Vorinostat in Combination With Chemotherapy in Relapsed/Refractory Solid Tumors and CNS Malignancies

Eligibility Criteria

• * Age: Patients must be less than or equal to 1 year and less than or equal to 30 years of age at initiation of protocol therapy.
• * Diagnosis: Patients must have a confirmed histologic diagnosis of a relapsed or refractory solid tumor or CNS malignancy.
• * Performance status: Patients over 16 years of age must have a Karnofsky score greater than or equal to 50. Children under 16 years of age must have a Lansky score greater than or equal to 50.
• * Prior therapy: Patients may have received prior therapy with vincristine, irinotecan, or temozolomide. They may not however have received therapy that included a treatment cassette of irinotecan and temozolomide in combination.
• * Prior myelosuppressive therapy: Patients must have not received myelosuppressive therapy in 3 weeks or nitrosourea chemotherapy within 6 weeks of initiation of protocol therapy.
• * Hematologic growth factor support: Patients may not have received G-CSF within the previous 3 days or peg-filgrastim within the past 7 days.
• * Biologic anti-neoplastic therapy: At least 21 days or 5 half-lives (whichever is of longer duration) must have elapsed since the last administration of biologic antineoplastic therapy.
• * Radiation therapy: ≥ 14 days since the last dose of local XRT; ≥ 6 months must have elapsed if prior TBI, craniospinal XRT or ≥ 50% radiation of pelvis; ≥ 6 wks must have elapsed if other substantial BM radiation.
• * Autologous or allogeneic stem cell transplant: No active graft vs. host disease or need for immunosuppressive therapy. At least 3 months must have passed since neutrophil engraftment.
• * Organ function:
• * Peripheral absolute neutrophil count (ANC) greater than or equal to 1000 cells/mcL.
• * Platelet count greater than or equal to100,000/mcL and no platelet transfusion within prior 7 days.
• * Hemoglobin greater than or equal to 8 gm/dL
• * Patients with known bone marrow metastatic disease may enroll on the study if they have a peripheral ANC greater than or equal to 750 cells/mcL. They will not be evaluable for hematologic toxicity.
• * Total bilirubin less than or equal to 1.5x upper limit of normal (ULN) for age.
• * SGPT (ALT) less than or equal to 5x ULN
• * Serum albumin greater than or equal to 2 gm/dL
• * Creatinine clearance or glomerular filtration rate \>70 ml/min/1.73 m2 or a serum creatinine based on age and gender as follows:
• * Pregnancy or breast feeding: Women who are pregnant or breast feeding will not be entered on the protocol due to the risks of fetal and teratogenic adverse events with the therapeutic agents used in the protocol therapy.
• * Corticosteroid use: Patients with CNS tumors who have not been on a stable or decreasing dose of corticosteroids for the 7 days prior to the initiation of protocol therapy.
• * Antineoplastic therapy: Patients receiving any other antineoplastic therapy.
• * Medication allergy:
• * Infection: Patients who have any uncontrolled infection, positive blood culture within 48 hours prior to protocol entry, or diagnosed or receiving therapy for Clostridium difficile infection.
• * Patients may not have taken valproic acid or any other histone deacetylase inhibitor for at least 2 weeks prior to study enrollment.
• * Children with neurofibromastosis Type 1, if being used for treatment of a low grade glioma.