Dovitinib Combined With Bortezomib and Dexamethasone for Relapsed/Refractory Multiple Myeloma

Inclusion Criteria:

- Diagnosis of multiple myeloma

- Karnofsky performance status ≥ 70

- Age ≥ 18 years old

- Evidence of relapsed or refractory disease as documented from the prior treatment
history

- Have received at least 1, but not more than 3, prior treatment regimens for multiple
myeloma including chemotherapy, autologous stem cell transplantation, immunotherapy,
or other investigational agents. Prior allogeneic stem cell transplant and prior
therapy with bortezomib (with no evidence of disease resistance to bortezomib) are
permitted.

- Last dose of chemotherapy no less than 4 weeks prior to receipt of study medication
and have recovered from the side effects of such therapy

- Last dose of biological therapy, or antibody, or other investigational agents, no
less than 4 weeks prior to receipt of study medication

- Subjects must have the following laboratory values:

- Absolute neutrophil count (ANC) ≥ 1.5 x 109/L

- Platelets ≥ 100 x 109/L

- Hemoglobin (Hgb) > 9 g/dL

- Serum total bilirubin: ≤ 1.5 x ULN

- ALT and AST ≤ 3.0 x ULN

- Serum creatinine ≤ 1.5 x ULN

- Willing and able to undergo bone marrow aspirates as per protocol, with/without bone
marrow biopsy according to the study center's practice. - Life expectancy of ≥ 12
weeks

- All subjects (male and female) of child bearing potential must agree to use adequate
contraceptive methods.

- Negative serum pregnancy test (≤ 72 hours prior to the first dosing of dovitinib) in
all women of childbearing potential

- Subjects who give a written informed consent obtained according to local guidelines

Exclusion Criteria:

- Subjects with CNS (central nervous system) disease

- Subjects with another primary malignancy within 3 years prior to starting study drug,
with the exception of adequately treated in-situ carcinoma of the uterine cervix, or
skin cancer

- Subjects who have received the last administration of an anticancer therapy including
chemotherapy, immunotherapy, hormonal therapy and monoclonal antibodies (but
excluding nitrosurea, mitomycin-C, targeted therapy and radiation) ≤ 4 weeks prior to
starting study drug, or who have not recovered from the side effects of such therapy

- Subjects who have had radiotherapy ≤ 4 weeks prior to starting study drug, or ≤ 2
weeks prior to starting study drug in the case of localized radiotherapy (e.g. for
analgesic purpose or for lytic lesions at risk of fracture), or who have not
recovered from radiotherapy toxicities

- Subjects who have undergone major surgery (e.g. intra-thoracic, intra-abdominal or
intra-pelvic), open biopsy or significant traumatic injury ≤ 4 weeks prior to
starting study drug, or subjects who have had minor procedures, percutaneous biopsies
or placement of vascular access device ≤ 1 week prior to starting study drug, or who
have not recovered from side effects of such procedure or injury

- Subjects with any of the following concurrent severe and/or uncontrolled medical
conditions which could compromise participation in the study:

- Impaired cardiac function or clinically significant cardiac diseases, including
any of the following:

1. History or presence of serious uncontrolled ventricular arrhythmias

2. Clinically significant resting bradycardia

3. LVEF assessed by 2-D echocardiogram (ECHO) < 50% or lower limit of normal
(whichever is higher) or multiple gated acquisition scan (MUGA) < 45% or
lower limit of normal (whichever is higher).

4. Any of the following within 6 months prior to starting study drug:
myocardial infarction (MI), severe/unstable angina, Coronary Artery Bypass
Graft (CABG), Congestive Heart Failure (CHF), Cerebrovascular Accident
(CVA), Transient Ischemic Attack (TIA), Pulmonary Embolism (PE)

5. Uncontrolled hypertension defined by a SBP ≥ 160 mm Hg and/or DBP ≥ 100 mm
Hg, with or without anti-hypertensive medication(s),

- Impairment of gastrointestinal (GI) function or GI disease that may
significantly alter the absorption of dovitinib (e.g. ulcerative diseases,
uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel
resection),

- Cirrhosis, chronic active hepatitis or chronic persistent hepatitis,

- Known diagnosis of human immunodeficiency virus (HIV) infection (HIV testing is
not mandatory),

- Subjects who are currently receiving anticoagulation treatment with therapeutic
doses of warfarin,

- Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g.
active or uncontrolled infection, uncontrolled diabetes) that could cause
unacceptable safety risks or compromise compliance with the protocol

- Pregnant or breast-feeding women

- Women of child-bearing potential, who are biologically able to conceive, not willing
to employ two forms of highly effective contraception

- Fertile males not willing to use contraception

- Subject has a known hypersensitivity to bortezomib, or known Grade ≥ 2
bortezomib-related neuropathy

- Subjects unwilling or unable to comply with the protocol