Gender
All
Age Group
18 Years and up
Accepting Healthy Volunteers
No
Inclusion Criteria:
- For entry into the study, the following criteria must be met prior to dosing on Day 1. No
exceptions will be granted. Eligibility criteria for this study have been carefully
considered to ensure the safety of the study participants and that the results of the study
can be used. It is imperative that participants fully meet all eligibility criteria.
1. Signed Written Informed Consent
- Participants must be able to give self-consent and then sign and date an
Institutional Review Board (IRB)/Independent Ethics Committee (IEC)-approved
written informed consent in accordance with local regulatory and institutional
guidelines. This consent must be obtained before the performance of any
protocol-related procedures that are not considered part of normal participant
care.
- Participants must be willing and able to comply with scheduled visits, treatment
schedule, laboratory testing, and other requirements of the study.
2. Type of Participant and Disease Characteristics
1. General inclusion criteria:
- Men or women ≥ 18 years of age.
- Have clinically confirmed relapsed/refractory Multiple Myeloma with up to 5
osseous lesions that can be treated with radiation therapy (SINS score ≤ 13
or Mirels' score ≤ 9) iii) Have undergone appropriate standard of care
treatment options (in the opinion of the treating investigator).
iv) Participants must have measurable disease as defined by RECIST Version 1.1,
including at least one tumor lesion that meets criteria for radiation.
1. . 0.25 cc to 65 cc of viable tumor approximately 5 cm in maximal dimension.
Tumors larger than 65 cc can be partially treated but the whole tumor should
receive at least the minimal prescribed dose confirmed by the study team.
v) Participants must have an Eastern Cooperative Oncology Group performance status
that is greater than or equal to 2 vi) Adequate organ function, as defined by lab
values that will be confirmed by the study doctor.
3. Age and Reproductive Status
- Participants must be males and females ≥ 18 years of age at the time of informed
consent.
- Participants who are women of childbearing potential (WOCBP) must have a negative
serum or urine pregnancy test within 72 hours prior to the start of study.
c) Participants who are women must not be breastfeeding. d) Participants who are
women of childbearing potential must agree to follow instructions for method(s)
of contraception for the duration of treatment with study drug(s) and up to 5
months post last dose of study drug(s).
e) Participants who are women of childbearing potential who are continuously not
heterosexually active are exempted from contraceptive requirements but still must
undergo pregnancy testing as described in this section.
f) Participants who are males and who are sexually active with women of
childbearing potential must agree to follow instructions for method(s) of
contraception for the duration of treatment with study drug(s) and up to 7 months
post last dose of study drug(s). In addition, male participants must be willing
to refrain from sperm donation during this time.
g) Participants who are azoospermic males are exempt from contraceptive
requirements.
Investigators shall counsel women of childbearing potential , and male participants who are
sexually active with women of childbearing potential , on the importance of pregnancy
prevention and the implications of an unexpected pregnancy. Investigators shall advise on
the use of highly effective methods of contraception, which have a failure rate of < 1%
when used consistently and correctly.
Exclusion Criteria:
1. Target Population
• Participants must not have SINS (spinal instability neoplastic score) less than 13
or Mirels' score less than 9 prior to starting radiation treatment
• Participants must not receive any concurrent anti-myeloma or systemic therapy of any
form.
• Participants who have not recovered (i.e. greater than grade 1 or at baseline) from
adverse events due to a previously administered agent will be excluded. Participants
may receive concurrent steroids.
i) Note: subjects with greater than grade 2 neuropathy are an exception to this
criterion and may qualify for the study.
ii) Note: if subject received major surgery, they must have recovered adequately from
the toxicity and/or complications from the intervention prior to starting therapy.
iii) Note: subjects with any grade alopecia are an exception to this criterion and may
qualify for the study • Participants must not have had prior radiation therapy
(defined as less than 10 percent of prior prescription dose) to the area planning to
be treated with radiation.
• Participants who have had prior cytotoxic chemotherapy must not receive that therapy
within 2 weeks of the initiation of radiation
• Participants who have had prior anti-cancer monoclonal antibody (mAb) or other small
molecules must not receive that therapy within 7 days of the initiation of radiation
• Participants must not have a known additional malignancy that could confuse analysis
of on-study treatment. Inclusion of all study participants with more than one
malignancy must be discussed and approved by the PI.
- Participants must not have a known history of non-infectious pneumonitis that
required steroids for treatment.
- Participants must not have evidence of interstitial lung disease.
- Participants must not have a current seizure disorder.
- Participants must not have a history or current evidence of any condition,
therapy or laboratory abnormality that might confound the results of the trial,
interfere with the subject's participation for the full duration of the trial, or
is not in the best interest of the subject to participate, in the opinion of the
treating investigator.
- Has known psychiatric or substance abuse disorders that would interfere with
cooperation with the requirements of the trial.
- Is pregnant or breastfeeding, or expecting to conceive or father children within
the projected duration of the trial, starting with the screening visit through
120 days after the last dose of trial treatment.
- If known active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C is detected
then patient is not eligible for treatment of liver lesions
- Participants must not have had uncontrolled or significant cardiovascular disease
including, but not limited to, any of the following:
- Myocardial infarction or stroke/transient ischemic attack within the past 6
months
- Uncontrolled angina within the past 3 months
- Any history of clinically significant arrhythmias (such as ventricular
tachycardia, ventricular fibrillation, or torsades de pointes)
- History of other clinically significant heart disease (e.g. cardiomyopathy,
congestive heart failure with New York Heart Association functional
classification III to IV, pericarditis, significant pericardial effusion, or
myocarditis)
- Cardiovascular disease-related requirement for daily supplemental oxygen
therapy.
- Participants may not concomitantly use statins while on study. However, a patient
using statins for over 3 months prior to study drug administration and in stable
status without creatine kinase (CK) rise may be permitted to enroll.
- Participants may not have current or history of clinically significant muscle
disorders (e.g. myositis), recent unresolved muscle injury, or any condition
known to elevate serum creatine kinase (CK) levels.
- Participants must not be prisoners or be involuntarily incarcerated.
- Participants must not be compulsorily detained for treatment of either a
psychiatric or physical (e.g., infectious disease) illness.
Eligibility criteria for this study have been carefully considered to ensure the
safety of the study participants and that the results of the study can be used. It is
imperative that participants fully meet all eligibility criteria.