Intervention: (2S)-2-[[(2S)-3-carboxy-2-[[2-[[(2S)-5-(diaminomethylideneamino)-2-[[4-oxo-4-[[4-(4-oxo-8-phenylchromen-2-yl)morpholin-4-ium-4-yl]methoxy]butanoyl]amino]pentanoyl]amino]acetyl]amino]propanoyl]amino]-3-hydroxypropanoate
Trial phase: Phase 2
SMILES: NC(N)=NCCCC(NC(=O)CCC(=O)OC[N+]1(c2cc(=O)c3cccc(-c4ccccc4)c3o2)CCOCC1)C(=O)NCC(=O)NC(CC(=O)O)C(=O)NC(CO)C(=O)[O-]
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 1
Group description: SF1126 1110 mg/m2 administered intravenously (IV) twice per week (separated by at least three days) for the first four treatment cycles (28 days) and then once weekly for subsequent cycles.

SF1126
Eligibility criteria:
Inclusion Criteria:

Diagnosis of recurrent or metastatic SCCHN or any site except lip, thyroid, salivary gland, or nasopharynx.
No known FDA-approved therapy available that's expected to prolong survival by greater than 3 months.

Tumors with at least one of the following known mutations in the PI-3K signaling pathway, via assays performed in a CLIA-approved setting (Foundation Medicine FoundationOne test will be used. This assay uses a cut-off of 5% allele fraction for mutations. Allele fraction will be requested on each sample):

PIK3CA,
PIK3CG,
PIK3R1, PIK3R5 and PIK3AP1 (regulatory subunits),
AKT and mTOR, or
PTEN Note: PIK3CA amplification is not eligible.
Prior receipt of platinum-containing chemotherapy for recurrent/metastatic disease or a history of progression of disease within 6 months of receiving platinum as part of concurrent chemoradiation.
Disease must not be amenable to potentially curative treatment..

Has recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy.

Myelosuppressive chemotherapy: At least 3 weeks since completion (6 weeks for nitrosourea)
Biologic (anti-neoplastic agent): At least 14 days since completion of therapy with a biologic agent.
Radiation (XRT):1 week must have elapsed from prior palliative XRT to non-target lesions.

Adequate Bone Marrow Function Defined for all subjects (including status post SCT):

Peripheral absolute neutrophil count (ANC) 1000/mm3; Note: must be >7 days from use of hematopoietic growth factor or 21 days from pegfilgastrim
Platelet count 75,000/ mm3 (transfusion independent for >7 days)
Hemoglobin 8.0 g/dL (may receive transfusions)

Adequate Renal Function Defined As:

Serum creatinine ≤ 1.5 x institution's ULN (upper limit of normal), or
Creatinine clearance 50 ml/min

Adequate Liver and Pancreatic Function Defined As:

Total bilirubin 1.5 x upper limit of normal, and
ALT or AST 5 x upper limit of normal, and
Albumin 2 g/dL

Adequate Central Nervous System Function Defined As:

Subjects with seizure disorder may be enrolled if on anticonvulsants and seizures are well controlled.

Exclusion Criteria:

Brain metastases or spinal cord compression, unless treatment was completed at least 4 weeks before study entry, and stable without steroid treatment for at least 4 weeks.
Evidence of severe or uncontrolled systemic diseases (e.g., unstable or uncompensated respiratory, cardiac [including life threatening arrhythmias], hepatic, or renal disease).
Unresolved toxicity ≥ CTCAE Grade 2 from previous anti-cancer therapy except alopecia or long-term radiation toxicity (radiation related toxicity 3 months or greater after radiation exposure).

Presence of cardiac impairment defined as:

Prior history of cardiovascular disease including heart failure that meets New York Hearth Association (NYHA) class III and IV definitions; OR
History of myocardial infarction/active ischemic heart disease within one year of study entry; OR
Uncontrolled dysrhythmias; OR
Poorly controlled angina.
Participation in a trial of an investigational agent within the prior 30 days.
Pregnant or breast-feeding females.
History of other malignancies except curatively excised carcinoma in situ of the cervix, non-melanomatous skin carcinoma or superficial bladder cancer or other solid tumors curatively treated with no evidence of disease for 3 years. Other cases will be reviewed and possibly allowed if discussed with and approved by the Principal Investigator.
Patients receiving therapeutic doses of warfarin.
Blood pressure greater than 170/90 or two standard deviations from normal based on age and weight nomogram on three separate measurements.