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Furlan A, Cea M, Pavan L, Galli M, Clissa C, Mangiacavalli S, Cafro AM, Girlanda S, Patriarca F, Minotto C, Bertoldero G, Barilà G, Pascarella A, Lico A, Paolini R, Rabassi N, Pescosta N, Porrazzo M, De Sabbata G, Pompa A, Bega G, Cavallin S, Guidotti F, Marcatti M, Rupolo M, Belotti A, Gherlinzoni F, Zambello R. A real-world retrospective-prospective analysis of efficacy and safety of combined ixazomib, lenalidomide, and dexamethasone in relapsed/refractory multiple myeloma: The northern Italy experience. Cancer Med 2024; 13:e7071. [PMID: 38558233 PMCID: PMC10983806 DOI: 10.1002/cam4.7071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Ixazomib, lenalidomide, and dexamethasone (IRd) have been approved for the treatment of relapsed/refractory multiple myeloma (RRMM) based on the results of the TOURMALINE-MM1. OBJECTIVES AND METHODS We conducted a retrospective-prospective analysis of 106 RRMM patients (pts) treated with IRd in 21 centers in Northern Italy, with the aim to evaluate the efficacy and safety of IRd in real life. RESULTS At IRd initiation, 34% of pts were aged ≥75 (median 72.5), 8.5% had an ECOG performance status ≥2, 54.7% of evaluable pts carried high-risk cytogenetic abnormalities [del17p and/or t(4;14) and/or t(14;16) and/or 1 g gain/amp], 60.2% had received ≥2 prior lines of therapy (pLoT), 57.5% were lenalidomide (Len)-exposed (including both Len-sensitive and Len-refractory pts), and 22% were Len-refractory. Main G ≥3 adverse events (AEs) were thrombocytopenia (16%) and neutropenia (12.3%). G ≥3 non-hematologic AEs included infections (9.4%) and GI toxicity (diarrhea 5.7%, hepatotoxicity 2.8%), VTE, skin rash, and peripheral neuropathy were mainly G1-2. The overall response rate was 56.4% (≥VGPR 30%). With a median follow-up of 38 m, median PFS (mPFS) was 16 m and the 1-year OS rate was 73%. By subgroup analysis, an extended PFS was observed for pts achieving ≥VGPR (mPFS 21.2 m), time from diagnosis to IRd ≥5 years (26.2 m), 1 pLoT (34.4 m), Len-naïve (NR), age ≥70 (20 m). In pts exposed to Len, non-refractory in any prior line and immediately prior to IRd, mPFS was 16 and 18 m, respectively. An inferior PFS was seen in Len-refractory pts (4.6 m). By multivariate analysis, independent predictors of PFS were age ≥70 (HR 0.6), time from diagnosis ≥5 years (HR 0.32), refractoriness to Len in any prior line (HR 3.33), and immediately prior (HR 4.31). CONCLUSION IRd might be effective and safe in RRMM pts with an indolent disease, in early lines of treatment, and who proved Len-sensitive, independent of age, and cytogenetic risk.
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Affiliation(s)
- Anna Furlan
- Divisione di Ematologia Ospedale Ca' Foncello di Treviso, ASL 2TrevisoItaly
| | - Michele Cea
- Hematology Unit, Department of Internal Medicine (DiMI)University of Genoa, IRCSS Ospedale Policlinico San MartinoGenovaItaly
| | - Laura Pavan
- Padua University School of MedicineHematology and Clinical ImmunologyPadovaItaly
| | - Monica Galli
- Hematology Division, Ospedale Papa Giovanni XXIIIBergamoItaly
| | - Cristina Clissa
- Hematology Unit and Stem Cells Transplant CenterAzienda Ospedaliera Universitaria Integrata di VeronaVeronaItaly
| | | | | | - Stefania Girlanda
- Medical Oncology and Hematology UnitASST Fatebenefratelli Sacco, PO FatebenefratelliMilanoItaly
| | - Francesca Patriarca
- Hematology UnitAzienda Sanitaria Universitaria Friuli Centrale, DAME, Udine University School of MedicineUdineItaly
| | - Claudia Minotto
- Medical Oncology and Hematology UnitAzienda ULSS 3 SerenissimaMiranoItaly
| | | | - Gregorio Barilà
- Hematology UnitAzienda ULSS3 Serenissima, Ospedale dell'AngeloVenezia‐MestreItaly
| | - Anna Pascarella
- Hematology UnitAzienda ULSS3 Serenissima, Ospedale dell'AngeloVenezia‐MestreItaly
| | - Albana Lico
- Hematology UnitAzienda ULSS8 Berica, Ospedale San BortoloVicenzaItaly
| | - Rossella Paolini
- Hematology UnitOspedale Santa Maria della MisericordiaRovigoItaly
| | - Nicholas Rabassi
- Hematology Unit and Stem Cells Transplant CenterOspedale Provinciale BolzanoBolzanoItaly
| | - Norbert Pescosta
- Hematology Unit and Stem Cells Transplant CenterOspedale Provinciale BolzanoBolzanoItaly
| | | | | | - Alessandra Pompa
- Hematology UnitIRCCS Fondazione Ca' Granda, Ospedale Maggiore PoliclinicoMilanoItaly
| | - Giulia Bega
- Medical Oncology UnitOspedale G. Fracastoro, Azienda ULSS 9 ScaligeraVeronaItaly
| | - Stefania Cavallin
- Medical Oncology UnitOspedale di Vittorio Veneto, Azienda ULSS 2 Marca TrevigianaVittorio VenetoItaly
| | | | | | - Maurizio Rupolo
- SOSD OncoematologiaIstituto Nazionale Tumori AvianoAvianoItaly
| | - Angelo Belotti
- Hematology UnitASST Spedali Civili di BresciaBresciaItaly
| | | | - Renato Zambello
- Padua University School of MedicineHematology and Clinical ImmunologyPadovaItaly
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Horigome Y, Iino M, Harazaki Y, Kobayashi T, Handa H, Hiramatsu Y, Kuroi T, Tanimoto K, Matsue K, Abe M, Ishida T, Ito S, Iwasaki H, Kuroda J, Shibayama H, Sunami K, Takamatsu H, Tamura H, Hayashi T, Akagi K, Maeda T, Yoshida T, Mori I, Shinozaki T, Iida S. A prospective, multicenter, observational study of ixazomib plus lenalidomide-dexamethasone in patients with relapsed/refractory multiple myeloma in Japan. Ann Hematol 2024; 103:475-488. [PMID: 37695378 PMCID: PMC10798923 DOI: 10.1007/s00277-023-05428-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023]
Abstract
Real-world studies permit inclusion of a more diverse patient population and provide more information on the effectiveness of treatments used in routine clinical practice. This prospective, multicenter, observational study investigated the effectiveness and safety of ixazomib plus lenalidomide and dexamethasone (IRd) in 295 patients with relapsed/refractory multiple myeloma (RRMM) in routine clinical practice in Japan. Patients had a median age of 74 years, 80.0% were aged ≥ 65 years, 42.0% had received ≥ 3 lines of prior treatment, and 28.5% were "frail" according to the International Myeloma Working Group frailty score. After a median follow-up of 25.0 months, median progression-free survival (PFS) was 15.3 (95% CI 12.4-19.5) months, while median overall survival was not reached. The overall response rate was 53.9%, and 31.5% of patients had a very good partial response or better. In the subgroup analysis, median PFS was better in patients with 1 versus 2 or ≥ 3 lines of prior treatment (29.0 vs 19.2 or 6.9 months) and paraprotein versus clinical relapse (16.0 vs 7.9 months), but median PFS was not notably affected by frailty score or age group. Dose adjustment was more frequent among patients aged > 75 years, especially early after IRd treatment initiation. Treatment-emergent adverse events (TEAEs) of any grade occurred in 84.4% of patients and 24.7% of patients discontinued treatment due to TEAEs; no new safety concerns were found. These findings suggest that oral IRd triplet regimen is an effective and tolerable treatment option for RRMM patients in real-world settings outside of clinical trials.ClinicalTrials.gov identifier: NCT03433001; Date of registration: 14 February 2018.
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Affiliation(s)
- Yuichi Horigome
- Department of Hematology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masaki Iino
- Department of Hematology, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Yoriko Harazaki
- Department of Hematology, Miyagi Cancer Center, Natori, Japan
| | - Takahiro Kobayashi
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yasushi Hiramatsu
- Department of Hematology and Oncology, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Taiga Kuroi
- Department of Hematology, Chugoku Central Hospital, Fukuyama, Japan
| | - Kazuki Tanimoto
- Department of Hematology and Oncology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - Kosei Matsue
- Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Masahiro Abe
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School, Tokushima, Japan
| | - Tadao Ishida
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Shigeki Ito
- Department of Hematology and Oncology, Iwate Medical University Hospital, Iwate, Japan
| | - Hiromi Iwasaki
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hirohiko Shibayama
- Department of Hematology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | | | - Hideto Tamura
- Department of Hematology, Nippon Medical School, Tokyo, Japan
| | - Toshiaki Hayashi
- Department of Hematology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kiwamu Akagi
- Division of Molecular Diagnosis and Cancer Prevention, Saitama Cancer Center, Ina, Japan
| | - Takahiro Maeda
- Division of Precision Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahiro Yoshida
- Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Co. Ltd, Tokyo, Japan
| | - Ikuo Mori
- Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Co. Ltd, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Institute of Medical and Pharmaceutical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan.
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Bakırtaş M, Dal MS, Yiğenoğlu TN, Giden AO, Serin I, Başcı S, Kalpakci Y, Korkmaz S, Ekinci O, Albayrak M, Basturk A, Ozatli D, Dogu MH, Hacıbekiroglu T, Çakar MK, Ulas T, Miskioglu M, Gulturk E, Eser B, Altuntas F. Real-world data on the effectiveness and safety of Ixazomib-Lenalidomide-Dexamethasone therapy in relapsed/refractory multiple myeloma patients: a multicenter experience in Turkey. J Chemother 2023; 35:563-569. [PMID: 37211906 DOI: 10.1080/1120009x.2023.2208439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 04/03/2023] [Accepted: 04/22/2023] [Indexed: 05/23/2023]
Abstract
A multicenter, retrospective, observational study was conducted to explore effectiveness and safety of ixazomib plus lenalidomide with dexamethasone (IRd) in relapsed/refractory multiple myeloma (RRMM) patients following at least ≥ two lines of therapy. Patients' treatment responses, overall response rate, progression-free survival rate, and adverse events were recorded. Mean age of 54 patients was 66.5 ± 9.1 years. There were 20 patients (37.0%) with progression. Median progression-free survival was 13 months in patients who received a median of three therapy lines in a 7.5-month follow-up period. Overall response rate was 38.5%. Of 54 patients, 19 (40.4%) had at least one adverse event, and nine (19.1%) had an adverse event of at least grade 3 or more. Of 72 adverse events observed in 47 patients, 68% were grade 1 or 2. Treatment was not stopped in any patient due to adverse events. IRd combination therapy was effective and safe in heavily treated RRMM patients.
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Affiliation(s)
- Mehmet Bakırtaş
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Mehmet Sinan Dal
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Tuğçe Nur Yiğenoğlu
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | | | - Istemi Serin
- Istanbul Training and Research Hospital, Department of Hematology, University of Health Sciences, Istanbul, Turkey
| | - Semih Başcı
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Yasin Kalpakci
- Department of Hematology, Sakarya University, Sakarya, Turkey
| | - Serdal Korkmaz
- Kayseri City Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Kayseri, Turkey
| | - Omer Ekinci
- Gazi Yasargil Training and Research Hospital, Department of Hematology, University of Health Sciences, Diyarbakir, Turkey
| | - Murat Albayrak
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
| | | | - Duzgun Ozatli
- Department of Hematology, Ondokuz Mayis University, Samsun, Turkey
| | - Mehmet Hilmi Dogu
- Liv Hospital Ulus, Department of Hematology, Istinye University, Istanbul, Turkey
| | | | - Merih Kızıl Çakar
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Turgay Ulas
- School of Medicine, Department of Internal Medicine, Division of Hematology, Near East University, Nicosia, Cyprus
| | - Mine Miskioglu
- Department of Hematology, Celal Bayar University, Manisa, Turkey
| | - Emine Gulturk
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Hematology, University of Health Sciences, Istanbul, Turkey
| | - Bulent Eser
- Department of Hematology, Medical Park Antalya Hospital, Antalya, Turkey
| | - Fevzi Altuntas
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
- School of Medicine, Department of Internal Medicine, Division of Hematology, Ankara Yildirim Beyazit University, Ankara, Turkey
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Minarik J, Radocha J, Jungova A, Straub J, Jelinek T, Pika T, Pour L, Pavlicek P, Harvanova L, Pospisilova L, Krhovska P, Novakova D, Jindra P, Spicka I, Plonkova H, Stork M, Bacovsky J, Maisnar V, Hajek R. Ixazomib, Lenalidomide and Dexamethasone in Relapsed and Refractory Multiple Myeloma in Routine Clinical Practice: Extended Follow-Up Analysis and the Results of Subsequent Therapy. Cancers (Basel) 2022; 14:cancers14205165. [PMID: 36291949 PMCID: PMC9601107 DOI: 10.3390/cancers14205165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/04/2022] [Accepted: 10/19/2022] [Indexed: 11/18/2022] Open
Abstract
Simple Summary We report the final outomes of the addition of ixazomib to the combination of lenalidomide and dexamethasone in patients with relapsed and refractory multiple myeloma in the routine clinical practice. With prolonged follow-up, the overall response rate was similar in both cohorts, but the addition of ixazomib induced more deeper responses. Median progression free survival was significantly better in patients receiving ixazomib and translated into better overal survival. Inferior results were seen in patients who were pretreated with lenalidomide in previous regimens. We conclude that the treatment using IRD regimen in routine practice is easy, well tolerated, and with very good therapeutic outcomes, comparable to the outcomes of the clinical trial. Abstract Background: We confirmed the benefit of addition of ixazomib to lenalidomide and dexamethasone in patients with relapsed and refractory multiple myeloma (RRMM) in unselected real-world population. We report the final analysis for overall survival (OS), second progression free survival (PFS-2), and the subanalysis of the outcomes in lenalidomide (LEN) pretreated and LEN refractory patients. Methods: We assessed 344 patients with RRMM, treated with IRD (N = 127) or RD (N = 217). The data were acquired from the Czech Registry of Monoclonal Gammopathies (RMG). With prolonged follow-up (median 28.5 months), we determined the new primary endpoints OS, PFS and PFS-2. Secondary endpoints included the next therapeutic approach and the survival measures in LEN pretreated and LEN refractory patients. Results: The final overall response rate (ORR) was 73.0% in the IRD cohort and 66.8% in the RD cohort. The difference in patients reaching ≥VGPR remained significant (38.1% vs. 26.3%, p = 0.028). Median PFS maintained significant improvement in the IRD cohort (17.5 vs. 12.5 months, p = 0.013) with better outcomes in patients with 1–3 prior relapses (22.3 vs. 12.7 months p = 0.003). In the whole cohort, median OS was for IRD vs. RD patients 40.9 vs. 27.1 months (p = 0.001), with further improvement within relapse 1-3 (51.7 vs. 27.8 months, p ˂ 0.001). The median PFS of LEN pretreated (N = 22) vs. LEN naive (N = 105) patients treated by IRD was 8.7 vs. 23.1 months (p = 0.001), and median OS was 13.2 vs. 51.7 months (p = 0.030). Most patients in both arms progressed and received further myeloma-specific therapy (63.0% in the IRD group and 53.9% in the RD group). Majority of patients received pomalidomide-based therapy or bortezomib based therapy. Significantly more patients with previous IRD vs. RD received subsequent monoclonal antibodies (daratumumab—16.3% vs. 4.3%, p = 0.0054; isatuximab 5.0% vs. 0.0%, p = 0.026) and carfilzomib (12.5 vs. 1.7%, p = 0.004). The median PFS-2 (progression free survival from the start of IRD/RD therapy until the second disease progression or death) was significantly longer in the IRD cohort (29.8 vs. 21.6 months, p = 0.016). There were no additional safety concerns in the extended follow-up. Conclusions: The IRD regimen is well tolerated, easy to administer, and with very good therapeutic outcomes. The survival measures in unsorted real-world population are comparable to the outcomes of the clinical trial. As expected, patients with LEN reatment have poorer outcomes than those who are LEN-naive. The PFS benefit of IRD vs. RD translated into significantly better PFS-2 and OS, but the outcomes must be accounted for imbalances in pretreatment group characteristics (especially younger age and stem cell transplant pretreatment), and in subsequent therapies.
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Affiliation(s)
- Jiri Minarik
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, 779 00 Olomouc, Czech Republic
- Correspondence: ; Tel.: +420-588-44-5351
| | - Jakub Radocha
- 4th Department of Internal Medicine—Hematology, Faculty Hospital, Charles University in Hradec Kralove, 500 03 Hradec Kralove, Czech Republic
| | - Alexandra Jungova
- Hematology and Oncology Department, Charles University Hospital Pilsen, 323 00 Pilsen, Czech Republic
| | - Jan Straub
- 1st Medical Department—Clinical Department of Haematology, First Faculty of Medicine and General Teaching Hospital Charles University, 110 00 Prague, Czech Republic
| | - Tomas Jelinek
- Department of Hematooncology, University Hospital Ostrava, Faculty of Medicine University of Ostrava, 708 00 Ostrava, Czech Republic
| | - Tomas Pika
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, 779 00 Olomouc, Czech Republic
| | - Ludek Pour
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Faculty of Medicine Masaryk University, 625 00 Brno, Czech Republic
| | - Petr Pavlicek
- Department of Internal Medicine and Hematology, 3rd Faculty of Medicine, Charles University and Faculty Hospital Kralovske Vinohrady, 100 34 Prague, Czech Republic
| | - Lubica Harvanova
- Department of Hematology and Transfusiology, University Hospital, Faculty of Medicine, Slovak Medical University and Comenius University, 831 01 Bratislava, Slovakia
| | - Lenka Pospisilova
- Institute of Biostatistics and Analyses, Ltd., 602 00 Brno, Czech Republic
| | - Petra Krhovska
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, 779 00 Olomouc, Czech Republic
| | - Denisa Novakova
- 4th Department of Internal Medicine—Hematology, Faculty Hospital, Charles University in Hradec Kralove, 500 03 Hradec Kralove, Czech Republic
| | - Pavel Jindra
- Hematology and Oncology Department, Charles University Hospital Pilsen, 323 00 Pilsen, Czech Republic
| | - Ivan Spicka
- 1st Medical Department—Clinical Department of Haematology, First Faculty of Medicine and General Teaching Hospital Charles University, 110 00 Prague, Czech Republic
| | - Hana Plonkova
- Department of Hematooncology, University Hospital Ostrava, Faculty of Medicine University of Ostrava, 708 00 Ostrava, Czech Republic
| | - Martin Stork
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Faculty of Medicine Masaryk University, 625 00 Brno, Czech Republic
| | - Jaroslav Bacovsky
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, 779 00 Olomouc, Czech Republic
| | - Vladimir Maisnar
- 4th Department of Internal Medicine—Hematology, Faculty Hospital, Charles University in Hradec Kralove, 500 03 Hradec Kralove, Czech Republic
| | - Roman Hajek
- Department of Hematooncology, University Hospital Ostrava, Faculty of Medicine University of Ostrava, 708 00 Ostrava, Czech Republic
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Goel U, Kumar S. An update on the safety of ixazomib for the treatment of multiple myeloma. Expert Opin Drug Saf 2022; 21:1143-1160. [PMID: 36178708 DOI: 10.1080/14740338.2022.2130892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Treatment options for multiple myeloma (MM) have rapidly expanded over the past few years with several newly approved drugs. While there is need to explore treatments that lead to longer responses and survival, special consideration should be given on reducing treatment burden, reducing toxicities, and improving quality of life. Ixazomib is the first oral proteasome inhibitor for the treatment of MM, combining clinical efficacy with a favorable safety profile. AREAS COVERED Here, we discuss the clinical efficacy and safety of ixazomib. Pharmacokinetic considerations, management of common toxicities, and the impact of the drug on the current and future treatment strategies are also discussed. EXPERT OPINION Ixazomib is an effective and welltolerated MM drug. It is also being studied in combination with other newer agents. It does not have long-term cumulative toxicities, and the most adverse events are mild and manageable. These findings, along with the ease of oral administration, make it a possible option for long-term treatment approaches for MM patients, as well as in the frail/elderly patient population.
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Affiliation(s)
- Utkarsh Goel
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Shaji Kumar
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
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