azd6244 (selumetinib) in treating patients with multiple myeloma

Conditions: Recurrent Plasma Cell Myeloma; Refractory Plasma Cell Myeloma

Summary: this phase ii trial studies how well selumetinib works in treating patients with multiple myeloma, a type of cancer in which a specific protein is over active. selumetinib may stop the growth of cancer cells by blocking this protein.

primary objectives: i. to assess the response rate of azd6244 (selumetinib) hydrogen sulfate capsules in patients with relapsed or refractory multiple myeloma (mm). secondary objectives: i. to evaluate the toxicity of azd6244 in patients with mm. ii. to estimate progression-free survival and duration of response to azd6244. iii. to test whether azd6244 hydrogen sulfate capsules downregulate tumor cell phosphorylated mitogen-activated protein kinase (perk)1/2. outline: patients receive selumetinib orally (po) twice daily (bid) on days 1-28. courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. after completion of study treatment, patients are followed up every 6 weeks.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of multiple myeloma with relapsed or refractory disease following at least two prior therapies * measurable disease defined as: * serum monoclonal protein \>= 1 gm/dl or * urine monoclonal protein of \>= 200 mg/24 hours, or * measurable free light chains by free light chain assay of \>= 10 mg/dl with abnormal kappa to lambda free light chain ratio, or * measurable bone disease, defined as \>= 1 unidimensionally measurable lesion (longest diameter to be recorded) \>= 20 mm with conventional techniques or \>= 10 mm with spiral computed tomography (ct) scan (for patients with lytic bone disease) * eastern cooperative oncology group (ecog) performance status =\< 2 * absolute neutrophil count: \>= 1,000/μl (independent of blood cell growth factors) * platelets: \>= 75,000/μl (independent of blood cell growth factors or transfusion) * total bilirubin: =\< 1.5 x upper normal limit; however, patients with documented gilbert's syndrome are eligible * aspartate aminotransferase (ast) (serum glutamic oxaloacetic transaminase \[sgot\])/alanine aminotransferase (alt) (serum glutamate pyruvate transaminase \[sgpt\]): \< 2.5 x upper limit of normal (uln) * creatinine: \< 3.0 x uln * known human immunodeficiency virus (hiv) infected patients meeting the following characteristics are eligible: * cluster of differentiation (cd)4 cell count \>= 500/mm\^3 * meeting either of the following: * willing to suspend antiretroviral therapy for duration of protocol therapy or * on stable regimen of combination antiretroviral therapy that does not include either zidovudine or stavudine for at least 12 weeks and without evidence of toxicity * no hiv-associated condition that defines acquired immunodeficiency syndrome (aids) * prior allogeneic stem cell transplant is allowed provided that all of the following conditions are met: * \>= 6 months have elapsed since allogeneic transplant * no graft vs. host disease (gvhd) is present * not currently on immunosuppressive therapy * women of child-bearing potential must agree to use a medically accepted form of contraception prior to, during, and for four weeks following study treatment; men must agree to use a medically accepted form of contraception prior to, during, and for sixteen weeks following study treatment * able and willing to provide a written informed consent * prior palliative and/or localized radiation therapy is permitted, provided at least 14 days have passed from date of last radiation therapy * pulse oximetry of \>= 95% on room air exclusion criteria: * any concurrent condition or planned treatment that would compromise study objectives or represent an unacceptable patient risk, including but not limited to: * planned concurrent treatment for multiple myeloma other than bisphosphonates; ongoing corticosteroids for indications other than multiple myeloma allowed as long as the dose does not exceed 60 mg of prednisone per day or equivalent * persisting effects of any previous or ongoing treatment that might compromise delivery of study treatment or assessment of adverse events * planned concurrent treatment with any other investigational agents * cytotoxic chemotherapy less than 2 weeks, or biologic therapy less than 2 weeks, or corticosteroids less than 2 weeks prior to registration * no other malignancy unless the patient has been disease-free for \>= 1 year * known multiple myeloma of central nervous system or leptomeninges * history of allergic reactions attributed to compounds of similar chemical or biologic composition to azd6244 * previous mitogen activated protein kinase (mek) inhibitor use * uncontrolled hypertension, i.e., persistent blood pressure (bp) of \>= 160/95 * significant cardiovascular disease (new york heart association class ii, iii or iv cardiac disease), hypertrophic cardiomegaly or restrictive cardiomyopathy, myocardial infarction within the past 6 months, unstable angina, unstable arrhythmia unstable or a need for anti-arrhythmic therapy (use of medication for atrial fibrillation is allowed, if stable for at least 3 months) * refractory nausea and vomiting, chronic gastrointestinal diseases (e.g. inflammatory bowel disease), or significant bowel resection that would preclude adequate absorption * uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements * pregnant or nursing * left ventricular ejection fraction (lvef) =\< 45% by echocardiogram (echo) or multigated acquisition scan (muga) scan * any requirement for supplemental oxygen