Inclusion Criteria:
- Patients must have histologically confirmed malignancy (solid tumor or lymphoma) that
is metastatic or unresectable and for which standard curative or palliative measures
do not exist or are no longer effective
- Patients may have received prior treatment with either any HDAC inhibitor therapy or
17AAG, as long as they did not experience dose limiting toxicity (DLT) with these
prior treatments; DLTs include
- Toxicity: neutrophils; DLT: grade 4 toxicity (< 500/μL) for >= 7 days
- Toxicity: febrile neutropenia; DLT: ANC < 1000/μL of any duration accompanied by
fever >= 38.5ºC
- Toxicity: platelets; DLT: grade 4 toxicity (< 25,000/μL) for >= 7 days or of any
duration if accompanied by clinically significant bleeding
- Toxicity: non-hematologic; DLT: >= grade 3 as per NCI Common Terminology
Criteria for Adverse Events, Version 3.0** (except alopecia); ** for nausea and
vomiting, grade 3 toxicity with maximal anti-emetic treatment will be considered
dose-limiting; grade 3 diarrhea in spite of maximal anti-diarrheal therapy will
be considered dose-limiting; hypersensitivity reactions to 17AAG will not be
considered a DLT; asymptomatic grade 3 hypophosphatemia will not be considered a
DLT
- Toxicity: cardiac; DLT: ≥ grade 3 QTc prolongation
- ECOG performance status =< 2 (Karnofsky >= 60%)
- Life expectancy of greater than 12 weeks
- Leukocytes >= 3,000/mcL
- Absolute neutrophil count >= 1,500/mcL
- Platelets >= 75,000/mcL
- Total bilirubin within normal institutional limits
- AST(SGOT)/ALT(SGPT) =< 2.5 X institutional upper limit of normal
- Creatinine within normal institutional limits OR creatinine clearance >= 60
mL/min/1.73 m^2 for patients with creatinine levels above institutional normal
- Eligibility of patients receiving any medications or substances known to affect or
with the potential to affect the activity or pharmacokinetics of PXD101 or 17AAG will
be determined following review of their case by the Principal Investigator or Study
Chair; efforts should be made to switch patients who are taking enzyme-inducing
anticonvulsant agents to other medications
- The effects of PXD101 and 17AAG on the developing human fetus are unknown; for this
reason and because HDAC inhibitors as well as other therapeutic agents used in this
trial are known to be teratogenic, women of child-bearing potential and men must
agree to use adequate contraception (hormonal or barrier method of birth control;
abstinence) prior to study entry and for the duration of study participation; should
a woman become pregnant or suspect she is pregnant while participating in this study,
she should inform her treating physician immediately
- Ability to understand and the willingness to sign a written informed consent document
- Within 4 weeks of first treatment: Left ventricular ejection fraction ≥ 45% per
nuclear cardiac imaging or echocardiography
Exclusion Criteria:
- Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for
nitrosoureas or mitomycin C) prior to entering the study or those who have not
recovered (≤ grade 1) from clinically significant adverse events due to agents
administered more than 4 weeks earlier
- Patients may not be receiving any other investigational agents
- Patients with known brain metastases should be excluded from this clinical trial
because of their poor prognosis and because they often develop progressive neurologic
dysfunction that would confound the evaluation of neurologic and other adverse events
- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to PXD101; there are no known allergic reactions attributed to compounds
of similar chemical or biological composition to 17AAG; patients with known egg
allergy should be excluded as the agent is diluted in EPL diluent
- Patients should not have taken valproic acid, another histone deacetylase inhibitor,
for at least 2 weeks prior to enrollment
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, or psychiatric illness/social situations that would limit compliance with
study requirements
- Pregnant women are excluded from this study because PXD101 is an HDAC inhibitor with
the potential for teratogenic or abortifacient effects; because there is an unknown
but potential risk for adverse events in nursing infants secondary to treatment of
the mother with PXD101, breastfeeding should be discontinued if the mother is treated
with PXD101; these potential risks may also apply to other agents used in this study
- HIV-positive patients on combination antiretroviral therapy are ineligible because of
the potential for pharmacokinetic interactions with PXD101; in addition, these
patients are at increased risk of lethal infections when treated with
marrow-suppressive therapy; appropriate studies will be undertaken in patients
receiving combination antiretroviral therapy when indicated
- History of allergic reactions to eggs
- Patients who have significant cardiac disease including heart failure that meets New
York Heart Association (NYHA) class III and IV definitions, history of myocardial
infarction within 12 months of study entry, ischemic or severs valvular heart
disease, uncontrolled dysrhythmias, uncontrolled hypertension, a condition requiring
anti-arrhythmic therapy, or poorly controlled or unstable angina pectoris
- Patients who have a history of serious ventricular arrhythmia (VT or VF, >= 3 beats
in a row) or QTc >= 450 msec for men and 470 msec for women or a history of long QT
Syndrome
- Patients taking concomitant medications that prolong or may prolong QTc or may cause
Tosade des Pointes