Efficacy Study of CYT997 in Multiple Myeloma

Inclusion Criteria:

* Diagnosis of multiple myeloma per International Working Group (IWG) criteria
* Have received at least 1 but no more than 4 prior lines of therapy
* Have failed to respond to the most recently administered anti-myeloma therapy
* Have a life expectancy of at least 3 months
* Eastern Cooperative Oncology Group (ECOG) performance status \< 3
* At registration absolute neutrophil count \> 1x10\^9/L and platelet count \> 50 x 10\^9/L unsupported
* At registration bilirubin less than 1.5 x upper limit of normal and transaminases less than 2 x upper limit of normal and serum creatinine less than 0.19 mmol/L
* Written informed consent
* Must agree to adequate contraceptive measure if indicated

Exclusion Criteria:

* Patients with monoclonal gammopathy of undetermined significance
* Known or suspected hypersensitivity to CYT997
* Patient with uncontrolled intercurrent illness
* Active infections or other illnesses that precludes chemotherapy administration or patient compliance.
* Pregnant or lactating women.
* Patients who have received any other investigational agents in the last 3 weeks prior to the start of treatment.
* Patients with the following conditions will be excluded:

  * myocardial infarction or stroke within 6 months
  * unstable angina pectoris or acute ischemic changes on ECG
  * history of diabetic retinopathy
  * symptomatic peripheral arterial disease
  * major surgery in the last 30 days
* Patients with uncontrolled diarrhea despite optimal medication and those with any history of acute gastrointestinal bleeding
* Patients with a baseline prolongation of the QTc interval of Common Terminology Criteria (CTC) Grade 1 (QTc \> 0.45-0.47 sec) or greater
* Patients with impaired cardiac function or clinically significant cardiac diseases, including any one of the following:

  * left ventricular ejection fraction (LVEF) \< 45% as determined by multigated acquisition (MUGA) scan or echocardiogram;
  * complete left bundle branch block;
  * obligate use of a cardiac pacemaker;
  * congenital long QT syndrome;
  * history or presence of ventricular tachyarrhythmia;
  * presence of unstable atrial fibrillation (ventricular response \> 100 bpm). -Patients with stable atrial fibrillation are eligible, provided they do not meet any of the other cardiac exclusion criteria;
  * clinically significant resting bradycardia (\< 50 bpm);
  * right bundle branch block + left anterior hemiblock (bifascicular block);
  * angina pectoris ≤ 3 months prior to starting study drug;
  * acute myocardial infarction (MI) ≤ 3 months prior to starting study drug; or
  * other clinically significant heart disease (e.g., congestive heart failure (CHF), uncontrolled hypertension, history of labile hypertension, or history of poor compliance with an antihypertensive regimen).
* Patients currently receiving treatment with medications known to prolong the QTc interval and/or to induce Torsades de Pointes arrhythmia.