LBH589 is a drug that may slow down the growth of cancer cells or kill cancer cells by blocking certain enzymes. LBH589 has shown effects against cancer in laboratory studies and in studies using animals; however, it is not known if this medicine will show the same activity in humans. As of May 2006, approximately 100 patients have received treatment with either an intravenous or capsule form of LBH589. Only the capsule form of LBH589 will be used in this study. In addition, information from other research studies and laboratory studies suggests that this study drug may help to treat lung cancer. The main goal during the Phase I portion of this research study is to find out the highest and safest dose of LBH589 that can be given in combination with pemetrexed in subjects with lung cancer without causing severe side effects. The main goal of the Phase II portion of this study is to find how the patient's lung cancer responds to the LBH589 in combination with pemetrexed. This study will also investigate how the patient's body processes the combination of LBH589 and pemetrexed. To determine this, the investigators will measure the amount of study drug in the patient's blood. This will be done with a series of blood tests, called pharmacokinetic (PK) tests. Other purposes of this study will be to determine the side effects of LBH589 in combination with pemetrexed and whether or not this combination is effective in treating your type of cancer.
Objectives 1. To determine the maximum tolerated dose of LBH589 given on a three times weekly schedule when combined with pemetrexed for the treatment of patients with advanced thoracic malignancies, except squamous cell carcinoma of the lung (phase I part). 2. To determine the overall response rate and non-progression rate (clinical benefit rate) and progression-free survival of the combination of LBH589 and pemetrexed in patients with previously-treated advanced NSCLC (phase II part). 3. To determine the pharmacodynamic effects of LBH589 and pemetrexed on levels of histone deacetylase (HDAC) 1 and 6 in peripheral blood mononuclear cells, as well as on levels of vascular endothelial growth factor (VEGF) levels in the blood. 4. To identify biomarkers in baseline, archival tumor tissue that may correlate with antitumor efficacy. Subject population Phase I: We will enroll patients treated with any number of prior regimen and all thoracic malignancies, except squamous cell carcinoma of the lung. Phase II: We will enroll patients with recurrent or progressive NSCLC who have received 1 prior chemotherapy regimen (1 additional regimen in the setting of initial curative treatment is allowed if completed \>1 year earlier). Treatment plan * Pemetrexed 500mg/m2 IV, day 1, every 21 days, on the first day of the week LBH589 is given. * LBH589 three-times-a-week (doses will be at least 2 days apart, e.g. Monday, Wednesday, Friday), until disease progression or intolerable toxicities LBH589 will start the week prior to the first pemetrexed cycle and pharmacodynamic (PD) studies will be performed (week -1) Study design and sample size: This is a phase I/II study. Phase I: 9-18 patients (estimated); Phase II: 17-41 patients (estimated).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
LBH589 three-times-a-week (doses will be at least 2 days apart, e.g. Monday, Wednesday, Friday), until disease progression or intolerable toxicities LBH589 will start the week prior to the first pemetrexed cycle and PD studies will be performed (week -1). Dose level: 1 LBH589: 10 mg Pemetrexed: 500 mg/m2 Dose level: 2 LBH589: 15 mg Pemetrexed: 500 mg/m2 Dose level: 3 LBH589: 20 mg Pemetrexed: 500 mg/m2 Dose level: 4 LBH589: 30 mg Pemetrexed: 500 mg/m2
Pemetrexed 500mg/m2 IV, day 1, every 21 days, on the first day of the week LBH589 is given.
Hillman Cancer Center
Pittsburgh, Pennsylvania, United States
To determine the maximum tolerated dose of LBH589 given on a three times weekly schedule when combined with pemetrexed for the treatment of patients with advanced thoracic malignancies, except squamous cell carcinoma of the lung (phase I part)
Time frame: 6 months
Determine the overall response rate and non-progression rate (clinical benefit rate) and progression-free survival of the combination of LBH589 and pemetrexed in patients with previously-treated advanced NSCLC (phase II part).
Time frame: 1 year
Determine the pharmacodynamic effects of LBH589 and pemetrexed on levels of HDAC 1 and 6 in peripheral blood mononuclear cells, as well as on levels of VEGF levels in the blood.
Time frame: 1 year
Identify biomarkers in baseline, archival tumor tissue that may correlate with antitumor efficacy.
Time frame: 1 year
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