Lenalidomide and Temsirolimus in Treating Patients With Previously Treated Multiple Myeloma
This phase I trial is studying the side effects and best dose of temsirolimus when given together with lenalidomide in treating patients with previously treated multiple myeloma. Lenalidomide may stop the growth of multiple myeloma by blocking blood flow to the cancer. Drugs used in chemotherapy, such as temsirolimus, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Temsirolimus may also stop the growth of cancer cells by blocking some of the enzymes needed for their growth. Giving lenalidomide together with temsirolimus may kill more cancer cells
Refractory Multiple Myeloma
Stage II Multiple Myeloma
Stage III Multiple Myeloma
Other: flow cytometry
Other: immunohistochemistry staining method
Other: pharmacological study
|Study Design:||Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||A Phase I Trial of CC-5013 (Lenalidomide) and CCI-779 in Patients With Relapsed or Refractory Multiple Myeloma|
- Maximum tolerated dose (MTD) of temsirolimus when given together with lenalidomide [ Time Frame: Course 1 (first 28 days) ] [ Designated as safety issue: Yes ]The MTD is the dose level at which less than 2 out of 6 patients experience dose limiting toxicities (DLT). The National Cancer Institute Common Terminology Criteria for Adverse events (CTCAE) version 3.0 will used to characterize toxicities.
- Toxicity of lenalidomide and temsirolimus combination therapy in previously treated mulple myeloma patients [ Time Frame: From the time of their first treatment with lenalidomide and temsirolimus ] [ Designated as safety issue: Yes ]Measured by NCI CTCAE version 3.0.
- Pharmacokinetic analysis of lenalidomide [ Time Frame: Baseline and days 1 and 22 (lenalidomide only) of course 1 ] [ Designated as safety issue: No ]Plasma drug levels will be measured by liquid chromatography and tandem mass spectroscopy.
- Pharmacodynamics of temsirolimus in peripheral blood mononuclear cells (PBMC) [ Time Frame: Days 1 and 8 of course 1 ] [ Designated as safety issue: No ]PBMC will be used to assess the phosphorylation status of p70S6K to evaluate the pharmacodynamic activity of each dose level. This will assist in determining the biologically active dose in the event that dose limiting toxicity is not observed. The analysis of p70^S6K and phospho (P)-p70^S6K will be assessed by Western blotting using specific antibodies. The expression level will be quantified by densitometry. The inhibition of P- p70S6K will be correlated with clinical endpoints and PK parameters.
- Assessment of serum cytokines; IL-2, sIL-2R, TNF-alpha, IFN-gamma, IL-1 beta, IL-1Ra, GM-CSF, IL-8, IL-6, sIL-6R, MIP-1 alpha, VEGF, and b-FGF [ Time Frame: Baseline and then every 4 weeks ] [ Designated as safety issue: No ]Assessed by ELISA.
- Assessment of peripheral blood immune cell subsets [ Time Frame: Baseline and then every 4 weeks ] [ Designated as safety issue: No ]We will investigate immune cell subsets by flow-cytometry.
|Study Start Date:||March 2007|
|Primary Completion Date:||February 2012 (Final data collection date for primary outcome measure)|
Experimental: Treatment (antiangiogenesis, chemotherapy, enzyme inhibitor)
Patients receive temsirolimus IV over 30 minutes on days 1, 8, 15, and 22 and oral lenalidomide once daily on days 1-21. Treatment repeats every 28 days for 12 courses in the absence of disease progression or unacceptable toxicity.
Other: flow cytometry
Correlative studiesOther: immunohistochemistry staining method
Other Name: immunohistochemistryOther: pharmacological study
Other Name: pharmacological studiesDrug: lenalidomide
Other Names:Drug: temsirolimus
I. Determine the maximum tolerated dose of CCI-779 (temsirolimus) when given together with lenalidomide in patients with previously treated multiple myeloma.
I. Determine the toxicity of this regimen in these patients. II. Determine the clinical response of patients treated with this regimen. III. Determine the pharmacokinetics of this regimen. IV. Determine the pharmacodynamic effects of this regimen in these patients. V. Determine the effect of this regimen on immunological cellular and serological parameters and hematopoietic precursor cells.
OUTLINE: This is a dose-escalation study of CCI-779.
Patients receive temsirolimus intravenously (IV) over 30 minutes on days 1, 8, 15, and 22 and oral lenalidomide once daily on days 1-21. Treatment repeats every 28 days for 12 courses in the absence of disease progression or unacceptable toxicity.
Patients achieving at least a partial response after 12 courses may continue to receive CCI-779 and lenalidomide as above in the absence of disease progression. Cohorts of 3 patients receive escalating doses of CCI-779 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. Ten patients are treated at the MTD. Patients undergo blood sample and bone marrow collection periodically during study treatment for pharmacokinetic and pharmacodynamic studies, and to determine the immunomodulatory effects of CCI-779 and lenalidomide.
|United States, Ohio|
|Ohio State University Medical Center|
|Columbus, Ohio, United States, 43210|
|Principal Investigator:||Craig Hofmeister||Ohio State University|