Vorinostat (SAHA) in Uterine Sarcoma

Study Overview
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Brief Summary
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Uterine sarcomas are rare tumors with a poor prognosis. The main purpose of this phase II proof-of-principle- pilot study is to test the efficacy of the hydroxamic acid-based Histone deacetylase inhibitor (HDACI) Vorinostat (SAHA) as monotherapy in patients with HDAC-positive, progressive, metastatic uterine sarcomas and mixed epithelial and mesenchymal tumors after prior anti-proliferative therapy.

Detailed Description
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This is an open-label, single arm, proof of concept-study of the HDAC-inhibitor vorinostat in patients with refractory uterine sarcoma that have been pre-tested for an high expression of HDAC. Patients will receive Vorinostat, 400 mg (4 capsules á 100mg of Zolinza) orally once daily for the first 14 days of a 21 day cycle. Treatment will be continued for 4 cycles (treatment period 1). Patients with a response or stable disease after 4 cycles as determined by computed tomography (CT) of target an non target-lesions will be continued on vorinostat therapy at the tolerated schedule and dosage until disease progression, unacceptable toxicity or patients' withdrawal of the consent. At the maximum, a total of 12 cycles will be administered over a 9 months period (treatment periods 2 and 3).

Official Title
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A Pilot Study of Peroral Vorinostat (SAHA) in Patients With Refractory Histone Deacetylase-positive Uterine Sarcoma

Conditions
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Leiomyosarcoma, Endometrial Stromal Tumors, Carcinosarcomas Uterine

Intervention / Treatment
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* Drug: Vorinostat Oral Capsule


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically confirmed metastatic uterine sarcoma (endometrial stromal sarcoma, undifferentiated uterine sarcoma, leiomyosarcoma, adenosarcoma and carcinosarcoma High HDAC-positivity of the tumor determined by immunohistochemistry Patients must have received prior systemic antineoplastic therapy Patient is not amenable for curative therapy Age >= 18 years Estimated life expectancy > 3 months Measurable disease on CT/MRI (at least one measurable lesion >1cm) or chest X-ray (at least one measurable lesion >2cm) Karnofsky performance status of 60-100 Adequate hematologic, renal and hepatic function Subject is able to swallow and retain oral medication and does not have uncontrolled emesis No fertility preserved Written informed consent Exclusion Criteria: Lack of or low expression of HDAC (see 4.1 Pre-Screening) Significant cardiac disease Other invasive malignant tumor diagnosed within the last 5 years (e.g. metastases from breast cancer in the last 3 years) Significant bowel obstruction Severe uncontrolled infection Known HIV-positivity Symptomatic brain metastasis or leptomeningeal disease Pre-existing significant liver disease, severe hepatic impairment (Bilirubin no greater than 1.5 times upper limit of normal (ULN) and/or aspartate aminotransferase (AST)/ alanine aminotransferase (ALT) greater than 2.5 times ULN) Known history of allergic reaction to vorinostat or similar medications Systemic therapy or an investigational agent within 21 days prior to study inclusion Uncontrolled hypertension (sustained systolic blood pressure > 150 mmHg or diastolic pressure > 100 mmHg despite optimal medical management) Major surgery within 3 weeks of enrollment when diagnosed at an early stage Symptomatic congestive heart failure Unstable angina pectoris or cardiac arrhythmia Myocardial infarction within last 6 months Known active hepatitis B or hepatitis C Psychiatric illness/social situations that would limit compliance with study requirements- Prior history of thrombotic or thromboembolic events, unless adequately controlled by anticoagulant therapy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Vorinostat, Zolinza Oral Capsules<br>Vorinostat Oral Capsules 400mg daily | Drug: Vorinostat Oral Capsule<br>* Vorinostat, 400 mg orally once daily for the first 14 days of a 21 day cycle Treatment will be continued for 4 cycles. Patients with a response or stable disease after 4 cycles will be continued on vorinostat therapy at the tolerated schedule and dosage until disease progression, unacceptable toxicity or patients' withdrawal of the consent. At the maximum, a total of 12 cycles will be administered over a period of 9 months.<br>* Other names: Zolinza;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progression-free Survival (PFS) | Change from Baseline Tumor Size to last available observation with respect to progress as defined by RECIST 1.1 (CT-Scan every 12 weeks up to 9 months) | 9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of Treatment-Emergent Adverse Events (Safety and Tolerability) | This endpoint is evaluated by the amount of clinical adverse experiences. | 9 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Uterine sarcoma, Histone deacetylases