David Siegel, MD
John Theurer Cancer Center
Hackensack, New Jersey, USA
A phase I study of carfilzomib, lenalidomide, vorinostat, and dexamethasone (QUAD) in relapsed and/or refractory multiple myeloma (MM)
Carfilzomib in combination with an immunomodulatory agent has proven efficacy in NDMM and RRMM. There is also synergistic activity of the combination of a proteasome inhibitor and a histone-deacetylase inhibitor Methods: To determine the toxicity and activity of the quadruplet using carfilzomib with lenalidomide, vorinostat and dexamethasone. The primary objectives were to determine the maximum tolerated dose (MTD) and the safety/tolerability of QUAD. Secondary objectives included ORR, DOR, TTP and TTNT. All patients had relapsed or RRMM after at least one line of Tx. Tx consisted of 28-d cycles of lenalidomide d 1-21, vorinostat d 1-7 and 15-21, IV carfilzomib d 1, 2, 8, 9, 15 and 16 and IV/po dexamethasone 40 mg q wk. A standard 3+3 dose escalation schema to determine DLTs occurring in Cycle 1. AEs were graded using the NCI-CTCAE v3. Response was assessed by the modified IMWG criteria.
Visit our website at: http://www.myeloma.org