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Duffy Null-Specific Dose Modifications for the Treatment of Duffy Null Phenotype Multiple Myeloma and Stage II and III Triple Negative Breast Cancer

Trial Status: active

This phase I trial tests the effect of using Duffy null specific dose modification guidelines in treating multiple myeloma and stage II and III triple negative breast cancer patients with the Duffy null (DN) phenotype. People with the DN phenotype, a blood subtype common in some populations, often have lower neutrophil counts (a white blood cell). Standard dosing guidelines for chemotherapy, including dexamethasone, bortezomib, lenalidomide, daratumumab (Dara-RVD), pembrolizumab, paclitaxel, carboplatin, doxorubicin, and cyclophosphamide (Keynote 522), may not account for these naturally lower counts and may lead to unnecessary dose reductions or treatment delays, which can worsen cancer outcomes. Bortezomib blocks several molecular pathways in a cell and may cause tumor cells to die. It is a type of proteasome inhibitor and a type of dipeptidyl boronic acid. Lenalidomide may help the immune system kill abnormal blood cells or tumor cells. It may also prevent the growth of new blood vessels that tumors need to grow. Lenalidomide is a type of antiangiogenesis agent and a type of immunomodulating agent. Daratumumab is in a class of medications called monoclonal antibodies. It binds to a protein called CD38, which is found on some types of immune cells and tumor cells, including myeloma cells. Daratumumab may block CD38 and help the immune system kill tumor cells. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the tumor, and may interfere with the ability of tumor cells to grow and spread. Paclitaxel is in a class of medications called antimicrotubule agents. It stops tumor cells from growing and dividing and may kill them. Carboplatin is in a class of medications known as platinum-containing compounds. It works in a way similar to the anticancer drug cisplatin, but may be better tolerated than cisplatin. Carboplatin works by killing, stopping or slowing the growth of cancer cells. Doxorubicin comes from the bacterium Streptomyces peucetius. It damages deoxyribonucleic acid (DNA) and may kill tumor cells. It is a type of anthracycline antitumor antibiotic. Cyclophosphamide is in a class of medications called alkylating agents. It works by damaging the cell’s DNA and may kill tumor cells. It may also lower the body’s immune response. Dexamethasone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen the side effects of chemotherapy drugs. Giving planned chemotherapy with dose adjustments based on DN status and neutrophil counts may be safe and tolerable and may avoid dose reductions and neutropenic fever in patients with multiple myeloma or stage II/III triple negative breast cancer.