RATIONALE: Bortezomib and vorinostat may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving bortezomib together with vorinostat may kill more cancer cells. PURPOSE: This phase II trial is studying how well giving bortezomib together with vorinostat works in treating patients with high-risk myelodysplastic syndrome or acute myelogenous leukemia.
OBJECTIVES: Primary * To determine the clinical response to bortezomib and vorinostat in patients with high-risk myelodysplastic syndromes or acute myeloid leukemia, as defined by the International Working Group response criteria. Secondary * To characterize the quantitative and qualitative toxicities of this regimen in these patients. * To assess the effect of this regimen on natural killer (NK) cell function, in terms of activating and inhibitory receptor alterations, target cell ligand and HLA class I modulation, and NK-mediated cell killing. * To correlate the above changes with clinical response. OUTLINE: Patients receive bortezomib subcutaneously (SQ) on days 1, 4, 8, and 11 and oral vorinostat once daily on days 1-14. Treatment repeats every 21 days for 3 courses in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete response, partial response, or hematologic improvement may receive 3 additional courses of therapy (for a maximum of 6 courses). Bone marrow and peripheral blood samples are collected at baseline and at the completion of 3 courses of therapy for analysis of target cells (myeloid blasts) (i.e., HLA class I receptor analysis and natural killer \[NK\] cell receptor ligand analysis) and analysis of activating NK cell receptor alterations and NK-mediated cell killing. After completion of study treatment, patients are followed periodically for up to 1 year.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
16
1.3mg/m\^2 via peripheral subcutaneous administration on day 1, 4, 8, 11 of a 21 day cycle
400 mg orally (po) every day on days 1-14 of a 21 day cycle
Masonic Cancer Center, University of Minnesota
Minneapolis, Minnesota, United States
Number of Patients by Best Clinical Response
Assessed by the International Working Group response criteria: Complete Remission - \<5% myeloblasts with normal maturation of all cell lines; Partial Remission - bone marrow blasts decreased by \> 50% over pre-treatment but still \>5%; and Hematologic Improvement - hemoglobin increase by \> 1.5g/dl or decreased transfusions by at least 4/8 week period, platelet absolute increase of \>30 X 10\^9/L for those starting at \>20 X 10\^9/L . For those \< 20 X 10\^9 /L at baseline increase by 100%.
Time frame: At Completion of Course 3 (Day 63)
Correlative Laboratory Studies
Analysis of Natural Killer (NK) Cell Activating and Inhibitory Receptor Alterations, NK Cell Receptor Ligand Alterations, HLA Class I Expression on Target Cells (Myeloid Blasts), and NK-mediated Cell Killing
Time frame: Pre-Study and After 3 Cycles
Correlation of Cell Alterations With Clinical Response
Analysis of Natural Killer (NK) Cell Activating and Inhibitory Receptor Alterations, NK Cell Receptor Ligand Alterations, HLA Class I Expression on Target Cells (Myeloid Blasts), and NK-mediated Cell Killing
Time frame: Pre-Study and After 3 Cycles
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