Overview

Bortezomib and Pegylated Liposomal Doxorubicin Hydrochloride in Treating Patients With Previously Untreated Symptomatic Multiple Myeloma

Status:
Completed
Trial end date:
2008-01-08
Target enrollment:
0
Participant gender:
All
Summary
This phase II trial studies the side effects and how well bortezomib and pegylated liposomal doxorubicin hydrochloride work in treating patients multiple myeloma that are experiencing symptoms and have not received prior treatment. Bortezomib and pegylated liposomal doxorubicin hydrochloride may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.
Phase:
Phase 2
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
National Cancer Institute (NCI)
Treatments:
Bortezomib
Doxorubicin
Liposomal doxorubicin
Criteria
Inclusion Criteria:

- Patients must have a histologically confirmed diagnosis of symptomatic multiple
myeloma with evaluable disease parameters

- A diagnosis of symptomatic multiple myeloma requires:

- A monoclonal serum and/or urine protein

- Clonal bone marrow plasmacytosis, or a histologically confirmed plasmacytoma

- Related organ or tissue impairment, consisting of:

- Hypercalcemia (serum calcium > 0.25 mmol/l above the upper limit of normal,
or > 2.75 mmol/l [i.e. > 11.5 mg/dl]) AND/OR

- Renal insufficiency (serum creatinine > 173 mmol/l [i.e., > 2 mg/dL]);
(please note that serum creatinine may not be >= 2.5 mg/dL) AND/OR

- Anemia (hemoglobin 2 g/dl below the lower limit of normal, or hemoglobin <
10 g/dl) AND/OR

- Bony lesions (lytic bony lesions, or osteoporosis with compression
fractures) AND/OR

- Other findings, such as symptomatic hyperviscosity, amyloidosis, or
recurring bacterial infections (> 2 episodes in 12 months)

- Patients may not have undergone any prior therapy, with the following exceptions:

- Prior plasmapheresis with plasma exchange (PLEX) for a hyperviscosity syndrome is
allowed, providing the patient has no current evidence of hyperviscosity and has
not required PLEX for at least one week prior to initiation of therapy

- Prior radiation therapy to areas of spinal cord compression by plasmacytomas,
painful lesions due to bony involvement, or other myeloma-related indications, is
allowed provided that radiation will have been completed 3 weeks before
initiation of therapy

- Prior surgical intervention, such as for bony fractures or other myeloma-related
complications, is allowed provided that this will have been completed 3 weeks
before the initiation of therapy, and patients have recovered from surgery

- Prior therapy with corticosteroids for indications other than multiple myeloma is
allowed, provided such therapy has been discontinued at least two weeks prior to
study entry, and at least two weeks before their baseline disease evaluation

- Prior supportive therapy with bisphosphonates or erythropoietin is allowed

- Inclusion of females of childbearing potential requires a negative pregnancy test

- Eastern Cooperative Oncology Group (ECOG) performance status =< 2

- Patients may not have a prior history of a hypersensitivity reaction to pegylated
liposomal doxorubicin or doxorubicin, bortezomib or other boronic acid-based compounds

- Patients with a history of reactions to liposomal drug formulations other than
pegylated liposomal doxorubicin will be evaluated individually, and if their
reactions were felt to have been due to the liposomal component itself, as
opposed to the encapsulated agent, they will be excluded at the discretion of the
investigators

- Patients who are known to be human immunodeficiency virus (HIV)-seropositive and are
taking anti-retrovirals may not participate in this study; patients who are
HIV-seropositive and not on anti-retroviral therapy, and who otherwise meet the organ
function criteria, will be eligible for the study

- Patients who are known to have active hepatitis A, B, or C viral infection may not
participate in this study

- No electrocardiogram (EKG) evidence of acute ischemia

- No EKG evidence of medically significant conduction system abnormalities

- No history of myocardial infarction within the last 6 months

- Left ventricular ejection fraction (LVEF) must be >= 45% by either echocardiography or
radionuclide-based multiple gated acquisition (radionuclide ventriculography [RNV] or
multiple gate acquisition scan [MUGA])

- No class 3 or class 4 New York Heart Association congestive heart failure

- Creatinine < 2.5 mg/dL

- Alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) and
aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) =<
2.5 times the upper limit of the institutional normal value

- Total bilirubin =< 1.2 times the upper limit of the institutional normal value

- Absolute neutrophil count (ANC) >= 1,000/ul

- Platelets >= 100,000/ul

- Hemoglobin >= 8 g/dl (transfusion- and/or growth factor-dependent patients are not
excluded if the above parameters can be achieved with such support)

- For those patients receiving warfarin (Coumadin), unfractionated heparin, or
low-molecular weight heparin therapy, the applicable coagulation parameter that is
being monitored must be within the accepted therapeutic ranges for those indications