Phase II Study of the IGF-1 Inhibitor Pasireotide Lar in Combination With the m-TOR Inhibitor Everolimus in Patients With Relapsed/Refractory Multiple Myeloma
Multiple myeloma (MM) is a B-cell malignancy of plasma cells. It represents the second most
common hematological malignancy, with non-Hodgkin's lymphoma being the most common.In this
protocol, we propose a regimen consisting of a novel combination of two agents with a
promising preclinical activity, i.e., pasireotide (IGF-1 inhibitor) and everolimus (mTOR
inhibitor), exploring the efficacy of this therapy in patients with MM. We propose
enrollment after failure to the first two lines of FDA-approved agents, even in patients who
did not have high-dose chemotherapy and SCT. In fact, overall survival after SCT has been
shown to be identical when "early" SCT is compared to "late" SCT, i.e., administered at the
time of relapse. This provides an important opportunity to test our novel therapeutic
approach, reserving SCT for relapse. The advantage of the this strategy is that similar
overall survival outcomes can be achieved with fewer patients undergoing SCT. Both
everolimus and pasireotide have the potential of being clinically effective against myeloma.
A phase II trial of the mTOR inhibitor temsirolimus, an analogue of everolimus, produced a
response rate of 38% in relapsed/refractory multiple myeloma. The IGF-1 inhibitor
pasireotide is a promising agent, because IGF has been recently found to be one of the most
important growth signal molecule in myeloma cells. The combination of everolimus and
pasireotide should have a synergistic antimyeloma effect because preclinical data invitro
have shown that combined inhibition of mTOR inhibition and IGF-1 led to a synergistic
increase of cell growth inhibition in multiple myeloma cells and might represent a potential
new treatment strategy.
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Primary objective
Initially 12 patients will be enrolled. If there are no responses among these patients with the combination pasireotide + everolimus in the treatment the study will be terminated.
12 patients enrolled
Yes
Giampaolo Talamo, MD
Principal Investigator
Milton S. Hershey Medical Center
United States: Food and Drug Administration
PSHCI 09-095
NCT01234974
December 2010
December 2013
Name | Location |
---|---|
Penn State Milton S. Hershey Medical Center | Hershey, Pennsylvania 17033 |