Carfilzomib and Dexamethasone in Treating Patients With Multiple Myeloma Who Previously Underwent a Stem Cell Transplant

Launched by MAYO CLINIC · Mar 14, 2013

Keywords

ClinConnect Summary

PRIMARY OBJECTIVES:

I. To assess the complete response (CR) rate with carfilzomib and dexamethasone consolidation following an upfront single stem cell transplant (SCT).

SECONDARY OBJECTIVES:

I. To assess the toxicity of carfilzomib and dexamethasone when used as consolidation therapy in patients post SCT.

II. To determine the progression free rate at 1 and 2 years post SCT. III. To evaluate progression-free survival and overall survival.

TERTIARY OBJECTIVES:

I. To determine the proportion of patients achieving a minimal residual disease (MRD) negative status.

II. To assess the HevyL...

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Eligibility criteria

• Inclusion Criteria:
• • Creatinine =\< 3 mg/dL
• • Absolute neutrophil count \>= 1,000/uL
• • Platelet count \>= 75,000/uL
• • Hemoglobin \>= 8.0 g/dL
• • Previous diagnosis of symptomatic multiple myeloma (MM)
• • Received single autologous stem cell transplantation 60-120 days prior to registration
• • Received the autologous SCT =\< 12 months of their diagnosis of myeloma to be eligible for the study
• • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1 or 2
• • Recovered from toxicity of previous chemotherapy (excludes grade 1 neurotoxicity and hematological toxicity)
• • Voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that the subject may withdraw consent at any time without prejudice to future medical care
• • Negative pregnancy test performed =\< 7 days prior to registration, for women of childbearing potential only
• • Willingness to return to one of the enrolling institutions for follow-up (during the active monitoring phase of the study); NOTE: during the active monitoring phase of a study (i.e., active treatment and observation), participants must be willing to return to the consenting institution for follow-up
• * Measurable disease of multiple myeloma at the time of baseline values for disease assessment as defined by at least one of the following:
• • Serum monoclonal protein \>= 1.0 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
• • NOTE: for patients with no relapse prior to transplant, measurable disease at the time of diagnosis
• • NOTE: for patients who have had a disease relapse prior to transplant, measurable disease at the time of the most recent relapse immediately prior to transplant; NOTE: if the patient had treatment for the relapsed disease prior to transplant, the patient must have measurable disease at the time of relapse prior to this therapy
• • Willing to provide bone marrow and blood samples for correlative research purposes
• Exclusion Criteria:
• • Prior allogeneic bone marrow/peripheral blood stem cell transplant
• • Evidence of disease progression post SCT at the time of consideration for the study enrollment
• • Myocardial infarction =\< 6 months prior to registration
• • New York Heart Association (NYHA) class III or IV heart failure
• • Uncontrolled angina
• • Severe uncontrolled ventricular arrhythmias
• • Electrocardiographic (ECG) evidence of acute ischemia or active conduction system abnormalities; NOTE: prior to study entry, any ECG abnormality at screening has to be documented by the investigator as not medically relevant
• • Seroreactivity for human immunodeficiency virus (HIV), human T-cell lymphotrophic virus (HTLV) I or II, hepatitis B virus (HBV), or hepatitis C virus (HCV)
• • Other active malignancy requiring therapy; EXCEPTIONS: non-melanotic skin cancer or carcinoma-in-situ of the cervix; NOTE: if there is a history or prior malignancy, they must not be receiving other specific treatment for their cancer
• • Pregnant women or women of reproductive capability who are unwilling to use effective contraception
• • 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 28 days after stopping treatment
• • Other co-morbidity, which would interfere with patient's ability to participate in the trial, e.g. uncontrolled infection, uncompensated lung disease
• • 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
• • Known allergies to any of the components of the investigational treatment regimen or required ancillary treatments