Panobinostat, Carfilzomib, and Dexamethasone in Patients With Relapsed or Refractory Multiple Myeloma

Exclusion Criteria

• •Another bone marrow malignancy
• •Another cancer with expected survival of \< 2 years
• •Active viral, bacterial, or fungal infection progressing on current treatment
• •Clinically significant uncontrolled heart disease and/or recent cardiac event within 6 months prior to enrollment, such as:
• •* History of angina pectoris, symptomatic pericarditis, or myocardial infarction
• •* Left ventricular ejection fraction (LVEF) \< 45% as determined by echocardiogram (ECHO) or multi gated acquisition (MUGA) scan
• •* History or presence of any significant, uncontrolled, or persistent cardiac arrhythmias, e.g. ventricular, supraventricular, nodal arrhythmias or conduction abnormality; stable atrial fibrillation within 6 months prior to randomization is permitted
• •* Resting heart rate \< 50 bpm
• •* Complete left bundle branch block (LBBB), bifascicular block
• •* Congenital long QT syndrome
• •* Any clinically significant ST segment and/or T-wave abnormalities
• •* Corrected QT (QTcF) \> 450 msec for males and \> 470 msec for females using Fridericia's correction on screening electrocardiogram (ECG)
• •* History of documented congestive heart failure (New York Heart Association functional classification III-IV)
• •* Uncontrolled hypertension defined by a systolic blood pressure (SBP) \>= 150 mmHg and/or diastolic blood pressure (DBP) \>= 100 mmHg with or without antihypertensive medication; NOTE: initiation or adjustment of antihypertensive medication(s) is allowed prior to screening
• •* Other clinically significant heart disease or vascular disease
• •Currently taking medications that have known or definite risk of prolonging the QT interval or inducing Torsades de pointes (TdP); the medication must be discontinued or switched to a safe alternative medication prior to starting treatment; specific exception is allowed for patients on long-standing medications that have risk of prolonging QT interval or inducing TdP if screening ECG does not indicate a prolonged QT abnormality
• •Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of panobinostat or dexamethasone (e.g. ulcerative disease uncontrolled nausea, vomiting, malabsorption syndrome, obstruction, or stomach and/or small bowel resection)
• •Unresolved diarrhea \>= Common Terminology Criteria for Adverse Events (CTCAE) grade 2 or a medical condition associated with chronic diarrhea (such as irritable bowel syndrome, inflammatory bowel disease)
• •Major surgery =\< 14 days prior to starting study treatment or side effects of surgery that have not recovered to \< CTCAE grade 2