Study of Velcade® and Bone Formation in Patients With Relapsed/Refractory Multiple Myeloma

Inclusion Criteria:

History of histologically documented MM with relapsed or progressive disease after at least one line of prior therapy.

Patient has measurable disease in which to capture response, defined as one or more of the following:

Serum M-protein level > 1.0 gm/dl (10.0 g/L) measured by serum protein electrophoresis or immunoglobulin electrophoresis; or
Urinary M-protein excretion > 1000 mg/24 hours; or
Bone marrow plasmacytosis of > 30% by bone marrow aspirate and/or biopsy; or
Serum free light chains (by the Freelite test) > 2 X the upper limit of normal, in the absence of renal failure.
Evidence of active disease by radiographic techniques
Performance status (PS) of <= 2 as per Southwest Oncology Group scale, unless PS of 3-4 based solely on bone pain.
Patients must have a platelet count >= 50,000/mm3, and an absolute neutrophil count of at least 1,000/μl.
Patients must have adequate renal function defined as creatinine clearance > 30ml/min.
Patients must have adequate hepatic function defined as serum transaminases and direct bilirubin < 2 X the upper limit of normal.
Pregnant or nursing women may not participate. Women of childbearing potential must have a negative pregnancy test documented within one week of registration. Women of reproductive potential may not participate unless they have agreed to use an effective contraceptive method.
Male or female adults of at least 18 years of age.
Patients must have signed and Institutional Review Board approved written informed consent form and demonstrate willingness to meet follow-up schedule and study procedure obligations

Exclusion Criteria:

Chemotherapy or radiotherapy received within the previous 4 weeks.
Has received previous bortezomib therapy
Significant neurotoxicity, defined as grade > 2 neurotoxicity per National Cancer Institute Common Toxicity Criteria.
Platelet count < 50,000/mm3, or ANC < 1,000/μl
Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome.
Patient has hypersensitivity to bortezomib, boron, or mannitol
Clinically significant hepatic dysfunction as noted by bilirubin or AST >3 times the upper normal limit or clinically significant concurrent hepatitis.
New York Hospital Association Class III or Class IV heart failure.
Myocardial infarction within the last 6 months.
Non-secretory multiple myeloma, unless the patient has measurable lesions on computed tomography, magnetic resonance imaging and/or positron emission tomography.
Uncontrolled, active infection.
Patients with a history of treatment for clinically significant ventricular cardiac arrhythmias.
Poorly controlled hypertension, diabetes mellitus, or other serious or psychiatric illness that could potentially interfere with the completion of treatment according to this protocol.
Pregnant or potential for pregnancy. Women of childbearing potential will have a pregnancy [beta-HCG] test at screening, and will be required to use a medically approved contraceptive method. Pregnancy testing will be performed prior to administration of each cycle of study drug.
Breast-feeding women may not participate.