The purpose of this study test the hypothesis that the combination of simvastatin and zoledronic acid (for reversal of drug resistance), with bortezomib, high-dose methylprednisolone and bendamustine on a day 1,8 schedule (to reduce toxicity) will be an effective and well-tolerated treatment for relapsed and refractory multiple myeloma
OBJECTIVES Primary To estimate the overall response rate (ORR) (complete response (CR) + very good partial response (VGPR) + partial response (PR)) of patients with multiple myeloma who have relapsed or are refractory after bortezomib treatment and will now receive a combination therapy of simvastatin, zoledronic acid, bortezomib, bendamustine and methylprednisolone. To evaluate safety and tolerability of studied therapy. Secondary 1. To estimate the progression-free Survival (PFS), time to progression (TTP), overall survival (OS) and duration of response (DOR). 2. To describe toxicities (frequency and severity) during the treatment. 3 To estimate clinical benefit response (CBR) (ORR + minor response (MR)) and stable disease (SD). 4 Explore factors associated with ORR, PFS, OS, toxicity.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
1. Simvastatin 80 mg PO daily starting day -2 through day 10. 2. Zoledronic acid 4 mg IV over 15 minutes on day 1 and then monthly 3. Bortezomib 1.3 mg/m2/day IV bolus on days 3,6 and 10. 4. Bendamustine 100 mg/m2/day IV over 30 minute infusion on days 3 and 10. 5. Methylprednisolone 1g/m2 IV over 30 minutes on days 1 and 8.
Response to treatment as defined by The International Myeloma Working Group response criteria for multiple myeloma.
Response catergories (IMWG): Complete Remission(CR), Very Good Partial Remission(VGPR), Partial Remission (PR), Minor Response (MR), Progressive Disease (PD), Stable Disease, Relapse,Refractory Disease, Overall Response.
Time frame: 4 weeks after first dose of simvastatin
Progression Free Survival (PFS)
PFS is measured from date of study enrollment until the date of progressive disease is documented.
Time frame: After 1 year of follow-up.
Incidence Rate of Toxicity
Decriptive statistics will be provided regarding incidence rates of toxcity. Patients will be monitored for safety throughout the study.
Time frame: End of study; monitoring during study.
Overall Survival (OS)
OS is measured from date of study enrollment until death.
Time frame: After 1 year of follow-up
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