Belinostat for Solid Tumors and Lymphomas in Patients With Varying Degrees of Hepatic Dysfunction
Condition: Neoplasms; Lymphomas
MeSH terms: Lymphoma
Study type: Interventional
Phase: Phase 1

Summary: 
      Background:

      - Belinostat is an experimental cancer treatment drug that works by helping to turn on genes
      that limit cell growth and survival of cancer cells. These genes are often switched off in
      tumors. Belinostat has been given to patients with different types of cancer to measure its
      safety and effectiveness, but it has not been given in a formal trial to cancer patients who
      have abnormal liver function. Because belinostat is processed by the liver, its safety and
      effectiveness needs to be established in individuals who have abnormal liver function.
      Researchers are interested in comparing the effects of belinostat as a cancer treatment drug
      in individuals with normal and abnormal liver function.

      Objectives:

        -  To test the safety and effectiveness of belinostat in individuals who have solid tumors
           and lymphomas and who also have abnormal liver function.

        -  To compare the results of belinostat treatment in individuals with normal and abnormal
           liver function.

      Eligibility:

        -  Individuals at least 18 years of age who have been diagnosed with solid tumors or
           lymphomas that have not responded to standard treatment.

        -  Individuals with normal liver function and varying degrees of abnormal liver function
           (mild, moderate, severe) are eligible.

      Design:

        -  Participants will be screened with a full medical history and physical examination, as
           well as blood and urine tests, and tumor imaging studies. Participants will then be
           divided into study groups based on their liver function.

        -  Participants will receive belinostat in cycles of treatment. Except for cycle 1, all
           cycles will last 21 days. Cycle 1 will last 28 days. For cycle 1 only, participants will
           receive a single dose of belinostat 1 week before the regular 21-day treatment cycle
           starts.

        -  In each cycle, participants will receive belinostat once a day for 5 days, and will be
           asked to keep a medication diary to record any side effects.

        -  Participants will have regular clinic visits with blood and urine sample collection and
           imaging studies to evaluate the cancer's response to treatment.

        -  Participants may continue to take belinostat for as long as the cancer responds to the
           treatment.
    

Detailed description: 
      Background:

        -  Belinostat is a histone deacetylase (HDAC) inhibitor. HDACs are frequently deregulated
           in cancer cells, leading to an increase in deacetylation and the silencing of genes that
           normally control cell cycle arrest and apoptosis.

        -  Belinostat has growth inhibitory activity in several malignancies in vitro and in vivo,
           both as a single agent and in combination with chemotherapeutic agents. Several Phase I
           and II clinical trials have been conducted to date in patients with solid tumor and
           hematologic malignancies; belinostat has been generally well tolerated.

        -  Belinostat is metabolized in the liver and therefore, the safety and dosing of
           belinostat needs to be established in patients with varying degrees of hepatic
           dysfunction.

      Objectives:

        -  Establish the safety and tolerability of belinostat given on days 1 through 5 of 21-day
           cycles to patients with varying degrees of liver dysfunction.

        -  Define the maximum tolerated dose (MTD) and recommended dose of belinostat given on days
           1 through 5 of 21-day cycles to patients with varying degrees of liver dysfunction.

        -  Evaluate the pharmacokinetics (PK) of one dose of belinostat (400 mg/m(2)) in patients
           with varying degrees of liver dysfunction.

        -  Obtain preliminary evidence of anti-tumor activity at tolerable doses of belinostat in
           patients with varying degrees of liver dysfunction.

        -  Measure direct versus indirect bilirubin levels and correlate these with observed
           toxicities, PK.

      Eligibility:

      -Adults with solid tumors or lymphomas whose disease has progressed after standard therapy or
      who have no acceptable standard treatment options. Patients with normal and varying degrees
      of hepatic dysfunction (mild, moderate, and severe) are eligible.

      Study Design:

      -Patients will be divided into 4 dose escalation cohorts based on their level of liver
      dysfunction. Belinostat will be administered intravenously (IV) over 30 minutes. On day -7
      (Cycle 1 only), all patients will receive a single dose of 400 mg/m(2) belinostat. On days 1
      through 5 of each cycle, patients will receive belinostat at a dose dependent on the level of
      hepatic dysfunction and dose level. Mild, moderate, and severe liver dysfunction cohorts will
      begin on dose level 1; patients with normal hepatic function will not have their dose
      escalated (see below). The total length of Cycle 1 will be 28 days; all other cycles will be
      21 days. No more than 12 evaluable patients with normal hepatic function will be accrued.
    

Intervention name(s): Belinostat
Intervention type(s): Drug
Intervention description(s): Belinostat was administered intravenously (IV) over 30 minutes on days 1 through 5 of a 21-day cycle. All patients were administered a single dose of 400 mg/m(2) of belinostat on Cycle 1 Day -7 for pharmacokinetic analysis (the total length of Cycle 1 was 28 days).
Other intervention name(s): Beleodaq
Intervention MeSH terms: Belinostat
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Histone Deacetylase Inhibitor; Liver Dysfunction; Pharmacokinetics; UGT1A1 Polymorphisms; Solid Tumor; Cancer; Lymphoma