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Belinostat in Treating Patients With Recurrent or Metastatic Thymoma and Thymic Carcinoma That Cannot be Removed by Surgery
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), October 2008
Sponsored by: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00589290
  Purpose

RATIONALE: Belinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It may also stop the growth of thymoma and thymic carcinoma by blocking blood flow to the tumor.

PURPOSE: This phase II trial is studying how well belinostat works in treating patients with recurrent or metastatic thymoma and thymic carcinoma that cannot be removed by surgery.


Condition Intervention Phase
Thymoma and Thymic Carcinoma
Drug: belinostat
Procedure: DNA methylation analysis
Procedure: flow cytometry
Procedure: immunohistochemistry staining method
Procedure: laboratory biomarker analysis
Phase II

MedlinePlus related topics: Cancer
Drug Information available for: Belinostat
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Multicenter Phase II Study of Belinostat (PXD101) in Previously Chemotherapy Treated Thymoma and Thymic Carcinoma

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Objective response rate (complete response plus partial response) according to RECIST criteria [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Durations of response, progression-free survival, and overall survival [ Designated as safety issue: No ]
  • Changes in p21, VEGF, and other angiogenic cytokines as measured by immunohistochemistry [ Designated as safety issue: No ]

Estimated Enrollment: 25
Study Start Date: December 2007
Estimated Primary Completion Date: February 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To assess the objective response rate of belinostat according to RECIST criteria in patients with relapsed or refractory thymoma or thymic carcinoma.

Secondary

  • To evaluate the safety profile for belinostat monotherapy.
  • To evaluate time to response, duration of response, progression-free survival, and overall survival.
  • To identify chromosomal gains or losses by using comparative genomic hybridization and gene methylation status using a methylation microarray, in thymoma/thymic carcinomas and correlate with clinical outcome.
  • To assess expression levels of particular proteins in the pretreatment tumor sample by immunohistochemistry and correlate them with clinical outcome.
  • To identify and measure changes in p21 and protein hyperacetylation in PBMC, VEGF, and bFGF in plasma and evaluate correlation with clinical outcome.
  • To measure changes in modulation of T-cell function in peripheral blood lymphocytes.

OUTLINE: This is a multicenter study.

Patients receive belinostat IV over 30 minutes on days 1-5. Treatment repeats every 3 weeks for 12 courses and then every 4 weeks thereafter in the absence of disease progression or unacceptable toxicity.

Existing tumor blocks are analyzed for comparative genomic hybridization, methylation microarray analysis, and tissue immunohistochemistry studies. Blood samples are collected during courses 1 and 2 for circulating plasma biomarkers of response (including VEGF) and for protein hyperacetylation and T-cell modulation analyses by flow cytometry.

After completion of study treatment, patients are followed for 30 days.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed invasive recurrent or metastatic thymoma or thymic carcinoma

    • Unresectable disease
    • Progressive disease
  • Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as > 20 mm with conventional techniques or as > 10 mm with spiral CT scan
  • Must have had at least one prior platinum-containing chemotherapy regimen
  • Tumor not amenable to potentially curative therapy as assessed by the investigator
  • No symptomatic brain metastases

    • Patients who have had treatment for their brain metastases and whose brain metastatic disease status has remained stable for ≥ 3 months without steroids allowed at the discretion of the principal investigator

PATIENT CHARACTERISTICS:

Inclusion Criteria:

  • ECOG performance status 0-2
  • Life expectancy > 3 months
  • Absolute neutrophil count > 1,500/μL
  • Platelet count > 100,000/μL
  • INR and PTT ≤ 1.5 times upper limit of normal (ULN) (unless abnormality can be explained by the presences of lupus anticoagulant or in the therapeutic range if on anticoagulation)
  • Total bilirubin ≤ 1.5 times ULN
  • AST and ALT ≤ 3 times ULN
  • Creatinine ≤ 1.5 times ULN OR creatinine clearance > 45 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for at least 2 months after completion of study treatment

Exclusion Criteria:

  • Uncontrolled medical illness including, but not limited to, any of the following:

    • Ongoing or uncontrolled, symptomatic congestive heart failure (AHA class II or greater)
    • Uncontrolled hypertension
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness/social situations that would limit compliance with study requirements
  • Marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval > 500 msec)
  • Long QT Syndrome
  • HIV-positive patients
  • History of another invasive malignancy in the past five years

    • Adequately treated noninvasive, nonmelanoma skin cancers, in situ carcinoma of the cervix, focal papillary adenocarcinoma of the thyroid allowed

PRIOR CONCURRENT THERAPY:

  • Recovered to baseline or ≤ grade 1 from any acute toxicity related to prior therapy
  • No limit to the number of prior chemotherapy regimens received for study disease
  • No prior chemotherapy within the past 4 weeks
  • No prior treatment with drugs of the HDAC inhibitor class
  • At least 28 days since any prior radiotherapy or major surgery

    • Target lesions cannot be selected within previously irradiated areas, unless newly arising or clearly progressing after irradiation as proven by repeat scanning
  • Concurrent corticosteroids for myasthenia gravis, other paraneoplastic syndromes, or other chronic conditions are allowed
  • No other concurrent investigational agents or commercial therapies
  • No concurrent alternative, complementary therapies or over-the-counter agents without approval of the principal investigator
  • No concurrent medication that may cause QTc prolongation or Torsades de Pointes
  • No concurrent use of any of the following medications:

    • Ketoconazole
    • Itraconazole
    • Ritonavir
    • Products containing grapefruit juice
    • Cyclosporine
    • Carbamazepine
    • Phenytoin
    • Phenobarbital
    • Prophylactic use of filgrastim (G-CSF) or sargramostim (GM-CSF)
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00589290

Locations
United States, Indiana
Indiana University Melvin and Bren Simon Cancer Center Recruiting
Indianapolis, Indiana, United States, 46202-5289
Contact: Clinical Trials Office - Indiana University Cancer Center     317-274-2552        
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office Recruiting
Bethesda, Maryland, United States, 20892-1182
Contact: Clinical Trials Office - Warren Grant Magnusen Clinical Center     888-NCI-1937        
Sponsors and Collaborators
Investigators
Principal Investigator: Giuseppe Giaccone, MD, PhD NCI - Medical Oncology Branch
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000581356, NCI-08-C-0033, NCI-P07249
Study First Received: December 25, 2007
Last Updated: January 6, 2009
ClinicalTrials.gov Identifier: NCT00589290  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
recurrent thymoma and thymic carcinoma
invasive thymoma and thymic carcinoma

Study placed in the following topic categories:
Thoracic Neoplasms
Thymoma
Thymus Neoplasms
Recurrence
Neoplasms, Glandular and Epithelial
Carcinoma

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site
Neoplasms by Histologic Type
Neoplasms, Complex and Mixed

ClinicalTrials.gov processed this record on January 16, 2009