HDAC Inhibitor AR-42 and Pomalidomide in Treating Patients With Relapsed Multiple Myeloma

Inclusion Criteria

• •Patients with measurable disease as defined by any of the following:
• •* Serum M-protein \>= 0.5 g/dl (\>= 500 mg/dL)
• •* Urine monoclonal protein \>= 200 mg/24h
• •* Involved free light chain (FLC) level \>= 10 mg/dl (\>= 100 mg/l) and an abnormal serum free light chain ratio (\< 0.26, or \> 1.65)
• •Patients must have previously received Lenalidomide and proteasome inhibitor.
• •Patients must be lenalidomide failures: disease progression on a prior lenalidomide-based therapy or progression within 60 days of the last dose of a lenalidomide; patients should have received at least 2 cycles of a lenalidomide-based regimen at standard doses to be evaluable for refractoriness; prior intolerance to lenalidomide does not exclude participation in the study except in cases of severe allergic reaction
• •Prior radiation is permitted; however, at least 2 weeks must have elapsed since the completion of therapy and patients must have recovered from all therapy-associated toxicities to no greater than grade 1 at the time of registration; patients with symptomatic disease may receive palliative corticosteroids up to 1 week before initiating therapy
• •Patient must have received 2 or more prior lines of systemic therapy for myeloma; patients must be off last treatment for at least 2 weeks (wks) by the beginning of treatment on this protocol
• •Patients must have a Karnofsky performance score of 50% or greater
• •Patients must have absolute neutrophil count (ANC) \> 1000/uL
• •Platelets \>= 75,000/uL
• •Total bilirubin =\< 1.5 mg/dL
• •Alkaline phosphatase =\< 4 x institutional upper limit of normal (IULN)
• •Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 3 x IULN
• •Patients must have a serum creatinine limit of ≤1.5 ULN or creatinine clearance of ≥60 ml/min measured within 14 days of registration.
• •All study participants must be registered into the mandatory POMALYST (pomalidomide) Risk Evaluation and Mitigation Strategy (REMS) program, and be willing and able to comply with the requirements of the POMALYST REMS program
• •Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL prior to starting therapy and prior to beginning another cycle (if applicable); women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately; a female of childbearing potential (FCBP) is a sexually mature woman who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
• •The patient must be willing to comply with fertility requirements as below:
• •* Male patients must agree to use an adequate method of contraception for the duration of the study and for 28 days afterwards
• •* Female patients must be either postmenopausal, free from menses \>= 2 yrs, surgically sterilized, willing to use two adequate barrier methods of contraception to prevent pregnancy, or agree to abstain from heterosexual activity starting with screening (4 weeks prior to initiating treatment) and 28 days after treatment, per POMALYST REMS™ program
• •* Patients must agree not to donate blood, sperm/ova during the course of taking protocol therapy and for at least 4 weeks after stopping treatment