Vorinostat and Bortezomib in Treating Young Patients With Refractory or Recurrent Solid Tumors, Including Central Nervous System Tumors and Lymphoma
Condition: Childhood Burkitt Lymphoma; Childhood Central Nervous System Choriocarcinoma; Childhood Central Nervous System Germ Cell Tumor; Childhood Central Nervous System Germinoma; Childhood Central Nervous System Mixed Germ Cell Tumor; Childhood Central Nervous System Teratoma; Childhood Central Nervous System Yolk Sac Tumor; Childhood Choroid Plexus Tumor; Childhood Craniopharyngioma; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Medulloepithelioma; Childhood Meningioma; Childhood Mixed Glioma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Childhood Oligodendroglioma; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Central Nervous System Embryonal Tumor; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Malignant Germ Cell Tumor; Recurrent Childhood Medulloblastoma; Recurrent Childhood Pineoblastoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Childhood Subependymal Giant Cell Astrocytoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Childhood Visual Pathway and Hypothalamic Glioma; Recurrent Childhood Visual Pathway Glioma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Unspecified Childhood Solid Tumor, Protocol Specific
MeSH terms: Burkitt Lymphoma; Lymphoma; Neoplasms; Glioma; Lymphoma, Non-Hodgkin; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Lymphoma, Large B-Cell, Diffuse; Neoplasms, Germ Cell and Embryonal; Astrocytoma; Lymphoma, Large-Cell, Immunoblastic; Plasmablastic Lymphoma; Meningioma; Ependymoma; Medulloblastoma; Lymphoma, Large-Cell, Anaplastic; Oligodendroglioma; Neuroectodermal Tumors; Neuroectodermal Tumors, Primitive; Teratoma; Lymphomatoid Granulomatosis; Lymphoma, Extranodal NK-T-Cell; Endodermal Sinus Tumor; Choriocarcinoma; Craniopharyngioma; Adamantinoma; Choroid Plexus Neoplasms; Pinealoma; Germinoma; Recurrence
Study type: Interventional
Phase: Phase 1

Summary: 
      This phase I trial is studying the side effects and best dose of vorinostat when given
      together with bortezomib in treating young patients with refractory or recurrent solid
      tumors, including CNS tumors and lymphoma. Vorinostat and bortezomib may stop the growth of
      tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow
      to the tumor.
    

Detailed description: 
      PRIMARY OBJECTIVES:

      I. To determine the maximum-tolerated dose and/or recommended phase II dose of vorinostat in
      combination with bortezomib in pediatric patients with refractory or recurrent solid tumors,
      including central nervous system tumors and lymphoma.

      II. To define and describe the toxicities of this regimen in these patients. III. To
      characterize the pharmacokinetics 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 assess the biologic activity of bortezomib by measuring NF-κB activity in peripheral
      blood mononuclear cells (PBMC).

      III. To assess the biologic activity of bortezomib by measuring endoplasmic reticulum stress
      response using the GRP78 molecular chaperone marker in PBMC.

      OUTLINE: This is a multicenter, dose-escalation study of vorinostat.

      Patients receive oral vorinostat once daily on days 1-5 and 8-12 and bortezomib IV over 3-5
      seconds on days 1, 4, 8, and 11. Courses repeat every 21 days for up to 2 years in the
      absence of disease progression or unacceptable toxicity. Blood samples are collected at
      baseline and during course 1 of study for further analysis.

      After completion of study therapy, patients are followed up within 30 days.
    

Intervention name(s): vorinostat; bortezomib; pharmacological study; laboratory biomarker analysis
Intervention type(s): Drug; Drug; Other; Other
Intervention description(s): Given orally; Given IV; Correlative studies; Correlative studies
Other intervention name(s): L-001079038; SAHA; suberoylanilide hydroxamic acid; Zolinza; LDP 341; MLN341; VELCADE; pharmacological studies
Intervention MeSH terms: Bortezomib; Vorinostat
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment