This phase I trial is studying the side effects and best dose of vorinostat when given together with temozolomide in treating young patients with relapsed or refractory primary brain tumors or spinal cord tumors. Vorinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Vorinostat may help temozolomide work better by making tumor cells more sensitive to the drug.
PRIMARY OBJECTIVES: I. To estimate the maximum tolerated dose and/or recommended phase II dose of vorinostat in combination with temozolomide in pediatric patients with relapsed or refractory primary CNS tumors. II. To define and describe the toxicities of this regimen in these patients. SECONDARY OBJECTIVES: I. To preliminarily define the antitumor activity of this regimen within the confines of a phase I study. II. To characterize the pharmacokinetic parameters of vorinostat in these patients. III. To determine whether acetylated histones in peripheral blood mononuclear cells can be identified as a surrogate marker of the biologic effect of vorinostat at various treatment doses. IV. To assess the feasibility of collecting and analyzing serum DNA for methylation of the MGMT promoter and describe the relationship between promoter methylation and clinical responses within the confines of this phase I study. OUTLINE: This is a multicenter, dose-escalation study of vorinostat. Patients receive oral vorinostat and oral temozolomide once daily on days 1-5. Courses repeat every 28 days for up to 13 courses in the absence of disease progression or unacceptable toxicity. Patients may undergo blood sample collection periodically for pharmacokinetic and correlative laboratory studies by western blotting and MGMT promoter methylation assays. After completion of study therapy, patients are followed up for 30 days.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
27
Childrens Memorial Hospital
Chicago, Illinois, United States
C S Mott Children's Hospital
Ann Arbor, Michigan, United States
University of Minnesota Medical Center-Fairview
Minneapolis, Minnesota, United States
Oregon Health and Science University
Portland, Oregon, United States
St. Jude Children's Research Hospital
Memphis, Tennessee, United States
Baylor College of Medicine
Houston, Texas, United States
Seattle Children's Hospital
Seattle, Washington, United States
Hospital for Sick Children
Toronto, Ontario, Canada
Hospital Sainte-Justine
Montreal, Quebec, Canada
Maximum tolerated dose defined as the maximum dose at which fewer than one-third of patients experience DLT using NCI CTCAE version 4.0
In addition to determination of the MTD, a descriptive summary of all toxicities will be reported.
Time frame: 28 days
Pharmacokinetic parameters of vorinostat in combination with temozolomide
The PK parameters will be summarized with simple summary statistics, including means, medians, ranges, and standard deviations (if numbers and distribution permit).
Time frame: Pre-dose, 15 and 30 minutes, 1, 2, 4, 6, 8, and 24 hours
Response assessed according to RECIST criteria
Will be reported descriptively.
Time frame: Up to 30 days
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