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A Phase 1 Study of CCI-779 in Combination With Dexamethasone in Multiple Myeloma

Phase 1
18 Years
Not Enrolling
Refractory Multiple Myeloma, Stage I Multiple Myeloma, Stage II Multiple Myeloma, Stage III Multiple Myeloma

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Trial Information

A Phase 1 Study of CCI-779 in Combination With Dexamethasone in Multiple Myeloma


I. To assess the toxicity and safety of temsirolimus in combination with dexamethasone in
patients with recurrent or refractory multiple myeloma.

II. To assess a dose of temsirolimus that is capable of inhibiting the mammalian target of
rapamycin (mTOR) in myeloma tumor cells.


I. To assess the efficacy of temsirolimus in combination with dexamethasone in these

II. To correlate the efficacy of this regimen with molecular characteristics of the
individual tumor clones.

OUTLINE: This is a multicenter, dose-escalation study of temsirolimus.

Patients receive temsirolimus intravenously (IV) over 30 minutes once weekly on days 1, 8,
15, and 22 and oral dexamethasone once on days 1, 2, 8, 9, 15, 16, 22, and 23. Courses
repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo bone marrow aspiration and blood sample collection periodically for
correlative studies. Correlative studies include analysis of p70S6 kinase activity in
peripheral blood mononuclear cells and in multiple myeloma cells; analysis of the degree of
AKT phosphorylation and degree of PTEN expression in multiple myeloma cells by
immunohistochemistry; Ras mutational analysis; and Myc 5'UTR mutational analysis.

After completion of study treatment, patients are followed for 4 weeks.

Inclusion Criteria:

- Pathologically confirmed multiple myeloma

- Measurable levels of M protein in serum and/or urine

- Recurrent or refractory disease

- Progressive disease after treatment with ≥ 2 separate chemotherapeutic regimens

- At least 1 of the regimens must have included high-dose dexamethasone (40
mg on days 1-4, 9-12, and 17-20) or medium-dose dexamethasone (40 mg on
days 1, 8, 15, and 22) of a 28-day course

- ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%

- Life expectancy ≥ 8 weeks

- Absolute neutrophil count > 1,000/mm^3

- Platelet count > 100,000/mm ^3

- Total bilirubin < 2 mg/dL

- AST and ALT < 3 times upper limit of normal

- Creatinine < 2 mg/dL

- Fasting cholesterol < 350 mg/dL

- Fasting triglycerides < 400 mg/dL

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No history of allergic reactions attributed to compounds of similar chemical or
biological composition to temsirolimus or dexamethasone

- No concurrent uncontrolled illness including, but not limited to, any of the

- Ongoing or active infection

- Poorly controlled hypertension

- Diabetes mellitus

- Symptomatic congestive heart failure

- Unstable angina pectoris

- Cardiac arrhythmia

- Psychiatric illness or social situation that would limit compliance with study

- See Disease Characteristics

- At least 4 weeks since prior cytotoxic therapy

- More than 4 weeks since prior chemotherapy and recovered

- No concurrent anticonvulsive or antiarrhythmic medications

- No concurrent enzyme-inducing antiepileptic drugs (e.g., phenytoin, carbamazepine, or
phenobarbital) or other CYP3A4 inhibitors or inducers (e.g., rifampin or Hypericum
perforatum [St. John wort])

- No concurrent prophylactic hematopoietic colony-stimulating factors

- No other concurrent investigational therapy

- No other concurrent anticancer therapy

Type of Study:


Study Design:

Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Maximum tolerated dose of temsirolimus

Outcome Description:

The MTD is the dose level at which less than 2 out of 6 subjects experience DLT. Assessed according to the NCI Common Toxicity Criteria (CTC).

Outcome Time Frame:

Course 1 (first 28 days)

Safety Issue:


Principal Investigator

Alan Lichtenstein

Investigator Role:

Principal Investigator

Investigator Affiliation:

Veterans Administration Los Angeles Healthcare System


United States: Food and Drug Administration

Study ID:




Start Date:

December 2008

Completion Date:

Related Keywords:

  • Refractory Multiple Myeloma
  • Stage I Multiple Myeloma
  • Stage II Multiple Myeloma
  • Stage III Multiple Myeloma
  • Multiple Myeloma
  • Neoplasms, Plasma Cell



Veteran's Administration Medical CenterLas Angeles, California  90073