A Phase I Study of PXD101 in Combination With Azacitidine (5-Aza) for Advanced Hematologic Malignancies
PRIMARY OBJECTIVES:
I. Determine the maximum tolerated dose of PXD101 (belinostat) when given in combination
with azacitidine (when azacitidine is utilized at a dose range where its effects on cellular
differentiation are known to be predominant) in patients with advanced hematologic cancers
or other diseases.
SECONDARY OBJECTIVES:
I. Identify any additive or synergistic effects of this regimen on pharmacodynamic
parameters, including apoptosis and re-expression of specific target genes.
II. Assess any evidence of clinical activity (complete remission, partial remission,
hematologic improvement, stable disease) of this regimen in these patients.
OUTLINE: This is a dose-escalation study of belinostat followed by a randomized study.
Patients receive azacitidine subcutaneously (SC) and belinostat intravenously (IV) over 30
minutes on days 1-5. Courses repeat every 28 days in the absence of disease progression or
unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of belinostat 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. After the MTD is
determined, additional patients with myelodysplastic syndromes (MDS) or acute myeloid
leukemia (with trilineage dysplasia or arising from MDS) are randomized to 1 of 2 treatment
arms.
Arm I: Patients receive azacitidine SC on days 1-5.
Arm II: Patients receive azacitidine as in arm I and belinostat at the MTD IV over 30
minutes on days 1-5.
In both arms, courses repeat every 28 days in the absence of disease progression or
unacceptable toxicity. After receiving one course, patients randomized to arm I may
crossover to receive treatment on arm II.
For patients enrolled in the randomized portion of the study, bone marrow aspirates are
obtained at baseline, and after course 1 for correlative studies. Samples are examined by
gene expression analysis of p15 and p21, DNA methylation of p15INK4B, and apoptosis by
RT-PCR and flow cytometry. Pharmacodynamic assays are also performed.
After completion of study treatment, patients are followed periodically for up to 2 years.
Interventional
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Maximum tolerated dose of belinostat in combination with azacitidine
Graded using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 or 4.0.
Course 1 (28 days)
Yes
Olatoyosi Odenike
Principal Investigator
University of Chicago Comprehensive Cancer Center
United States: Food and Drug Administration
NCI-2009-00146
NCT00351975
June 2006
Name | Location |
---|---|
University of Wisconsin Hospital and Clinics | Madison, Wisconsin 53792-0001 |
University of Chicago Comprehensive Cancer Center | Chicago, Illinois 60637-1470 |