Study of Panobinostat in Patients With Neuroendocrine Tumors
Condition: Neuroendocrine Tumors
MeSH terms: Neuroendocrine Tumors
Intervention: panobinostat (LBH589)
Intervention description: Panobinostat will be taken once daily at 20 mg three times a week (every Monday, Wednesday, Friday). It will be taken as long as patients are benefiting from treatment.
Intervention MeSH terms: Panobinostat
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 15.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No

Summary:

      This summary will use Panobinostat (LBH589) in patients with neuroendocrine tumors to see how
      the patient's tumor responds to panobinostat. Additionally, this study will examine how long
      it takes neuroendocrine tumor patient's cancer to progress while taking the drug and examine
      the overall survival of patients using panobinostat. Also, the study will examine the
      toxicity and tolerability of panobinostat in the patient population. Finally, this study will
      look at the effect of panobinostat on Notch 1 signaling before and after treatment with
      panobinostat.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Histologically confirmed, metastatic, low grade neuroendocrine neoplasms. Small cell
             lung cancers, paragangliomas, and pheochromocytomas are excluded

          -  Must have measurable disease as defined by RECIST

          -  4 weeks from completion of major surgery, chemotherapy, or other systemic therapy or
             local liver therapy to study registration. Concurrent octreotide is allowed.

          -  Not allowed to be on concurrent chemotherapy or radiation

          -  18 years of age or older

          -  ECOG Performance status of equal to or less than 2

          -  Able to sign and date a written informed consent prior to participation in the study

          -  Baseline MUGA or ECHO must demonstrate LVEF greater than or equal to the lower limit
             of the institutional normal

          -  Must have the following laboratory criteria: Neutrophil count greater than 1500/mm3,
             platelet count greater than 100,000/mm3L, hemoglobin greater than or equal to 9 g/dL,
             AST/SGOT and ALT/SGPT less than or equal to 2.5 x ULN, serum bilirubin less than or
             equal to 1.5 x ULN, serum creatinine less than or equal to 1.5 x ULN, total serum
             calcium greater than or equal to LLN, serum potassium greater than or equal to LLN,
             serum sodium greater than or equal to LLN, serum albumin greater than or equal to LLN
             or 3g/dl,

          -  Women of child bearing potential must have a negative urine pregnancy test within 72
             hours of first administration of study treatment and must be willing to use two
             methods of contraception

          -  Patients with a history of hypertension must be well controlled (to less than 150/90
             mmHg) on a stable regimen of anti-hypertensive therapy

        Exclusion Criteria:

          -  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 the first panobinostat treatment

          -  Impaired cardiac function including any of the following: Screening ECG with a QTc
             greater than 450 msec, patients with congenital long QT syndrome, history of
             unsustained ventricular tachycardia, any history of ventricular fibrillation or
             torsades de pointes, bradycardia defined as heart rate less than 50 beats per minutes,
             patients with a myocardial infarction or unstable angina within 6 months of study
             entry, congestive heart failure, right bundle branch block or left anterior hemiblock

          -  Uncontrolled hypertension

          -  Unresolved diarrhea greater than CTCAE grade 1

          -  Impairment of gastrointestinal (GI) function or GI disease that may significantly
             alter the absorption of oral panobinostat

          -  Other concurrent sever and/or uncontrolled medical conditions

          -  Patients with a history of another primary malignancy that, in the opinion of the
             investigator, would interfere with the assessment of the primary endpoint of the study

          -  Patients with known positivity for human immunodeficiency virus (HIV) or hepatitis C,
             baseline testing is not required

          -  Any significant history of non-compliance to medical regimens or with inability to
             grant a reliable informed consent

          -  Any medication which may cause QTc prolongation or inducing torsades de pointes

          -  Use of concomitant medications that may interact with panobinostat