This phase II trial studies how well busulfan, melphalan, and bortezomib before first-line stem cell transplant works in treating patients with multiple myeloma. Giving chemotherapy before a peripheral blood stem cell transplant may stop the growth of cancer cells by stopping them from dividing or killing them. After treatment, stem cells are collected from the patient's blood and stored. The stem cells are then returned to the patient to replace the blood-forming cells that were destroyed by the chemotherapy.
PRIMARY OBJECTIVES: I. To determine the complete response rate as defined by the International Myeloma Working Group (IMWG) criteria for patients with multiple myeloma treated with high dose chemotherapy with pharmacokinetic (PK) directed intravenous (IV) busulfan, bortezomib and melphalan (Bu/BTZ/Mel140) followed by autologous hematopoietic stem cell transplantation (ASCT) as first line therapy. SECONDARY OBJECTIVES: I. To determine the overall response rate of the regimen Bu/BTZ/Mel140. II. To determine the treatment related toxicity and mortality of the regimen, including 100-day mortality rates. III. To determine the duration of response, time to progression, progression-free survival, event-free survival and overall survival for this conditioning regimen. IV. To determine whether there is a gender or race difference in the pharmacokinetic profile of IV busulfan. V. To determine methylation and gene expression signatures of pre-treatment bone marrow plasma cells and explore associations of these signatures with outcome. OUTLINE: CONDITIONING: Patients receive busulfan IV over 3 hours on days -6 to -3, melphalan IV over 20 minutes on day -2, and bortezomib IV over 3-5 seconds on days -6, -3, 1, and 4. TRANSPLANT: Patients undergo autologous peripheral blood stem cell transplant (PBSCT) on day 0. After completion of study treatment, patients are followed up for up to 5 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
19
Given IV
Given IV
Given IV
Undergo autologous PBSCT
Undergo autologous PBSCT
Rutgers Cancer Institute of New Jersey
New Brunswick, New Jersey, United States
NYU Cancer Institute
New York, New York, United States
Memorial Sloan-Kettering Cancer Center
New York, New York, United States
Albert Einstein College of Medicine
The Bronx, New York, United States
Rate of Complete Response as Determined by the IMWG Criteria
Number of patients achieved complete response after the treatment regimen
Time frame: Day 100
Overall Response Rate
Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
Time frame: Up to day 100
Mortality
Time frame: Up to day 100
Time-to-progression
Time frame: From start of treatment to disease progression with deaths, up to 2 years
Progression-free Survival
The progression free survival was assessed over a period of 2 years
Time frame: 2 years
Overall Survival
The overall survival of patients was measured of a period of 2 years.
Time frame: 2 years
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