Phase II Trial of Nab-paclitaxel (Abraxane®) in Patients With Relapsed or Refractory Multiple Myeloma
Trial status: Open for Enrollment
Why is this study being done?
I. To evaluate the efficacy (overall response rate) of single agent nab-paclitaxel (Abraxane®) in patients with relapsed or refractory multiple myeloma.
I. To evaluate the adverse events associated with use of single agent nab-paclitaxel (Abraxane) in patients with relapsed or refractory multiple myeloma.
II. To evaluate overall survival, time to progression, and duration of response among patients with relapsed or refractory multiple myeloma undergoing treatment with single agent nab-paclitaxel (Abraxane®).
Patients receive paclitaxel albumin-stabilized nanoparticle formulation intravenously (IV) over 30 minutes on days 1, 8, and 15. Treatment repeats every 28 days for 12 courses in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 3-6 months for up to 3 years.
Who is eligible to participate?
- Absolute neutrophil count >= 500/mm^3
- Platelet count >= 25000/mm^3
- Hemoglobin >= 6 g/dL
- Total bilirubin =< 2.5 X institutional upper limit of normal (ULN)
- Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) =< 5 X ULN
- Serum glutamic pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 5 X ULN
- Creatinine =< 3 mg/dL
- Patients with relapsed or refractory myeloma who have had >= 3 lines of prior therapy
- Measurable disease of multiple myeloma as defined by at least ONE of the following:
- Serum monoclonal protein >= 1.0 g/dL
- > 200 mg of monoclonal protein in the urine on 24 hour electrophoresis
- Serum immunoglobulin free light chain >= 10 mg/dL AND abnormal serum immunoglobulin kappa to lambda free light chain ratio
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) >= 2 (2, 3 or 4)
- Ability to understand and the willingness to sign a written informed consent document
- Negative (serum) pregnancy test done =< 7 days prior to registration, for women of childbearing potential only; NOTE: Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
- Willing to return to enrolling institution (Mayo Clinic in Arizona) for follow-up and all study treatments
- Myelosuppressive therapy for myeloma =< 14 days prior to registration or those who have not recovered from acute reversible adverse events due to agents administered > 21 days earlier
- Other concurrent chemotherapy, radiotherapy, or any ancillary therapy considered investigational
*NOTE: Bisphosphonates are considered to be supportive care rather than therapy, and are thus allowed while on protocol treatment; patients may be receiving stable doses of corticosteroids with a maximum dose of 10 mg of prednisone per day if they are being given for disorders other than lymphoma such as rheumatoid arthritis, polymyalgia rheumatica or adrenal insufficiency, or asthma
- Other active malignancy =< 3 years prior to registration; EXCEPTIONS: Non-melanotic skin cancer or carcinoma-in-situ of the cervix; NOTE: If there is a history or prior malignancy, they must not be receiving other specific treatment (i.e. other investigational therapy, anti-neoplastic therapy, etc.) for their cancer
- Any of the following:
- Pregnant women or women of reproductive ability who are unwilling to use effective contraception
- Nursing women - NOTE: Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with nab-paclitaxel (Abraxane®), breastfeeding should be discontinued if the mother is treated with nab-paclitaxel (Abraxane®)
- Men who are unwilling to use a condom (even if they have undergone a prior vasectomy) while having intercourse with any woman, while taking the drug and for 28 days after stopping treatment
- Other co-morbidity which would interfere with patient's ability to participate in trial, e.g. uncontrolled infection, uncompensated heart or lung disease
- Patients with a >= grade 2 peripheral neuropathy