Aflibercept for Relapsed Multiple Myeloma

Inclusion Criteria:

* Histologically or cytologically confirmed multiple myeloma

  * Stage II or III disease according to Salmon-Durie staging criteria
* Relapsed or refractory disease
* Progressive disease
* Measurable disease, defined by ≥ 1 of the following criteria:

  * Serum M protein ≥ 1.0 g/dL by serum protein electrophoresis
  * Free light chain measurement \> 200 mg/dL
  * Urinary M protein excretion ≥ 200 mg/24 hours
* Must have received ≥ 2 prior therapies\* for multiple myeloma that meet the following criteria:

  * Antimyeloma therapeutic regimen consisting of ≥ 1 complete course of single-agent or combination-agent therapy, or a planned series of treatments (e.g., 3-4 courses of induction therapy followed by a stem cell harvest procedure followed by conditioning high-dose therapy supported by stem cell transplantation)
  * Antimyeloma regimen is discontinued because of the development of resistant disease or severe therapy-related toxicity
  * Individual antimyeloma regimen will be considered to have been discontinued when all agents of the regimen have been permanently stopped
  * A prior regimen will not be considered to have been discontinued for the modification of drug doses, or if less than all the agents of a combination regimen have been discontinued, or if the regimen has been halted temporarily for the development of a plateau phase of myeloma
  * Maintenance therapy will not be considered an additional regimen
  * If new agents are added to an existing regimen, presumably because of tumor resistance, the old regimen will be considered to have ended and a new regimen to have started
* No evidence of central nervous system (CNS) disease, including primary brain tumor or brain metastasis
* Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2 OR Karnofsky PS 60-100%
* Life expectancy \> 12 weeks
* White blood cell (WBC) ≥ 3,000/mm\^3
* Absolute neutrophil count ≥ 1,500/mm\^3
* Platelet count ≥ 75,000/mm\^3
* Bilirubin ≤ 1.5 times upper limit of normal (ULN)
* Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 times ULN
* Creatinine ≤ 2.0 mg/dL OR creatinine clearance ≥ 60 mL/min
* No albuminuria only

  * Urine protein: creatinine ratio \< 1 OR 24-hour urine protein with an albumin level \< 500 mg
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception during and for ≥ 6 months after completion of study therapy

Exclusion criteria:

* No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
* No known history of allergic reactions attributed to compounds of similar chemical or biological composition to other agents used in the study
* No serious or nonhealing wound, ulcer, or bone fracture
* No significant traumatic injury within the past 28 days
* No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days
* No clinically significant cardiovascular disease
* No prothrombin time (PT) or international normalized ratio (INR) \> 1.5 (unless patient is on full-dose warfarin)
* No evidence of bleeding diathesis or coagulopathy
* No uncontrolled intercurrent illness that would limit compliance with study requirements, including ongoing or active infection
* No psychiatric illness or social situations that would limit study compliance
* No concurrent major surgery
* No concurrent immunosuppressive agents (including steroids)
* No other concurrent investigational agents