Trial of CUDC-907 in Children and Young Adults With Relapsed or Refractory Solid Tumors, CNS Tumors, or Lymphoma
Phase: Phase 1
DFCI Protocol ID: 16-371
This research study is evaluating a novel drug called CUDC-907 as a possible treatment for resistant (refractory) pediatric solid tumors (including neuroblastoma), lymphoma, or brain tumors.
Dana-Farber Cancer Institute, Children's Hospital Boston
Steven Dubois MD,
Dana Farber Cancer Institute
Dana-Farber Cancer Institute:
Childrens Hospital Pediatric Clinical Translation Investigation Program CTIP, email@example.com
- Age > 1 years and ≤ 21 years at time of enrollment.
- Karnofsky performance status ≥ 50% for patients ≥16 years of age and Lansky ≥ 50% for
patients <16 years of age (see Appendix A)
- Diagnosis requirement
- For Parts A and B, participants must have evaluable or measurable disease (see
- For Part A, participants must have histologically confirmed solid tumors, CNS tumors,
or lymphoma based upon biopsy or surgery at initial diagnosis and/or
relapse/progression. The only exception to histologic confirmation is for pediatric
tumors that are routinely diagnosed exclusively by standard clinical imaging
criteria: diffuse intrinsic pontine glioma and optic pathway glioma.
- For Part B, participants must have one of the following diagnoses histologically
- Neuroblastoma with evidence of Mycn/Myc positivity based on any of the
- MYCN amplification (> 4 copy amplification) from COG reference laboratory
or other CLIA-certified laboratory; or
- Mycn protein expression > 1+ according to validated assay in Children's
Hospital Los Angeles (CHLA) Clinical Pathology Laboratory; or
- Myc expression > 1+ according to validated assay in CHLA Clinical Pathology
- One of the following mature B cell lymphoma diagnoses:
- Diffuse large B cell lymphoma
- Burkitt lymphoma
- Participants must have disease that is relapsed or refractory and for which standard
curative or palliative measures do not exist or are no longer effective.
- Patients must have fully recovered from the acute toxic effects of all prior
anti-cancer therapy except organ function as noted in Section 3.1.6). Patients must
meet the following minimum washout periods prior to enrollment:
- Myelosuppressive chemotherapy: At least 14 days after the last dose of
myelosuppressive chemotherapy (42 days for nitrosourea or mitomycin C).
- At least 14 days after local palliative XRT (small port);
- At least 90 days must have elapsed after prior TBI, craniospinal XRT or if >50%
radiation of pelvis;
- At least 42 must have elapsed if other substantial BM radiation;
- At least 42 days must have passed since last MIBG or other radionuclide therapy.
- Small molecule biologic therapy: At least 7 days following the last dose of a
biologic agent. For agents with known adverse events occurring beyond 7 days, this
duration must be extended beyond the time in which adverse events are known to occur.
If extended duration is required, this should be discussed and approved by the study
- Monoclonal antibody: At least 21 days or 3 half-lives of the antibody after the last
dose, whichever is longer.
- Myeloid growth factors: At least 14 days following the last dose of long-acting
growth factor (e.g. Neulasta) or 7 days following short-acting growth factor.
- Stem Cell Infusion or Cellular Therapies: The patient must have no evidence of graft
versus host disease and at least 42 days must have elapsed after transplant, stem
cell infusion, or cellular therapy.
- Major Surgery: At least 3 weeks from prior major surgical procedure. Note: Biopsy and
central line placement/removal are not considered major.
- PI3K and HDAC inhibitors: The patient must not have received prior CUDC-907 therapy.
Prior treatment with individual PI3K or HDAC inhibitors is allowed. Patients must not
have received therapy with the combination of PI3K and HDAC inhibitors.
- Participants must have normal organ function as defined below.
- Bone Marrow Function:
- Absolute neutrophil count ≥1,000/uL
- Platelets ≥75,000/uL and transfusion independent, defined as not receiving a
platelet transfusion for at least 5 days prior to CBC documenting eligibility.
- Hepatic Function:
- Total bilirubin ≤ 1.5 x upper limit of normal for age
- ALT (SGPT) ≤ 135 U/L For the purpose of this study, the ULN for ALT is 45 U/L
- Serum albumin > 2 g/dL
- Renal Function:
--A serum creatinine based on age/gender as follows: Age Maximum Serum Creatinine
(mg/dL) Male Female
1. to < 2 years 0.6 0.6
2. to < 6 years 0.8 0.8
6 to < 10 years 1 1 10 to < 13 years 1.2 1.2 13 to < 16 years 1.5 1.4
≥ 16 years 1.7 1.4 OR
--Creatinine clearance ≥ 70 mL/min/1.73 m2 for participants with creatinine levels
above institutional normal.
- Adequate Cardiac Function: QTc < 480 msec
- Adequate GI Function: Diarrhea < grade 2 by CTCAE version 4
- Adequate Metabolic Function: Fasting glucose < grade 2 (< 160 mg/dL or < 8.9 mmol/L)
without the use of antihyperglycemic agents.
- Additional Agent-Specific Requirements
- Patients must be able to swallow either intact capsules or mini-tabs without chewing.
- In order to limit dose deviations due to rounding, patients must have a body surface
area of at least 0.5 m2
- For patients with CNS tumors (primary or metastatic), any baseline neurologic
deficits (including seizure) must be stable for at least one week prior to study
- Ability to understand and/or the willingness of the patient (or parent or legally
authorized representative, if minor) to provide informed consent, using an
institutionally approved informed consent procedure.
- Patients must not be receiving any of the following concomitant medications:
- Pharmacologic doses of systemic corticosteroids unless for CNS metastatic or primary
disease. For patients with CNS metastatic or primary tumors receiving
corticosteroids, they should be on a stable or decreasing dose over the 7 days prior
to registration and meet criteria.
- For all patients, receipt of systemic physiologic replacement steroids, topical
and/or inhaled corticosteroids is acceptable.
- Non-steroidal anti-inflammatory drugs, oral anticoagulants, and therapeutic heparins.
- Pregnant participants will not be entered on this study given that the effects of
CUDC-907 on the developing human fetus are unknown.
- Because there is an unknown but potential risk for adverse events in nursing infants
secondary to treatment of the mother with CUDC-907, breastfeeding mothers are not
- Participants of child-bearing or child-fathering potential must agree to use adequate
contraception (hormonal birth control; intrauterine device; double barrier method; or
total abstinence) throughout their participation, including up until 30 days after
last dose of CUDC-907.
- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to CUDC-907.
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
- Patients with a known history of HIV, hepatitis B, and/or hepatitis C (testing not
required as part of screening).
- Patients with a known history of type 1 or type 2 diabetes mellitus.
- Patients with gastrointestinal disease or disorder that could interfere with
absorption of CUDC-907, such as bowel obstruction or inflammatory bowel disease.