
- Patients with relapsed/refractory leukemia with a confirmed diagnosis of acute
myelogenous leukemia or acute lymphoblastic leukemia who have in vitro kinase
inhibitor sensitivity as determined by our functional kinase inhibitor screen
- Patients have relapsed and are refractory to at least 1 cycle of salvage therapy
- Patients have not received leukemia treatment within 2 weeks of starting study drug
- Eastern Cooperative Oncology Group (ECOG) performance status greater than 2
- Patients must have normal organ function as defined by protocol
- Normal corrected QT (QTc) interval on screening electrocardiogram (ECG) evaluation
- Discontinuation of any medications known to contribute significantly to the risk of
QT prolongation up to 48 hours prior to start of study drug
- Discontinuation of anti-coagulants and anti-platelet drugs up to 5 days prior to
start of study drug
- No uncontrolled infections as determined by the investigator
- No uncontrolled thyroid disease
- No active graft-versus-host disease (GVHD)
- Must be able to take oral medication
- Women of childbearing potential must have a negative serum or urine pregnancy test
within 72 hours prior to the start of study drug administration
- Persons of reproductive potential must agree to use an adequate method of
contraception throughout treatment and for at least 4 weeks after study drug is
stopped. Women of childbearing potential and men with a significant other of
childbearing potential must be advised of the importance of avoiding pregnancy during
trial participation and the potential risk factors for an unintentional pregnancy
- Ability to understand and the willingness to sign a written informed consent and
Health Insurance Portability and Accountability Act (HIPAA) document
Exclusion Criteria:
- Patients may not receive concurrent chemotherapy, radiotherapy or immunotherapy, nor
have received any other investigational agents within the last 14 days of start of
screening
- Patients may not have pleural or pericardial effusion of any grade
- Known pulmonary arterial hypertension (dasatinib subjects only)
- Uncontrolled angina, greater than New York Heart Association (NYHA) class III
congestive heart failure or myocardial infarction within 6 months prior to study
enrollment
- Diagnosed congenital long QT syndrome
- Any history of clinically significant ventricular arrhythmias
- Subjects with hypokalemia or hypomagnesemia that cannot be corrected prior to kinase
inhibitor administration
- History of significant bleeding disorder unrelated to cancer.
- Concomitant medications that are generally accepted to have a risk of causing
Torsades de Pointes.
- Drugs that affect the Cytochrome P450 3A4 (CYP3A4) system
(inducers/inhibitors/substrates) are allowed but should be used with caution
depending on specific kinase inhibitor used.
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements.
- Pregnant or lactating women are excluded from this study because of possible risk to
the fetus or infant
- Known Human immunodeficiency virus (HIV) positive patients are excluded from the
study because of possible risk of lethal infection when treated with marrow
suppressive therapy.