Clinical trial NCT02477215 (phase 1/phase 2, status: completed)
Conditions: multiple myeloma
ICD codes: C90.01, C90.02, C90.00
Drugs: mln9708, dexamethasone, bendamustine (multiple dose levels), bendamustine (mtd)
SMILES: [H][C@@](CC(C)C)(N=C(O)CN=C(O)C1=C(Cl)C=CC(Cl)=C1)B(O)O, C[C@@H](O[C@H]1OCCN(CC2=NNC(=O)N2)[C@H]1C1=CC=C(F)C=C1)C1=CC(=CC(=C1)C(F)(F)F)C(F)(F)F, ClCCN(CCCl)P1(=O)NCCCO1, ClCCN(CCCl)P1(=O)NCCCO1
Eligibility criteria:

        INCLUSION CRITERIA:

          1. Male or female patients 18 years or older.

          2. Voluntary written consent must be given before performance of any study related
             procedure not part of standard medical care, with the understanding that consent may
             be withdrawn by the patient at any time without prejudice to future medical care.

          3. Female patients who:

               -  Are postmenopausal for at least one year before the screening visit, OR

               -  Are surgically sterile, OR

               -  If they are of childbearing potential, agree to practice two effective methods of
                  contraception, at the same time, from the time of signing the informed consent
                  form through 90 days after the last dose of study drug, OR • Agree to practice
                  true abstinence when this is in line with the preferred and usual lifestyle of
                  the subject. (Periodic abstinence [eg, calendar, ovulation, symptothermal,
                  post-ovulation methods] and withdrawal are not acceptable methods of
                  contraception.)

             Male patients, even if surgically sterilized (ie, status post-vasectomy), must agree
             to one of the following:

               -  Agree to practice effective barrier contraception during the entire study
                  treatment period and through 90 days after the last dose of study drug, OR

               -  Agree to practice true abstinence when this is in line with the preferred and
                  usual lifestyle of the subject. (Periodic abstinence (eg, calendar, ovulation,
                  symptothermal, postovulation methods] and withdrawal are not acceptable methods
                  of contraception.)

          4. Patients must have have histologically or cytologically confirmed symptomatic Multiple
             Myeloma, who are non-responsive to or ineligible for autologous stem cell transplant,
             and who progress after prior exposure to proteasome inhibitor (bortezomib,
             carfilzomib) and lenalidomide or pomalidomide or thalidomide (IMID); and
             refractory/progressing to at least one of these agents and must meet at least one of
             the following parameters of measurable disease:

               -  Measurable levels of monoclonal protein (M protein): > 1 g/dL of immunoglobin G
                  (IgG) or immunoglobin M (IgM) M-protein or > 0.5 g/dL immunoglobin A (IgA) or
                  immunoglobin D (IgD) M protein on serum protein electrophoresis OR > 200 mg/24h
                  of free light chain proteinuria on a 24 hour urine protein electrophoresis which
                  must be obtained within 4 weeks prior to registration OR > 10 mg/dL involved free
                  light chain on serum free light chain testing with an abnormal kappa:lambda light
                  chain ratio.

               -  Patients with lytic bone disease, defined as at least one lytic lesion that can
                  be accurately measured in at least one dimension.

          5. Eastern Cooperative Oncology Group (ECOG) performance status and/or other performance
             status 0, 1, or 2.

          6. Patients are eligible after autologous or allogeneic stem cell transplantation.
             Allogeneic transplantation can be enrolled only if they have no ongoing transplant
             related side effects.

          7. Patients must be at least 2 weeks from major surgery, radiation therapy, participation
             in other investigational trials and have recovered from clinically significant
             toxicities of these prior treatments

          8. Patients must meet the following clinical laboratory criteria:

               -  Absolute neutrophil count (ANC) ≥ 1,000/mm3 and platelet count ≥ 75,000/mm3.
                  Platelet transfusions or granulocyte-colony stimulating factor (G-CSF) can be
                  used to help patients meet eligibility criteria but are not allowed within 3 days
                  before study enrollment.

               -  Total bilirubin < 1.5 x the upper limit of the normal range (ULN), , OR, direct
                  bilirubin within normal limits (WNL), when total bilirubin is >>< 1.5 x the ULN.

               -  Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 3 x ULN.

               -  Calculated creatinine clearance ≥ 30 mL/min.

        EXCLUSION CRITERIA

        Patients meeting any of the following exclusion criteria are not to be enrolled in the
        study:

          1. Female patients who are lactating or have a positive serum pregnancy test during the
             screening period.

          2. Failure to have fully recovered (ie, ≤ Grade 1 toxicity) from the reversible effects
             of prior chemotherapy except for peripheral neuropathy, which is addressed in
             exclusion criteria no. #14.

          3. Major surgery within 14 days before enrollment.

          4. Radiotherapy within 14 days before enrollment. If the involved field is limited
             (single disease focus not involving pelvis and involving <36 Gy radiation), 7 days
             will be considered a sufficient interval between treatment and administration of
             Ixazomib provided hematologic inclusion parameters are met.

          5. Central nervous system involvement.

          6. Infection requiring systemic antibiotic therapy or other serious infection within 14
             days before study enrollment.

          7. Evidence of current uncontrolled cardiovascular conditions, including uncontrolled
             hypertension, uncontrolled cardiac arrhythmias, symptomatic congestive heart failure,
             unstable angina, or myocardial infarction within the past 6 months.

          8. Systemic treatment, within 14 days before the first dose of IXAZOMIB, with strong
             inhibitors of cytochrome P1A2 (CYP1A2) (fluvoxamine, enoxacin, ciprofloxacin), strong
             inhibitors of cytochrome P3A (CYP3A) (clarithromycin, telithromycin, itraconazole,
             voriconazole, ketoconazole, nefazodone, posaconazole) or strong CYP3A inducers
             (rifampin, rifapentine, rifabutin, carbamazepine, phenytoin, phenobarbital), or use of
             Ginkgo biloba or St. John's wort.

          9. Ongoing or active systemic infection, active hepatitis B or C virus infection, or
             known human immunodeficiency virus (HIV) positive.

         10. Any serious medical or psychiatric illness that could, in the investigator's opinion,
             potentially interfere with the completion of treatment according to this protocol.

         11. Known allergy to any of the study medications, their analogues, or excipients in the
             various formulations of any agent.

         12. Known GI disease or GI procedure that could interfere with the oral absorption or
             tolerance of IXAZOMIB including difficulty swallowing.

         13. Diagnosed or treated for another malignancy where the expected survival is less than
             two years will be excluded. Patients with nonmelanoma skin cancer or carcinoma in situ
             of any type are not excluded if they have undergone complete resection.

         14. Patient has ≥ Grade 2 peripheral neuropathy, or Grade 2 with pain on clinical
             examination during the screening period.

         15. Participation in other clinical trials, including those with other investigational
             agents not included in this trial, within 30 days of the start of this trial and
             throughout the duration of this trial.

         16. Patients that have previously been treated with IXAZOMIB, or participated in a study
             with IXAZOMIB whether treated with IXAZOMIB or not.

         17. Patients with a history of severe chronic obstructive pulmonary disease requiring
             ongoing oxygen support or those with a resting oxygen saturation <92% on room air
             irrespective of the cause.