Personalizing DNA Damage in Multiple Myeloma

Summary: 

There are over 30,000 patients who are newly diagnosed with multiple myeloma annually in the United States. Multiple myeloma patients that are fit enough are treated with high dose melphalan, a chemotherapeutic, followed by autologous stem cell transplant. This treatment strategy has not changed in 30 years, but it produces the longest overall survival. However, due to 5-fold interpatient variability in melphalan exposure, only 10% of patients are functionally cured, 5% have too high an exposure and die due to transplant-related toxicities, and approximately 20% are melphalan-resistant and relapse within 12 months of transplant. Thus, new methods are needed to improve upon how melphalan is administered to increase the number of patients that achieve a functional cure. This phase I pilot study will assess a real-time exposure-based dosing algorithm that allows for personalized melphalan dosing.

Trial Registration: ClinicalTrials.gov Identifier: NCT04483206