Patient description: A 17 year old boy complains of vomiting, non-bloody diarrhea, abdominal pain, fever, chills and loss of appetite for the past 3 days. He ate a salad at a restaurant prior to his diarrhea onset. Physical exam was remarkable for pallor, jaundice, and diffuse abdominal tenderness. Lab results were as follows: Hemoglobin: 9.7 g/dL Platelet: 110,000 /cu.mm Creatinine: 3.6 mg/dL blood urea nitrogen (BUN): 73 mg/dL direct bilirubin: 2.4 mg/dL lactate dehydrogenase (LDH): 881 IU/L (normal: 110-265 IU/L) Peripheral blood smear showed a moderate number of schistocytes and helmet cells. Shiga-like toxin-producing E. coli (STEC) stx1/stx2 were found in stools. He has no other underlying disease and he is not on any medications.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  NUT Midline Carcinoma (NMC) Triple Negative Breast Cancer (TNBC) Non-small Cell Lung Cancer (NSCLC) Castration-resistant Prostate Cancer (CRPC) Males and females ≥18 years of age for NSCLC, TNBC, and CRPC Males and females ≥16 years of age for NMC Diagnosis of one of the following advanced solid tumors for which standard therapy either does not exist or has proven ineffective, intolerable or inacceptable for the participant: NMC;TNBC; NSCLC; or CRPC Have at least 1 measurable lesion per Response Evaluation in Solid Tumors (RECIST) 1.1. CRPC participants may be enrolled with objective evidence of disease as per Prostate Cancer Working Group (PCWG2) Life expectancy ≥3 months Eastern Cooperative Oncology Group (ECOG) Performance Status ≤1 Have an interval of ≥3 weeks (or ≥2 weeks for NMC participants) since chemotherapy (≥6 weeks for nitrosoureas or mitomycin C), immunotherapy, hormone therapy or any other anticancer therapy or surgical intervention resection, or ≥3 half-lives for monoclonal antibodies, or ≥5 half-lives for other non-cytotoxic agents (whichever is longer) CRPC participants must maintain ongoing androgen deprivation therapy with a gonadotropin releasing hormone (GnRH) analogue, antagonist or orchiectomy providing serum testosterone is <50 ng/dL (<1.7 nmol/L) Participants receiving bisphosphonate or denosumab therapy must be on stable doses for at least 4 weeks before start of study therapy Females must not be pregnant (negative urine or serum human chorionic gonadotropin test within 72 hours of study start)  Has inability to swallow oral medications or presence of a gastrointestinal disorder (e.g. malabsorption) deemed to jeopardize intestinal absorption of birabresib Has persistent grade >1 clinically significant toxicities related to prior antineoplastic therapies (except for alopecia). Stable sensory neuropathy ≤ grade 2 National Cancer Institute (NCI) Common Terminology for Adverse Events (CTCAE) Version 4.0 is accepted Known primary central nervous system (CNS) malignancy or symptomatic or untreated CNS metastases. Treated and stable CNS metastases are allowed History of prior or concomitant malignancies within 3 years of study start Have other serious illness or medical condition, such as active infection, unresolved bowel obstruction, psychiatric disorders, or cerebrovascular accident within 1 year of study start Known human immunodeficiency virus (HIV) and/or active Hepatitis B or C infections Have one of the following cardiac-related conditions: Congestive heart failure or angina pectoris (except if medically controlled); myocardial infarction (within 1 year of study start); uncontrolled hypertension; or uncontrolled arrhythmias Other concomitant anticancer treatment Participation in another clinical trial or treatment with any investigational drug (excluding anticancer treatments) within 30 days of study start