Bortezomib in Treating Patients With Newly Diagnosed Multiple Myeloma

Inclusion Criteria:

Patients must not have received prior myeloma specific therapy (chemotherapy, radiotherapy, or biologic therapy) other than bisphosphonate therapy

Patients may have received radiation of plasmacytoma (for example, solitary plasmacytoma); the last such treatment must have occurred >= 4 weeks prior to registration

Patients must be recently diagnosed with symptomatic multiple myeloma confirmed by meeting one or more of the following criteria (obtained =< 30 days prior to registration):

NOTE: serum protein electrophoresis (SPEP), urine protein electrophoresis (UPEP) and marrow biopsy all must be done at baseline in order to evaluate response

Monoclonal protein in the serum >= 1 g/dl (measurable disease), or
Monoclonal light chain in the urine protein electrophoresis >= 200 mg/24 hours (measurable disease), or
Bone marrow plasmacytosis >= 30% without either of the values in above (evaluable disease)

Patients must meet one or more of the following (all tests must be been drawn =< 30 days prior to registration but all results are not required to be available at time of registration as long as at least one of the following criteria has been met; if patient is otherwise eligible, plasma cell labeling index [PCLI] is not required, but is requested):

Beta-2 microglobulin >= 5.5 mcg/mL, or
PCLI >= 1, or
Deletion 13 by cytogenetics
Platelet count >= 20,000/mm^3, with or without transfusion support
Hemoglobin >= 7.0 g/dL, with or without transfusion support
Absolute neutrophil count (ANC) >= 500/mm^3 without growth factor support
Direct bilirubin within =< 1.5 x upper normal limits (UNL)
Alkaline phosphatase =< 2.5 x UNL
Aspartate aminotransferase (AST) =< 2.5 x UNL
Calculated or measured creatinine clearance >= 20 mL/minute
Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2; exception: PS = 3 if secondary to acute bone event (fracture)

Patients may not receive concurrent chemotherapy, radiotherapy or biologic therapy while on study; the exception for corticosteroids is made for those taking chronic corticosteroids for disorders other than myeloma, such as rheumatoid arthritis, adrenal insufficiency, etc.

NOTE: Bisphosphonates are considered to be supportive care rather than therapy, and are thus allowed while on protocol treatment
Patients must not have a history of allergic reaction attributable to compounds containing boron or mannitol

Patient must not have a peripheral neuropathy > grade 1, as defined by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE version 3.0):

Grade 2: Objective sensory (or motor) loss or paresthesia (including tingling), interfering with function, but not interfering with activities of daily living (ADL)
Grade 3: Sensory (or motor) loss or paresthesia interfering with ADL
Grade 4: Permanent sensory (or motor) loss that interferes with function
Patient must be capable of understanding the investigational nature, potential risks and benefits of the study

Patient must have adequate cardiac function; patient must not have:

History of a myocardial infarction within 6 months of enrollment
New York Heart Association (NYHA) class III or IV heart failure
Uncontrolled angina or electrocardiographic evidence of acute ischemia
Severe uncontrolled ventricular arrhythmias or electrocardiographic evidence of active conduction system abnormalities
Cardiac amyloidosis
Patient must not have any other serious medical or psychiatric illness that could potentially interfere with the completion of treatment according to this protocol
Patient must not have poorly controlled hypertension
Women must not be pregnant or breast feeding; all females of childbearing potential must have a blood test or urine study within 7 days prior to registration to rule out pregnancy
Women of childbearing potential and sexually active males must be strongly advised to use an accepted and effective method of contraception