Background:
High-grade neuroendocrine carcinomas (HGNEC) are cancers that develop in different parts
of the body, including the digestive tract, genitals, neck, and head. One drug
(belinostat), combined with 2 other drugs (etoposide and cisplatin), is approved to treat
HGNEC. But some people may have a gene variant that affects how quickly their body gets
rid of the drug; these people may do better with different dosages of belinostat.
Objective:
To test higher or lower doses of belinostat based on gene variants in people with HGNEC.
Eligibility:
People aged 18 years and older with HGNEC.
Design:
Participants will be screened. They will have a physical exam with blood tests. Some
blood will be used for genetic testing. They will have imaging scans and a test of their
heart function. Samples of tumor tissue may be collected.
All 3 study drugs (belinostat, etoposide, cisplatin) are given through a tube attached to
a needle inserted into a vein. Treatment will be given in 21-day cycles.
For cycles 1 through 6: Participants will come to the clinic for the first 4 days. They
will be given all 3 drugs. Imaging scans and other tests will be repeated. Each visit
will last 4 to 8 hours.
After cycle 6: Participants may continue treatment with belinostat alone. They will come
to the clinic for the first 3 days of each cycle. They may continue treatment for up to 5
years if the drug is helping them.
Participants will have a follow-up visit 30 days after their last dose of belinostat.
Then they will receive follow-up visits by phone or email every 3 to 6 months.
Additional locations may be listed on ClinicalTrials.gov for NCT06406465.
Locations matching your search criteria
United States
Maryland
Bethesda
National Institutes of Health Clinical CenterStatus: Active
Contact: National Cancer Institute Referral Office
Phone: 888-624-1937
 Background:
  -  Extrapulmonary High-Grade Neuroendocrine Neoplasms (HGNENs) are all high-grade
     neoplasms that may resemble small cell carcinoma or large cell Neuroendocrine
     Carcinomas (NEC) of the lung. Poorly differentiated NECs are often associated with a
     rapidly progressive disease and a proliferative rate (Ki67%) >20%.
  -  As a general rule, poorly differentiated NECs are treated with platinum-based
     regimens according to small cell carcinoma guidelines.
  -  This protocol will study a continuous infusion of the histone deacetylase (HDAC)
     inhibitor belinostat in combination with cisplatin and etoposide for patients with
     advanced neuroendocrine neoplasms.
Objective:
-To determine if pharmacogenomic intervention can normalize the area under the curve
(AUC) at cycle 6 between UGT1A1*28 and UGT1A1*60 genotypes) of belinostat administered as
a continuous 48 h infusion in combination with cisplatin and etoposide in participants
with neuroendocrine malignancies based on UGT1A1*28 and UGT1A1*60 genotypes.
Eligibility:
  -  The protocol will be open to participants with Extrapulmonary High-Grade
     Neuroendocrine Neoplasms (HGNENs)
  -  Participants will be recruited based on genotype, with n=9 carrying UGT1A1*1/*1 or
     UGT1A1*1/*28 and n=30 carrying any other combination of variant alleles at UGT1A1*28
     or UGT1A1*60.
  -  Age >=18 years
  -  ECOG Performance Status 0-2
Design:
  -  Parallel design in which the starting dose of belinostat is administered as a
     48-hour continuous infusion at two possible doses based on genotype: 1)
     400mg/m^2/day for UGT1A1*28/*28 or at least one UGT1A1*60 allele UGT1A1*28 and
     UGT1A1*60 genotypes or 2) 600 mg/m^2/day for wild-type participants and those
     carrying UGT1A1*1/*28 in the absence of other variant alleles.
  -  To define pharmacokinetics, toxicities of belinostat provided to participants who
     carry the above genotype groups.
  -  All participants will also receive cisplatin at 60 mg/m^2 IV on day 2, and etoposide
     at 80 mg/m^2 IV daily x3 on days 2 - 4.
Lead OrganizationNational Cancer Institute
Principal InvestigatorJaydira Del Rivero