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Review

Advances in targeted therapy for the treatment of patients with relapsed/refractory multiple myeloma

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References

  • References of special note have been highlighted as:
  • • of interest
  • •• of considerable interest
  • Brenner H, Gondos A, Pulte D. Recent major improvement in long-term survival of younger patients with multiple myeloma. Blood. 2008;111(5):2521–2526.
  • Palumbo A, Mina R. Management of older adults with multiple myeloma. Blood Rev. 2013;27(3):133–142.
  • Dimopoulos MA, Delimpasi S, Katodritou E, et al. Significant improvement in the survival of patients with multiple myeloma presenting with severe renal impairment after the introduction of novel agents. Ann Oncol. 2014;25(1):195–200.
  • National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. Multiple myeloma. Version 2. 2014. [Internet]. [cited 2014 Aug 29]. Available from: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp.
  • Palumbo A, Sezer O, Kyle R, et al. International Myeloma Working Group guidelines for the management of multiple myeloma patients ineligible for standard high-dose chemotherapy with autologous stem cell transplantation. Leukemia. 2009;23(10):1716–1730.
  • Richardson PG, Sonneveld P, Schuster M, et al. Extended follow-up of a phase 3 trial in relapsed multiple myeloma: final time-to-event results of the APEX trial. Blood. 2007;110(10):3557–3560.
  • Siegel DS, Martin T, Wang M, et al. A phase 2 study of single-agent carfilzomib (PX-171-003-A1) in patients with relapsed and refractory multiple myeloma. Blood. 2012;120(14):2817–2825.
  • Kropff M, Baylon HG, Hillengass J, et al. Thalidomide versus dexamethasone for the treatment of relapsed and/or refractory multiple myeloma: results from OPTIMUM, a randomized trial. Haematologica. 2012;97(5):784–791.
  • Dimopoulos MA, Chen C, Spencer A, et al. Long-term follow-up on overall survival from the MM-009 and MM-010 phase III trials of lenalidomide plus dexamethasone in patients with relapsed or refractory multiple myeloma. Leukemia. 2009;23(11):2147–2152.
  • San-Miguel J, Weisel K, Moreau P, et al. Pomalidomide plus low-dose dexamethasone versus high-dose dexamethasone alone for patients with relapsed and refractory multiple myeloma (MM-003): a randomised, open-label, phase 3 trial. Lancet Oncol. 2013;14(11):1055–1066.
  • San Miguel JF, Hungria VTM, Yoon S-S, et al. Panobinostat plus bortezomib and dexamethasone in patients with relapsed or relapsed and refractory multiple myeloma who received prior bortezomib and IMiDs: a predefined subgroup analysis of PANORAMA 1 [abstract]. J Clin Oncol. 2015;33(15 Suppl):8526.
  • Lonial S, Weiss BM, Usmani SZ, et al. Phase II study of daratumumab (DARA) monotherapy in patients with ≥3 lines of prior therapy or double refractory multiple myeloma (MM): 54767414MMY2002 (Sirius) [abstract]. J Clin Oncol. 2015;33(15 Suppl):LBA8512.
  • Martin TG, Hsu K, Strickland SA, et al. A phase I trial of SAR650984, a CD38 monoclonal antibody, in relapsed or refractory multiple myeloma [abstract]. J Clin Oncol. 2014;32(Suppl 5):8532.

• SAR650984 demonstrated promising efficacy with an ORR of 33% in heavily pretreated and refractory patients when administered as a single agent in phase 1 studies; further evaluation is warranted.

  • Martin TG, Hsu K, Charpentier E, et al. A phase Ib dose escalation trial of SAR650984 (anti-CD-38 mAb) in combination with lenalidomide and dexamethasone in relapsed/refractory multiple myeloma [abstract]. J Clin Oncol. 2014;32(Suppl 5):8512.
  • Lonial S, Dimopoulos M, Palumbo A, et al. Elotuzumab therapy for relapsed or refractory multiple myeloma. N Engl J Med. 2015;373(7):621–631.

•• Patients taking elotuzumab in combination with lenalidomide and dexamethasone demonstrated an ORR of 79% and PFS of 19.4 months in an open-label phase 3 study.

  • Voorhees PM, Manges RF, Sonneveld P, et al. A phase 2 multicentre study of siltuximab, an anti-interleukin-6 monoclonal antibody, in patients with relapsed or refractory multiple myeloma. Br J Haematol. 2013;161(3):357–366.
  • Kaufman JL, Niesvizky R, Stadtmauer EA, et al. Phase I, multicentre, dose-escalation trial of monotherapy with milatuzumab (humanized anti-CD74 monoclonal antibody) in relapsed or refractory multiple myeloma. Br J Haematol. 2013;163(4):478–486.
  • Bensinger W, Maziarz RT, Jagannath S, et al. A phase 1 study of lucatumumab, a fully human anti-CD40 antagonist monoclonal antibody administered intravenously to patients with relapsed or refractory multiple myeloma. Br J Haematol. 2012;159(1):58–66.
  • White D, Kassim A, Bhaskar B, et al. Results from AMBER, a randomized phase 2 study of bevacizumab and bortezomib versus bortezomib in relapsed or refractory multiple myeloma. Cancer. 2013;119(2):339–347.
  • Kelly KR, Chanan-Khan A, Somlo G, et al. Indatuximab ravtansine (BT062) in combination with lenalidomide and low-dose dexamethasone in patients with relapsed and/or refractory multiple myeloma: clinical activity in len/dex-refractory patients [abstract]. Blood. 2013;122(21):758.
  • Kumar SK, Bensinger WI, Zimmerman TM, et al. Phase 1 study of weekly dosing with the investigational oral proteasome inhibitor ixazomib in relapsed/refractory multiple myeloma. Blood. 2014;124(7):1047–1055.
  • Richardson PG, Baz R, Wang M, et al. Phase 1 study of twice-weekly ixazomib, an oral proteasome inhibitor, in relapsed/refractory multiple myeloma patients. Blood. 2014;124(7):1038–1046.
  • Richardson PG, Spencer A, Cannell P, et al. Phase 1 clinical evaluation of twice-weekly marizomib (NPI-0052), a novel proteasome inhibitor, in patients with relapsed/refractory multiple myeloma (MM) [abstract]. Blood. 2011;118(21):302.
  • Vij R, Savona M, Siegel D, et al. Updated results from a multicenter, open-label, dose-escalation phase 1B/2 study of single-agent oprozomib (OPZ) in patients (pts) with hematologic malignancies, including multiple myeloma (MM). Haematologica. 2015;100(S1):251.
  • Lonial S, Shah J, Zonder J, et al. Prolonged survival and improved response rates with ARRY-520 in relapsed/refractory multiple myeloma (RRMM) patients with low alpha 1 acid glycoprotein (AAG) levels: results from a phase 2 study [abstract]. Blood. 2013;122(21):285.

• ARRY-520 is a novel first-in-class agent for MM and has demonstrated an ORR of 16% when used alone or in combination with dexamethasone in patients refractory to bortezomib, lenalidomide and dexamethasone.

  • Stewart AK, Vij R, Laubach JP, et al. Phase I study of aurora kinase inhibitor MLN8237 and bortezomib in relapsed or refractory multiple myeloma [abstract]. Blood. 2012;120(21):1859.
  • Niesvizky R, Lentzsch S, Badros AZ, et al. A phase I study of PD 0332991: complete CDK4/6 inhibition and tumor response in sequential combination with bortezomib and dexamethasone for relapsed and refractory multiple myeloma [abstract]. Blood. 2010;116(21):860.
  • Richardson PG, Chanan-Khan AA, Lonial S, et al. Tanespimycin and bortezomib combination treatment in patients with relapsed or relapsed and refractory multiple myeloma: results of a phase 1/2 study. Br J Haematol. 2011;153(6):729–740.
  • Jakubowiak AJ, Richardson PG, Zimmerman T, et al. Perifosine plus lenalidomide and dexamethasone in relapsed and relapsed/refractory multiple myeloma: a Phase I Multiple Myeloma Research Consortium study. Br J Haematol. 2012;158(4):472–480.
  • Richardson PG, Wolf J, Jakubowiak A, et al. Perifosine plus bortezomib and dexamethasone in patients with relapsed/refractory multiple myeloma previously treated with bortezomib: results of a multicenter phase I/II trial. J Clin Oncol. 2011;29(32):4243–4249.
  • Voorhees PM, Spencer A, Sutherland HJ, et al. Novel AKT inhibitor afuresertib in combination with bortezomib and dexamethasone demonstrates favorable safety profile and significant clinical activity in patients with relapsed/refractory multiple myeloma [abstract]. Blood. 2013;122(21):283.
  • Yee AJ, Hari P, Marcheselli R, et al. Outcomes in patients with relapsed or refractory multiple myeloma in a phase I study of everolimus in combination with lenalidomide. Br J Haematol. 2014;166(3):401–409.
  • Ghobrial IM, Weller E, Vij R, et al. Weekly bortezomib in combination with temsirolimus in relapsed or relapsed and refractory multiple myeloma: a multicentre, phase 1/2, open-label, dose-escalation study. Lancet Oncol. 2011;12(3):263–272.
  • Hofmeister CC, Yang X, Pichiorri F, et al. Phase I trial of lenalidomide and CCI-779 in patients with relapsed multiple myeloma: evidence for lenalidomide-CCI-779 interaction via P-glycoprotein. J Clin Oncol. 2011;29(25):3427–3434.
  • Siegel DS, Krishnan A, Lonial S, et al. Phase II trial of SCIO-469 as monotherapy (M) or in combination with bortezomib (MB) in relapsed refractory multiple myeloma (MM) [abstract]. Blood. 2006;108(11):3580.
  • Mateos MV, Cibeira MT, Richardson PG, et al. Phase II clinical and pharmacokinetic study of plitidepsin 3-hour infusion every two weeks alone or with dexamethasone in relapsed and refractory multiple myeloma. Clin Cancer Res. 2010;16(12):3260–3269.
  • Neri P, Duggan P, Gratton K, et al. Phase I study of the PARP1-2 inhibitor veliparib in combination with bortezomib in patients with relapsed or refractory multiple myeloma [abstract]. Blood. 2012;120(21):1862.
  • Facon T, Leleu X, Stewart AK, et al. Dasatinib in combination with lenalidomide and dexamethasone in patients with relapsed or refractory multiple myeloma: preliminary results of a phase I study [abstract]. Blood. 2009;114(22):1876.
  • Ghobrial IM, Munshi NC, Harris BN, et al. A phase I safety study of enzastaurin plus bortezomib in the treatment of relapsed or refractory multiple myeloma. Am J Hematol. 2011;86(7):573–578.
  • San-Miguel JF, Hungria VT, Yoon SS, et al. Panobinostat plus bortezomib and dexamethasone versus placebo plus bortezomib and dexamethasone in patients with relapsed or relapsed and refractory multiple myeloma: a multicentre, randomised, double-blind phase 3 trial. Lancet Oncol. 2014;15(11):1195–1206.
  • Siegel DS, Richardson P, Dimopoulos M, et al. Vorinostat in combination with lenalidomide and dexamethasone in patients with relapsed or refractory multiple myeloma. Blood Cancer J. 2014;4:e182.
  • Leleu X, Touzeau C, Benboubker L, et al. Phase Ib dose escalation study of oral quisinostat, a histone deacetylase inhibitor, in combination with bortezomib and dexamethasone for patients with relapsed multiple myeloma [abstract]. J Clin Oncol. 2013;31(Suppl):8530.
  • Galli M, Salmoiraghi S, Golay J, et al. A phase II multiple dose clinical trial of histone deacetylase inhibitor ITF2357 in patients with relapsed or progressive multiple myeloma. Ann Hematol. 2010;89(2):185–190.
  • Santo L, Hideshima T, Kung AL, et al. Preclinical activity, pharmacodynamic, and pharmacokinetic properties of a selective HDAC6 inhibitor, ACY-1215, in combination with bortezomib in multiple myeloma. Blood. 2012;119(11):2579–2589.
  • Harrison SJ, Quach H, Link E, et al. A high rate of durable responses with romidepsin, bortezomib, and dexamethasone in relapsed or refractory multiple myeloma. Blood. 2011;118(24):6274–6283.
  • Chen C, Gutierrez M, de Nully Brown P, et al. Anti tumor activity of selinexor (KPT-330), a first-in-class oral selective inhibitor of nuclear export (SINE) XPO1/CRM1 antagonist in patients (pts) with relapsed/refractory multiple myeloma (MM) or Waldenstrom’s macroglobulinemia (WM) [abstract]. Blood. 2013;122(21):1942.
  • Kumar SK, Dispenzieri A, Lacy MQ, et al. Continued improvement in survival in multiple myeloma: changes in early mortality and outcomes in older patients. Leukemia. 2014;28(5):1122–1128.
  • Pozzi S, Marcheselli L, Bari A, et al. Survival of multiple myeloma patients in the era of novel therapies confirms the improvement in patients younger than 75 years: a population-based analysis. Br J Haematol. 2013;163(1):40–46.
  • Stewart AK, Rajkumar SV, Dimopoulos MA, et al. Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma. N Engl J Med. 2015;372(2):142–152.
  • Kumar SK, Lee JH, Lahuerta JJ, et al. Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: a multicenter international myeloma working group study. Leukemia. 2012;26(1):149–157.
  • Jekarl DW, Min CK, Kwon A, et al. Impact of genetic abnormalities on the prognoses and clinical parameters of patients with multiple myeloma. Ann Lab Med. 2013;33(4):248–254.
  • Egan JB, Shi CX, Tembe W, et al. Whole-genome sequencing of multiple myeloma from diagnosis to plasma cell leukemia reveals genomic initiating events, evolution, and clonal tides. Blood. 2012;120(5):1060–1066.
  • Keats JJ, Chesi M, Egan JB, et al. Clonal competition with alternating dominance in multiple myeloma. Blood. 2012;120(5):1067–1076.
  • Druker BJ, Guilhot F, O’Brien SG, et al. Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. N Engl J Med. 2006;355(23):2408–2417.
  • Kortuem KM, Zidich K, Schuster SR, et al. Activity of 129 single-agent drugs in 228 phase I and II clinical trials in multiple myeloma. Clin Lymphoma Myeloma Leuk. 2014;14(4):284–290.
  • Obeng EA, Carlson LM, Gutman DM, et al. Proteasome inhibitors induce a terminal unfolded protein response in multiple myeloma cells. Blood. 2006;107(12):4907–4916.
  • Jagannath S, Barlogie B, Berenson JR, et al. Updated survival analyses after prolonged follow-up of the phase 2, multicenter CREST study of bortezomib in relapsed or refractory multiple myeloma. Br J Haematol. 2008;143(4):537–540.
  • Jagannath S, Barlogie B, Berenson J, et al. A phase 2 study of two doses of bortezomib in relapsed or refractory myeloma. Br J Haematol. 2004;127(2):165–172.
  • Richardson PG, Barlogie B, Berenson J, et al. A phase 2 study of bortezomib in relapsed, refractory myeloma. N Engl J Med. 2003;348(26):2609–2617.
  • Richardson PG, Sonneveld P, Schuster MW, et al. Bortezomib or high-dose dexamethasone for relapsed multiple myeloma. N Engl J Med. 2005;352(24):2487–2498.
  • Barlogie B, Desikan R, Eddlemon P, et al. Extended survival in advanced and refractory multiple myeloma after single-agent thalidomide: identification of prognostic factors in a phase 2 study of 169 patients. Blood. 2001;98(2):492–494.
  • Weber DM, Chen C, Niesvizky R, et al. Lenalidomide plus dexamethasone for relapsed multiple myeloma in North America. N Engl J Med. 2007;357(21):2133–2142.
  • Dimopoulos M, Spencer A, Attal M, et al. Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma. N Engl J Med. 2007;357(21):2123–2132.
  • Pineda-Roman M, Zangari M, van Rhee F, et al. VTD combination therapy with bortezomib-thalidomide-dexamethasone is highly effective in advanced and refractory multiple myeloma. Leukemia. 2008;22(7):1419–1427.
  • Richardson PG, Xie W, Jagannath S, et al. A phase 2 trial of lenalidomide, bortezomib, and dexamethasone in patients with relapsed and relapsed/refractory myeloma. Blood. 2014;123(10):1461–1469.
  • Zhu YX, Braggio E, Shi CX, et al. Cereblon expression is required for the antimyeloma activity of lenalidomide and pomalidomide. Blood. 2011;118(18):4771–4779.
  • Rajkumar SV, Blood E, Vesole D, et al. Phase III clinical trial of thalidomide plus dexamethasone compared with dexamethasone alone in newly diagnosed multiple myeloma: a clinical trial coordinated by the Eastern Cooperative Oncology Group. J Clin Oncol. 2006;24(3):431–436.
  • Yang G, Chen W, Wu Y. Bortezomib, dexamethasone plus thalidomide for treatment of newly diagnosed multiple myeloma patients with or without renal impairment. Chin J Cancer Res. 2013;25(2):155–160.
  • Richardson PG, Weller E, Lonial S, et al. Lenalidomide, bortezomib, and dexamethasone combination therapy in patients with newly diagnosed multiple myeloma. Blood. 2010;116(5):679–686.
  • Jagannath S, Vij R, Stewart AK, et al. An open-label single-arm pilot phase II study (PX-171-003-A0) of low-dose, single-agent carfilzomib in patients with relapsed and refractory multiple myeloma. Clin Lymphoma Myeloma Leuk. 2012;12(5):310–318.
  • Richardson PG, Siegel DS, Vij R, et al. Pomalidomide alone or in combination with low-dose dexamethasone in relapsed and refractory multiple myeloma: a randomized phase 2 study. Blood. 2014;123(12):1826–1832.
  • Leleu X, Attal M, Arnulf B, et al. Pomalidomide plus low-dose dexamethasone is active and well tolerated in bortezomib and lenalidomide-refractory multiple myeloma: Intergroupe Francophone du Myelome 2009-02. Blood. 2013;121(11):1968–1975.
  • Wang M, Martin T, Bensinger W, et al. Phase 2 dose-expansion study (PX-171-006) of carfilzomib, lenalidomide, and low-dose dexamethasone in relapsed or progressive multiple myeloma. Blood. 2013;122(18):3122–3128.
  • Richardson PG, Hofmeister C, Raje NS, et al. MM-005: Phase 1 trial of pomalidomide (POM), bortezomib (BORT), and low-dose dexamethasone (LoDEX [PVD]) in lenalidomide (LEN)-refractory and proteasome inhibitor (PI)-exposed myeloma [abstract]. J Clin Oncol. 2014;32(Suppl 5):8589.
  • Shah J, Stadtmauer EA, Abonour R, et al. Phase I/II dose expansion of a multi-center trial of carfilzomib and pomalidomide with dexamethasone (Car-Pom-d) in patients with relapsed/refractory multiple myeloma [abstract]. Blood. 2013;122(21):690.
  • Badros AZ, Vij R, Martin T, et al. Carfilzomib in multiple myeloma patients with renal impairment: pharmacokinetics and safety. Leukemia. 2013;27(8):1707–1714.
  • Ghobrial IM, Kaufman JL, Siegel DS, et al. Clinical profile of single-agent modified-release oprozomib tablets in patients (pts) with hematologic malignancies: updated results from a multi-centre, open-label, dose escalation phase 1b/2 study [abstract]. Blood. 2013;122(21):3184.
  • Hari P, Shain K, Voorhees PM, et al. Oprozomib (opz) and dexamethasone (dex) in patients (pts) with relapsed and/or refractory multiple myeloma (RRMM): updated results from dose escalation in phase 1b/2, multicenter, open-label study [abstract]. Haematologica. 2015;100(S1):254.
  • Berenson J, Cartmell A, Bessudo A, et al. Updated results from CHAMPION-1, a phase I/II study investigating weekly carfilzomib with dexamethasone for patients (Pts) with relapsed or refractory multiple myeloma (RRMM) [abstract]. J Clin Oncol. 2015;33(15 Suppl):8527.
  • Dimopoulos M, Moreau P, Palumbo A, et al. Carfilzomib and dexamethasone (Kd) vs bortezomib and dexamethasone (Vd) in patients (pts) with relapsed multiple myeloma (RMM): results from the phase III study ENDEAVOR [abstract]. J Clin Oncol. 2015;33(15 Suppl):8509.
  • Richardson PG, Bensmaine A, Doerr T, et al. MM-007: A phase 3 trial comparing the efficacy and safety of pomalidomide (POM), bortezomib (BORT), and low-dose dexamethasone (LoDEX [PVD]) versus BORT and LoDEX (VD) in subjects with relapsed or refractory multiple myeloma (RRMM) [abstract]. J Clin Oncol. 2015;33(15 Suppl):TPS8610.
  • Biogen Idec. Rituxan (rituximab) injection [prescribing information]. 2014. [Internet]. [cited 2014 Sep 23]. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/103705s5432lbl.pdf
  • Hsi ED, Steinle R, Balasa B, et al. CS1, a potential new therapeutic antibody target for the treatment of multiple myeloma. Clin Cancer Res. 2008;14(9):2775–2784.
  • Collins SM, Bakan CE, Swartzel GD, et al. Elotuzumab directly enhances NK cell cytotoxicity against myeloma via CS1 ligation: evidence for augmented NK cell function complementing ADCC. Cancer Immunol Immunother. 2013;62(12):1841–1849.
  • Zonder JA, Mohrbacher AF, Singhal S, et al. A phase 1, multicenter, open-label, dose escalation study of elotuzumab in patients with advanced multiple myeloma. Blood. 2012;120(3):552–559.
  • Plesner T, Arkenau H-T, Lokhorst HM, et al. Safety and efficacy of daratumumab with lenalidomide and dexamethasone in relapsed or relapsed, refractory multiple myeloma [abstract]. J Clin Oncol. 2014;32(Suppl 5):8533.

• An ongoing phase 1/2 study demonstrated that patients treated with daratumumab in combination with lenalidomide and dexamethasone had an ORR of 73%.

  • Jakubowiak A, Offidani M, Pegourie B, et al. A randomized, open-label Phase 2 study of bortezomib and dexamethasone with or without elotuzumab in patients with relapsed/refractory multiple myeloma [abstract]. Haematologica. 2015;100(S1):9.
  • Lacy MQ, Alsina M, Fonseca R, et al. Phase I, pharmacokinetic and pharmacodynamic study of the anti-insulinlike growth factor type 1 Receptor monoclonal antibody CP-751,871 in patients with multiple myeloma. J Clin Oncol. 2008;26(19):3196–3203.
  • Lokhorst HM, Plesner T, Laubach JP, et al. Targeting CD38 with daratumumab monotherapy in multiple myeloma. N Engl J Med. 2015;373(13):1207–1219.
  • Jansen JH, Boross P, Overdijk MB, et al. Daratumumab, a human CD38 antibody induces apoptosis of myeloma tumor cells via Fc receptor-mediated crosslinking [abstract]. Blood. 2012;120(21):2974.
  • de Weers M, Tai YT, van der Veer MS, et al. Daratumumab, a novel therapeutic human CD38 monoclonal antibody, induces killing of multiple myeloma and other hematological tumors. J Immunol. 2011;186(3):1840–1848.
  • Palumbo A, Dimopoulos M, Reece D, et al. Twin randomized studies of daratumumab (DARA; D) plus standard of care (lenalidomide/dexamethasone or bortezomib/dexamethasone [DRd or DVd]) versus Rd or Vd alone in relapsed or refractory multiple myeloma (MM): 54767414 MMY3003 (Pollux) and 54767414 MMY3004 (Castor) [abstract]. J Clin Oncol. 2015;33(15 Suppl):TPS8609.
  • Nakagawa M, Oda Y, Eguchi T, et al. Expression profile of class I histone deacetylases in human cancer tissues. Oncol Rep. 2007;18(4):769–774.
  • Wada T, Kikuchi J, Nishimura N, et al. Expression levels of histone deacetylases determine the cell fate of hematopoietic progenitors. J Biol Chem. 2009;284(44):30673–30683.
  • Mitsiades CS, Mitsiades NS, McMullan CJ, et al. Transcriptional signature of histone deacetylase inhibition in multiple myeloma: biological and clinical implications. Proc Natl Acad Sci U S A. 2004;101(2):540–545.
  • Kawaguchi Y, Kovacs JJ, McLaurin A, et al. The deacetylase HDAC6 regulates aggresome formation and cell viability in response to misfolded protein stress. Cell. 2003;115(6):727–738.
  • Richardson P, Mitsiades C, Colson K, et al. Phase I trial of oral vorinostat (suberoylanilide hydroxamic acid, SAHA) in patients with advanced multiple myeloma. Leuk Lymphoma. 2008;49(3):502–507.
  • Dimopoulos M, Siegel DS, Lonial S, et al. Vorinostat or placebo in combination with bortezomib in patients with multiple myeloma (VANTAGE 088): a multicentre, randomised, double-blind study. Lancet Oncol. 2013;14(11):1129–1140.
  • Farag SS, Zhang S, Jansak BS, et al. Phase II trial of temsirolimus in patients with relapsed or refractory multiple myeloma. Leuk Res. 2009;33(11):1475–1480.
  • Geng C, Hou J, Zhao Y, et al. A multicenter, open-label phase II study of recombinant CPT (Circularly Permuted TRAIL) plus thalidomide in patients with relapsed and refractory multiple myeloma. Am J Hematol. 2014;89(11):1037–1042.
  • Richardson PG, Schlossman RL, Alsina M, et al. PANORAMA 2: panobinostat in combination with bortezomib and dexamethasone in patients with relapsed and bortezomib-refractory myeloma. Blood. 2013;122(14):2331–2337.
  • Food and Drug Administration. Farydak (panobinostat): highlights of prescribing information. 2015. [cited 2015 Aug 28]. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/205353s000lbl.pdf

• Panobinostat was recently approved (February 2015) in combination with bortezomib and dexamethasone for patients who had failed on lenalidomide and an IMiD. PFS was 10.6 months in a phase 3 study.

  • Berdeja JG, Gregory T, Matous J, et al. A phase I/II study of the combination of panobinostat (PAN) and carfilzomib (CFZ) in patients (pts) with relapsed or relapsed/refractory multiple myeloma (MM) [abstract]. J Clin Oncol. 2015;33(15 Suppl):8513.
  • Chari A, Cho HJ, Parekh S, et al. A phase II study of panobinostat with lenalidomide and weekly dexamethasone in myeloma [abstract]. J Clin Oncol. 2015;33(15 Suppl):8528.
  • Hess G, Herbrecht R, Romaguera J, et al. Phase III study to evaluate temsirolimus compared with investigator’s choice therapy for the treatment of relapsed or refractory mantle cell lymphoma. J Clin Oncol. 2009;27(23):3822–3829.
  • Motzer RJ, Escudier B, Oudard S, et al. Efficacy of everolimus in advanced renal cell carcinoma: a double-blind, randomised, placebo-controlled phase III trial. Lancet. 2008;372(9637):449–456.
  • Carter BZ, Mak DH, Woessner R, et al. Inhibition of KSP by ARRY-520 induces cell cycle block and cell death via the mitochondrial pathway in AML cells. Leukemia. 2009;23(10):1755–1762.
  • Shah JJ, Zonder J, Cohen A, et al. ARRY-520 shows durable responses in patients with relapsed/refractory multiple myeloma in a phase 1 dose-escalation study [abstract]. Blood. 2011;118(21):1860.
  • Shah JJ, Zonder JA, Cohen A, et al. The novel KSP inhibitor ARRY-520 is active both with and without low-dose dexamethasone in patients with multiple myeloma refractory to bortezomib and lenalidomide: results from a phase 2 study [abstract]. Blood. 2012;120(21):449.
  • Dimopoulos MA, Palumbo A, Hajek R, et al. Factors that influence health-related quality of life in newly diagnosed patients with multiple myeloma aged ≥ 65 years treated with melphalan, prednisone and lenalidomide followed by lenalidomide maintenance: results of a randomized trial. Leuk Lymphoma. 2014;55(7):1489–1497.
  • Maltezas D, Dimopoulos MA, Katodritou I, et al. Re-evaluation of prognostic markers including staging, serum free light chains or their ratio and serum lactate dehydrogenase in multiple myeloma patients receiving novel agents. Hematol Oncol. 2013;31(2):96–102.
  • Food and Drug Administration. Guidance for industry. Clinical trial endpoints for the approval of cancer drugs and biologics. 2007. [Internet]. [cited 2014 Aug 29]. Available from: http://www.fda.gov/downloads/Drugs/…/Guidances/ucm071590.pdf
  • Anderson KC, Kyle RA, Rajkumar SV, et al. Clinically relevant end points and new drug approvals for myeloma. Leukemia. 2008;22(2):231–239.
  • Tuma R. Progression-free survival remains debatable endpoint in cancer trials. J Natl Cancer Inst. 2009;101(21):1439–1441.
  • Felix J, Aragao F, Almeida JM, et al. Time-dependent endpoints as predictors of overall survival in multiple myeloma. BMC Cancer. 2013;13:122.
  • Menis J, Hasan B, Besse B. New clinical research strategies in thoracic oncology: clinical trial design, adaptive, basket and umbrella trials, new end-points and new evaluations of response. Eur Respir Rev. 2014;23(133):367–378.
  • American Society of Clinical Oncology. Extraordinary responders drive concept of basket trial design. ASCO Daily News Wrap Up. 2014;19:22.
  • Davies H, Bignell GR, Cox C, et al. Mutations of the BRAF gene in human cancer. Nature. 2002;417(6892):949–954.
  • Chapman MA, Lawrence MS, Keats JJ, et al. Initial genome sequencing and analysis of multiple myeloma. Nature. 2011;471(7339):467–472.
  • Kim KB, Cabanillas ME, Lazar AJ, et al. Clinical responses to vemurafenib in patients with metastatic papillary thyroid cancer harboring BRAF(V600E) mutation. Thyroid. 2013;23(10):1277–1283.
  • Willyard C. ‘Basket studies’ will hold intricate data for cancer drug approvals. Nat Med. 2013;19(6):655.
  • A study of zelboraf (Vemurafenib) in patients with BRAF V600 mutation-positive cancer (NCT01524978). 2012. [Internet]. [cited 2015 Aug 26]. Available from: https://clinicaltrials.gov/ct2/show/study/NCT01524978.

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