To determine the maximum tolerated dose (MTD), if present, and dose schedule of ACY-1215 (ricolinostat) in combination with pomalidomide and low-dose dexamethasone in patients with relapsed-and-refractory multiple myeloma.
To determine the maximum tolerated dose (MTD), if present, and to identify a recommended dose and schedule of ricolinostat administered in an alternative liquid formulation (ALF) (10mg/mL) in combination with pomalidomide and low-dose dexamethasone in patients with relapsed or relapsed-and-refractory multiple myeloma. To evaluate the safety and any anti-tumor activity of ricolinostat administered in combination with pomalidomide and dexamethasone as treatment for patients with relapsed or relapsed-and-refractory multiple myeloma, including duration of response. To assess the Pharmacokinetics and Pharmacodynamics of all three medications administered in combination, and to assess the Pharmacokinetics of ricolinostat and pomalidomide specifically. An evaluation of the relationship between response and biomarkers relating to interacellular acetylation may also be completed.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
16
Escalating dose Cohorts to determine a potential Maximum Tolerated Dose to recommend for a dosing schedule.
UT Southwestern Medical Center Simmons Comprehensive Cancer Center
Dallas, Texas, United States
CTRC at The UT Health Science Center at San Antonio
San Antonio, Texas, United States
University of Utah Huntsman Cancer Institute
Salt Lake City, Utah, United States
Determine Maximum Tolerated Dose (MTD) if any, and recommended dose schedule
Identify the MTD of ACY-1215 administered in an alternative liquid formulation (ALF) if present, and identify a recommended dose and schedule. Patients will be followed for completion of 6 28-day Cycles of Study Treatment (for ITT Population analysis).
Time frame: Every 56 days on treatment, estimated average of 4 months.
Safety
To assess the type, frequency, and severity of adverse events (AEs) and relationship of AEs to study drug.
Time frame: Upon completion of a 28-day treatment cycle and for the duration of treatment, an estimated average of 4 months.
Anti-Tumor Activity
Anti-tumor activity will be measured by objective response to treatment as assessed by the site Investigators using International Myeloma Working Group (IMWG) Uniform Response criteria. Anti-tumor activity will also be measured by duration of response, time to response, and time to progression. The Response rate will be the percentage of patients who achieve PR or better. The number of patients who have at least MR or better will also be collected as clinical benefit response. Progression-free survival (PFS) will be defined as the time from first dose of study treatment to the first documentation of disease progression or death from any cause during the study. For responders, time to tumor response and response duration will be analyzed.
Time frame: Upon completion of a 28-day treatment cycle and for the duration of treatment, an estimated average of 4 months.
Pharmacokinetics
Plasma levels of ACY-1215 will be measured to assess the single and multiple dose PK of AC-1215 in combination with pomalidomide and low-dose dexamethasone. Plasma levels of pomalidomide will be measured to assess the PK of pomalidomide in combination with ACY-1215 and low-dose dexamethasone.
Time frame: Up to 8 days post first dose
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Pharmacodynamics
Exposure response of ACY-1215 in combination with pomalidomide and low-dose dexamethasone, including biomarkers relating to intracellular protein acetylation, protein levels, mRNA and microRA expression profiles.
Time frame: Up to 24 hours post first dose