Dinaciclib, Bortezomib, and Dexamethasone in Treating Patients With Relapsed Multiple Myeloma

• Status: Completed
• Trial end date: 2016-11-22
• Target enrollment: 0
• Participant gender: All

Summary

This phase I trial studies the side effects and best dose of dinaciclib and bortezomib when given together with dexamethasone in treating patients with multiple myeloma that has returned after a period of improvement. Dinaciclib and bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as dexamethasone, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving dinaciclib and bortezomib together with dexamethasone may kill more cancer cells.

• Phase: Phase 1
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: National Cancer Institute (NCI)
• Treatments: BB 1101; Bortezomib; Dexamethasone; Dexamethasone 21-phosphate; Dexamethasone acetate; Ichthammol

Criteria

Inclusion Criteria:

• Serum creatinine =< 2.5 mg/dL

• Absolute neutrophil count >= 1000/uL

• Untransfused platelet count >= 75000/uL

• Hemoglobin >= 8 g/dL

• Total bilirubin =< 1.5 times institutional upper limit of normal (ULN)

• Patients with relapsed multiple myeloma who have already received one or more standard treatment regimens

• Measurable disease of multiple myeloma as defined by at least ONE of the following:

• Serum monoclonal protein >= 1 g/dL

• >= 200 mg of monoclonal protein in the urine on 24 hour electrophoresis

• Serum immunoglobulin free light chain >= 10 mg/dL and abnormal serum immunoglobulin kappa to lambda free light chain ratio

• Monoclonal bone marrow plasmacytosis >= 30% (evaluable disease)

• Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1 or 2

• Adequate residual organ function per treating physician discretion; Note: there is no limit with regard to the number of prior therapies

• Provide informed written consent

• Negative pregnancy test done =< 7 days prior to registration, for women of childbearing potential only

• Willing to provide samples for correlative research purposes

• Willing to return to consenting institution for follow-up during the study

• Recovered (i.e., =< grade 1 toxicity) from the reversible effects of prior antineoplastic therapy

Exclusion Criteria:

• Any of the following recent therapies:

• Alkylators (e.g. melphalan, cyclophosphamide) =< 14 days prior to registration

• Anthracyclines =< 14 days prior to registration

• High dose corticosteroids, immune modulatory drugs (thalidomide or lenalidomide), or proteosome inhibitors (bortezomib) =< 7 days prior to registration

• Concomitant high dose corticosteroids (concurrent use of corticosteroids); EXCEPTION:

patients may be on chronic steroids (maximum dose 20 mg/day prednisone equivalent) if they are being given for disorders other than amyloid, i.e., adrenal insufficiency, rheumatoid arthritis, etc.

• Other active malignancy =< 2 years prior to registration; EXCEPTIONS: non-melanotic skin cancer or carcinoma in-situ of the cervix; NOTE: if there is a history of prior malignancy, they must not be receiving other specific treatment for their cancer

• Any of the following:

• Pregnant women or women of reproductive ability who are unwilling to use 2 effective methods of contraception from the time of signing the informed consent form through 30 days after the last dose of study drug

• Nursing women

• Men who are unwilling to use a condom (even if they have undergone a prior vasectomy) while having intercourse with any woman, while taking the drug and for 30 days after stopping treatment

• Other co-morbidity which would interfere with patient's ability to participate in trial, e.g. uncontrolled infection, uncompensated heart or lung disease

• Other concurrent chemotherapy, radiotherapy, or any ancillary therapy considered investigational; NOTE: bisphosphonates are considered to be supportive care rather than therapy, and are thus allowed while on protocol treatment

• Peripheral neuropathy >= grade 2 on clinical examination during the screening period

• Major surgery =< 14 days prior to registration

• Currently taking strong or moderate inhibitors/inducers of cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4); Note: dinaciclib is a CYP3A4 substrate; patients should not take grapefruit/grapefruit juice or St. John's wort; use of strong or moderate CYP3A4 inhibitors is prohibited from < 7 days prior to registration; use of CYP3A4 inducers is prohibited from =< 7 days prior to registration

• Any of the following conditions:

• Myocardial infarction =< 6 months prior to registration or has New York Heart Association (NYHA) class III or IV heart failure

• Uncontrolled angina

• Severe uncontrolled ventricular arrhythmias

• Electrocardiographic evidence of acute ischemia

• Active conduction system abnormalities; NOTE: prior to study entry, any electrocardiogram (ECG) abnormality at screening must be documented by the investigator as not medically relevant

• Known hypersensitivity to bortezomib, boron, or mannitol

• Serious medical or psychiatric illness likely to interfere with participation in this clinical study per the judgment of the treating physician