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Vorinostat and Bortezomib in Treating Patients With Relapsed or Refractory Multiple Myeloma
This study has been completed.
First Received: March 29, 2006   Last Updated: November 16, 2008   History of Changes
Sponsors and Collaborators: University of Maryland Greenebaum Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00310024
  Purpose

RATIONALE: Vorinostat and bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving vorinostat together with bortezomib may kill more cancer cells.

PURPOSE: This phase I trial is studying the side effects and best dose of vorinostat when given together with bortezomib in treating patients with relapsed or refractory multiple myeloma.


Condition Intervention Phase
Multiple Myeloma and Plasma Cell Neoplasm
Drug: bortezomib
Drug: dexamethasone
Drug: vorinostat
Phase I

Genetics Home Reference related topics: aceruloplasminemia hemophilia
MedlinePlus related topics: Cancer Multiple Myeloma
Drug Information available for: Dexamethasone Dexamethasone acetate Doxiproct plus Suberoylanilide hydroxamic acid Bortezomib Dexamethasone Sodium Phosphate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Study of SAHA in Combination With Bortezomib in Relapsed and Refractory Multiple Myeloma

Further study details as provided by National Cancer Institute (NCI):

Estimated Enrollment: 40
Study Start Date: November 2005
Primary Completion Date: February 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose (MTD) of vorinostat (SAHA) when given together with bortezomib in patients with relapsed or refractory multiple myeloma (MM).
  • Determine the toxicity of this regimen in these patients.

Secondary

  • Determine whether giving SAHA together with bortezomib inhibits histone deacetylation in normal cells (buccal mucosal cells and/or peripheral blood monocytes) as well as in MM cells.
  • Evaluate the effect of dexamethasone when given together with SAHA and bortezomib.
  • Explore molecular mechanisms involved in apoptosis in MM mediated by SAHA and bortezomib.
  • Correlate change of histone acetylation with clinical outcome in patients treated with this regimen.

OUTLINE: This is a multicenter, dose escalation study of vorinostat (SAHA).

Patients receive bortezomib IV on days 1, 4, 8, and 11 followed by oral SAHA twice daily on days 4-11. Beginning in course 3, some patients may receive low-dose oral dexamethasone on days 4-8. Treatment repeats every 21 days for up to 8 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of SAHA until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. An additional cohort of 10 patients receive treatment at the MTD.

Patients undergo blood collection and tumor biopsies periodically during study for pharmacologic and biomarker correlative studies.

After completion of study treatment, patients are followed at least once a month.

PROJECTED ACCRUAL: Approximately 40 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically and clinically confirmed multiple myeloma

    • Relapsed or refractory disease after prior chemotherapy or transplantation* NOTE: *Patients relapsing after prior allogeneic transplantation are eligible only if they have no evidence of active graft-versus-host disease requiring immune suppression
  • Measurable disease, defined by quantitative immunoglobulin levels in serum and/or urine and bone marrow plasmacytosis

    • Non-secretory disease allowed provided MRI or positron emission tomography or CT scan can accurately measure at least one plasmacytoma lesion
  • No known CNS involvement

PATIENT CHARACTERISTICS:

  • Life expectancy > 3 months
  • ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
  • Absolute neutrophil count ≥ 1,000/mm³ (unless myelosuppression is secondary to bone marrow plasmacytosis [> 80% involvement])
  • Platelet count ≥ 50,000/mm³ (unless myelosuppression is secondary to bone marrow plasmacytosis [> 80% involvement])
  • Bilirubin ≤ 2 times upper limit of normal (ULN)
  • AST and ALT ≤ 2 times ULN
  • Creatinine < 2 mg/dL OR creatinine clearance > 40 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able to swallow pills
  • Patients with a history of seizures are eligible provided seizures are under adequate control with non-enzyme inducing anticonvulsant medication
  • No history of allergic reactions attributed to study agents
  • No sensory or motor neuropathy ≥ grade II
  • No uncontrolled current illness including, but not limited to, the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness or social situation that would limit study compliance
  • No grade 3 QT prolongation (i.e., > 500 msec) at baseline

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Prior bortezomib allowed
  • At least 2 weeks since prior therapy for multiple myeloma
  • Concurrent growth factors (filgrastim [G-CSF] and epoetin alfa) to sustain peripheral blood counts (during the first course of therapy only) allowed
  • Concurrent steroid therapy (≤ 20 mg of prednisone) for patients requiring chronic use for disorders other than myeloma allowed
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No other concurrent investigational or commercial agents or therapies for this malignancy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00310024

Locations
United States, Maryland
Greenebaum Cancer Center at University of Maryland Medical Center
Baltimore, Maryland, United States, 21201-1592
United States, New York
New York Weill Cornell Cancer Center at Cornell University
New York, New York, United States, 10021
Sponsors and Collaborators
University of Maryland Greenebaum Cancer Center
Investigators
Principal Investigator: Ashraf Z. Badros, MD University of Maryland Greenebaum Cancer Center
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000466109, MSGCC-GCC-0514, NCI-6835
Study First Received: March 29, 2006
Last Updated: November 16, 2008
ClinicalTrials.gov Identifier: NCT00310024     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
refractory multiple myeloma
stage I multiple myeloma
stage II multiple myeloma
stage III multiple myeloma

Study placed in the following topic categories:
Anticarcinogenic Agents
Dexamethasone
Anti-Inflammatory Agents
Blood Protein Disorders
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Antiemetics
Paraproteinemias
Hemostatic Disorders
Hormones
Hemorrhagic Disorders
Anti-Inflammatory Agents, Non-Steroidal
Analgesics
Dexamethasone acetate
Immunoproliferative Disorders
Antineoplastic Agents, Hormonal
Hematologic Diseases
Blood Coagulation Disorders
Vorinostat
Bortezomib
Vascular Diseases
Glucocorticoids
Protease Inhibitors
Multiple Myeloma
Analgesics, Non-Narcotic
Peripheral Nervous System Agents
Antirheumatic Agents
Lymphoproliferative Disorders
Neoplasms, Plasma Cell

Additional relevant MeSH terms:
Anticarcinogenic Agents
Anti-Inflammatory Agents
Dexamethasone
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Blood Protein Disorders
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Antiemetics
Paraproteinemias
Hemostatic Disorders
Hormones
Hemorrhagic Disorders
Sensory System Agents
Therapeutic Uses
Anti-Inflammatory Agents, Non-Steroidal
Cardiovascular Diseases
Analgesics
Immunoproliferative Disorders
Neoplasms by Histologic Type
Antineoplastic Agents, Hormonal
Immune System Diseases
Hematologic Diseases
Vorinostat
Bortezomib
Vascular Diseases
Gastrointestinal Agents
Enzyme Inhibitors
Protective Agents
Glucocorticoids

ClinicalTrials.gov processed this record on May 07, 2009