The purpose of this research study is to determine how multiple myeloma responds when the study drug vorinostat is added to the standard treatment of bortezomib and pegylated liposomal doxorubicin (PLD). After participants complete the three drug combination and if their multiple myeloma has decreased, the investigators also want to learn what effects (both good and bad) when vorinostat and bortezomib are given to people with multiple myeloma over a longer period of time. This type of treatment is called 'Maintenance Therapy'.
This is a prospective, open-label single arm phase II trial of vorinostat, bortezomib and pegylated liposomal doxorubicin (PLD) followed by vorinostat/bortezomib (VB) maintenance therapy for patients with relapsed and relapsed and refractory multiple myeloma (MM). The primary hypothesis being evaluated is that the addition of vorinostat to the PLD and bortezomib backbone (VB-PLD) will improve the overall response rate (ORR) as compared to a historical control of PLD in combination with bortezomib.\[1\] We anticipate that the addition of maintenance therapy will not improve the ORR, but may improve the quality (depth) of response and progression free survival (PFS). Secondary endpoints include PFS, high quality response rates (very good partial responses (VGPR) + complete responses (CRs)), duration of remission (DOR), quality of life (QOL), overall survival (OS) and tolerability of the regimen in patients with relapsed and relapsed and refractory multiple myeloma.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Oral, 400mg, taken days 4 through 11 of each cycle.
subcutaneous injection, 1.3mg/m2, Days 1, 4, 8, and 11 every cycle
Intravenous, 30mg/m2, Day 4
Lineberger Comphrehensive Cancer Center at University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Estimate the overall response rate.
Estimate the overall response rate (ORR) of the vorinostat, PLD and bortezomib regimen (VB/PLD) followed by vorinostat/bortezomib (VB) maintenance in patients with relapsed and relapsed/refractory multiple myeloma. Criteria for response will be based on the International Uniform Response Criteria for Multiple Myeloma, modified to incorporate criteria for minor response (MR). The overall response rate will be defined as the total number of patients whose response are PR or above, divided by the number of response evaluable patients.
Time frame: 18 months
Evaluate the quality of life measures in patients.
QOL will be evaluated using the EORTC QLQ-C30 and QLQ-MY20 survey instruments.
Time frame: 18 months
Assess the safety and tolerability.
Safety will be assessed via the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4 (CTCAE v4). The analysis of safety will be based on the frequency of adverse events and their severity for patients who received any study medicine.
Time frame: 18 months
Estimate the overall survival.
A patient's survival time will be defined as the time from start of treatment to the date of his or her death.
Time frame: 36 months
Estimate Progression-free survival
A patient's progression-free survival (PFS) will be defined as the time from start of treatment until the date he or she has documented progression or dies.
Time frame: 36 months
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