Carfilzomib, Oral Cyclophosphamide, and Dexamethasone for RRMM

Prior treatment

• 1\. Subjects who were previously exposed to carfilzomib
• 1\. Subjects who were previously exposed to cyclophosphamide 3. Subjects diagnosed with POEMS SD, Waldenstrom macroglobulinemia, Plasma cell leukemia 4. Subjects with concurrent heart conditions
• Myocardial infarction within 6 months prior to treatment, New York Heart Association class III or IV heart failure, uncontrolled angina, history of severe coronary artery disease,

Other illness

• Uncontrolled hypertension ( with medication: systolic BP \>= 160 mmHg or diastolic BP \>= 100 mmHg) 5. Chronc obstructive pulmonary disease (FEV1 \< 60%), history of asthma within 2 years 6. Surgery under general anesthesia withing 2 weeks 7. Subjects diagnosed with malignancies within 5 years (except for cured skin cancer, cervical cancer, intraepithelial gastrointestinal tract cancer after curative procedures or surgery for more than 3 years) 8. Any other clinically significant medical disease or condition that, in the Investigator's opinion, may interfere with protocol adherence or a subject's ability to give informed consent 9. Pregnant or breatfeeding subjecs

Other

• Uncontrolled arrythmias (CVDAE version4 grade 2 or more) or symptomatic EKG abnormalities
• 12-lead EKG : baseline ATcF \> 470msec
• 2D Echocardiography or MUGA scan : systolic EF \< 40% with clinically significant symptoms

• Subjects aged 19 years or older
• ECOG performance status 0 to 2
• Diagnosed with multiple myeloma by IMWG criteria
• Subjects previously treated with 1 or more lines of therapy
• Subjects previously treated with lenalidomide-based combination or sigle drug therapy
• Subjects with relapsed and/or refractory multiple myeloma
• Subjects with measurable disease at the time of treatment initiation
  • serum M protein \>=0.5 g/dL, or
  • 24h urine M protein \>= 200mg/24h
  • serum free light chain difference \>=10mg/dL and abnormal FLC ratio
• Adequate organ function
  • absolute neutrophil count \>= 1.0 x 109/L
  • platelelt count \>= 50 x 109/L (plasmacytoma in the bone: \>=30 x 109/L)
  • Hb \>=8g/dL
  • serum creatinine \< 3.0mg/dL or CCR \>=15mL/min
  • serum AST and ALT \<=3 x ULN
  • serum total bilirubin \<= 3 x ULN
• Subjects able to swallow oral drugs
• Subjects who had experienced toxicities to previous therapies: resolved from previous toxicities or stabilized of the toxicity to grade 1
• Subjects who had received allogenetic stem cell transplantation: no acitve graft-versus-host disease
• Subjects without clinically relevant bleeding
• Subjects who have informed consent to the study
• Females of childbearing potential (FCBP) must be negative to pregnancy testing and give consent to practice contraception before and during the treatment