RATIONALE: Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as mitoxantrone, etoposide, and cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving bortezomib together with combination chemotherapy may kill more cancer cells. PURPOSE: This phase I trial is studying the side effects and best dose of bortezomib when given together with mitoxantrone, etoposide, and cytarabine in treating patients with relapsed or refractory acute myeloid leukemia.
PRIMARY OBJECTIVES: I. To determine the DLT, MTD, and the recommended Phase 2 dose of bortezomib in combination with MEC in patients with relapsed/refractory AML. SECONDARY OBJECTIVES: I. To describe the non-dose limiting toxicities associated with bortezomib in combination with MEC in patients with relapsed/refractory AML. II. To describe any preliminary evidence of clinical activity of this combination (CR rate) in relapsed/refractory AML. III. To determine the median CD74 antigen expression in patients achieving a response versus those patients not achieving a response. OUTLINE: This is a dose-escalation study of bortezomib. Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8 and 11; and mitoxantrone IV, etoposide IV over 1 hour, and intermediate-dose cytarabine IV over 6 hours on days 1-6. Treatment continues in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 4-5 weeks.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
3
Given IV
Given IV
Given IV
Given IV
Correlative studies
Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
Cleveland, Ohio, United States
MTD of bortezomib
Time frame: two times a week until Day 28, then every week until Day 45 (+/- 2 days), then 4 wks after treatment.
Non-dose limiting toxicities
Time frame: two times a week until Day 28, then every week until Day 45 (+/- 2 days), then 4 wks after treatment.
CR/ CRp rate
Time frame: repeated 4 weeks after the post-treatment bone marrow aspirate/biopsy.
CD74 antigen expression
Time frame: to be performed only on the pre-treatment sample
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