Phase II Trial of LBH589 in Refractory Colorectal Cancer
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LBH589 will be administered orally at a dose of 30mg (1 - 20mg capsule and 2 - 5g capsules) on Monday, Wednesday and Friday of each week (three times a week). Patients may continue treatment with oral LBH589 until they experience unacceptable toxicity that precludes further treatment, disease progression, and/or at the discretion of the investigator.
The LBH589 capsules should be swallowed by mouth with a glass of water in the morning. The recommended way to take LBH589 is after not eating for at least 2 hours. You should also not eat for another 2 hours after taking your LBH589 capsules. The daily dose of LBH589 should be taken at approximately the same time each day. You should avoid eating grapefruit, seville oranges, or drinking grapefruit or seville orange juice during the study.
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Ages Eligible for Study:
18 Years and older (Adult, Senior)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Male or female patients aged ≥ 18 years old
Patients with measurable metastatic colorectal cancer
Refractory to at least 2 standard chemotherapy/biologic regimens to include 5FU, oxaliplatin, irinotecan, bevacizumab, cetuximab or combinations thereof
ECOG Performance Status of ≤ 2
Ability to provide written informed consent obtained prior to participation in the study and any related procedures being performed
Laboratory values as follows:
Neutrophil count of >1500/mm3
Platelet count of > 100,000/mm3L
Hemoglobin ≥ 9 g/dL
AST/SGOT and ALT/SGPT ≤ 2.5 x upper limit of normal (ULN) or ≤ 5.0 x ULN if the transaminase elevation is due to disease involvement
Serum bilirubin ≤ 1.5 x ULN
Serum creatinine ≤ 1.5 x ULN or 24-hour creatinine clearance ≥ 50 ml/min
Total serum calcium (corrected for serum albumin) or ionized calcium ≥ LLN
Serum potassium ≥ LLN
Serum sodium ≥ LLN
Serum albumin ≥ LLN or 3g/dl
Patients with any elevated Alkaline Phosphatase due to bone metastasis can be enrolled
Baseline MUGA or ECHO must demonstrate LVEF ≥ the lower limit of the institutional normal
TSH and free T4 within normal limits (patients may be on thyroid hormone replacement)
Women of childbearing potential (WOCBP) must have a negative serum pregnancy test within 7 days of the first administration of study treatment. and must be willing to use two methods of contraception one of them being a barrier method during the study and for 3 months after last study drug administration
Radiographically bi-dimensionally measurable disease that has not been previously irradiated. If the patient has had previous radiation to the marker lesion(s), there must be evidence of progression since the radiation
Life expectancy must be greater than 12 weeks
Prior HDAC, DAC, HSP90 inhibitors or valproic acid for the treatment of cancer
Patients who will need valproic acid for any medical condition during the study or within 5 days prior to first LBH589 treatment
Impaired cardiac function including any one of the following:
Screening ECG with a QTc > 450 msec confirmed by central laboratory prior to enrollment to the study
Patients with congenital long QT syndrome
History of sustained ventricular tachycardia
Any history of ventricular fibrillation or torsades de pointes
Bradycardia defined as heart rate < 50 beats per minute. Patients with a pacemaker and heart rate ≥ 50 beats per minute are eligible.
Patients with a myocardial infarction or unstable angina within 6 months of study entry
Congestive heart failure (NY Heart Association class III or IV)
Right bundle branch block and left anterior hemiblock (bifasicular block)
Concomitant use of drugs with a risk of causing torsades de pointes
Concomitant use of CYP3A4 inhibitors
Patients with unresolved diarrhea > CTCAE grade 1
Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral LBH589
Other concurrent severe and/or uncontrolled medical conditions
Patients who have received chemotherapy, any investigational drug or undergone major surgery < 4 weeks prior to starting study drug or who have not recovered from side effects of such therapy.
Concomitant use of any anti-cancer therapy or radiation therapy
Women who are pregnant or breast feeding or women of childbearing potential (WOCBP) not willing to use a double barrier method of contraception during the study and 3 months after the end of treatment. One of these methods of contraception must be a barrier method. WOCBP are defined as sexually mature women who have not undergone a hysterectomy or who have not been naturally postmenopausal for at least 12 consecutive months (i.e., who has had menses any time in the preceding 12 consecutive months). Women of childbearing potential (WOCBP) must have a negative serum pregnancy test within 7 days of the first administration of oral LBH589
Male patients whose sexual partners are WOCBP not using a double method of contraception during the study and 3 months after the end of treatment. One of these methods must be a condom
Patients with a history of another primary malignancy within 5 years other than curatively treated CIS of the cervix, or basal or squamous cell carcinoma of the skin
Patients with known positivity for human immunodeficiency virus (HIV) ) or hepatitis C; baseline testing for HIV and hepatitis C is not required
Patients with any significant history of non-compliance to medical regimens or with inability to grant a reliable informed consent