Phase I Study of Carfilzomib-based Chemotherapy Mobilization for Autologous Stem Cell Transplantation in Multiple Myeloma
This phase I study utilizes a 3+3 design with escalating cohorts of Carfilzomib at 20mg/m2, 27mg/m2, 36mg/m2, 45mg/m2, 56mg/m2, and 70mg/m2 to be administered concomitantly with Cyclophosphamide 2 gm/m2, Dexamethasone and Granulocyte colony-stimulating factor (G-CSF)
• Subject has a confirmed diagnosis of multiple myeloma as specified by the International Myeloma Working Group criteria and must have measurable disease as defined by at least one of the following criteria:
• Serum monoclonal protein ≥ 0.5 g/dL
• ≥200 mg of monoclonal protein in the urine on 24-hour electrophoresis
• Serum immunoglobulin free light chain: involved FLC ≥ 10 mg/dL (≥ 100 mg/L) AND abnormal serum immunoglobulin kappa to lambda free light chain ratio
• MRD positivity in peripheral blood by flow cytometry.
• Subject previously received treatment with Carfilzomib.
• Subject is ≥18 years of age at the time of signing the informed consent form.
• Subject has an ECOG performance status of \< 2.
• Subjects must have completed any induction therapy and have achieved less than a CR.
• Subject has a life expectancy of \>12 weeks.
‣ Absolute neutrophil count (ANC) ≥1000 cells/mm3 (≥500 for patients with bone marrow biopsy displaying \>50% involvement by myeloma)
⁃ Platelets count ≥ 50,000/mm3 (≥ 30,000 for patients with bone marrow biopsy displaying \>50% involvement by myeloma)
⁃ Hemoglobin \> 9.0 g/dL
⁃ Serum SGOT/AST \<3.0 x upper limits of normal (ULN)
⁃ Serum SGPT/ALT \<3.0 x upper limits of normal (ULN)
⁃ Serum total bilirubin \<1.5 x ULN
• Subject must have a MUGA scan or echo with LVEF ≥40% within 6 months of enrollment.
• Females of childbearing potential (FCBP) must have a negative serum pregnancy test should be done within 7 days of treatment initiation and a negative urine pregnancy test within the 24 hours prior to the first study drug administration
• FCBP and male subjects who are sexually active with FCBP must agree to use 2 highly effective concomitant methods of contraception including a male condom during the study and for 90 days following the last dose of study treatment
• Male subjects must agree to not donate sperm while taking carfilzomib and for 90 days after the last dose of carfilzomib.