Refractory Plasma Cell Myeloma Clinical Trial
Official title:
Phase I/II Bortezomib, Melphalan and Low Dose TBI Conditioning for Patients Undergoing Autologous Stem Cell Transplantation for Multiple Myeloma
This phase I/II trial studies the side effects and best dose of bortezomib when given together with melphalan, and total-body irradiation before stem cell transplant and to see how well it works in treating patients with multiple myeloma. Giving chemotherapy and total-body irradiation before a stem cell transplant stops the growth of cancer cells by stopping them from dividing or killing them. The stem cells that were collected from the patient's blood or bone marrow are returned to the patient to replace the blood-forming cells that were destroyed by the chemotherapy and total-body irradiation.
PRIMARY OBJECTIVES:
I. To determine the maximum tolerated dose (MTD) of bortezomib that can be added to high dose
melphalan and low dose total body irradiation as part of conditioning chemotherapy for
myeloma. (Phase I) II. To determine the efficacy of the bortezomib added to high dose
melphalan and low dose total-body irradiation (TBI) in patients with myeloma undergoing stem
cell transplantation, as defined by achievement of complete response (CR). (Phase II)
SECONDARY OBJECTIVES:
I. To examine the toxicities associated with addition of bortezomib to high dose melphalan
and TBI in patients with multiple myeloma (MM).
II. To determine the progression free rate at 1 and 2 years.
TERTIARY OBJECTIVES:
I. To determine the proportion of patients achieving a minimal residual disease (MRD)
negative status.
II. To assess the HevyLite assay prior to and during treatment.
OUTLINE: This is a phase I, dose-escalation study of bortezomib followed by a phase II study.
CONDITIONING REGIMEN: Patients receive bortezomib intravenously (IV) on days -5 and -2, TBI
twice daily (BID) on days -5 and -2, and melphalan IV over 1 hour on days -4 and -3.
TRANSPLANT: Patients undergo autologous bone marrow or peripheral blood stem cell transplant
on day 0.
After completion of study treatment, patients are followed up at 100 days and then every 90
days for up to 3 years.
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