This phase I trial is studying the side effects and best dose of tipifarnib and bortezomib in treating patients with acute leukemia or chronic myelogenous leukemia in blast phase. Tipifarnib and bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving tipifarnib together with bortezomib may kill more cancer cells.
PRIMARY OBJECTIVE: I. Determine the dose-limiting toxicity and maximum tolerated dose of tipifarnib and bortezomib in patients with relapsed or refractory acute myeloid leukemia, acute lymphoblastic leukemia, or chronic myeloid leukemia in blast phase. SECONDARY OBJECTIVES: I. Determine the effect of this regimen on farnesyltransferase and proteasome inhibition in peripheral blood mononuclear cells in these patients. II. Determine the clinical efficacy of this regimen in these patients. OUTLINE: This is a dose-escalation study. Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11 and oral tipifarnib twice daily on days 1-14. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients with partial response or stable disease may continue therapy beyond 6 courses at the discretion of the investigator. Cohorts of 3-6 patients receive escalating doses of bortezomib and tipifarnib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Blood is collected periodically for protein expression studies. Bone marrow aspirates obtained at baseline are examined by immunohistochemistry for Ki-67 activity.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
35
Moffitt Cancer Center
Tampa, Florida, United States
Dose-limiting toxicity and maximum tolerated dose of tipifarnib and bortezomib
Time frame: 21 days
Changes in apoptotic protein expression (Bim, Bax, AKT)
Time frame: Baseline and day 8
Clinical efficacy (response rate) evaluated using the revised International Working Group Criteria (IWG) for AML
Time frame: Up to 3 years
Farnesytransferase and proteasome inhibition in peripheral blood mononuclear cells
Time frame: Day 8
Farnesytransferase and proteasome inhibition in peripheral blood mononuclear cells
Time frame: Day 15
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