This phase Ib trial studies the side effects and best doses of carfilzomib and bendamustine hydrochloride when given together with dexamethasone in treating patients with multiple myeloma that has returned or does not respond to treatment. Carfilzomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as bendamustine hydrochloride, work to stop the growth of cancer cells by killing the cells. Biological therapies, such as dexamethasone, may stimulate the immune system and stop cancer cells from growing. Giving carfilzomib, bendamustine hydrochloride, and dexamethasone may be a better way to treat multiple myeloma.
PRIMARY OBJECTIVES: I. To determine the maximum tolerated dose (MTD) of carfilzomib in combination with bendamustine (bendamustine hydrochloride) and dexamethasone, up to a maximum bendamustine dose of 90 mg/m\^2. SECONDARY OBJECTIVES: I. To evaluate the safety of carfilzomib in combination with bendamustine and dexamethasone, at the MTD. II. To evaluate the response rate and duration of response of carfilzomib in combination with bendamustine and dexamethasone, in patients with relapsed and or refractory multiple myeloma. OUTLINE: This is a dose-escalation study of carfilzomib and bendamustine hydrochloride. Patients receive dexamethasone orally (PO) or intravenously (IV) over 20 minutes on days 1, 2, 8, 9, 15, 16, 22, and 23 of courses 1-3; on days 1, 2, 15, and 16 of courses 4-12; and on days 1 and 2 of all subsequent courses. Patients also receive bendamustine hydrochloride IV over 10 minutes on days 1 and 2 of courses 1-3 and on day 1 of all subsequent courses and carfilzomib IV over 30 minutes on days 1, 2, 8, 9, 15, and 16 of courses 1-12 and on days 1, 2, 15, and 16 of all subsequent courses. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for 30 days, every 3 months for 1 year, and then every 6 months thereafter.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
M D Anderson Cancer Center
Houston, Texas, United States
Maximum tolerated dose of carfilzomib and bendamustine hydrochloride when given together with dexamethasone, defined as the dose level below which dose limiting toxicity is observed in greater than or equal to 33% of subjects
Time frame: 28 days
Recommended Phase 1b dose of carfilzomib and bendamustine hydrochloride when given together with dexamethasone
The Phase 1b recommended dose of both agents will be determined from a qualitative assessment of a broad set of considerations that include the following: safety and tolerability, disease response, and biologic activity.
Time frame: Up to 6 years
Best overall response, including stringent complete remission, complete remission, very good partial remission, and partial remission
Overall response will be defined using the International Myeloma Working Group Uniform Response Criteria, with the addition of minimal response according to the European Group for Blood and Marrow Transplant criteria.
Time frame: 112 days (4 courses of therapy)
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