A Phase 1, Open-label, Dose-escalation Study of Dasatinib and All-Trans Retinoic Acid for Relapsed/Refractory and/or Elderly Patients With Acute Myelogenous Leukemia

Inclusion Criteria:

- Signed informed consent form (ICF) indicating that the subject has been informed of
the procedures to be followed, the experimental nature of the therapy, alternatives,
potential benefits, side-effects, risks, and discomforts

- Confirmed diagnosis of non-APL AML (WHO criteria) that is refractory to available
therapy (i.e., has failed two induction regimens)-or- that has relapsed within six
months of attaining a remission. Patients who relapse more than six months after
achieving a remission, who cannot achieve a second remission after two standard
re-induction chemotherapy regimens, will also be candidates. Patients who develop
AML after a pre-existing hematologic disease (myelodysplastic syndrome,
myeloproliferative syndrome) or after prior exposure to chemotherapy (secondary AML)
will be considered eligible for study. Additionally we will include patients age 65
years or older with relapsed or de novo AML who are not candidates for induction
chemotherapy, given the inferior prognosis in this group of patients.

- Confirmed diagnosis of non-APL AML in a patient age 65 or older

- Males or non-pregnant, non-breastfeeding females 18 years of age or older

- ECOG Performance Status less than or equal to 3

- Life expectancy of at least 2 months

- Subjects with reproductive capability must agree to practice adequate contraception
methods. Males must be surgically sterilized or be willing to use condoms from the
first dose of study drug until at least 30 days after the last dose. Females must be
surgically sterilized, postmenopausal for at least 1 year, or willing to use an
appropriate double barrier method or oral, patch, implant, or injectable
contraception from the first dose of study drug until at least 30 days after the last
dose

- Adequate baseline laboratory assessments:

- Total bilirubin level ≤1.5 times institutional upper limit of normal (ULN), alanine
aminotransferase (ALT) or aspartate aminotransferase (AST) ≤2.5 x ULN

- Estimated plasma creatinine clearance of ≥50 mL/min (using the Cockroft-Gault
equation) (Cockroft-Gault, 1976): CLcreat = ((140 - age) x body mass x 0.85 if
female) / 72 x creatinine where age is given in years, body mass is given in kg, and
creatinine is given in mg/dL

Exclusion Criteria:

- Patient with a diagnosis of Acute Promyelocytic Leukemia

- Known or clinically suspected CNS involvement

- Treatment with an investigational agent within 30 days prior to the first dose of
dasatinib/ATRA or planning to receive an investigational agent during the study

- Currently receiving anticancer therapy

- Screening ECG QTc interval ≥500 msec for females, ≥470 msec for males.

- Chronic diarrhea

- Gastrointestinal diseases that could affect drug absorption including post surgical
states such as gastric bypass

- Gastrointestinal diseases that could alter the assessment of safety, including
irritable bowel syndrome, ulcerative colitis, Crohn's disease, or hemorrhagic
coloproctitis.

- Positive HIV serology

- Uncontrolled, life-threatening infection that is not responding to antimicrobial
therapy

- Pregnant or Breastfeeding

- A diagnosis of another active malignancy with the exception of non-melanoma skin
cancer or cervical cancer

- History of psychiatric disorder which may compromise compliance