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Brief Title: Vorinostat and Isotretinoin in Treating Patients With High-Risk Refractory or Recurrent Neuroblastoma
Official Title: Phase I Study of Vorinostat in Combination With 13-Cis-retinoic Acid in Patients With Refractory/Recurrent Neuroblastoma
Study ID: NCT01208454
Brief Summary: This phase I trial is studying the side effects and the best dose of vorinostat when given together with isotretinoin to see how well it works in treating patients with high-risk refractory or recurrent neuroblastoma. Vorinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Isotretinoin may help vorinostat work better by making tumor cells more sensitive to the drug. Giving vorinostat together with isotretinoin may be an effective treatment for neuroblastoma.
Detailed Description: PRIMARY OBJECTIVES: I. To determine the maximum tolerated dose (MTD) of vorinostat pediatric suspension administered daily 4 times per week orally for two weeks, in combination with twice daily 13-cis-retinoic acid (\[cisRA\], isotretinoin) orally for 14 days to children with refractory or recurrent neuroblastoma. II. To define the toxicities of vorinostat administered in combination with cisRA. SECONDARY OBJECTIVES: I. To determine the pharmacokinetics of vorinostat given as a pediatric suspension. II. To describe the relationship of vorinostat pharmacokinetics to the occurrence of systemic toxicity. III. To determine the pharmacokinetics of cisRA given in combination with vorinostat. IV. To describe histone acetylation levels in peripheral blood mononuclear cells after different doses of vorinostat. V. To describe, within the context of a Phase I study, the response rate of vorinostat combined with cisRA in patients with recurrent/refractory neuroblastoma. VI. To describe the toxicity and response rate of vorinostat at the determined maximal tolerated dose combined with cisRA in patients ages 22-30 years of age at study entry with recurrent/refractory neuroblastoma. OUTLINE: This is a dose-escalation study of vorinostat. Patients receive isotretinoin orally (PO) twice daily (BID) on days 1-14, PO suspension\* of vorinostat once daily (QD) on days 1-4 of course 1, and capsules of vorinostat PO QD on days 1-4 and 8-11 of course 2 and subsequent courses. Treatment repeats every 28 days for up to 24 courses in the absence of disease progression or unacceptable toxicity. EXPANSION COHORT 1 (=\< 21 years of age): Once the maximum-tolerated dose (MTD) has been determined, patients are treated at that dose level as above. EXPANSION COHORT 2 (22-30 years of age): Patients receive isotretinoin as above and vorinostat at the MTD on days 1-3 and 8-10. After completion of study therapy, patients are followed up periodically. NOTE: \*Patients less than 10 years of age are encouraged to continue to use oral suspension beyond course 1.
Minimum Age:
Eligible Ages: CHILD, ADULT
Sex: ALL
Healthy Volunteers: No
Children's Hospital Los Angeles, Los Angeles, California, United States
Lucile Packard Children's Hospital Stanford University, Palo Alto, California, United States
UCSF Medical Center-Parnassus, San Francisco, California, United States
Children's Hospital Colorado, Aurora, Colorado, United States
Children's Healthcare of Atlanta - Egleston, Atlanta, Georgia, United States
University of Chicago Comer Children's Hospital, Chicago, Illinois, United States
Boston Children's Hospital, Boston, Massachusetts, United States
C S Mott Children's Hospital, Ann Arbor, Michigan, United States
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
Cook Children's Medical Center, Fort Worth, Texas, United States
Seattle Children's Hospital, Seattle, Washington, United States
Hospital for Sick Children, Toronto, Ontario, Canada
Name: Julie Park
Affiliation: New Approaches to Neuroblastoma Treatment (NANT)
Role: PRINCIPAL_INVESTIGATOR