Dasatinib in Treating Patients With Unresectable or Metastatic Squamous Cell Skin Cancer or RAI Stage 0-I Chronic Lymphocytic Leukemia

Inclusion Criteria:

Diagnosis of 1 of the following

Histologically or cytologically confirmed squamous cell carcinoma of the skin

Unresectable or metastatic disease
Squamous cell histology represents ≥ 50% of the biopsy specimen
May or may not be related to autologous or allogeneic organ transplantation

Chronic lymphocytic leukemia (CLL)

RAI stage 0-I
Stable disease
Patients with basalosquamous cell disease (basal cell with squamous differentiation) are eligible
Measurable disease, defined as at least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques or ≥ 10 mm by spiral CT scan
Must be willing to undergo a pre-treatment tumor biopsy

Brain metastases are allowed provided the following are true:

Received definitive therapy consisting of external beam radiation therapy, gamma knife therapy, or surgical resection resulting in clinically stable disease
Lesions are under control for at least 4 weeks after completion of definitive therapy, as measured by repeat MRI or CT scans
No requirement for dexamethasone
ECOG performance status 0-1 OR Karnofsky 60-100%
Life expectancy > 6 months
WBC ≥ 3,000/mm^3
Absolute neutrophil count ≥ 1,500/mm^3
Platelets ≥ 100,000/mm^3
Total bilirubin ≤ 1.5 times upper limit of normal(ULN)
AST/ALT ≤ 2.5 times ULN
Potassium 3.5 - 5.1 mmol/L
Calcium > lower limit of normal
Creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 60 mL/min
No known HIV 1 or HIV 2 positivity
No known hepatitis C or hepatitis B positivity
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No history of allergic reactions attributed to compounds of similar chemical or biological composition to dasatinib
No QTc prolongation, defined as a QTc interval of ≥ 480 msecs or other significant ECG abnormality
No condition that impairs the ability to swallow and retain dasatinib tablets (e.g., gastrointestinal tract disease resulting in an inability to take oral medication, requirement for IV alimentation, prior surgical procedure affecting absorption, or active peptic ulcer disease)

No clinically significant cardiovascular disease including the following:

Myocardial infarction within 6 months
Uncontrolled angina within 3 months
Diagnosed or suspected congenital long QT syndrome
Any history of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, or Torsades de Pointe)
Any history of second or third degree heart block (may be eligible if the subject currently has a pacemaker)
Heart rate consistently < 50 beats/minute on pre-entry ECG
Uncontrolled hypertension
Ejection fraction < 45% by transthoracic echo

No uncontrolled intercurrent illness including, but not limited to, the following:

Ongoing or active infection requiring intravenous antibiotics
History of significant bleeding disorder, including congenital (von Willebrand's disease) or acquired (anti-factor VIII antibodies) disorders
Psychiatric illness or social situations that would limit compliance with study requirements
No prior malignancy except for adequately treated basal cell cancer, carcinoma in situ of the cervix, or other cancer for which the patient has been disease free for 3 years
No gastro-esophageal reflux disease dependent on proton pump inhibitors, H2 blockers, or antacids
Recovered from prior therapy
No more than 1 prior therapy with a monoclonal antibody
No more than 1 prior chemotherapy regimen

No prior tyrosine kinase inhibitor therapy

Prior erlotinib hydrochloride allowed
More than 2 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) and recovered

At least 4 weeks since prior radiotherapy

Measurable disease must be outside the radiotherapy port
At least 2 weeks since prior topical therapy
At least 4 weeks since prior surgery requiring general anesthesia and intubation
At least 120 days (4 months) since prior amiodarone
At least 7 days since prior and no concurrent anti-thrombotic and/or platelet agents (e.g., warfarin, heparin, low molecular weight heparin, aspirin [full dose and 81 mg dose] and/or ibuprofen)
At least 7 days since prior and no concurrent agents with pro-arrhythmic potential
More than 7 days or 5 half lives, whichever is greater, since prior and no concurrent agents or substances that induce or inhibit CYP3A4
No concurrent bisphosphonate therapy for the first 8 weeks of dasatinib treatment
No other concurrent investigational agents
No concurrent combination antiretroviral therapy for HIV-positive patients