CPI-613 in Treating Patients With Myelodysplastic Syndromes Who Failed Previous Therapy

Inclusion Criteria:

Histologically or cytologically documented MDS of any risk group that has failed previous therapy (therapy failure is defined as patients who have been sufficiently treated with previous agents without response in the opinion of the treating physician, or whose disease has progressed or relapsed while on a hypomethylating agent)
Eastern Cooperative Oncology Group (ECOG) performance status of =< 3
Expected survival > 2 months
Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must use accepted contraceptive methods (abstinence, intrauterine device [IUD], oral contraceptive or double barrier device) during the study, and must have a negative serum or urine pregnancy test within 1 week prior to treatment initiation
Fertile men must practice effective contraceptive methods during the study, unless documentation of infertility exists
Patients must have fully recovered from the acute, non-hematological, non-infectious toxicities of any prior treatment with cytotoxic drugs, radiotherapy or other anti-cancer modalities; patients with persisting, non-hematologic, non-infectious toxicities from prior treatment =< grade 2 are eligible, but must be documented as such
Aspartate aminotransferase (AST/serum glutamic oxaloacetic transaminase [SGOT]) =< 3 x upper normal limit (UNL)
Alanine aminotransferase (ALT)/serum glutamate pyruvate transaminase (SGPT) =< 3 x UNL (=< 5x ULN if liver metastases present)
Bilirubin =< 1.5 x UNL
Serum creatinine =< 1.5 mg/dL or 133 umol/L
International normalized ratio (or INR) must be < 1.5
Albumin >= 2.0 g/dL or >= 20 g/L
Mentally competent, ability to understand and willingness to sign an Institutional Review Board (IRB)-approved written informed consent form
Have access via central line (e.g., portacath)

Exclusion Criteria:

Serious medical illness, such as significant cardiac disease (e.g. symptomatic congestive heart failure, unstable angina pectoris, coronary artery disease, myocardial infarction within the past 3 months, uncontrolled cardiac arrhythmia, pericardial disease or New York Heart Association class III or IV), or severe debilitating pulmonary disease, that would potentially increase patients' risk for toxicity
Patients with active central nervous system (CNS) or epidural tumor
Any active uncontrolled bleeding or bleeding diathesis (e.g., active peptic ulcer disease)
Any condition or abnormality which may, in the opinion of the investigator, compromise his or her safety
Pregnant women, or women of child-bearing potential not using reliable means of contraception
Fertile men unwilling to practice contraceptive methods during the study period
Lactating females
Life expectancy less than 2 months
Unwilling or unable to follow protocol requirements
A history of additional risk factors for torsades de pointes (e.g., heart failure, hypokalemia, family history of long QT syndrome, etc.)
Evidence of active infection or serious infection within the past month
Requirement for immediate palliative treatment of any kind including surgery
Prior illicit drug addiction
Patients with large and recurrent pleural or peritoneal effusions requiring frequent drainage (e.g. weekly)
Patients with any amount of clinically significant pericardial effusion
Patients with known human immunodeficiency virus (HIV) infection; (Note: patients with known HIV infection are excluded because patients with an immune deficiency are at increased risk of lethal infections when treated with marrow-suppressive therapy, and because there may be unknown or dangerous drug interactions between CPI-613 and anti-retroviral agents used to treat HIV infections)
Patients who have received radiotherapy, surgery, treatment with cytotoxic agents (except CPI-613), treatment with biologic agents, immunotherapy, or any other anti-cancer therapy of any kind, or any other standard or investigational treatment for their cancer, or any other investigational agent for any indication, within the past 2 weeks prior to initiation of CPI-613 treatment
Patients that have received a chemotherapy regimen with stem cell support in the previous 6 months